Now with hCG, concerning bloodwork 7 months into TRT

[Mission]

Hoping to get some advice about my latest labs and protocol. I’m not sure what changes would be best at this point. I’m not confident in my TRT office and am considering switching docs. Anyway brief background….

Initial protocol and 1st labs after 7 weeks on TRT led to this:

Doing this twice per week…
50mg Tcyp subq
500IU hCG troche (sublingual)
0.25mg anastrozole

TT=848 (264-916)
FT(direct)=19.2 (8.7-25.1)
E2, sensitive=16 (8-35)
SHBG=48 (16.5-55.9)
CBC and metabolic tests all in range

That was about 5 months ago. I insisted the doc switch me to liquid hCG since there’s a lot of questions around the troches getting absorbed. I wanted to keep the testes alive, prevent shrinkage, and backfill other hormonal pathways – finally got the order. I wanted to lower my anastrozole dose after the last results but I figured if I’m taking real hCG, my e2 may go up and require the AI, so I kept that the same…

Doing this twice per week for the past 8 weeks now…
50mg Tcyp subq
500 IU hCG liquid subq at the time of T injection
0.25mg anastrozole

Recent bloodwork after a 12-hour fast. This was done in trough about 2 hours after I would usually dose. I was sure to be well-hydrated the day before and had a few glasses of water prior to the bw. Usual blood pressure these days is low 120s/70 and was that morning…

TT=964 (264-916) High
FT(direct)=25.4 (8.7-25.1) High
E2, sensitive=34.6 (8-35)
SHBG=40.0 (16.5-55.9)

I was pleased that H & H were okay…
Hemoglobin 16.7 (13.0-17.7)
Hematocrit 49.0 (37.5-51.0)

But my kidney results are concerning….
BUN 21 (6-20) High
Creatinine 1.50 (0.76-1.27) High
eGFR 59 (>59) Low
My creatinine has always hovered around the top of the range even before TRT, but BUN is usually low teens. I’m not an overly muscular dude – 170 lbs at 18% BF, 35 y/o. Don't take creatine supps and according to diet log, didn't have any protein powders since a week before bloods.

Everything else was in range other than slightly elevated cholesterol. What sparked me to get the followup bloodwork was I haven’t been feeling so hot the past 2-3 weeks. I feel a bit listless and unmotivated. My libido/desire is near 0 most days which is one of the main reasons I started TRT in the first place. A bit moody and easily irritated too. My workouts have been okay. I’ve been doing running and stationary bike HIIT, not much weight lifting recently. I did run a 3 miler the day before the bloodwork, though that’s an intermediate distance for me and causes no DOMS. Diet was changed about halfway between the 2 blood tests so for a while it’s been a net goal 1700 calories per day and I keep under 100g carbs/day (~80g is typical, all from fruit, vegetables, sweet potato). Of course I have the occasional weekend ‘slip’.

Aside from the kidneys I’m also concerned with my TT/FT being so high in a trough reading and my e2 creeping upwards. It seems this form of hCG I’m now taking is certainly doing something compared to that troche. Any advice would be appreciated

 

[Vince Carter]

Id retest the kidney labs to see if they're repeatable. It reads like your obeying my typical advice on fasting, etc etc

By liquid HCG are you referring to injectable HCG?

 

[Jiu Jitsu Dude]

@Mission: How are you feeling with your protocal?

 

[ratbag]

HCG troche (sublingual) does not work... all TRT experts know this except those that don't. You are correct your TT, FT and E2 are higher because of injected HCG. Your numbers may be at the top of range but I wouldn't worry yet. As VC mentions you should get your kidney labs retested to confirm. Since your not feeling well you should get a full thyroid panel, ferritin done and probably DHEA.

 

[Vince]

Personally I think your labs look really good. I agree with ratbag, get a complete thyroid panel with TSH, free T4, free T3, reverse T3 and both antibodies.

 

[Mission]

By liquid HCG are you referring to injectable HCG?

Exactly, it's an 11000IU vial reconstituted with BAC water.

@Mission: How are you feeling with your protocal?

Not so hot. When my E2=16 on my last bloodwork I posted I thought I was having low E2 sides like dry eyes, mouth, sleepy all the time and tired eyes. I'm glad it's not low anymore but now I'm feeling a bit blue and libido is in the garbage. On the upside, my recovery time from workouts is great on TRT and when I do get around to lift weights I get great pumps and vascularity without any pre-workout supplements. I've also lost 25 lbs and around ~10% BF since I started.

HCG troche (sublingual) does not work... all TRT experts know this except those that don't. You are correct your TT, FT and E2 are higher because of injected HCG. Your numbers may be at the top of range but I wouldn't worry yet. As VC mentions you should get your kidney labs retested to confirm. Since your not feeling well you should get a full thyroid panel, ferritin done and probably DHEA.

Thanks, sounds like a plan. I did have DHEA-S done a couple months ago. Result was 239 ug/dl (35-570)

Personally I think your labs look really good. I agree with ratbag, get a complete thyroid panel with TSH, free T4, free T3, reverse T3 and both antibodies.

Thanks - I wouldn't bat an eye at the TT/FT and E2 results if I felt outstanding right now. I was thinking about lowering hCG dose from 500 to 400 2x/week and keeping everything else the same. Maybe my sweet spot for T is a little lower. It's also worth noting the 1st bloodwork listed was between doses, not at trough.