First post, bloodwork, first protocol, opinions welcome..

[trt reznor]

Hello, everyone.

I've been haunting these forums and many like it over the years while researching TRT. I had my results checked over and given a protocol yesterday, along with having my first shots done. I'd love to hear the opinions of some of the veteran forumites here, thanks for your time!

About me:
Height 5'10", Weight 195, Age 36. I should say that I've previously tried Clomid about 4 years ago. I carry my fat in my stomach and chest, and have bordered on having full on man boobs since my teens. The Doc had me on 50mg per day, which proved to cause anxiety and panic attacks within a short time. I cut my dose down to 25mg/day then EOD, but eventually stopped altogether because I didn't feel any better.

The bloodwork results I received yesterday were actually somewhat surprising, since first off they were better than my readings 4.5 years ago, plus the fact that I don't seem to really be hormonally deficient, despite the way I feel. (Lethargy, low sexual function, low motivation. These symptoms have been with me my whole adult life). But I went ahead and started the treatment anyway.

I brought up my interest in the daily injection protocols, after reading some of CoastWatcher and other member's success. But he recommended a less frequent protocol to start with, for less hassle. He seems open minded enough to try whatever i want to go with if this doesn't work.

Starters:
-375iu HCG x2 week (mon and thur)
-70mg Test Cyp SubQ x2 week (tues and fri)
-D3 Supp 20,000iu /day for two weeks, then 10,000iu/day for 2 months, finally 5,000iu/day maintenance dose
-L-Arginine Sup, 500mg/day

I opted out of the Cortisol management supp for now to help keep the cost of this initial visit down.

First Observations: It's been 24hrs since I took my first shot (both the HCG 375iu and 140mg Test cyp, both SubQ. The rest of my test will come in the mail in 1 week). I don't expect to feel anything on the first day, but I feel like I have more energy/mental clarity than yesterday, while my penis seems "more flaccid" or softer and less sensitive than normal. Maybe these are placebo effects. I understand there is also a transitional period.

Please look over my results and let me know what you think of my levels, my first protocol, and if I'm crazy for even going on TRT in the first place. Thanks so much.

ps- if the pics are hard to read, I can transcribe, just let me know!

 

[trt reznor]

For some reason, when I first posted this thread the pics all popped up, then they turned into ? marks. Not sure what's up with that.

 

[Deleted member 16042]

Initial look, The protocol looks potentially OK with a couple caveats:

Your hematocrit baseline is high to start with. Monitor this closely on TRT. It probably will climb to where you will need to donate blood, but ability to do so also depends on ferritin level. So once this starts, monitor ferritin.

2x/ week may be OK, or you may experience a bit of roller coaster due to your SHBG level. You might do better on every 2 or 3 day dosage with that SHBG.

You should find out what estradiol test was used. Should be sensitive LC/MS/MS methodology.

While in "normal range" Your thyroid numbers are not ideal. TSH above 2.0 is an indicator you might benefit from thyroid treatment. Your Free T3 is pretty good but could potentially stand to be a little higher, plus T4 is a bit low. Basically ideal ranges are TSH below 2.0, T3 closer to top of range but along with free T4, at least in upper 50% of "normal range. So not terrible by any means.

BTW, you can expect to feel different for a while (hopefully quite a bit better) during the "honeymoon" phase while your testicles are still producing T, until your own testosterone production shuts down. When that happens you may feel slight decrease in or effect or a potentially more profound let down as total blood levels then decrease to stable level based on your ongoing dosage.

