Judge my blood work. Do I need an AI?

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Vince

Super Moderator
@Vince @sh1973 Just curious, why would you guys advise him to lower his dose when he feels great? Not only does he feel great, but other than a slightly elevated prolactin, his numbers look perfect, including his E2.
He posted his numbers, so we can comment on them. His total T and e2 are both in the high range. I wonder if he needs his T to be that high. Personally I think lowering his testosterone dose would make sense.
 
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Gman86

Member
He posted his numbers, so we can comment on them. His total T and e2 are both in the high range. I wonder if he needs his T to be that high. Personally I think lowering his testosterone dose would make sense.

Thanks for the reply Vince. I’ll have to respectfully disagree though. Plus, as of January, your free T is almost double the top of the range for your age group. It was 32.3 pg/mL (6.6 - 18.1) as of January. Why is his too high, but yours isn’t too high when it’s way over the top of the range for your age? Ranges are not the end all be all. They are just a guideline. The top of the range for b12 is 1000. Unanimously everyone will tell you having a B12 level 50-100% above that is a good thing. But him having a free T above range, or an E2 ever so slightly above range is a reason for him to change his dose to lower these values, even while feeling great? Again, ranges are just guidelines, and everyone is biologically unique. We all have to find what works for us as individuals. Some feel amazing with free T mid range, or even a little below mid range. Some have tried everything and only feel good with free T close to double the top of the range. We’ve seen it all here. Some guys feel amazing with E2 around 70-90. Vince Carter reports only feeling good with a single digit E2 level. The OP’s numbers, to me, look perfectly balanced. But it honestly doesn’t matter really what his numbers look like, as long as they’re not extremely out of range, which none of them are even close to being. All that matters is that he feels great. Sorry for the long winded reply lol, but bottom line, whatever you do, don’t change a thing. What do you hope to achieve, to feel even better? Some men try to get greedy, or tweak their protocol based off of numbers, and they end up ruining everything. And even worse, when they try to go back to the original protocol that they felt great on, they just don’t get the same results, and are always chasing how they felt originally before tweaking things. Don’t be one of those guys. Don’t get greedy and think you can feel better than you do right now. Just let them prescribe you the ai and don’t take it like Sean Mosher said.
 
Last edited:

madman

Super Moderator
Just got these labs done.
3 months trt.
28yr old male
Started because of low T 150-200.
100mg test cyp mon and thurs
250iu HCG tues and fri
NO AI


Was tested for pituitary tumor and testicalular before TRT started because of my naturally high IGF-1 just to be safe.

I’m a small dude, zero fat, zero mood swings, sex Drive is awesome and I feel great I repeat zero issues. I lift 3x a week
.


BUT I’m I told I need an AI by the trt clinic…
After reading stuff on here I’m against it but you guys tell me.



This is key if you feel great overall as of now.....do not touch a thing and definitely avoid the a.i. at all cost!

Although your TT/FT levels are high for a trough if you feel good overall and blood markers are healthy than stick to your protocol.

You are only 3 months in and although you feel great now things may very well continue although if any issues arise as time goes on you can look into lowering your dose slightly.

Do understand seeing as you are only injecting every 3.5 days that your peak TT/FT/E2 levels are going to be much higher post injection.

The testing method you had done for free testosterone.....direct immunoassay is known to be inaccurate and no longer recommeneded.

If you truly want to know where your FT levels sit than you would need to have it tested using the gold standard Equilibrium Dialysis or Ultrafiltration (next best) or you can simply use the newer calculated TruT method (which is on par with results obtained by the gold standard Equilibrium Dialysis) available online to the general public for free.

TruT Free Testosterone Calculator by FPT


Using the newer calculated method if we take your TT1204 ng/dL, SHBG 12.4 nmol/L, Albumin 4.8 ng/dL than your FT (trough) is 41.89 ng/dL ( well over the top end of the reference range of 16-31 ng/dL).....so again do understand that your peak levels will be much higher post injection.
Screenshot (512).png



Although your SHBG is low and many tend to do better injecting more frequently as in EOD or in many cases daily.....just stick to your current protocol simply because you feel great overall as of now!

You need to work on your lipids.....your HDL is low and LDL is elevated.

Downfall is it looks to be that you are being treated by one of those ever too common TRT mills which not only tend to start patients out on an absurdly high dose of 200 mg/week of T but more importantly are mindlessly starting patients off on an aromatase inhibitor which in most cases turns out to be a SHIT SHOW to say the least.

