blood week tests after around 9 weeks

Here are my latests bloodwork. I am feeling great with everything but still having some trouble getting in the estrogen sweet spot. The biggest problem I still have is fatigue, my energy levels are ok but I would not consider them good at all, If anyone can take a look at my labs and give me some suggestions that would be great thanks

I inject 250mg test Depot 1x a week and take 0.1mg arimidex 1x a week currently, I am looking to decrease my dosage to around 100-125mg test soon and maybe add in hcg, what do you guys think?

Bit hard to read but here are the values
T3 Free 5.95 (3.1-6.8)
T4 Free 14.79 (12-22)
TSH 3.91 (0.27 - 4.2)
Prolactin 405.7 (98-456)
Testosterone 21.77 (2.4-8.3)
Ferritin 61.52 (13-400)

theoneguy said:

Bit hard to read but here are the values
T3 Free 5.95 (3.1-6.8)
T4 Free 14.79 (12-22)
TSH 3.91 (0.27 - 4.2)
Prolactin 405.7 (98-456)
Testosterone 21.77 (2.4-8.3)
Ferritin 61.52 (13-400)

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One of the most important pieces of blood work is your SHBG and looking over your labs yours is low 19.89 nmol/L (range 17.3-65.8)

Ones SHBG will dictate does/injection frequency and is critical to the overall effectiveness of trt.

Men with low/low-normal SHBG tend to do better injecting lower doses of testosterone more frequently (daily, EOD) as oppose to men with high/high-normal SHBG who tend to do better injecting higher doses of testosterone less frequently (once weekly).....mind you some can do well injecting higher doses twice weekly (every 3.5 days).

Your protocol is wrong and the dose you are injecting 250mg/week is very high especially for someone with low SHBG as men with lower SHBG can hit higher FT levels on lower doses of testosterone injected more frequently.

When was your blood work drawn as your TT is astronomically high at 21.77 ng/ml (range 2.4-8.3) and your FT 109.45 is just over top end of the range but could very well be higher (range 23.3-103.0) as in your countries lab it is listed as FIA% (free androgen index),

I am thinking that if you are only injecting once weekly 250mg/week and because you have low SHBG that your blood work was done at your peak as in right after your injection because your TT is absurdly high at 21.77 ng/ml (range 2.4-8.3) and it would be hard to believe that you have a TT 21.77 ng/ml at trough (end of the week just before your next injection) with such a low SHBG.

I would say the reason you do not feel well is your protocol is wrong for someone with low SHBG and your e2 may be too low due to use of the aromatase inhibitor.

Even though you had your e2 tested 20.13 pg/ml (range 7.6-42.6) it was the wrong test as you need the estradiol sensitive (LC/MS-MS) to truly know where your e2 sits and the estradiol sensitive test is likely not available in your country.

Also looks like you have a dysfunctional thyroid and your prolactin is high which can have a negative effect on ones libido/erectile function.

Your TT is 21.77 ng/ml (range at lab in your country 2.4-8.3) and when converted to units commonly used at US labs (ng/dl) it would be a WHOPPING 2178 ng/dl (range 264-916) and if converted to units commonly used at Canadian labs (nmol/L) it would be 75.5 nmol/L (range 7.6-31.4)

Bloodwork was taken 2-3 days after my injection. Yes I do not have access to the sensitive E2 test as I do not live in America. I basically lost 7kg of my muscle mass in 6 weeks while getting all my tests done and getting ready to start trt so started on the higher dosage to rebuild as much of my muscle as possible.

I am getting to the end now 12 weeks so will most likely drop my dosage down starting this week to 100-125mg week probably start at 100mg week and see what results bring back. I am super sensitive to adex I only take 0.05 to 0.1 mg 2x week depending on how i feel. The doctors in the country where I live really have no idea so definitely open to suggestions on thyroid etc.

theoneguy said:

Bloodwork was taken 2-3 days after my injection. Yes I do not have access to the sensitive E2 test as I do not live in America. I basically lost 7kg of my muscle mass in 6 weeks while getting all my tests done and getting ready to start trt so started on the higher dosage to rebuild as much of my muscle as possible.

I am getting to the end now 12 weeks so will most likely drop my dosage down starting this week to 100-125mg week probably start at 100mg week and see what results bring back. I am super sensitive to adex I only take 0.05 to 0.1 mg 2x week depending on how i feel. The doctors in the country where I live really have no idea so definitely open to suggestions on thyroid etc.

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One of the key factors is knowing your SHBG pre-trt which you do not have and even though it may be very low now at 19.9 nmol/L (range 17.3-65.8) I would be sure that it was higher pre-trt (exactly how much higher who knows) as you never had it tested and you have been injecting a really high dose 250mg/week for 9 weeks and at that dose injected once weekly it would definitely lower ones SHBG as as high dose of androgens would do that.

Once you drop your dose down to more reasonable levels you will need to wait 6 weeks until your blood levels stabilize than you will have to retest your TT, FT, e2 (although wrong test) and your SHBG to see where it sits as it may come back up as you lower your dose than you will have to adjust your weekly injection frequency based on your SHBG levels and depending on where your TT, FT sit you may need to tweak your does to find where you feel best (relief/improvement of low t symptoms).

Although TT is good to know FT is what really matters at it is the unbound active fraction of testosterone and once your FT is in a healthy range for your body and e2 is in check along with other hormones especially thyroid/adrenals than overall you should feel well.

Adjusting ones protocol to ones SHBG is CRITICAL and can make or break the effectiveness of trt.

ok thanks that is great to know
My PRE TRT bloodwork was
Testosterone 10.49 (8.36 - 28.7)
SHBG 33.06 (17.3-65.8)
Free T 31.73 (23.3-103)
E2 11.85 (7.6-42.6)

Also I see what you are saying about the low T4 and high TSH, Could this be cured by getting iodine and vitamin D levels and B12 checked and corrected or would I need to look at taking a synthetic T4 hormone?

theoneguy said:

Also I see what you are saying about the low T4 and high TSH, Could this be cured by getting iodine and vitamin D levels and B12 checked and corrected or would I need to look at taking a synthetic T4 hormone?

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Thyroid treatment can be complex and you should get treated by a doctor who specializes in this area as self treatment can end up causing nothing but grief!

Your thyroid should have been addressed before jumping on testosterone but it is what it is and if I were in your situation I would definitely look into finding a doctor who understands how to treat low t and thyroid dysfunction.

madman said:

Thyroid treatment can be complex and you should get treated by a doctor who specializes in this area as self treatment can end up causing nothing but grief!

Your thyroid should have been addressed before jumping on testosterone but it is what it is and if I were in your situation I would definitely look into finding a doctor who understands how to treat low t and thyroid dysfunction.

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Could my thyroid problem be as simple as deficiency in B12, iodine or vitamin D as my numbers don't look terrible or is it something that can only be fixed with medication?

That large dosage is hamming your SHBG, you need to inject smaller dosage EOD, even twice weekly would be better than one large weekly injection.