Need help interpreting BLOOD WORK trt

I and started at an anti-aging clinic a few months ago. I have a follow up appointment in a week with my doctor but I get my blood work through the health system website and notice my labs look wacked out now. I was looking for help in understanding why. When I first got my blood work done for pre treatment my stats were 32 yrs old 5'8 218 lbs. high BF but also high muscle percent. Once my labs came back they put me on the hcg diet 500 calories a day so I inject hcg 200 units a day for 43 days 200mg of test cyp 2x a week with 1 mg of anastrozole 2x a week with the test. MIC/B12/L-CARNITINE 10/40/40/1/100MG once a day. I understand the test cyp sounds like a lot for trt at 400 mg a week. At 3 weeks into the diet and regiment I have lost 17 lbs of body fat haven't lost any strength and don't feel like I've gained any significant muscle I work out heavy and do cardio 6 days a week. I had my blood work done a few days ago at 5 weeks on the diet and medication regiment and this is the before and after. I should note though that I do tend to starve myself on some days not eating period. Overall I feel very good, high energy and libido is high. I should also note I take an "all in one supplement for mens healther which includes 10,000iu of vitamin d a day and 100MG DHEA a day.

start of meds and diet August 2nd blood results Sept5th blood work results

glucose 89mg 79mg

Albumin 4.5g 5.3g

SHGB 28nm

IGF-1 135ng 132ng

DHEA 176 mcg rr 82-448mcg 610mcg

Total testosterone 438ng rr 250-1100ng 907mg rr 241-827ng

Free testosterone 63.4 pg rr 46-224pg 18.4pg rr 5.1-41.5pg

vitamin D 37ng 41ng

PSA 0.6 0.8

TSH 2.17ulu 4.37ulu

T3 free 2.6pg rr 2.3-4.2pg

progesterone 0.3ng rr .3-1.9ng 2.0ng

Cholesterol 165mg rr 100-199mg 256mg

HDL 55mg rr 40-59mg 41mg

LDL 99MG rr <100 193mg

triglycerides 54mg rr 50-149mg 112mg

Insulin fasting 5.1mu rr 3.0-28mu 1.9mu

HS-CRP 1.52mg rr <3.0 high risk 2.82mg

T4 .96ng rr .6-1.8 1.00ng

estradiol 25pg 29pg

hgba1c 5.4 rr <5.7% <4.5


Some results came from different labs which is why I added two reference ranges for those particular ones.

Also where there is missing data It means I have not gotten results back yet or at all. I should also note that I have more bloodwork coming back and done that is not noted. I'm curious why I have many great changes and labs outside of reference ranges now including significant ones like cholesterol and insulin. Im also curious why my total T is high now which is obvious why but then again my free T is within normal range. I was under the impression that would work together. Also it makes me nervous seeing my hs-crp rise. Any help and info is appreciated. As I said I see my doctor soon but Im curious for the time being. I will update results and answers from my doc as I go. Thanks.

I should also mention cbc was no different nothing abnormal same with kidney and liver function.

Whoa!... to both the dosages in your protocol and blood numbers.

My questions:

-Strategically, did this clinic state they want to bitch slap your body into weight loss then back you out of it once changes occur? Because those dosages are really high across the board. This is no usual conservative beginning to TRT.

-AI based on E2 at 25 right off the bat seems unwise

-Your original T numbers were not great but not terrible depending on symptoms and whether low T is the actual cause. Was it your choice or this clinics choice to put you on such a radical dose of T? Did you know this will shut down your own production of T? Was HCG monotherapy or clomid discussed?

-No LH is shown. Did they determine primary vs secondary hypogonadism?

-Subsequent TSH is up considerably, definitely a concern

The dosage was there call. I currently take 200iu of hcg a day sq. Once the diet is over im supposed to got to 500iu on injection days. Havent got my lh back yet.

I believe standard and the reference range for shbg is what you mentioned. The results of that lab was at 5 weeks exactly from the start of injections.

test guy145 said:

The dosage was there call. I currently take 200iu of hcg a day sq. Once the diet is over im supposed to got to 500iu on injection days. Havent got my lh back yet.

Click to expand...

Generally speaking, the standard approach is to treat the symptoms and the numbers by correcting with dosages for optimal ranges rather than blowing them out of the water with supraphysiological overdose. (And underdose when it comes to caloric deficit.) Seems what you're doing is going to wreck havoc. The only rationale I can think of is this is a shotgun approach for a short period of time to make changes fast (albeit potentially dangerous) and they'll switch you back to more normal or optimal physiological dosages after a little time. But I would not go for this, no way no how myself. Slow and steady is the game here, not blowing your physiology out of the water.

the blood work was taken 4 days after the last shot

In my next visit they talked about making dose adjustments based off the labs and moving to a 1200 calorie a day diet

I'm confused. You are on 400mg of testosterone a week and a month later your total came back at 907? That's impossible. 4 weeks isn't ideal but is MORE than enough time for 400mg to push your total near 2000. My SHBG is in the gutter and 300 put me at 1700ng/dL at 4 weeks.

Your Free T3 is LOW. It's at 15.8% of Range Value, and in an optimal setting you would want to see this at 50% to 80%. Your metabolism will be sluggish at best unless you get the thyroid working for you. Free T3 is critical for metabolism, energy, promoting ATP, etc., but it also needs to be compared and assessed with other KEY important labs ... You have TSH, but need Free T4, Reverse T3, and it would be important to see your antibodies; both TPO and TgAb. Iron, ferritin & electrolytes will need to also come into the picture, but at least start with the primary thyroid labs to get a better picture.