Can I get help with these mid protocol labs?

[PushrodV8]

It's not the full test range, I did test total, free and e2 as I had a hunch my e2 was high and it is. I don't go for my full labs again until a month or so.
https://ibb.co/b9KGby

I am prescribed anastrozole .125 mg but don't take it. Only if I get symptoms but it's clearly high. How should I incorporate it?

My protocol is 50mg test cyp 200mg m/w/f as well as 300iu hcg m/w/f

My test seems low as well for being on 150mg. I'm obviously getting aromitization, shbg could be low? Again I only did partial labs probably should have added the full range

I'm primary hypogondal. Dont know if it matters, on HCG, still have testicular atrophy, week 5.

My PRE TRT SHGB was Sex Horm Binding Glob, Serum 19.1 nmol/L 16.5 - 55.9 01

 

[CoastWatcher]

You said you're injecting 150mg of testosterone. But how are you doing that? Twice weekly? EOD? Weekly? Your SHBG is certainly on the lower end.

 

[PushrodV8]

You said you're injecting 150mg of testosterone. But how are you doing that? Twice weekly? EOD? Weekly? Your SHBG is certainly on the lower end.

Its tucked in my post, sorry the format is off.

My protocol is 50mg test cyp 200mg m/w/f as well as 300iu hcg m/w/f

I have a mini consult scheduled with defy, I was under the impression with 150mg of test + the hcg, I should be seeing higher test levels.

I mean I was 209 ng/dl, im bummed my body can only manager a lousy mid 569 ng/dl. I was crossing my fingers for 1200 lol. A man can dream...

 

[CoastWatcher]

Its tucked in my post, sorry the format is off.

My protocol is 50mg test cyp 200mg m/w/f as well as 300iu hcg m/w/f

I have a mini consult scheduled with defy, I was under the impression with 150mg of test + the hcg, I should be seeing higher test levels.

I mean I was 209 ng/dl, im bummed my body can only manager a lousy mid 569

It's certainly not the response you wanted. You're receiving quality care, knowledgeable medical professionals, and it isn't unusual to find out that the starting protocol needs an adjustment.

What were the prescribing instructions for the anastrozole?

 

[PushrodV8]

It's certainly not the response you wanted. You're receiving quality care, knowledgeable medical professionals, and it isn't unusual to find out that the starting protocol needs an adjustment.

What were the prescribing instructions for the anastrozole?

Oh yeah Defy is great! Don't get me wrong, my body is just proving itself to be difficult.

Anastrozole was only if I experienced symptoms such as sore nipples, being overly emotional, etc and even then only twice a week so as not to affect the testosterone levels.

The reason I got mid month blood work was I was feeling "so so" the day after pinning, some light fatigue.

I have not started anastrozole yet.

 

[madman]

Its tucked in my post, sorry the format is off.

My protocol is 50mg test cyp 200mg m/w/f as well as 300iu hcg m/w/f

I have a mini consult scheduled with defy, I was under the impression with 150mg of test + the hcg, I should be seeing higher test levels.

I mean I was 209 ng/dl, im bummed my body can only manager a lousy mid 569 ng/dl. I was crossing my fingers for 1200 lol. A man can dream...

You are sorely misinformed if you think getting to a 1200 ng/dl TT is something special as sure TT is good to know but FT is what truly matters as it is the unbound fraction of testosterone and most men with low/lowish SHBG can achieve higher FT levels even with an average TT and they can also achieve higher FT using lower doses of testosterone especially when injecting more frequently.

Although your TT 569 ng/dl on paper may not impress you your FT 22.2 pg/ml (range 9.3-26.5) is near the upper end of the physiological range!

 

[PushrodV8]

You are sorely misinformed if you think getting to a 1200 ng/dl TT is something special as sure TT is good to know but FT is what truly matters as it is the unbound fraction of testosterone and most men with low/lowish SHBG can achieve higher FT levels even with an average TT and they can also achieve higher FT using lower doses of testosterone especially when injecting more frequently.

Although your TT 569 ng/dl on paper may not impress you your FT 22.2 pg/ml (range 9.3-26.5) is near the upper end of the physiological range!

Makes sense, I definitely don't know nearly enough about this stuff.

It was just depressing seeing the levels that were once 209, barely above 569. Hearing my free test is good, is definitely a positive.

