Disappointing first follow-up labs

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TDCNINJA

Member
I have been on TRT for 2 months now and it doesn't look, upon first glance, that my numbers are very good. But as a newbie maybe I just don't have the experience yet to see.

My total testosterone has limped up to 349 from 332

Free testosterone has increased to 9.6 from 3.8 (LOW)

Sensitive estradiol has shot up to 38.4 (High) from 19.9. This is especially disappointing as I inject daily subQ. And as I'm obese, I'm not sure how that plays into things. There is no way in the world that I want to take an AI. But since my follow up today will almost certainly include an increase in the amount of testosterone I inject, I may have to bite the bullet.

My SHBG has lowered to 33 from 42.2

My IGF-1 has increased to 121 from 100

My DHEA-S has increased to 270 from 169.4

My hemoglobin is almost unchanged and just slightly lower at 12(LOW) from 12.4 (LOW)

My hematocrit also has just slightly lowered to 36.2 (LOW) from 38.2 (LOW)

My T4 is slightly lower at 1.22 from 1.37

My T3 is virtually unchanged at 3.2 from 3.1

I didn't previously test my Reverse T3, though I should have. The results today show it to be high at 27.4 (HIGH)

My current protocol is:
.05ml (10mg) of testosterone cypionate injected subQ - daily
100IU of HCG - daily
25mg of DHEA
T3/T4 - 4.5mcg-Liothyronine /19mcg-Levothyroxine

In terms of how I feel, well, I feel much better than I did. I certainly went through an almost euphoric rise in mood and general well-being. Depression and anxiety have markedly decreased.

I have noticed that in the past week, I have come back to earth, so to speak. I still feel fairly calm and stable - though I still have a very hard time getting to sleep.

My erections have come back to life after being almost completely dead. I did experiment once while on vacation by doubling my Test-Cyp dose to 20mg and my erections were much harder and durable. I was able to engage in sexual intercourse for the first time in 2 years. My libido is also starting to improve from non-existent but still have a lot of room for improvement.

As always, I welcome your thoughts/observations as that is how I learn by reading your opinions.
 
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fifty

Well-Known Member
10mg daily?

I would consider a change to 14mg daily and hcg 250iu 2x/wk. Edit: Or maybe 14-16mg and dump hcg.
 
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Free T is too low, I concur with upping your dose to 14mg/D. Your dose should get your trough Free T up to the max lab range.
I would dump the DHEA, too, and leave the HCG use as is and reevaluate that later.
 

TDCNINJA

Member
Well done, Mark and Sean. My provider did just that. Stopped my T3/T4 Leo/Livo and put me on a T3.

My new plan is as follows:

INCREASE T Cyp 200 mg/mL – 0.10 mL (20mg) SQ Daily.
INCREASE HCG 200 IU SQ Daily. To reverse/prevent testicular atrophy. Increase Free T.
BEGIN Anastrozole 0.125 mg one by mouth 1-3 times per week as needed per elevated E2 symptoms
CONTINUE DHEA 25 mg one by mouth every night. To Decrease SHBG and Raise Free T.
DISCONTINUE (T3/T4)
BEGIN Cytomel/ Liothyronine capsule (compounded T3) (SR)
 
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HealthMan

Member
Your dosage is rather low. Why are you afraid of AIs? Keep in mind that because if tried 20mg daily for a short period of time and felt better that doesn’t mean you will feel the same when taking 20mg daily in the long term. Hormone fluctuations when changing protocols can make you feel great/bad for a short period of time while things level out. 14mg seems a plausible next step like fifty mentioned. You E2 will definitely go up. If you start to have symptoms there is not much you can do other than: use an AI, lose fat, drop and decrease HCG.
 

Vtail

Active Member
FWIW: 25 mg of DHEA each night increased my blood level from 48 to 417 in 3 weeks (LabCorp range 49 - 344). Can't say I felt any different from it.
 

TDCNINJA

Member
Your dosage is rather low. Why are you afraid of AIs? Keep in mind that because if tried 20mg daily for a short period of time and felt better that doesn’t mean you will feel the same when taking 20mg daily in the long term. Hormone fluctuations when changing protocols can make you feel great/bad for a short period of time while things level out. 14mg seems a plausible next step like fifty mentioned. You E2 will definitely go up. If you start to have symptoms there is not much you can do other than: use an AI, lose fat, drop and decrease HCG.

I will take 20mg because that's what my provider told me to take. I will also take the AI for the same reason.

I'm headed to Tiger Muay Thai, MMA, and Fitness, in Phuket, Thailand, on July 1. I'm going there for the express purpose of weight loss and fitness. I'll probably be there for around a year.

Wish me luck!
 
Vince those are not my words. That is a cut and paste from the order from my provider.

At Defy when you have a consultation, and after you are finished, they send you a written follow-up with your plan from the provider.
quoted you without the intent that those are you words, I know they're from your provider but the fact remains, its not how that works or what will come of it. Too I've been a Defy patient for 5 years and they've never sent me notes on anything after a consult.
 

Cataceous

Super Moderator
What Hormones Does DHEA Change?
So let's look at just what hormones were changed by DHEA.

1. Free Testosterone. This rose significantly just as expected from 17 to 29 pg/ml from weeks 1 to 8. I say expected, because there is a well-known study out there that echoes these results. In fact, this study showed that, when combined with HIIT, it doubled free testosterone levels. See my page on How to Increase your Testosterone Levels Naturally for the specific study involved.

2. SHBG. It is no secret that DHEA drops SHBG, but what is not as well known is that it does not lower it by all that much. In this study, and keep in mind that this with a large dose, SHBG only dropped from 55 to 49 nmol/l from weeks 1 to 8. This is just a little over 10%. Nevertheless, it did go down as expected.
...
 
You always so very conspicuously leave out the DHEA > Estrogen conversion.

55-49 didn't change any one's treatment in any appreciable way and can be as simple as hydration.
 

TDCNINJA

Member
quoted you without the intent that those are you words, I know they're from your provider but the fact remains, its not how that works or what will come of it. Too I've been a Defy patient for 5 years and they've never sent me notes on anything after a consult.

I've had two consults. Afterwards they send me a written/plan order. Maybe it's the provider's preference. I haven't been doing this long enough to know how they do things.

I'm new to HRT
 
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