First labs 11 weeks into TRT. Should I be concerned?

[WharfRat]

I searched the posts and didn’t quite find the thing that satisfied, so apologies for risking a useless post (my first one, at that). Of course I plan to talk through with provider, but I can’t stop myself from wanting to get balls deep in research.

Took my first labs since starting TRT. Labs were drawn about 11 weeks since beginning a course of 120 Cyprionate split into two subq shots per week. Labs were taken at trough in the morning.

Prior to beginning, I was at

• 369 total,
• 6.9 free,
• SHBG 39.5,
• estradiol 9.4,
• IGF 1

These latest labs (attached) seem nuts for the amount I’m taking?

• >1500 total
• 35.7 free,
• Estradiol 24.9
• DHT 92

My blood pressure is on the high side of normal but unchanged from before therapy. The attached shows negligible movement in hematocrit (I think?). How do I feel? Fine. Felt super great for a bit, last few weeks not as super great but still better than before TRT by miles.

Is this super abnormal for the dose I’m on, and should I be concerned? I guess, all other things being equal, why not have more, if my other health markers are fine and I feel fine? But is this super excessive and risky? Would love any thoughts from folks smarter than me. I still struggle with how these numbers interact.

Thanks for any input.

 

[Cataceous]

...
Is this super abnormal for the dose I’m on, and should I be concerned? I guess, all other things being equal, why not have more, if my other health markers are fine and I feel fine? But is this super excessive and risky? Would love any thoughts from folks smarter than me. I still struggle with how these numbers interact.

Thanks for any input.

We have debated this subject a lot. You have been dosed at a level that is likely on the order of double what your healthy natural production would be. It's no surprise that your numbers are off the charts. A lack of acute effects does not imply long-term safety in such levels. Hematocrit may still rise over time, increasing blood viscosity and leading to unnecessary wear and tear on the vasculature. Some individuals may be susceptible to long-term cardiotoxicity. Other side effects can arise over time as the the full effects of HPTA suppression take hold. The worst part about this situation is that you have not been able to experience normal levels before heading off into La-la land. You have no point of reference as to whether physiological levels would give better results than what you're currently experiencing.

A low-and-slow approach is preferred, in which doses start around 50-70 mg TC/week, divided into at least two injections. You give this plenty of time to stabilize before evaluating, and then slowly increase over time if there's still evidence of hypogonadism. Starting with a high dose as you have is problematic because the habituation to higher levels can make dose decreases unpleasant and misleading; you think anything lower is too low, but that's only because your body needs a significant amount of time to readjust to normal levels. In contrast, dose increases are more likely to be nice; a honeymoon period is common when starting TRT because the boost in levels boosts neurotransmitters transiently. The initial effect is more pronounced because natural production of testosterone is initially adding to what you're taking before it is suppressed.

In any case, what I would do in your situation is cut back to 70-80 mg TC/week and then give it a few months. At that point evaluate the situation as objectively as you can. If you're doing well then stay with it. If you're having problems then try to determine whether they are a result of too much or too little testosterone. Some of us find that doses lower than midrange are needed to give the best results. Do not fall into the delusion that more testosterone must be better. This is not the case when good overall health is the goal.

 

[WharfRat]

We have debated this subject a lot. You have been dosed at a level that is likely on the order of double what your healthy natural production would be. It's no surprise that your numbers are off the charts. A lack of acute effects does not imply long-term safety in such levels. Hematocrit may still rise over time, increasing blood viscosity and leading to unnecessary wear and tear on the vasculature. Some individuals may be susceptible to long-term cardiotoxicity. Other side effects can arise over time as the the full effects of HPTA suppression take hold. The worst part about this situation is that you have not been able to experience normal levels before heading off into La-la land. You have no point of reference as to whether physiological levels would give better results than what you're currently experiencing.

A low-and-slow approach is preferred, in which doses start around 50-70 mg TC/week, divided into at least two injections. You give this plenty of time to stabilize before evaluating, and then slowly increase over time if there's still evidence of hypogonadism. Starting with a high dose as you have is problematic because the habituation to higher levels can make dose decreases unpleasant and misleading; you think anything lower is too low, but that's only because your body needs a significant amount of time to readjust to normal levels. In contrast, dose increases are more likely to be nice; a honeymoon period is common when starting TRT because the boost in levels boosts neurotransmitters transiently. The initial effect is more pronounced because natural production of testosterone is initially adding to what you're taking before it is suppressed.

