Current Labs and Previous Labs

[XJL]

I'm 52 and been on TRT for the past 14 years. RX for 100 mg Test. Cyp. IM and .25 A-dex per week for almost the entire time after getting tuned up. Labs done annually. Injecting 1x per week and A-dex two days after. Previous labs 4 days after Test. inj. were:

TT-1423
TF-134
T-Bioav.-283
SHBG-62
E2 (sensitive)-20
DHT-92

Doctor says TT and DHT is too high. Reduces Test. Cyp to 80 mg per week, keeps A-dex dose the same at .25. Next labs 5 days after test. inj. are:

TT-586
TF-45
T-Bioav.-90
SHBG-63
E2(sensitive)-<15
DHT-50

Doctor is at a loss. Agrees to take me back to 100 mg. of Test. per week and has me stop A-Dex completely. I switched to 50mg Test. every 3.5 days subq. and I will do labs at the through next time. It has been 3 weeks and I feel alot better already.

Any thoughts or suggestions would be appreciated.

 

[Vince]

A couple thoughts, you should do labs on injection day before you inject, fasting for 12 hours. Looks like your E2 may be somewhat low?

Follow your new protocol for 6 weeks before doing labs.

 

[XJL]

A couple thoughts, you should do labs on injection day before you inject, fasting for 12 hours. Looks like your E2 may be somewhat low?

Follow your new protocol for 6 weeks before doing labs.

Going forward that is my plan for all lab work. The low E2 also negatively affected my lipids raising total cholesterol, and LDL. What is the correlation and have you had a similar experience?

 

[ratbag]

Aside of what Vince has pointed out I see a couple of problems. Firstly your MD's original labs were done at 4 days after injection and after he changed to 80mg he did labs at 5 days? This is inconsistent. Secondly your 2nd labs show low E2 and he has you on the same dose of A-dex? It would appear that you shouldn't be taking A-dex as it's probably driving your E2 too low.

 

[XJL]

Aside of what Vince has pointed out I see a couple of problems. Firstly your MD's original labs were done at 4 days after injection and after he changed to 80mg he did labs at 5 days? This is inconsistent. Secondly your 2nd labs show low E2 and he has you on the same dose of A-dex? It would appear that you shouldn't be taking A-dex as it's probably driving your E2 too low.

He had me stop A-dex completely. I don't think I need it at all even at 100 mg Test. per week since at that dose my E2 was only 20. I am fairly lean and my body fat is about 18-20%. I've read that E2 levels are naturally lower in leaner males with less overall body fat? Do you think this is accurate?

On my first labs TT is off the charts but Free T and Bioav. is low. Any way to change that? SHBG is high too.

 

[Vince Carter]

Its super tough to compare labs from one to the other if a schedule isn't strictly followed as ratbag stated. To compare they have to be the same protocol, same day, even the same lab might be necessary, anything less is a little bit of guesswork, it's not a waste though.

 

[Vince]

He had me stop A-dex completely. I don't think I need it at all even at 100 mg Test. per week since at that dose my E2 was only 20. I am fairly lean and my body fat is about 18-20%. I've read that E2 levels are naturally lower in leaner males with less overall body fat? Do you think this is accurate?

On my first labs TT is off the charts but Free T and Bioav. is low. Any way to change that? SHBG is high too.

High shbg can cause low free T, not always though. Lean men can also have high estradiol levels.

 

[XJL]

Is there a way to lower SHBG?

 

[Vince]

Man who have high shbg should only inject T once-weekly.

 

[XJL]

That's what I've been reading and what Dr. John Crisler advocates sometimes but even when I was doing once weekly it was still high as indicated in the labs. Nevertheless, I am going to go back to once weekly sub q. According to what I understand, you need the larger volume of T to overcome the SHBG's effects.

My dilemma is I just feel better with every 3.5 days......

What is the best way to revert back to once per week when you have been doing every 3.5 days?

 

[Vince Carter]

Androgen therapy typically lowers SHBG but how much is an individual thing, may not work for everyone, but yes, you'd have to run a higher TT in to try and overcome the SHBG and get your Free T to move up. But it's all about feeling better so if 3.5d is what that is for you then you should go with it.

 

[CoastWatcher]

Androgen therapy typically lowers SHBG but how much is an individual thing, may not work for everyone, but yes, you'd have to run a higher TT in to try and overcome the SHBG and get your Free T to move up. But it's all about feeling better so if 3.5d is what that is for you then you should go with it.

This nicely captures the situation. If you feel better on a twice weekly protocol - follow that one. Attend to your lab values, certainly, but don't feel bound by them.

 

[XJL]

Not to overly complicate this discussion, but I went to every 3.5 days/ 2X a week in conjunction with stopping the A-Dex completely. Maybe this is a factor too.

 

[CoastWatcher]

Not to overly complicate this discussion, but I went to every 3.5 days/ 2X a week in conjunction with stopping the A-Dex completely. Maybe this is a factor too.

I wouldn't be surprised if it was a factor. I know my own doctor has made it very clear one - and only one - change at a time.

 

[XJL]

That makes a lot of sense. Thank you! What is the best way to revert back to once per week when you have been doing every 3.5 days?

 

[Vince Carter]

Just add 7 days to your next injection, the same cumulative total mg's your using now and start over and go thru the adjustment period of 4-6 weeks with labs.

 

[XJL]

Just add 7 days to your next injection, the same cumulative total mg's your using now and start over and go thru the adjustment period of 4-6 weeks with labs.

My schedule has been Wed. PM 50 mg and Sat. AM 50 mg. so you are saying do 100 mg this Wed. and each Wed. thereafter? Would the Test. spike be insignificant?

 

[CoastWatcher]

My schedule has been Wed. PM 50 mg and Sat. AM 50 mg. so you are saying do 100 mg this Wed. and each Wed. thereafter? Would the Test. spike be insignificant?

Impossible to say. The higher SHBG will help you, but it will vary from patient to patient.

 

[Vince Carter]

Yes Id do it just like that...no one can say what your numbers could be though 100mg is a pretty basic dose usually the start point for TRT is 100mg/W