6 week results attached, low T and very low E2 - what to do?

[get1200]

Hi all - this website is a great resource. Thank you all for keeping discussions going.

I'm 29, 6'1 and 205 lbs. I've been weight lifting since i was 12 with an OK diet, so I'm in pretty decent shape. For the last 5 years, I've been having the typical lot T symptoms, getting worse as time went on. Sleep issues, easy to fatigue, barely any progress in the gym, mental fog (worst one), and did not want to do anything. Ordered blood work out of curiosity, and results said my T is 440, and E2 was 12 on the non-sensitive test.

Went to a doctor a month later, he pulled more blood work, results of which were close to original blood work, except T, which was even lower. Doc put me on 100mg/week cyp 1x/week. I typically felt good for 3-4 days after the injection, and then day 5-7 I felt horrible - almost worse than before TRT. Libido is OK at best, erections are much weaker than they were 2-3 years ago.

At 6 weeks on TRT, doc had me pull blood work, which is below. This was pulled right before my next injection. Since then, I've switched to 50mg 2x/week. After the appointment, doc switched me to 60mg 2x/week, so 120mg total.

Basically, on 100mg/week and NO AI, my T is 249 and my E2 is 5.1. I also pulled a sensitive E2 test myself, and it came out to be 13.9. I'm hoping now on 120mg/week split into two doses, i'll be more stable at a higher T number, but what's up with my E2 being so low? Doc is not concerned about it.

What do you guys think? Should I work on bringing it up somehow?

Thanks in advance.

 

[MarkM]

These are a little hard to read. Looks like your Total T and Free T are both below range. Your Sensitive E2 at 13.9 is also very low and if you are using LabCorp their range should be 8.0 - 35.0. It was good that you pulled the Sensitive E2 on your own because it appears your doctor pulled the wrong one.

At first glance it appears you need to increase your dose of testosterone. One key thing we need to know is what your SHBG is. That will determine what type of protocol you need to be on. If it is low, you would probably do better on injections more often, either ED or EOD. If SHBG is high, one large injection typically works better, it looks like you have tried that and it did not work well, however, it could be that your dose was just too low.

Really need to know that key ingredient....SHBG.......... for us to be able to give you a clearer direction that might help you.

 

[CoastWatcher]

Welcome to Excelmale. As noted, your SHBG answers all sorts of questions in regard to protocol design. It is an absolutely necessary test. We hope you'll become an active member!

 

[Systemlord]

Welcome new member.

You may be a hyper excreter, basically SHBG isn't grabbing ahold of the T you're injecting. That's why it's important to measure SHBG before TRT commences. I know a guy who hypersecretes testosterone fast and has to inject 50mg EOD to keep his testosterone elevated.

There's thought to be a variability in the stickiness of SHBG from person to person.

 

[get1200]

Thanks for the replies so far. You are all correct in that none of my tests include SHBG.

If I run my new protocol of 60mg 2x/week for 3 weeks and retest for Test (total/free), sensitive E2, and SHBG from Discounted Labs, would this be enough, in combination with my existing tests, to begin optimizing my protocol with?

My doc said my test results are fine and he's confident that in increasing my dose from 100mg/week to 120mg/week, my protocol will be optimal and i'll feel great with 2x/week.

 

[MarkM]

Thanks for the replies so far. You are all correct in that none of my tests include SHBG.

If I run my new protocol of 60mg 2x/week for 3 weeks and retest for Test (total/free), sensitive E2, and SHBG from Discounted Labs, would this be enough, in combination with my existing tests, to begin optimizing my protocol with?

My doc said my test results are fine and he's confident that in increasing my dose from 100mg/week to 120mg/week, my protocol will be optimal and i'll feel great with 2x/week.

On top of the test you mentioned, if it were me I would run a full thyroid panel if you haven't. So many of us have a thyroid that is under performing and that will give an individual low T symptoms. If the thyroid is not optimal then it won't matter much what your T results are because you will still feel under par. I would also check the iron and ferritin levels. Low iron and ferritin and have a huge impact on how you feel and your energy levels. They also impact the performance of your thyroid.

It is premature to say that you will feel optimized by increasing the dose to 120 mg from 100 mg. That might be true depending on where the SHBG sits or it could be way off. there is more to TRT than just increasing dose to feeling better. You really need to see your Free T improve to the high normal range while keeping the E2 in check. Based on where you testosterone numbers sit at 100 mg I am estimating that the 120 mg won't be sufficient enough to get you to high normal testosterone ranges. Then again, the SHBG will help considerably in determining next steps.

 

[Systemlord]

Thanks for the replies so far. You are all correct in that none of my tests include SHBG.

If I run my new protocol of 60mg 2x/week for 3 weeks and retest for Test (total/free), sensitive E2, and SHBG from Discounted Labs, would this be enough, in combination with my existing tests, to begin optimizing my protocol with?

My doc said my test results are fine and he's confident that in increasing my dose from 100mg/week to 120mg/week, my protocol will be optimal and i'll feel great with 2x/week.

I like the optimism, but we are getting ahead of ourselves here. Your doctor hasn't even tested SHBG which is used to design a protocol, it will inform us how you hold onto your testosterone and for how long. It dictates dosing and injection frequencies.

When I see SHBG labs missing, it's a sure sign you're dealing with someone who doesn't understand the rules of the game.

 

[ratbag]

Get1200 your MD obviously doesn't have a clew that it's important to know what your SHBG is. At this point he is guessing by not knowing. I wouldn't make any changes until I knew what my SHBG is. No other TRT specialist would do that. The posts above are all correct. He is only guessing by not knowing this. Get your SHBG and TSH, FT3, FT4, RT3, TPO, TGAb, Ferritin. Then you will know how to set your protocol