The most sensible piece of advice is to start low and go slow and if anything most should just start out on a T only protocol to truly gauge how said dose of T effects ones TT/FT/E2 levels and to truly gauge how one responds to testosterone only.....hCG can eventually be added if needed/wanted!

One thing these T mills are good at is jacking one up on higher doses of T let alone driving your estradiol into the ground from the use of an aromatase inhibitor.

Do understand that although healthy T levels are critical for the effectiveness of a trt protocol.....more importantly healthy levels of it's metabolites DHT and estradiol are needed to experience the full spectrum of testosterones positive effects.

Do not fear estradiol as it is needed!
 

sh1973

Well-Known Member
I can point out a couple items right off the bat first of all his HDL cholesterol is pathetic and secondly his free testosterone level it is all the way off the chart at trough. Why on earth would you want to add another medication when all you have to do is lower the dose to bring things back in line.
 

madman

Super Moderator
Thanks for the reply Vince. I’ll have to respectfully disagree though. Plus, as of January, your free T is almost double the top of the range for your age group. It was 32.3 pg/mL (6.6 - 18.1) as of January. Why is his too high, but yours isn’t too high when it’s way over the top of the range for your age? Ranges are not the end all be all. They are just a guideline. The top of the range for b12 is 1000. Unanimously everyone will tell you having a B12 level 50-100% above that is a good thing. But him having a free T above range, or an E2 ever so slightly above range is a reason for him to change his dose to lower these values, even while feeling great? Again, ranges are just guidelines, and everyone is biologically unique. We all have to find what works for us as individuals. Some feel amazing with free T mid range, or even a little below mid range. Some have tried everything and only feel good with free T close to double the top of the range. We’ve seen it all here. Some guys feel amazing with E2 around 70-90. Vince Carter reports only feeling good with a single digit E2 level. The OP’s numbers, to me, look perfectly balanced. But it honestly doesn’t matter really what his numbers look like, as long as they’re not extremely out of range, which none of them are even close to being. All that matters is that he feels great. Sorry for the long winded reply lol, but bottom line, whatever you do, don’t change a thing. What do you hope to achieve, to feel even better? Some men try to get greedy, or tweak their protocol based off of numbers, and they end up ruining everything. And even worse, when they try to go back to the original protocol that they felt great on, they just don’t get the same results, and are always chasing how they felt originally before tweaking things. Don’t be one of those guys. Don’t get greedy and think you can feel better than you do right now. Just let them prescribe you the ai and don’t take it like Sean Mosher said.


Agree overall with everything you stated except:

Plus, as of January, your free T is almost double the top of the range for your age group. It was 32.3 pg/mL (6.6 - 18.1) as of January. Why is his too high, but yours isn’t too high when it’s way over the top of the range for your age?

- you very well know these levels were done using the piss poor inaccurate direct immunoassay and in that thread I did his calculation with the newer TruT method and his FT was at or just slightly just over the top end of the reference range 16-31 ng/dL.



Some have tried everything and only feel good with free T close to double the top of the range.

- when using an inaccurate testing method such as the direct immunoassay or tracer analog or even the outdated calculated models based of of the linear law-of-mass action Vermuelen method or empiric equations.....SURE!

-as far as one needing FT (trough) levels double the top end of the reference range when having FT tested using an accurate method such as the gold standard to Equilibrium Dialysis or Ultrafiltration (next best) or using the newer calculated TruT method (shown to be on par with results obtained by the gold standard Equilibrium Dialysis) to experience benefit from testosterone replacement.....I call BULLSHIT!

-for one to have a FT (trough) double the top end of the range using the newer calculated TruT method you are basically saying one would need a FT of 60 ng/dL.....highly doubtful one would need such.

-as you very well know that infamous doctor many seem to dick ride has stated that most of his patients do well having FT levels in the 30 ng/dL range.....an at least this is based off of one of the most accurate testing methods for FT as he uses Equilibrium Dialysis not the piss poor inaccurate direct immunoassay.....let alone the outdated calculated Vermeulen method!

-I would say most men will do well having a FT trough level in the 30+ ng/dL range.....sure some may choose/need slightly higher levels but highly doubtful anyone needs a trough of 50+ ng/dL to benefit from trt.
 

madman

Super Moderator
I can point out a couple items right off the bat first of all his HDL cholesterol is pathetic and secondly his free testosterone level it is all the way off the chart at trough. Why on earth would you want to add another medication when all you have to do is lower the dose to bring things back in line.


Keep in mind it is using the piss poor known to be inaccurate direct immunoassay.

Using the newer calculated TruT method his FT trough is in the low 40 ng/dL range.

Key here is he feel great overall on said protocol so he should stick to it.