 

[trt reznor]

LH 3.6 (1.5-9.3)

E2 31.7 (<40)

DHEA 229.7 (34.5-568.9)

DHT 31.7 (11.2-95.5)

TT 501 (280-1100)

SHBG 28 (14.55-94.6)

Free Test 11.22 (1.9-27)

T3, Free 3.5 (2.3-4.2)

T4, Free 1.30 (0.89-1.76)

TSH 2.485 (0.55-4.78)

Vitamin D 18 (30-100) *Low

Cholesterol Total 237 (<200) *High

HDL Chol 68 (>40)

LDL Chol 145 (<100) *High

IGF-1 94.8 (124-181) *Low

Cortisol 10.9ug/dl (no range given)

NOTE: I was a 4-6 drink per night drinker at the time of giving the original blood work, and have been for many years. I stopped drinking altogether about 3 weeks ago, so that may change some values. Also, I have more test results (another page and a half), if needed I can post.

 

[trt reznor]

Thanks for the fast response! My doctor did indeed mention hematocrit levels, and the fact that I may need to donate blood in the future. As far as the Thyroid, nothing was said about that.

Initial look, The protocol looks potentially OK with a couple caveats:

Your hematocrit baseline is high to start with. Monitor this closely on TRT. It probably will climb to where you will need to donate blood, but ability to do so also depends on ferritin level. So once this starts, monitor ferritin.

2x/ week may be OK, or you may experience a bit of roller coaster due to your SHBG level. You might do better on every 2 or 3 day dosage with that SHBG.

You should find out what estradiol test was used. Should be sensitive LC/MS/MS methodology.

While in "normal range" Your thyroid numbers are not ideal. TSH above 2.0 is an indicator you might benefit from thyroid treatment. Your Free T3 is pretty good but could potentially stand to be a little higher, plus T4 is a bit low. Basically ideal ranges are TSH below 2.0, T3 closer to top of range but along with free T4, at least in upper 50% of "normal range. So not terrible by any means.

BTW, you can expect to feel different for a while (hopefully quite a bit better) during the "honeymoon" phase while your testicles are still producing T, until your own testosterone production shuts down. When that happens you may feel slight decrease in or effect or a potentially more profound let down as total blood levels then decrease to stable level based on your ongoing dosage.

 

[Deleted member 16042]

Hmm, Free T as low as 1.9 in normal range? WTF?

 

[trt reznor]

So you're thinking the 2x/week test may lower my already low SHBG? Do you think the fact that they're SubQ injections might help with the roller coaster effect? I initially asked if I could start on a daily 16mg Test Enan w/ 250iu hCG x2/wk protocol like I've noticed have great success here (though I understand nothing in TRT is one size fits all), and he kind of shrugged it off and said let's go with an easier schedule first.

Initial look, The protocol looks potentially OK with a couple caveats:

Your hematocrit baseline is high to start with. Monitor this closely on TRT. It probably will climb to where you will need to donate blood, but ability to do so also depends on ferritin level. So once this starts, monitor ferritin.

2x/ week may be OK, or you may experience a bit of roller coaster due to your SHBG level. You might do better on every 2 or 3 day dosage with that SHBG.

You should find out what estradiol test was used. Should be sensitive LC/MS/MS methodology.

While in "normal range" Your thyroid numbers are not ideal. TSH above 2.0 is an indicator you might benefit from thyroid treatment. Your Free T3 is pretty good but could potentially stand to be a little higher, plus T4 is a bit low. Basically ideal ranges are TSH below 2.0, T3 closer to top of range but along with free T4, at least in upper 50% of "normal range. So not terrible by any means.

BTW, you can expect to feel different for a while (hopefully quite a bit better) during the "honeymoon" phase while your testicles are still producing T, until your own testosterone production shuts down. When that happens you may feel slight decrease in or effect or a potentially more profound let down as total blood levels then decrease to stable level based on your ongoing dosage.

 

[Deleted member 16042]

So you're thinking the 2x/week test may lower my already low SHBG? Do you think the fact that they're SubQ injections might help with the roller coaster effect? I initially asked if I could start on a daily 16mg Test Enan w/ 250iu hCG x2/wk protocol like I've noticed have great success here (though I understand nothing in TRT is one size fits all), and he kind of shrugged it off and said let's go with an easier schedule first.

