First labs after starting TRT - WOW!

[Craig74]

I'm on 120mg/week enanthate sub q (2 x 60mg/week) and nothing else (other than OTC supplements). I can't believe how much my T levels increased. I met with my doctor this morning and he is adding a low dose AI to bring down the E a bit but otherwise everything looks great.

And most importantly - I feel amazing.

 

[Systemlord]

I met with my doctor this morning and he is adding a low dose AI to bring down the E a bit but otherwise everything looks great.

Your Total and Free T levels are very high, surely you have room to reduce your dosage without much of a consequence, but an AI for E2 slightly over the ranges (+4.63 pg/mL) is ridiculous in the absence of symptoms.

You're in for a rude awakening if you take the AI because if you feel amazing now, you can only go in the other direction.

 

[Craig74]

Good point. I think it is pretty low dose AI (half mg per week I think 2x .25). I haven't filled it yet but I believe that is the dosage he prescribed. Certainly, if it makes me feel worse I will stop.

 

[Systemlord]

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[JayD]

Good point. I think it is pretty low dose AI (half mg per week I think 2x .25). I haven't filled it yet but I believe that is the dosage he prescribed. Certainly, if it makes me feel worse I will stop.

what days do you inject? and is it the same day/time every week?

 

[Craig74]

what days do you inject? and is it the same day/time every week?

Saturday morning at 7am and Tuesday at 5pm. Yes, I'm consistent.

 

[MarcoFL]

I would lower my T dose and would NOT add and AI! You will be chasing your tail forever doing that! I went from as high as 180mg per week to daily 14mg and feel way better!

 

[Vince]

I'm on 120mg/week enanthate sub q (2 x 60mg/week) and nothing else (other than OTC supplements). I can't believe how much my T levels increased. I met with my doctor this morning and he is adding a low dose AI to bring down the E a bit but otherwise everything looks great.

And most importantly - I feel amazing.

View attachment 14415

If you're feeling good, there's really no reason to adjust anything.

 

[madman]

I'm on 120mg/week enanthate sub q (2 x 60mg/week) and nothing else (other than OTC supplements). I can't believe how much my T levels increased. I met with my doctor this morning and he is adding a low dose AI to bring down the E a bit but otherwise everything looks great.

And most importantly - I feel amazing.

View attachment 14415

Piss poor move on your doctor's end seeing as you feel amazing let alone your estradiol is barely over the top-end and was most likely not tested using the most accurate assay (LC/MS-MS).

Glad to hear you are doing well seeing as you are past the 3-month mark since starting therapy which would be enough time to gauge how you truly feel overall on such protocol (dose T/injection frequency).

Just keep in mind that seeing as your TT trough is high 1311 ng/dL and more importantly FT is very high (mind you it was not tested using the most accurate assay) seeing that you are injecting 120 mg split (60 mg every 3.5 days) your peak TT/FT and estradiol will be much higher.

Also, keep in mind that although TT is important to know FT is what truly matters as it is the active unbound fraction of testosterone responsible for the positive effects.

The only way to know where your FT truly sits is to have it tested using the most accurate assays such as the gold standard Equilibrium Dialysis or Ultrafiltration (next best).

With a trough TT 1311 ng/dL and SHBG 36 nmol/L you can rest assured that your FT level is going to be absurdly high.

If you feel great overall then leave it be.

Forget jumping on the AI and even then if you were experiencing sides or feeling shitty on such protocol (dose T/injection frequency) the most sensible move would be to lower your overall weekly T-dose which would bring down your FT level let alone e2.

 

[madman]

Good point. I think it is pretty low dose AI (half mg per week I think 2x .25). I haven't filled it yet but I believe that is the dosage he prescribed. Certainly, if it makes me feel worse I will stop.

Should have never been prescribed in the first place!


I'm on 120mg/week enanthate sub q (2 x 60mg/week) and nothing else (other than OTC supplements). I can't believe how much my T levels increased. I met with my doctor this morning and he is adding a low dose AI to bring down the E a bit but otherwise everything looks great.

And most importantly - I feel amazing




Go figure!

 

[madman]

Next time you have blood work done make sure that you test your FT using the most accurate assays (ED or UF) let alone you left out important blood markers such as CBC which includes RBCs/hemoglobin/hematocrit.

You can use Nelson's discounted labs.


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[Trip McNeely]

Forget the AI. Don't even lower the dose at this point. You feel amazing and your numbers look great. Stay the course.

 

[Craig74]

The only way to know where your FT truly sits is to have it tested using the most accurate assays such as the gold standard Equilibrium Dialysis or Ultrafiltration (next best).

Do you know what the options are for Canadians in this regard? Bloodwork seems to go through the state run system and they determine what tests and methods are used. They won't even test for Vitamin D levels any more. Are there private options in Canada?

 

[madman]

Do you know what the options are for Canadians in this regard? Bloodwork seems to go through the state run system and they determine what tests and methods are used. They won't even test for Vitamin D levels any more. Are there private options in Canada?

Your FT was most likely done using the linear law-of-mass action cFTV as the piss poor direct immunoassay is no longer used and access to the gold standard Equilibrium Dialysis or Ultrafiltration is not readily available to everyone.


post #5

High Free T. but Regular T levels?

Quick question. I just restarted TRT after an approximate 5 month break for fertility reason. Im on HCG (250 twice per week,) and 120ml weekly shots of test E (divided in two subq weekly shots.) I just received my blood work and my resultare as follows: Testosterone 20nmolL Testosterone 576...

www.excelmale.com

No payout of pocket options in Canada other than Private Blood Tests in Canada - Attend Private Hospital with immediate which is based out of the UK and even then as far as I know this option is only available in my province of Ontario and blood work is done through Dynacare, not Lifelabs.