Could he feel just as good running slightly lower FT trough levels.....most likely but again he feels great and his blood work looks good and yes although his lipids need to be improved upon I would say that is more diet related as oppose to his T levels.
 

Gman86

Member
I can point out a couple items right off the bat first of all his HDL cholesterol is pathetic and secondly his free testosterone level it is all the way off the chart at trough. Why on earth would you want to add another medication when all you have to do is lower the dose to bring things back in line.

Nobody is saying for him to add in the ai. We’re all telling him to not add it. And his cholesterol can easily be improved with diet, exercise and improving thyroid function. I highly doubt lowering his free T would improve his cholesterol levels.
 

Vince

Super Moderator
Thanks for the reply Vince. I’ll have to respectfully disagree though. Plus, as of January, your free T is almost double the top of the range for your age group. It was 32.3 pg/mL (6.6 - 18.1) as of January. Why is his too high, but yours isn’t too high when it’s way over the top of the range for your age? Ranges are not the end all be all. They are just a guideline. The top of the range for b12 is 1000. Unanimously everyone will tell you having a B12 level 50-100% above that is a good thing. But him having a free T above range, or an E2 ever so slightly above range is a reason for him to change his dose to lower these values, even while feeling great? Again, ranges are just guidelines, and everyone is biologically unique. We all have to find what works for us as individuals. Some feel amazing with free T mid range, or even a little below mid range. Some have tried everything and only feel good with free T close to double the top of the range. We’ve seen it all here. Some guys feel amazing with E2 around 70-90. Vince Carter reports only feeling good with a single digit E2 level. The OP’s numbers, to me, look perfectly balanced. But it honestly doesn’t matter really what his numbers look like, as long as they’re not extremely out of range, which none of them are even close to being. All that matters is that he feels great. Sorry for the long winded reply lol, but bottom line, whatever you do, don’t change a thing. What do you hope to achieve, to feel even better? Some men try to get greedy, or tweak their protocol based off of numbers, and they end up ruining everything. And even worse, when they try to go back to the original protocol that they felt great on, they just don’t get the same results, and are always chasing how they felt originally before tweaking things. Don’t be one of those guys. Don’t get greedy and think you can feel better than you do right now. Just let them prescribe you the ai and don’t take it like Sean Mosher said.
Same protocol for one year, 16 mg of testosterone cypionate daily, 500 iu of HCG twice a week, 25 mg of DHEA, 10mg of pregnenolone and no AI.

Testosterone serum 880 ng/dL range 264 - 916
Free T 32.3 pg/mL range 6.6 - 18.1
DHEA - Sulfate 384.4 range 48.9 - 344.2
Estradiol, Sensitive 28.5 range 8.0 - 35.0
SHBG 39.7 range 19.3 - 76.4
HCT 48.0 range 37.5 - 51.0
DHT 54.0 range 30 - 85

Yes I have my labs done through LabCorp. I know the free T number is wrong. I'm planning on having my labs done again this coming Tuesday.
 

DragonBits

Well-Known Member
@madman

You said the truT reference range is 16-31 ng/dL, where did you get that number?

Maybe you stated it in a post, but you have many posts about TruT and I don't recall the one where you talked about where the reference range came from.
 
This is key if you feel great overall as of now.....do not touch a thing and definitely avoid the a.i. at all cost!

Although your TT/FT levels are high for a trough if you feel good overall and blood markers are healthy than stick to your protocol.

You are only 3 months in and although you feel great now things may very well continue although if any issues arise as time goes on you can look into lowering your dose slightly.

Do understand seeing as you are only injecting every 3.5 days that your peak TT/FT/E2 levels are going to be much higher post injection.

The testing method you had done for free testosterone.....direct immunoassay is known to be inaccurate and no longer recommeneded.

If you truly want to know where your FT levels sit than you would need to have it tested using the gold standard Equilibrium Dialysis or Ultrafiltration (next best) or you can simply use the newer calculated TruT method (which is on par with results obtained by the gold standard Equilibrium Dialysis) available online to the general public for free.

TruT Free Testosterone Calculator by FPT


Using the newer calculated method if we take your TT1204 ng/dL, SHBG 12.4 nmol/L, Albumin 4.8 ng/dL than your FT (trough) is 41.89 ng/dL ( well over the top end of the reference range of 16-31 ng/dL).....so again do understand that your peak levels will be much higher post injection.
View attachment 8163


Although your SHBG is low and many tend to do better injecting more frequently as in EOD or in many cases daily.....just stick to your current protocol simply because you feel great overall as of now!