In any case, what I would do in your situation is cut back to 70-80 mg TC/week and then give it a few months. At that point evaluate the situation as objectively as you can. If you're doing well then stay with it. If you're having problems then try to determine whether they are a result of too much or too little testosterone. Some of us find that doses lower than midrange are needed to give the best results. Do not fall into the delusion that more testosterone must be better. This is not the case when good overall health is the goal.

Your response makes sense and yes what a bummer to look forward to adjusting to a new dose. Thanks for the detailed response. Frustrating that I was started out at apparently so high a dose!

 

[Vince]

I searched the posts and didn’t quite find the thing that satisfied, so apologies for risking a useless post (my first one, at that). Of course I plan to talk through with provider, but I can’t stop myself from wanting to get balls deep in research.

Took my first labs since starting TRT. Labs were drawn about 11 weeks since beginning a course of 120 Cyprionate split into two subq shots per week. Labs were taken at trough in the morning.

Prior to beginning, I was at

• 369 total,
• 6.9 free,
• SHBG 39.5,
• estradiol 9.4,
• IGF 1

These latest labs (attached) seem nuts for the amount I’m taking?

• >1500 total
• 35.7 free,
• Estradiol 24.9
• DHT 92

My blood pressure is on the high side of normal but unchanged from before therapy. The attached shows negligible movement in hematocrit (I think?). How do I feel? Fine. Felt super great for a bit, last few weeks not as super great but still better than before TRT by miles.

Is this super abnormal for the dose I’m on, and should I be concerned? I guess, all other things being equal, why not have more, if my other health markers are fine and I feel fine? But is this super excessive and risky? Would love any thoughts from folks smarter than me. I still struggle with how these numbers interact.

Thanks for any input.

I'm one who needs higher levels to feel good. There's nothing wrong with using a lower dose. I believe Nelson injects 50 mg twice a week along with HCG which he combines in the same syringe. I also combine both HCG and T in the same syringe. Some members get anxiety from higher levels, if you're prone to anxiety, high levels probably won't work for you. I wish we all had our levels checked when we were 21. Then we would know what levels we should be shooting for.

 

[Phil Goodman]

Your response makes sense and yes what a bummer to look forward to adjusting to a new dose. Thanks for the detailed response. Frustrating that I was started out at apparently so high a dose!

Did you get your bloodwork done at true trough?Either way, you definitely don’t need to increase your dose as you hinted at in the first post. You could probably do alright on a lower dose, but for me personally if I were you I would start by going down to 100. Dropping all the way down to 70 would be substantial and possibly result in chasing your tail for quite a while.

Either way, glad to hear you’re doing a lot better than you were before trt, and that so far your health markers haven’t changed much. And if you incorporate healthy habits like good diet, exercise, and sleep hygiene they should improve significantly. Looking forward to hearing how your journey goes.

 

[WharfRat]

Did you get your bloodwork done at true trough?Either way, you definitely don’t need to increase your dose as you hinted at in the first post. You could probably do alright on a lower dose, but for me personally if I were you I would start by going down to 100. Dropping all the way down to 70 would be substantial and possibly result in chasing your tail for quite a while.

Either way, glad to hear you’re doing a lot better than you were before trt, and that so far your health markers haven’t changed much. And if you incorporate healthy habits like good diet, exercise, and sleep hygiene they should improve significantly. Looking forward to hearing how your journey goes.

Thanks! Yes, I drew blood about an hour after I would have taken my shot normally, so true trough.

I find it wild that a dose that my clinician would start so many others on would send my total T so far through the roof. I understand how factors like SHBG would impact how much total T ends up free, it confuses me how total T isn’t a more predictable factor of how much one puts into his body. I’m sure I knew the answer to that at some time but have forgotten.