Top it off that not only is it expensive but all the tests available when it comes to hormones can easily be requested through your own GP and will most likely be covered by provincial insurance (OHIP in Ontario).

Top it off that Private Blood Tests in Canada - Attend Private Hospital with immediate does not even offer the most accurate assays for Free Testosterone the gold standard Equilibrium Dialysis or Ultrafiltration (next best) let alone the estradiol sensitive (LC/MS-MS).

Your best bet would be to order FT (ED or UF) through Nelson's discountedlabs and then you would need to print off the requisition and travel across the border to have blood work done at Quest Diagnostics location.

Not sure which Quest location would be nearest to the border from the province you reside in.

Google maps.

Unfortunately due to the Covid pandemic, you are out of S**T out of luck for the time being!

 

[madman]

I'm on 120mg/week enanthate sub q (2 x 60mg/week) and nothing else (other than OTC supplements). I can't believe how much my T levels increased. I met with my doctor this morning and he is adding a low dose AI to bring down the E a bit but otherwise everything looks great.

And most importantly - I feel amazing.

View attachment 14415

Post your CBC as you left out critical blood markers.....RBCs/hemoglobin/hematocrit?

 

[Craig74]

Here is the rest of it.
Note: I donated blood for the first time yesterday to get the hemoglobin down a bit.

 

[madman]

Here is the rest of it.
Note: I donated blood for the first time yesterday to get the hemoglobin down a bit.

View attachment 14469

Clear as day now that your trough FT level is too high.

As you can clearly see your hematocrit/hemoglobin was high on your current protocol 120 mg T/week (60 mg every 3.5 days).

As I stated in one of your previous threads when starting trt or tweaking a protocol (increasing dose of T) it will drive up your RBCs/hemoglobin/hematocrit within the first month and can take up to 9-12 months to reach peak levels.

Now that you finally posted where your levels sat although you feel great overall on your current protocol you are going to most likely be struggling with high hematocrit/hemoglobin due to running a very high trough FT level and will most likely get caught up on the donating blood too frequently merry go round to try and manage it while at the same time crashing your iron/ferritin which can lead to other issues.

As I stated earlier if you feel great overall leave it be.

If you run into issues and find that you need to donate blood often to control it then it would be more sensible to lower your overall weekly T-dose and bring down your trough FT level as you easily have room to do such and would most likely feel just as good.

The downfall is unfortunately your trough TT/FT levels were driven up very high from the get-go and you will have a hard time accepting the fact that you would most likely feel just as good running lower levels.

Many will tend to donate when hematocrit starts creeping up over the high end but some leave it be unless it hits 52-54.

Donating too frequently to try and manage elevated RBCs/hemoglobin/hematocrit is a catch 22 as although it will bring levels down it can lead to crashing your iron/ferritin stores which can lead to many other issues.

Too many get caught up on where their TT levels sit at the true trough on such protocol (dose T/injection frequency) without paying attention to peak let alone FT level which is more important when managing your T levels.

Although TT is important to know FT is what truly matters as it is the active unbound fraction of testosterone responsible for the beneficial effects.

The key point being is that running too high of FT levels can result in elevated RBCs/hemoglobin/hematocrit let alone cause some other side-effects in sensitive individuals (genetically prone).

 

[madman]

You basically drove your TT from 389 ng/dL ---> to a whopping 1311 ng/dL at trough and more importantly, your FT went from a subpar 260 pmol/L --->to an absurd 1200 pmol/L at trough as your SHBG now sits at 33 nmol/L which is far from being high.

Even then your FT was not tested using an accurate assay (ED or UF) which would show you where your FT level truly sits and you can rest assured that running a trough TT 1311 ng/dL with an SHBG of only 33 nmol/L that your trough FT level will be absurdly high.

Your peak TT/FT/e2 levels are going to be higher.

That is why I asked you to post your CBC as it would be a given that hematocrit/hemoglobin would be high due to running a very high FT level.

You should have been upfront and mentioned that your hematocrit/hemoglobin was too high.

 

[Craig74]

You should have been upfront and mentioned that your hematocrit/hemoglobin was too high.

My hematocrit was 0.55 with a normal range of 0.40 to 0.54. It is only slightly too high. My doctor didn't seem concerned about it. I'll post my full labs in the future. Very much appreciate your feedback.

I'm also a bit confused how a dose of 120mg/week can have such a dramatic effect. It seems like many people are on higher doses than that. I guess every ones chemistry and situation is different.

 

[madman]

My hematocrit was 0.55 with a normal range of 0.40 to 0.54. It is only slightly too high. My doctor didn't seem concerned about it. I'll post my full labs in the future. Very much appreciate your feedback.

I'm also a bit confused how a dose of 120mg/week can have such a dramatic effect. It seems like many people are on higher doses than that. I guess every ones chemistry and situation is different.

Not surprising as many can achieve high-end let alone absurdly high TT/FT levels on such dose.

Most on trt are injecting 100-200 mg/week and even then most would never need the high-end dose (200mg/week) to achieve a healthy let alone high/absurdly high trough FT level.

Many are overmedicated when it comes to testosterone and you can blame the bro forums let alone numerous T-mills jacking men up on T from the get-go.

Let alone most have no clue where their FT levels truly sit as it is much higher than they think as they are not using accurate assays when testing.

A hematocrit of 55 is still considered high and most would recommend donating when it gets beyond 54.

Have no clue where your natural levels sat pre-trt as you are sitting at 49 as of now after donating.

Regardless as I stated this is going to be an ongoing battle trying to manage elevated hemoglobin/hematocrit (due to running an absurdly high trough FT) through frequent blood donations and it is a given that you will be bound to run into issues with iron/ferritin.

You are only 3 months in and much can change as time goes on.