You need to work on your lipids.....your HDL is low and LDL is elevated.

Downfall is it looks to be that you are being treated by one of those ever too common TRT mills which not only tend to start patients out on an absurdly high dose of 200 mg/week of T but more importantly are mindlessly starting patients off on an aromatase inhibitor which in most cases turns out to be a SHIT SHOW to say the least.

The most sensible piece of advice is to start low and go slow and if anything most should just start out on a T only protocol to truly gauge how said dose of T effects ones TT/FT/E2 levels and to truly gauge how one responds to testosterone only.....hCG can eventually be added if needed/wanted!

One thing these T mills are good at is jacking one up on higher doses of T let alone driving your estradiol into the ground from the use of an aromatase inhibitor.

Do understand that although healthy T levels are critical for the effectiveness of a trt protocol.....more importantly healthy levels of it's metabolites DHT and estradiol are needed to experience the full spectrum of testosterones positive effects.

Do not fear estradiol as it is needed!

Thanks for all this much appreciated!!

Guys just so you all know, I took this test on a Monday (my last T shot was the previous Thursday) I’m not sure if this was a long enough wait or not? Also my last HCG shot was that Friday.

So thurs T, fri HCG, Monday took test.
I ordered the labs through discountlabs.com

Can you or anyone here refer me to the correct test?

Lastly, as for my cholesterol... i eat clean, I work out 3x a week, I don’t party. I have no idea why it’s like that, and it’s been like that for a long time.

I started getting bloods at 24-25 for shits and giggles and it’s the one constant that’s been outstanding...that and IGF-1 is always high.
Idk what to do? Maybe I’m naturally like that?

Last ? For all, if I do HCG DAILY at 100iu instead of 250iu 2x a week will that help at all or not really? And by help I mean lower the e2 a bit. I feel fine so doesn’t matter for me 2x a week or everyday.
 

DragonBits

Well-Known Member
Nobody is saying for him to add in the ai. We’re all telling him to not add it. And his cholesterol can easily be improved with diet, exercise and improving thyroid function. I highly doubt lowering his free T would improve his cholesterol levels.

The OP said "I’m a small dude, zero fat, zero mood swings, sex Drive is awesome and I feel great I repeat zero issues. I lift 3x a week".

So I am not sure (traditional) diet or exercise will help, he never said boo about his thyroid. I am not a fan of tweaking thyroid based on numbers alone.

Maybe add alcohol, like 5-10 oz of wine a night will boost his hdl, his ldl is only slightly over range. I know wine boosted my hdl from 40 > 55. They assume any equivalent amount of % alcohol will work, it doesn't really matter what form.
 

DragonBits

Well-Known Member
Wow I never new that. Okay good to know.

I was surprised alcohol had such a big effect, never in my life had HDL been that high, typically it is always 40 =/- a bit. Previously in the last 20 years I only had maybe 1-2 beers in a week.

Changing HCG, what are you trying to help?

FYI, TRT often lowers hdl, though it also lowers total cholesterol and LDL-c concentrations.
---------------------------------------------------------------
Alcohol Consumption Raises HDL Cholesterol Levels by Increasing the Transport Rate of Apolipoproteins A-I and A-II

https://www.ahajournals.org/doi/full/10.1161/01.CIR.102.19.2347
 
I was surprised alcohol had such a big effect, never in my life had HDL been that high, typically it is always 40 =/- a bit. Previously in the last 20 years I only had maybe 1-2 beers in a week.

Changing HCG, what are you trying to help?

FYI, TRT often lowers hdl, though it also lowers total cholesterol and LDL-c concentrations.
---------------------------------------------------------------
Alcohol Consumption Raises HDL Cholesterol Levels by Increasing the Transport Rate of Apolipoproteins A-I and A-II

https://www.ahajournals.org/doi/full/10.1161/01.CIR.102.19.2347
Just curious if spacing it out will lower E2, but judging by everyone’s responses here it really doesn’t matter.
Out of curiosity, will 100iu every day have the same effect as 250iu .2x a week? Or do u need to take a lot at once?
 

DragonBits

Well-Known Member
Just curious if spacing it out will lower E2, but judging by everyone’s responses here it really doesn’t matter.
Out of curiosity, will 100iu every day have the same effect as 250iu .2x a week? Or do u need to take a lot at once?

I only used hcg for a short time, so it's not something I am familiar with. Dr. Saya published a paper which he posted here, people can point yo to that study.

I believe he used a higher dose than 250 iu, I don't know if 100 IU will have the same effect as 250 x a week, I suspect more at one time is more effective rather than spaced out.
 
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