 

[WharfRat]

I'm one who needs higher levels to feel good. There's nothing wrong with using a lower dose. I believe Nelson injects 50 mg twice a week along with HCG which he combines in the same syringe. I also combine both HCG and T in the same syringe. Some members get anxiety from higher levels, if you're prone to anxiety, high levels probably won't work for you. I wish we all had our levels checked when we were 21. Then we would know what levels we should be shooting for.

When you say higher levels, surely you don’t mean as high as I currently have—or do you?

Speaking of HCG - does that have an impact on your sustained levels? I assumed whatever is generated through the HCG would blow off pretty fast, but I’m learning quickly how little I know about anything

 

[Phil Goodman]

Thanks! Yes, I drew blood about an hour after I would have taken my shot normally, so true trough.

I find it wild that a dose that my clinician would start so many others on would send my total T so far through the roof. I understand how factors like SHBG would impact how much total T ends up free, it confuses me how total T isn’t a more predictable factor of how much one puts into his body. I’m sure I knew the answer to that at some time but have forgotten.

He started you off on that dose because it’s a good starting dose for putting the majority of patients at a good level. Consider yourself lucky that you appear to be more responsive than most.

With regard to your HCG question, no, the test generated from HCG doesn’t “blow off pretty fast”. HCG just restores natural production so anything produced in that front would circulate as any other naturally produced testosterone. As far as how much it affects levels, that depends on the dose as well as how responsive your balls are to the stimulation.

 

[Vince]

When you say higher levels, surely you don’t mean as high as I currently have—or do you?

Speaking of HCG - does that have an impact on your sustained levels? I assumed whatever is generated through the HCG would blow off pretty fast, but I’m learning quickly how little I know about anything

Here's the last Labs that I posted

Thread 'Vince's Labs from October 14, 2024'

Oct 23, 2024

Same protocol, 16 mg of testosterone cypionate daily, 500 iu of hcg every third day and no AI.

Pregnenolone 10 mg and 10 mg of DHEA.

My last injection before labs, about 27 1/2 hrs.

Labs are from LabCorp.

I did "not" get the Equilibrium Ultrafiltration for testing free testosterone. I didn't want to spend the extra money.

Testosterone, Serum 1482 ng/dL range 264-916
Free Testosterone 24.5 ng/dL range 6.6 -18.1
DHT 61 ng/dL (no range on results)
DHEA-Sulfate 260.0 H ug/dL range 30.9-295.6 (age adjusted)
Estradiol, Sensitive 26.7 pg/mL range 8.0-35.0
Sex Horm Binding Glob, Serum 57.5...

• Vince
• Replies: 7
• Forum: Blood Test Discussion

 

[Willyt]

I searched the posts and didn’t quite find the thing that satisfied, so apologies for risking a useless post (my first one, at that). Of course I plan to talk through with provider, but I can’t stop myself from wanting to get balls deep in research.

Took my first labs since starting TRT. Labs were drawn about 11 weeks since beginning a course of 120 Cyprionate split into two subq shots per week. Labs were taken at trough in the morning.

Prior to beginning, I was at

• 369 total,
• 6.9 free,
• SHBG 39.5,
• estradiol 9.4,
• IGF 1

These latest labs (attached) seem nuts for the amount I’m taking?

• >1500 total
• 35.7 free,
• Estradiol 24.9
• DHT 92

My blood pressure is on the high side of normal but unchanged from before therapy. The attached shows negligible movement in hematocrit (I think?). How do I feel? Fine. Felt super great for a bit, last few weeks not as super great but still better than before TRT by miles.

Is this super abnormal for the dose I’m on, and should I be concerned? I guess, all other things being equal, why not have more, if my other health markers are fine and I feel fine? But is this super excessive and risky? Would love any thoughts from folks smarter than me. I still struggle with how these numbers interact.

Thanks for any input.

I have about the same mid-high SHBG as you and would be around the same TT as you on that dose.

You experienced the honeymoon phase those first couple of weeks, never to be recaptured unfortunately. Don't chase that dragon (ask me how I know). You've got the right idea. Gradually ramp down - you'll feel bit shitty but it will normalize eventually

 

[madman]

I searched the posts and didn’t quite find the thing that satisfied, so apologies for risking a useless post (my first one, at that). Of course I plan to talk through with provider, but I can’t stop myself from wanting to get balls deep in research.