No, not that it will lower your SHBG, but that due to having lower SHBG you may benefit from more frequent dosing. This is because low SHBG creates an environment where your body uses, and excretes Free T more rapidly than an environment with higher SHBG which keeps T levels higher for longer periods of time. In effect low SHBG means you use up and lose the T faster, hence benefit from more frequent topping up.

And though some will argue the contrary, I also think that the SubQ vs IM aspect is mostly irrelevant.

 

[madman]

LH 3.6 (1.5-9.3)

E2 31.7 (<40)

DHEA 229.7 (34.5-568.9)

DHT 31.7 (11.2-95.5)

TT 501 (280-1100)

SHBG 28 (14.55-94.6)

Free Test 11.22 (1.9-27)

T3, Free 3.5 (2.3-4.2)

T4, Free 1.30 (0.89-1.76)

TSH 2.485 (0.55-4.78)

Vitamin D 18 (30-100) *Low

Cholesterol Total 237 (<200) *High

HDL Chol 68 (>40)

LDL Chol 145 (<100) *High

IGF-1 94.8 (124-181) *Low

Cortisol 10.9ug/dl (no range given)

NOTE: I was a 4-6 drink per night drinker at the time of giving the original blood work, and have been for many years. I stopped drinking altogether about 3 weeks ago, so that may change some values. Also, I have more test results (another page and a half), if needed I can post.

Honestly I would have addressed your thyroid before jumping on trt.....although your total is average and your free t is just under mid-range and definitely not low you should have looked into what assay was used when you had blood work done as some methods of free t can be inaccurate.

Even with a 500 TT you may very well have a descent free t especially as your shbg is lower.

If your shbg was high with a 500 TT than I could truly see your free t being low!

 

[ratbag]

All hormones need cortisol to work properly. If your low, you won't know this until you get a 4 x saliva test done. The serum test on your results is mostly used for addisons disease and does not determine what your diurnal ranges are. Thyroid and TRT needs cortisol to work properly. So in reality your cortisol levels need to be good before you start any hormone treatments. Getting your cortisol normal could well improve your base thyroid and TRT numbers. Anyways it's the first hormone to get checked and functioning properly, then you start on thyroid as madman stated. Once that is all dialed in then you could start TRT if you still need it.

 

[trt reznor]

Thyroid wasnt even mentioned in the discussion. We really just glossed over the numbers, since they seem to be in healthy ranges and no abnormalities were detected during my physical. What further testing and/or meds would be used to address that?

I understand these parameters aren't universal, and what might be in the normal range for one person, can make another feel like crap. And that's where I've been most days since my teens. I've had exposure to chemicals and long term low dose radiation from my last job, I thought may have played a part. But when I saw my test results yesterday I was stumped. Because I feel like I have all the effects of imbalances hormones, but the numbers don't lie. My family members- brothers, uncles, sister all are slim and trim and muscular people. I'm kind of the odd one out in that regard. I've always had a bigger frame but a low muscle/higher fat ratio no matter my diet or exercise. I've wondered if I would feel “balanced” on the higher end of the normal scale.

Honestly I would have addressed your thyroid before jumping on trt.....although your total is average and your free t is just under mid-range and definitely not low you should have looked into what assay was used when you had blood work done as some methods of free t can be inaccurate.

Even with a 500 TT you may very well have a descent free t especially as your shbg is lower.

If your shbg was high with a 500 TT than I could truly see your free t being low!

 

[trt reznor]

All hormones need cortisol to work properly. If your low, you won't know this until you get a 4 x saliva test done. The serum test on your results is mostly used for addisons disease and does not determine what your diurnal ranges are. Thyroid and TRT needs cortisol to work properly. So in reality your cortisol levels need to be good before you start any hormone treatments. Getting your cortisol normal could well improve your base thyroid and TRT numbers. Anyways it's the first hormone to get checked and functioning properly, then you start on thyroid as madman stated. Once that is all dialed in then you could start TRT if you still need it.

my doc actually recommended a Cortisol manager supplement to take every night, but I didn't get it because it was $65 at the office. So I just ordered a really well reviewed one on amazon, it will be here Friday and I'll mix that in.