 

[MarkM]

PushodV8,

Your Total T might not be where you want it but your Free T at 22.2 is 3.9% of your Total T which is very good. Most guys would be very happy with that. It is the Free T that does all the heavy lifting and most guys are fortunate to get 2 - 3% of Free T to Total T. That additional 1% point you're getting is huge.

 

[PushrodV8]

PushodV8,

Your Total T might not be where you want it but your Free T at 22.2 is 3.9% of your Total T which is very good. Most guys would be very happy with that. It is the Free T that does all the heavy lifting and most guys are fortunate to get 2 - 3% of Free T to Total T. That additional 1% point you're getting is huge.

Thank you for the response


I have noticed my lifts and recovery are going well. Free test is the culprit for that correct?

 

[madman]

PushodV8,

Your Total T might not be where you want it but your Free T at 22.2 is 3.9% of your Total T which is very good. Most guys would be very happy with that. It is the Free T that does all the heavy lifting and most guys are fortunate to get 2 - 3% of Free T to Total T. That additional 1% point you're getting is huge.

His SHBG pre-trt was 19.1 nmol/L.....his most recent labs he only tested TT, FT, e2

Using the Free & Bioavailable T Calculator if we use his TT 569 ng/dl and the pre-trt SHBG than his FT is 2.81% and BT is 65.8%

Ideally ones FT should be 2-3% of TT

https://www.nebido.com/en/hcp/research/testosterone-tools/free-calculator.php

 

[MarkM]

His SHBG pre-trt was 19.1 nmol/L.....his most recent labs he only tested TT, FT, e2

Using the Free & Bioavailable T Calculator if we use his TT 569 ng/dl and the pre-trt SHBG than his FT is 2.81% and BT is 65.8%

Ideally ones FT should be 2-3% of TT

https://www.nebido.com/en/hcp/research/testosterone-tools/free-calculator.php

Right, I understand that. I did not use the pre-TRT SHBG with his current Total and Free T levels. That would be like using pre-TRT estradiol with current T levels. Once TRT begins all numbers are likely to change. It is possible that with the already low SHBG, it went lower after he started TRT with 50 mg three times a week. That might account for his free T being higher. Nonetheless, his Free T as a percentage of his Total T is fairly good.

 

[madman]

Right, I understand that. I did not use the pre-TRT SHBG with his current Total and Free T levels. That would be like using pre-TRT estradiol with current T levels. Once TRT begins all numbers are likely to change. It is possible that with the already low SHBG, it went lower after he started TRT with 50 mg three times a week. That might account for his free T being higher. Nonetheless, his Free T as a percentage of his Total T is fairly good.

Lets say for sake his SHBG lowered to 10 if he had it done on the recent labs than with a TT 569 ng/dl using the calculated method his FT is 3.41% and BT is 79.9%.....and that is even if hid SHBG went from 19--->10 4 -5 weeks into trt.....most only see a drop in SHBG when injecting higher doses less frequently (once weekly).

http://www.issam.ch/freetesto.htm

 

[PushrodV8]

Thanks for all the replies, should I be taking my anastrozole with my elevated e2 or wait for my mini consult next week with defy. It's .125mg

thanks

 

[MarkM]

My E2 sits at 35.3, a little lower than yours and I do not take anastrozole. I would say it depends on how you feel. If you are not having signs of high E2 I would not take the anastrozole. E2 of 40 is over the range with a top end of 35 but it is not extremely high. Some people do very well with E2 up in the 50's range. It's an individual thing. I would not recommend taking anastrozole unless I absolutely had to and if I had to I would. If you can wait until your consult I would do that.

 

[PushrodV8]

Thank you Mark

 

[MarkM]

Thank you Mark

You're quite welcome!

 

[CoastWatcher]

My E2 sits at 35.3, a little lower than yours and I do not take anastrozole. I would say it depends on how you feel. If you are not having signs of high E2 I would not take the anastrozole. E2 of 40 is over the range with a top end of 35 but it is not extremely high. Some people do very well with E2 up in the 50's range. It's an individual thing. I would not recommend taking anastrozole unless I absolutely had to and if I had to I would. If you can wait until your consult I would do that.

Very solid advice.

Raising estradiol following a crash is accompanied by significant patient discomfort...tread carefully.