Took my first labs since starting TRT. Labs were drawn about 11 weeks since beginning a course of 120 Cyprionate split into two subq shots per week. Labs were taken at trough in the morning.

Prior to beginning, I was at

• 369 total,
• 6.9 free,
• SHBG 39.5,
• estradiol 9.4,
• IGF 1

These latest labs (attached) seem nuts for the amount I’m taking?

• >1500 total
• 35.7 free,
• Estradiol 24.9
• DHT 92

My blood pressure is on the high side of normal but unchanged from before therapy. The attached shows negligible movement in hematocrit (I think?). How do I feel? Fine. Felt super great for a bit, last few weeks not as super great but still better than before TRT by miles.

Is this super abnormal for the dose I’m on, and should I be concerned? I guess, all other things being equal, why not have more, if my other health markers are fine and I feel fine? But is this super excessive and risky? Would love any thoughts from folks smarter than me. I still struggle with how these numbers interact.

Thanks for any input.

Took my first labs since starting TRT. Labs were drawn about 11 weeks since beginning a course of 120 Cyprionate split into two subq shots per week. Labs were taken at trough in the morning.

These latest labs (attached) seem nuts for the amount I’m taking?

• >1500 total
• 35.7 free,
• Estradiol 24.9
• DHT 92

Always post labs with the refernce ranges and testing methods used especially for the most critical fraction free testosterone.

Hard to believe no one pointed this out as your free testosterone was tested using a known to be inaccurate assay the direct IA which no one should be using/relying on.

The only way to know where your FT truly sits is to have it tested using the most accurate assay the gold standard Equilibrium Dialysis especially in cases of altered SHBG.

Otherwise you would need to use/rely on the next best testing method the go to calculated linear law-of-mass action Vermeulen (cFTV) which will give a good approximation.

The standard starting dose across the board by those in the know for the majority is 100 mg T/week or better yet 50 mg T split twice-weekly.

Yes many of the endos and some uros will start patients on 60-80 mg T/week but this is usually older men.

No one needs to be starting therapy >100 mg T/week as there will always be time to increase the dose if need be and some men can easily achieve a healthy/high trough FT injecting 100 mg T/week especially split twice-weekly.

Even then it is always best to start low and go slow on a T only protocol so we can see how your body reacts to T and where said protocol dose of T/injection frequency has your trough TT and more importantly FT, estradiol and SHBG let alone critical blood markers RBCs, hemoglobin and hematocrit.

Something is way off with your RBCs, hemoglobin and hematocrit as they barely budged and it is a given that you will see an increase when using androgens and driving up your trough/steady-state FT so chances are you have low iron/ferritin or some other underlying issue going on.

Most men on therapy are injecting 100-200 mg T/week whether once weekly or split into more frequent injections.

There will always be those outliers who may need the higher-end dose but its far from common as in rare.

Some men can achieve stellar levels injecting <100 mg T/week especially when split into more frequent injections.

The majority of men can easily hit a healthy/high trough FT injecting 100-150 mg T/week especially when split into more frequent injections.

Even 150 mg T/week can easily be overkill for many.

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

Too many still caught up on the TT when FT is where its at.

As you can see you were started on a slightly higher dose 120 mg T/week split 60 mg twice-weekly and you are hitting an absurd trough TT>1500 ng/dL 3.5 days post-injection.

Your TT was not even tested using the most accurate assay (LC-MS/MS) as it was tested using the direct IA which caps out at 1500 ng/dL so you have no idea where it truly sits.

Even more concerning is your FT was not tested using an accurate assay so we have no idea where it truly sits and we also have no clue where your SHBG sits as it was not tested but even then with an absurd trough TT >1500 ng/dL your trough FT would be high even if you had highish/high SHBG.

You had highish baseline SHBG before jumping on T so even if it never budged and chances are it may be lower from the androgen load if we calculate your FT using the go to cFTV with an absurd trough TT >1500 ng/dL, highish SHBG 39.5 nmol/L and Albumin 4.3 g/dL (default) then your trough FT would could easily be a whopping 37-40 ng/dL or much higher if your SHBG has decreased.

More importantly your peak TT, FT and estradiol will be higher.

