Can someone take a look at my lab results. They’re 6 weeks from starting 200mg T cyp TRT. They have me taking clomid 50 mgs a week and anastrozole 1 mg a week divided throughout the week. I contacted them to get lab results because I was getting ED issues I didn’t have prior to starting the TRT.
Need to rethink this one.
Find a new doctor.
Anyone starting a man on the high-end dosed TRT protocol of 200 mg T/week is an idiot.
Most of those dime-a-dozen T mills let alone clueless doctors are starting men on that cookie-cutter protocol of 200mg T/week with an AI thrown in to boot to control the elevated estradiol due to the absurdly high TT/FT levels most men would hit on such dose of T.
Most men on TRT are injecting 100-200 mg T/week whether once weekly or split into more frequent injections such as twice-weekly (every 3.5 days), M/W/F, EOD, or daily.
Even the majority of men can easily hit a healthy let alone high trough FT level by injecting 100-150 mg T/week especially when split into more frequent injections.
Are there some outliers that may need the higher-end dose of 200 mg T/week, most definitely but they are far and few.
Not only were you started out on a high dose of T but to make matters worse an AI was thrown in to boot and it gets even worse as clomid serves no purpose when using exogenous T, especially high doses!
Too many red flags here.
Gets even worse as your FT was tested using the known to be inaccurate direct immunoassay.
In order to know where your FT level truly sits you would need to have it tested using what is considered the most accurate assays such as the gold standard Equilibrium Dialysis or Ultrafiltration, especially in cases of altered SHBG.
If you do not have access to such (highly doubtful) if you live in the US then you would need to rely on the linear law-of-mass action calculated FTV.
With a robust TT 600 ng/dL and low SHBG 13 nmoL/L, the direct immunoassay used for testing your free testosterone has it absurdly high which is doubtful.
If anything when we calculate your FT using the cFTV method then with a robust TT 600 ng/dL, low SHBG 13 nmol/L, and Albumin 4.3 g/dL (fixed) your FT would be on the high end at 19.3 ng/dL but not absurdly high.
Keep in mind that as of now cFTV tends to overestimate when compared against the gold standard Equilibrium Dialysis so your FT level may be a little lower.
It is a given that your FT level is going to be healthy/high-end even with a TT 600 ng/dL which is far from very high as your SHBG is low 13 nmol/L.
As you can see your your estradiol is high mind you it was not tested using the most accurate assay (LC/MS-MS).
Prolactin is also just over the top-end but not absurdly high.
Not sure why your doctor would bother testing LH/FSH as your hpta will be shut down when using exogenous T.
Top it all off you are missing some of the most important blood markers such as RBCs, hemoglobin, and hematocrit as it is a given that these blood markers will rise when driving up your FT.
Good chance that your hematocrit is high and even then where it sits 6 weeks in is not where it is going to stay as it can take anywhere from 6-9 months and in some cases up to 1 year to reach peak levels.
The shit kicker here is if you are injecting a whopping dose of T once weekly and your labs were done at true trough (7 days) post-injection which would be your lowest point then your peak (12-24 hrs) post-injection TT, FT, and estradiol levels will be much higher.
Even then your T levels would still be absurdly high during the first 3 days post-injection.
How many days post-injection were your labs drawn?
Now when it comes to libido let alone ED they are multifactorial.
Keep in mind that running too high a trough FT level can be just as bad in many ways as running too low a FT level especially when it comes to sexual function (libido/erections) let alone mood/energy as T has a tonic effect on the CNS and can easily make one feel amped up.
Many make the mistake of getting caught up in that more T is better mentality and end up running too high and in many cases, an absurdly high trough FT level only to end up struggling in the long run especially when it comes to libido/ED as they are blowing past their natty set-point!
