Can someone help me out with my labs. 6 weeks post starting TRT.

[Dissident442]

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.

 

[Systemlord]

I contacted them to get lab results because I was getting ED issues I didn’t have prior to starting the TRT.

Let me get this right, you didn’t have ED before therapy, so why did you start in the first place?

Anyway, your provider is screwing you over hard! You found a T-mill, providing you with medicines that’s causing your ED. A lot of these clinics want to make money and sell you product you don’t need and often have no clue how to manage male hormones.

You should’ve done more research before starting T therapy.

They have me taking clomid 50 mgs a week and anastrozole 1 mg a week

Clomid won’t do anything for you on injectable testosterone. The suppressive effects of exogenous testosterone is too great for clomid to work as intended.

 

[Dissident442]

my T levels were 264 before starting. The only symptom I didn’t have was ED issues. I had everything else.

 

[Dissident442]

My free T was also very low prior to TRT.

 

[FunkOdyssey]

My free T was also very low prior to TRT.

It sounds like you do need the TRT. However, as Systemlord said, you are being treated by a T mill with a bad cookie cutter protocol. What you want to do is start with a lower dose of testosterone and nothing else. You have too many variables here and you cannot determine which of them is responsible for how you're feeling.

I would drop the clomid, drop the AI, and lower the testosterone dose. If the doc doesn't agree, I would drop the doc too and start up with a more competent clinic like Defy.

As an example, the protocol defy started me on was 40 mg EOD (140 weekly) with nothing else. Something like that would be a much better starting point for you.

 

[Dissident442]

It sounds like you do need the TRT. However, as Systemlord said, you are being treated by a T mill with a bad cookie cutter protocol. What you want to do is start with a lower dose of testosterone and nothing else. You have too many variables here and you cannot determine which of them is responsible for how you're feeling.

I would drop the clomid, drop the AI, and lower the testosterone dose. If the doc doesn't agree, I would drop the doc too and start up with a more competent clinic like Defy.

As an example, the protocol defy started me on was 40 mg EOD (140 weekly) with nothing else. Something like that would be a much better starting point for you.

Ok I appreciate this answer. I’m only 6 weeks in so I’m sure they’re gonna adjust me. I was just curious as to which level was starting the ED.

 

[FunkOdyssey]

Ok I appreciate this answer. I’m only 6 weeks in so I’m sure they’re gonna adjust me. I was just curious as to which level was starting the ED.

The answer is not spelled out by your labs. It might be free T that is too high for you. It might have something to do with your E2, or not. It might be the AI you're taking. It might be the clomid interacting with estrogen receptors in a way that is not reported in your lab work.

There is too much going on here to make an educated adjustment to the drug dosages to fix it. You need to simplify this equation before you can solve it.

 

[Dissident442]

The answer is not spelled out by your labs. It might be free T that is too high for you. It might have something to do with your E2, or not. It might be the AI you're taking. It might be the clomid interacting with estrogen receptors in a way that is not reported in your lab work.

There is too much going on here to make an educated adjustment to the drug dosages to fix it. You need to simplify this equation before you can solve it.

Alright thank you

 

[madman]

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!

 

[Dissident442]

I got labs 7 days post

 

[madman]

It sounds like you do need the TRT. However, as Systemlord said, you are being treated by a T mill with a bad cookie cutter protocol. What you want to do is start with a lower dose of testosterone and nothing else. You have too many variables here and you cannot determine which of them is responsible for how you're feeling.

I would drop the clomid, drop the AI, and lower the testosterone dose. If the doc doesn't agree, I would drop the doc too and start up with a more competent clinic like Defy.

As an example, the protocol defy started me on was 40 mg EOD (140 weekly) with nothing else. Something like that would be a much better starting point for you.

140 mg T/week is still a fairly high starting dose.

If anything most should be started on 100 mg T/week whether once weekly or better yet split twice weekly (50mg T every 3.5 days) solo no hCG and definitely no AI!

Start low and go slow.

There is lots of time to increase the dose of T let alone add in hCG if need be!

 

[madman]

I got labs 7 days post

You are clearly overmedicated!

 

[madman]

I got labs 7 days post

Where did your SHBG sit pre-TRT?

 

[madman]

I got labs 7 days post

Page 2 of your labs is missing?

Where is your CBC which includes RBCs, hemoglobin, and hematocrit?

These are critical blood markers!

 

[Dissident442]

I just looked again and page two is only my information and the doctors information no other results.