Free & Bioavailable Testosterone calculator

Even if a man had a high SHBG 60 nmol/L with a whopping trough TT >1500 ng/dL his trough FT would still be very high!

You would easily have room to lower your dose and bring down your trough FT if need be.

If anything I would retest your trough TT using the most accurate assay (LC-MS/MS) and your trough FT using the most accurate assay ED so you can see where they truly sit but again your trough FT is going to be high.

Definitely no need to increase your dose further this would be a disaster.

This is the panel you want when testing TT/FT as it uses the most accurate assays.

Testosterone, Free (Equilibrium Dialysis) and Total, MS | Discounted Labs

Get an affordable and accurate testosterone test results with our Total Testosterone, M and Free (Equilibrium Dialysis) test. Visit DiscountedLabs.com for more information.

www.discountedlabs.com

 

[Cataceous]

He started you off on that dose because it’s a good starting dose for putting the majority of patients at a good level. ...
..

This statement is completely false and unsupported by any evidence. It's also opposed by formal recommendations for starting TRT with midrange testosterone levels, which are based on studies involving thousands of men.

 

[Vince]

This statement is completely false and unsupported by any evidence. It's also opposed by formal recommendations for starting TRT with midrange testosterone levels, which are based on studies involving thousands of men.

I'm sure you know as anyone does studies can be manipulated at almost every stage. That's why we always say at Excelmale what works for one. May not work for everyone.

 

[Cataceous]

I'm sure you know as anyone does studies can be manipulated at almost every stage.

That's a pointless remark if you don't have specific examples that have bearing on this thread. Of course peer review is supposed to lessen the odds of this happening, and it certainly makes studies more reliable overall than anecdotal evidence.

That's why we always say at Excelmale what works for one. May not work for everyone.

This doesn't change the fact that it is wrong to begin TRT dosing at levels that exceed normal physiology.

I would ask you and Phil to limit responses to links to a previous debate thread, if you must. Let's not overrun another thread with this issue.

 

[Vince]

That's a pointless remark if you don't have specific examples that have bearing on this thread. Of course peer review is supposed to lessen the odds of this happening, and it certainly makes studies more reliable overall than anecdotal evidence.



This doesn't change the fact that it is wrong to begin TRT dosing at levels that exceed normal physiology.

I would ask you and Phil to limit responses to links to a previous debate thread, if you must. Let's not overrun another thread with this issue.

I understand higher doses give you anxiety issues. Even though with lower doses you still have libido issues, correct? How was your libido at higher levels?

I know that's why you push the low dose. But like I said before, what works for you doesn't work for everyone.

 

[WharfRat]

View attachment 56152


Took my first labs since starting TRT. Labs were drawn about 11 weeks since beginning a course of 120 Cyprionate split into two subq shots per week. Labs were taken at trough in the morning.

These latest labs (attached) seem nuts for the amount I’m taking?

• >1500 total
• 35.7 free,
• Estradiol 24.9
• DHT 92

Always post labs with the refernce ranges and testing methods used especially for the most critical fraction free testosterone.

Hard to believe no one pointed this out as your free testosterone was tested using a known to be inaccurate assay the direct IA which no one should be using/relying on.

The only way to know where your FT truly sits is to have it tested using the most accurate assay the gold standard Equilibrium Dialysis especially in cases of altered SHBG.

Otherwise you would need to use/rely on the next best testing method the go to calculated linear law-of-mass action Vermeulen (cFTV) which will give a good approximation.

The standard starting dose across the board by those in the know for the majority is 100 mg T/week or better yet 50 mg T split twice-weekly.

Yes many of the endos and some uros will start patients on 60-80 mg T/week but this is usually older men.

No one needs to be starting therapy >100 mg T/week as there will always be time to increase the dose if need be and some men can easily achieve a healthy/high trough FT injecting 100 mg T/week especially split twice-weekly.

Even then it is always best to start low and go slow on a T only protocol so we can see how your body reacts to T and where said protocol dose of T/injection frequency has your trough TT and more importantly FT, estradiol and SHBG let alone critical blood markers RBCs, hemoglobin and hematocrit.

