13 weeks in on TRT first blood work results still low T levels

[Imazephed]

I did clomid for about 8 months before starting trt 13 weeks ago. Levels on clomid got to mid 400's. I wanted to feel the absolute best I could so I decided to try TRT. Just received my first blood work since starting and surprisingly I still am in the 400 range. I am on 3 ml test cyp and 40 units of hcg twice weekly and anastrozole .15 mg 3 x a week. I also am giving myself 20 units of b12 once weekly

Test total 447

free test 18.9

dhea sulfate 208

sex horm binding glob 14.3

tsh 1.67

psa .94

cholesterol 145

triglycerides 50

hdl 46

vldl 10

ldl 89

a1c 5.3



I was surprised that my t level is still in the 400 range I was hoping to be around 1000. Am I just getting to little? Does the rest look ok? I am still waiting on the estradiol sensitive results to come back. Should I increase my t dose or wait until I talk to dr Saya? I want to feel my best whatever that is. I just dont think I do with a 450 t level. Any idea where I am going wrong?

 

[ERO]

With your low SHBG you may need a higher weekly total amount of Test and/or to inject more than twice a week. A lot of us guys with very low SHBG like you inject a small amount of T daily.

Are you feeling anything from TRT? I ask because with SHBG in the range you have a lot of guys - myself included - do not.

 

[CoastWatcher]

I would NOT adjust your dose until you have spoken with Dr. Saya. Your consultation will be based on how you feel and these lab results, which reflect the current protocol you are on. Make a change prior to your discussion and neither you nor Dr. Saya will know where your levels sit, why you feel better/worse/ no different. Any sort of change now means you are guessing when you sit down with one another.

 

[Imazephed]

With your low SHBG you may need a higher weekly total amount of Test and/or to inject more than twice a week. A lot of us guys with very low SHBG like you inject a small amount of T daily.

Are you feeling anything from TRT? I ask because with SHBG in the range you have a lot of guys - myself included - do not.

I really dont want to have to inject every single day. I will if I have to but twice a week is about as much as I want to. As for feeling better. I do not feel any better than I did when on clomid. I do feel better than I did before I started any treatment at all but I dont feel as good as so many say trt makes them feel. I still feel weak and tired all the time. Really the only thing I have noticed since starting clomid then test is a reduction in the amount of anxiety I suffer from. I have never had any type of ed so I havent noticed anything different there.

I was thinking that test would be an immediate fix for my low t levels. I did not know that you could still have low levels when your are injecting it twice weekly. So am I understand you right you can still have low t levels if you have low shbg? What causes low shbg? Is it just genetics? Any thing I can do to boost shbg?

I want to feel as good as so many others say they feel. Dont get me wrong I dont want to stop and go back to feeling even worse than I do now like before I started trt. I do however want to feel as good as I possibly can.

 

[CoastWatcher]

I really dont want to have to inject every single day. I will if I have to but twice a week is about as much as I want to. As for feeling better. I do not feel any better than I did when on clomid. I do feel better than I did before I started any treatment at all but I dont feel as good as so many say trt makes them feel. I still feel weak and tired all the time. Really the only thing I have noticed since starting clomid then test is a reduction in the amount of anxiety I suffer from. I have never had any type of ed so I havent noticed anything different there.

I was thinking that test would be an immediate fix for my low t levels. I did not know that you could still have low levels when your are injecting it twice weekly. So am I understand you right you can still have low t levels if you have low shbg? What causes low shbg? Is it just genetics? Any thing I can do to boost shbg?

I want to feel as good as so many others say they feel. Dont get me wrong I dont want to stop and go back to feeling even worse than I do now like before I started trt. I do however want to feel as good as I possibly can.

In regard to daily injections, most men, the vast majority, don't need them. I do inject every morning, 16mg, and my protocol is an unqualified success. I adopted that injection schedule due to low SHBG and a creeping estradiol level. It allowed me to work around the former problem and overcome the latter complication. That noted, it's a small number of men who have to inject more often than two or three times a week. For low SHBG patients it's almost mandatory. The low SHBG value means that your system clears testosterone too quickly. Smaller, frequent injections overcome that problem. Low SHBG can, in some men, be a marker for diabetes, insulin resistance, and the like. However, for most of us it's simply the card we have to play. Raising it is almost impossible. I'm sure Dr. Saya will address all these issues, and more, when you speak with him. Keep in mind that this is not a sign that TRT has failed - it just needs further adjustments. Adjustments at the beginning of therapy are part and parcel of the game.

 

[ratbag]

I am on 3 ml test cyp and 40 units of hcg twice weekly

3 ml is a 600 mg shot, and twice is 1200 mg Testosterone weekly. Is this what you mean? Because if so this is way over what most use. Do you mean 30 units x 2 weekly?

 

[CoastWatcher]

3 ml is a 600 mg shot, and twice is 1200 mg Testosterone weekly. Is this what you mean? Because if so this is way over what most use. Do you mean 30 units x 2 weekly?

I realize I "corrected" that as I initially read it as he's a Defy patient. Thanks for raising the question, however, as it does make a world of difference!

 

[ratbag]

Yeah I'm assuming a typo as well... just had to throw it out there.

 

[Imazephed]

Yes .3 ml would be what I am taking twice a week. Every Tuesday and Friday. I had the blood drawn on Monday 3 full days after my last injection. Would that play a role in having such low results?

I would be willing to inject every day if it made me feel better. I guess I need to wait and talk to Dr Saya in 6 weeks or so when they can get me in. I was hoping it would be easy to see my numbers and adjust the amount of test I am taking to get my numbers up to a satisfactory level. I am learning that when it comes to getting your hormones in line nothing is black and white. What works for one wont necessarily work for the next. I have waited this long a little time wont kill me. Thanks everyone for the help

 

[ratbag]

.3 ml is 60mg twice a week and usually a good starting dose. With your low SHBG as ERO pointed out earlier can cause complications but once Dr. Saya sees the labs I'm sure he'll know where to take it.

 

[Dr Justin Saya MD]

Yes .3 ml would be what I am taking twice a week. Every Tuesday and Friday. I had the blood drawn on Monday 3 full days after my last injection. Would that play a role in having such low results?

I would be willing to inject every day if it made me feel better. I guess I need to wait and talk to Dr Saya in 6 weeks or so when they can get me in. I was hoping it would be easy to see my numbers and adjust the amount of test I am taking to get my numbers up to a satisfactory level. I am learning that when it comes to getting your hormones in line nothing is black and white. What works for one wont necessarily work for the next. I have waited this long a little time wont kill me. Thanks everyone for the help

Hi Imazephed, there will be a lot to discuss in your consult and it does appear you may need a dosage increase (and likely a shift to at least three time weekly injections). Full evaluation cannot be made until the E2 level is known (which may be riding on the low end - total E, not free E - with your less than expected T levels).

 

[Imazephed]

Thanks Dr Saya I was just hopping for a quick fix that I could implement now. Patience is not one of my strengths and heck who doesnt want to feel better. I should have known that my body would put up a fight. I will schedule as soon as my e2 comes back. Thanks

 

[Dalejoyce]

Imazephed: did you get a resolution to feeling better with low shgb? I am in Europe and suffering the same thing with limited options