 

[trt reznor]

Madman, just curious what your protocol and history is after looking at your avatar pic.

 

[ratbag]

Then your doc actually recognises that your cortisol level is questionable, and obviously sees it as a problem. Again if I can repeat myself, you need a proper 4x cortisol lab not the serum lab 99% of most MD's use. Generally if your serum level is low or questionable then it's very likely your saliva labs would be worse. Which means a cortisol problem. Cortisol manager supps very rarely work... it's the same for TRT supps they just don't work. If you want to get better you need to address this first or you'll be chasing your tail with low cortisol.

 

[trt reznor]

Then your doc actually recognises that your cortisol level is questionable, and obviously sees it as a problem. Again if I can repeat myself, you need a proper 4x cortisol lab not the serum lab 99% of most MD's use. Generally if your serum level is low or questionable then it's very likely your saliva labs would be worse. Which means a cortisol problem. Cortisol manager supps very rarely work... it's the same for TRT supps they just don't work. If you want to get better you need to address this first or you'll be chasing your tail with low cortisol.

How are cortisol problems generally addressed then?

 

[CoastWatcher]

Then your doc actually recognises that your cortisol level is questionable, and obviously sees it as a problem. Again if I can repeat myself, you need a proper 4x cortisol lab not the serum lab 99% of most MD's use. Generally if your serum level is low or questionable then it's very likely your saliva labs would be worse. Which means a cortisol problem. Cortisol manager supps very rarely work... it's the same for TRT supps they just don't work. If you want to get better you need to address this first or you'll be chasing your tail with low cortisol.

Please raise the issue again with your doctor. I have had significant adrenal problems for decades, Addison's Disease. Not what you're dealing with, but discussions over the years have reinforced the importance of cortisol in hormonal restoration/management.

 

[trt reznor]

CoastWatcher: I will contact them tomorrow about a Saliva test. In the meantime, I'll start taking the supplement he recommended. Also, thanks for chipping in. I followed your daily protocol details with interest before my first TRT appointment, and actually brought it up to him.

But, if my cortisol levels do come in deficient, what measures would they take for that?

 

[madman]

Madman, just curious what your protocol and history is after looking at your avatar pic.

Avatar pic is 2 years before I started trt!

 

[trt reznor]

Then your doc actually recognises that your cortisol level is questionable, and obviously sees it as a problem. Again if I can repeat myself, you need a proper 4x cortisol lab not the serum lab 99% of most MD's use. Generally if your serum level is low or questionable then it's very likely your saliva labs would be worse. Which means a cortisol problem. Cortisol manager supps very rarely work... it's the same for TRT supps they just don't work. If you want to get better you need to address this first or you'll be chasing your tail with low cortisol.

Ratbag, just curious as to why you think it's low cortisol and not high? I'm no expert on the matter, but I've definitely had enough traumatic experiences to throw my cortisol out of whack. Looking at the list on symptoms, I would say I line up more with the high end, in terms of my weight and where it's stored, as well as having problems with sleep most of my life.

 

[ratbag]

Why would your Doc suggest cortisol manager supps (your words) if you didn't need help? You didn't supply the range for your cortisol but usually serum cortisol is taken in the morning and it's supposed to be the highest of the day. Hormone experts like Defy know that you cannot determine the condition of your adrenals unless you take the 4 x saliva labs. Regular mainstream medicine MD's don't know this. They only use serum levels (blood) I too have adrenal problems and I was put on cortisol and I'm still on it 30mg daily (15+10+5) and I can tell you it changed my life. I couldn't handle any hormones until they got my cortisol sorted out. The biggest failing was going to my regular PCP endocrinologist. He woulds always say I'm normal and yet I was suffering badly. I learned the hard way that hormone experts are not your regular MD's. The proof is in how I feel. It's really that simple