Something is way off with your RBCs, hemoglobin and hematocrit as they barely budged and it is a given that you will see an increase when using androgens and driving up your trough/steady-state FT so chances are you have low iron/ferritin or some other underlying issue going on.

Most men on therapy are injecting 100-200 mg T/week whether once weekly or split into more frequent injections.

There will always be those outliers who may need the higher-end dose but its far from common as in rare.

Some men can achieve stellar levels injecting <100 mg T/week especially when split into more frequent injections.

The majority of men can easily hit a healthy/high trough FT injecting 100-150 mg T/week especially when split into more frequent injections.

Even 150 mg T/week can easily be overkill for many.

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

Too many still caught up on the TT when FT is where its at.

As you can see you were started on a slightly higher dose 120 mg T/week split 60 mg twice-weekly and you are hitting an absurd trough TT>1500 ng/dL 3.5 days post-injection.

Your TT was not even tested using the most accurate assay (LC-MS/MS) as it was tested using the direct IA which caps out at 1500 ng/dL so you have no idea where it truly sits.

Even more concerning is your FT was not tested using an accurate assay so we have no idea where it truly sits and we also have no clue where your SHBG sits as it was not tested but even then with an absurd trough TT >1500 ng/dL your trough FT would be high even if you had highish/high SHBG.

You had highish baseline SHBG before jumping on T so even if it never budged and chances are it may be lower from the androgen load if we calculate your FT using the go to cFTV with an absurd trough TT >1500 ng/dL, highish SHBG 39.5 nmol/L and Albumin 4.3 g/dL (default) then your trough FT would could easily be a whopping 37-40 ng/dL or much higher if your SHBG has decreased.

More importantly your peak TT, FT and estradiol will be
View attachment 56151

Even if a man had a high SHBG 60 nmol/L with a whopping trough TT >1500 ng/dL his trough FT would still be very high!

You would easily have room to lower your dose and bring down your trough FT if need be.

If anything I would retest your trough TT using the most accurate assay (LC-MS/MS) and your trough FT using the most accurate assay ED so you can see where they truly sit but again your trough FT is going to be high.

Definitely no need to increase your dose further this would be a disaster.

This is the panel you want when testing TT/FT as it uses the most accurate assays.

I maybe used imprecise language I. The original post - I’m certainly not considering increasing!

Would love to know if you know of a clinic that operates with NC folks who I can trust to know all the shit above and direct my treatment accordingly! Thanks for all the info!

 

[Cataceous]

...I know that's why you push the low dose. But like I said before, what works for you doesn't work for everyone.

Phil and Vince: I am moving these posts back to a thread we already overran...

C

Post in thread 'Post TRT - Libido is DEAD :('

Today at 11:48 AM

The recommended dose (as listed by the material YOU shared) listed the starting dose as 100 mg per week. This was to put patients at normal levels. If you’d like to rehash it we can, and I can also point explicitly to the statements contained within the materials that say that.

I see a statement that 100 mg per week is better than 200 mg/2 weeks, not that it's some ideal starting protocol. On the contrary, they say, "In general, smaller dosages at more frequent intervals are preferred over high, less frequent administrations to limit the duration of time spent outside (above or...

• Cataceous

• 

 

[Vince]

Vince I am moving these posts back to a thread we already overran...

C

Thread 'Post TRT - Libido is DEAD :('

Mar 6, 2026

I was on TRT for 3 years and stopped 7 weeks ago.
Since stopping, my libido has been completely dead.


Symptoms:

• no wet dreams
• no morning erections
• zero libido
• zero interest in sex
• I can still get an erection if I want
• energy level is good

Recovery meds:

• Clomid for 5 weeks
• past 2 weeks: enclomiphene 12.5mg day , last week was on 6.5mg daily.

Labs while on TRT (13 Jan 2026):

• Total testosterone: 563.6 ng/dL
• SHBG: 22.3 nmol/L...

• choppie
• libido trt
• Replies: 78
• Forum: When TRT Is Not Enough (ED, Libido, & More)

You stopped TRT? Or are you talking about someone else?

 

[Vince]

You stopped TRT? Or are you talking about someone else?

Oh I see the post from choppie. Yes, many can struggle on enclomiphene. How is your libido?