90 Day TRT Follow Up Labs - Advice Would be Appreciated

[Donovan P]

I have just received the results of my 90 day follow up labs and I am seeking advice on how to interpret them. Some of the highlights:

• Testosterone, Serum: 334 -> 1174 ng/dL
• Free Testosterone (Direct): 7.8 -> 32.2 pg/mL
• Estradiol, Sensitive: 11.5 -> 25.4 pg/mL
• SHBG, Serum: 46.7 -> 33.6 nmol/L
• DHEA-Sulfate: 572.9 -> 543.8 ug/dL
• TSH: 2.070 -> 1.840 uIU/mL

Despite huge increases in my testosterone levels, thus far, there have not been any noticeable improvements in my subjective symptoms (depressive mood, general lethargy, low libido, mediocre erectile quality, difficulty concentrating). In addition, I have not gained any strength in the gym, and my body weight and body composition are unchanged. Similarly, I have not experienced any negative side effects. I just don't feel any different.

I have attached my actual 90 day follow up lab results; TRT intake labs back in August; as well as an initial set of labs I did with another Physician in July (which lead to me looking further into Testosterone Deficiency, due to 342 ng/dl Total T).

Unlike my previous sets of labs, I intentionally stayed out of the gym for over 4 days before my 90 day follow up labs (11/23). That likely explains the huge decreases in BUN, Creatinine, and liver enzymes.

Some high level data about me:

• Just turned 28
• Height: 5'9
• Weight: 165 lbs.
• Body fat % - 15.0%, per a July 2018 DEXA Scan
• Current TRT protocol: 70mg TestCyp IM every 3.5 days; 400IU HCG SQ every 3.5 days.

Like I said, thus far, it honestly doesn't feel like anything is different at all.

I would really appreciate your guys' thoughts, and any advice you can offer to help me prepare for my appointment next week.

 

[Donovan P]

Any thoughts guys?

Let me know if I need to clarify anything.

 

[Vince]

From the levels that you posted, they all look good to me.

How long does testosterone take to show effects?

 

[Systemlord]

There are some guys who just don't feel well when free testosterone is over the ranges, it may just be that your body hasn't adjust to testosterone as the process is measured in 6-12 months and beyond.

Some guys don't feel well on HCG, it can ruin TRT for some and some it's makes all the difference in the world.

My money is on either the high free testosterone and or the HCG. It's one of the reasons why I like to start TRT in isolation so there are less moving parts to analyze. If you were to add HCG at a later date and things turned south, you would know it was the HCG that was causing problems.

Onset of effects of testosterone treatment and time span until maximum effects are achieved

Effects on sexual interest appear after 3 weeks plateauing at 6 weeks, with no further increments expected beyond. Changes in erections/ejaculations may require up to 6 months. Effects on quality of life manifest within 3–4 weeks, but maximum benefits take longer. Effects on depressive mood become detectable after 3–6 weeks with a maximum after 18–30 weeks. Effects on erythropoiesis are evident at 3 months, peaking at 9–12 months. Prostate-specific antigen and volume rise, marginally, plateauing at 12 months; further increase should be related to aging rather than therapy. Effects on lipids appear after 4 weeks, maximal after 6–12 months. Insulin sensitivity may improve within few days, but effects on glycemic control become evident only after 3–12 months. Changes in fat mass, lean body mass, and muscle strength occur within 12–16 weeks, stabilize at 6–12 months, but can marginally continue over years. Effects on inflammation occur within 3–12 weeks. Effects on bone are detectable already after 6 months while continuing at least for 3 years.
Conclusion
The time-course of the spectrum of effects of testosterone shows considerable variation, probably related to pharmacodynamics of the testosterone preparation. Genomic and non-genomic effects, androgen receptor polymorphism and intracellular steroid metabolism further contribute to such diversity.

 

[Donovan P]

Appreciate your guys' input.

 

[Mrj]

I can say my experiance with hcg is that it make me feel like shit. Its like i cant feel pleasure when im using it. It totaly removes my motivation and makes me depresed. And its not related to E2. And it feels like it activates my fight flight system. IF i was you i would try to skip hcg for a couple weeks If not fertilitet is the reason you use hcg.

 

[Donovan P]

I can say my experiance with hcg is that it make me feel like shit. Its like i cant feel pleasure when im using it. It totaly removes my motivation and makes me depresed. And its not related to E2. And it feels like it activates my fight flight system. IF i was you i would try to skip hcg for a couple weeks If not fertilitet is the reason you use hcg.

Once you came off the HCG, how long did it take you to feel better?

Was the testicular atrophy significant?

 

[Gman86]

I can say my experiance with hcg is that it make me feel like shit. Its like i cant feel pleasure when im using it. It totaly removes my motivation and makes me depresed. And its not related to E2. And it feels like it activates my fight flight system. IF i was you i would try to skip hcg for a couple weeks If not fertilitet is the reason you use hcg.

How do your know it’s not E2 related, if you don’t mind me asking?

And did you have to adjust your testosterone dose once you removed the HCG?

 

[Mrj]

Once you came off the HCG, how long did it take you to feel better?

Was the testicular atrophy significant?

Around 2 weeks. The first week it did hurt a little bit. Atrophy not so much 10%-15% maby, but i dont care about that. Feel so much better, hcg got me to a verry darkplace. Hcg realy wasnt for me.

 

[Mrj]

How do your know it’s not E2 related, if you don’t mind me asking?

And did you have to adjust your testosterone dose once you removed the HCG?

Got multiply labs on e2. All labs e2 was 20-28pg/ml

 

[Gman86]

Got multiply labs on e2. All labs e2 was 20-28pg/ml

Have you gotten your E2 tested now that you’re off HCG? And what is your SHBG at? This topic is very interesting to me, as I still have quite a bit of brain fog, and am really curious if I would do better off HCG or not. It’s been a part of my protocol since day one on TRT. So I appreciate your input. Thanks.

Oh also, did you have to adjust your testosterone dose once you removed the HCG?

 

[Mrj]

Have you gotten your E2 tested now that you’re off HCG? And what is your SHBG at? This topic is very interesting to me, as I still have quite a bit of brain fog, and am really curious if I would do better off HCG or not. It’s been a part of my protocol since day one on TRT. So I appreciate your input. Thanks.

Oh also, did you have to adjust your testosterone dose once you removed the HCG?

Not yet. But i feel Pretty god. Shbg 28-35. why dont you just try a couple weeks Without hcg and se how you feel? IF you dont feel better just start take it again.

 

[Gman86]

Not yet. But i feel Pretty god. Shbg 28-35. why dont you just try a couple weeks Without hcg and se how you feel? IF you dont feel better just start take it again.

I've tried that once. It was on for about a week and a half though. I didn't feel any different. Maybe I should of given it more time. But I think I remember my testicles starting to get even smaller than they are now, which made me hop right back on the HCG. On Empower's HCG, they are already smaller than before TRT, so it was scary seeing them disappear even more lol. My testicles weren't that big to begin with before TRT, so seeing them any smaller is no bueno.

Just boggles my brain wondering how some men do really well on HCG, and some feel horrible on it. Then some feel really good on DHEA, and some feel horrible on it. Both have been known to convert to E2 quite a bit, so it's hard not to assume that the common link between men not feeling good on these might be E2 related.

Did you adjust your testosterone dose when you stopped taking HCG?