Bloodwork comparison after 10 weeks of TRT

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Hello, friends. This is my first post here. I really appreciate there is a forum to talk about it, so I thank you all in advance.

So, I started TRT 10 weeks ago. This is my pre-TRT and 10-week in bloodwork. Most recent on the right side.

My protocol is 120mg/wk test cyp along with 250ui EOD of HCG (testes size vary a lot). I do it monday AM and thursday PM sub-q into the VG. Bloods were drawn thursday AM.

I also run 50mg ED proviron, 5mg ED tadalafil as well as thyroid medication (which seems to have helped improving my levels)

In the meantime I hit the gym regularly and fixed my diet. Managed to drop from 19 to 15% BF. It’s clearly visible I gained muscle and lost fat.

I feel that most of my issues were solved, but I’m not quite there yet. Libido is so-so, but I get morning wood every day, and erections are solid.

Red and white blood cells within range (HMT and HMG ok). Couldn’t test pregnenolone because insurance won’t cover and it’s very expensive.

Went to the doc yesterday and he suggested:
1) Increasing the dosage
2) Drop the proviron and add anavar for aiding fat loss (I'm on a caloric deficit diet).
3) Prescribed some things like saw palmetto and pygeum, as well as substances to protect the liver. Also, he prescribed AI (which I'm not so comfortable with).

I hope to get suggestions on protocol/dosage based on my recent bloodwork. Is prolactin hindering my libido (I took cabergoline once and it worked, but as soon as I stopped, it came back)? DHT too high (I'm not prone to balding)? Should I not mess with my E2?

Thank you again.

Defy Medical TRT clinic doctor
I assume the crazy DHT reading is due to the Proviron. This is not mass spectrometry-based test so it reacts to the mesteronlone. On the plus side all this DHT activity may be reducing the effects of the high estradiol, though your prolactin still went up some.

I think you're having the same issue I did, where hCG use greatly increases aromatization. In your case the E2/T ratio increased from 0.55% to 0.73%, with the normal range being something like 0.3-0.6%. Similar numbers to mine too. The increase in prolactin did hurt my libido and ability to achieve orgasm. Cabergoline worked somewhat, but always felt like a bandaid rather than a cure. For some reason forcing down estradiol with an AI did not resolve the problems. In the end I abandoned hCG in favor of a prohibitively complex restoration of upstream hormones.

I'd argue in favor of a dose reduction, particularly if this recent set of lab work is at a pre-injection trough. Peaks can be as much as 50% higher on twice-weekly dosing.

I think it's a mistake to use ancillaries like Proviron when just starting. It makes it hard to connect causes and effects. For all you know you might do better on a simple, no-frills protocol.
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