Can someone comment on my recent lasb?

[Deleted member 17030]

I have been on TRT for 5 years. The only thing my Dr ever tests is Total T, Hematocrit and PSA. My last labs he ordered Estrodial and Estrodial FREE and both test resluts came back automated to me as being flagged high. I see my dr tomorrow.

Labs from 1-26-2022

Total T 840
Hematocrit 44.4
PSA 1.3
Estrodial 47 (flagged as high)
Estrodial FREE 1.2 (flagged as high)

I am doing .4ml of testosterone cypionate every 7 days.

I also now the past 2 months have developed ED. Cant get as firm as before, barely enough to penetrate. This is all new. I am a 62 year old white male. Could this be related to the high estrodial?

Any more questions that could help please let me know. I have my 6 month appt with Dr tomorrow. He is a Urologist at a large hospital and has done my kidney stone surgery twice lol.

I have rare AB- blood and donate every 2 months if that matters.

Thanks,

 

[Systemlord]

I also now the past 2 months have developed ED. Cant get as firm as before, barely enough to penetrate. This is all new. I am a 62 year old white male. Could this be related to the high estrodial?

It could be a lot of things, ED can happen if your hormone levels are too high and doesn’t always happen right away.

Dr. Eugene Shippen has seen this in his practice over many decades where the body down regulates after a time of sustained exccess hormones.

It's going to be difficult to critic your protocol without a Free T measurement and we don't even know where your SHBG sits so we can't even calculate your Free T.

For all we know your SHBG could be high, common in older men and your Free T is low. I would expect to see hematocrit higher on TRT and will predict your Free T to be low.

 

[Systemlord]

I am doing .4ml of testosterone cypionate every 7 days.

This doesn't tell us anything, you've been on TRT for 5 years and still don't know how much test you're injecting?

How many mg are you injecting?

 

[madman]

I have been on TRT for 5 years. The only thing my Dr ever tests is Total T, Hematocrit and PSA. My last labs he ordered Estrodial and Estrodial FREE and both test resluts came back automated to me as being flagged high. I see my dr tomorrow.

Labs from 1-26-2022

Total T 840
Hematocrit 44.4
PSA 1.3
Estrodial 47 (flagged as high)
Estrodial FREE 1.2 (flagged as high)

I am doing .4ml of testosterone cypionate every 7 days.

I also now the past 2 months have developed ED. Cant get as firm as before, barely enough to penetrate. This is all new. I am a 62 year old white male. Could this be related to the high estrodial?

Any more questions that could help please let me know. I have my 6 month appt with Dr tomorrow. He is a Urologist at a large hospital and has done my kidney stone surgery twice lol.

I have rare AB- blood and donate every 2 months if that matters.

Thanks,

When were labs drawn?

We want to test at the true trough (lowest point) before your next injection.

You are missing important blood markers such as FT and SHBG.

Most men on trt are injecting TC/TE (200mg/mL) strength.

You are injecting .4 mL (40 units) most likely 200 mg/mL strength which would be 80 mg T/week.

Even with a fairly high-end TT 840ng/dL highly doubtful your FT would be low even if you have high SHBG.

You need a more thorough set of labs FT, SHBG, prolactin, thyroid/adrenals.

Have no idea what assay was used to test your estradiol.

Always good to post a full set of labs with reference ranges/assays used (TT, FT, estradiol).

Keep in mind that although TT is important to know FT is what truly matters as it is the active unbound fraction of testosterone responsible for the positive effects.

I would look into testing iron/ferritin as there is a good chance it is low due to the frequent blood donations (every 2 months).

ED usually has a multifactorial etiology.

The causes of erectile dysfunction let alone decreased libido are complex and multifactorial.

Not as simple as just having healthy hormones (testosterone/free testosterone, estradiol, dihydrotestosterone, prolactin).

 

[Systemlord]

He is a Urologist at a large hospital

This doesn't carry much weight in the field of TRT, which is a new field of medicine and sex hormones aren't taught in traditional medical schools and residency, so big hospital or not this doesn't automatically mean your Urologist is a good TRT doctor.

So far I'm unimpressed with your Urologist and the truth is most doctors are operating in the dark as it relates to TRT and only a few doctors are truly are exceptional.

I always tell new members not to expect much from any doctor prescribing TRT.