Help dialing in - TRT side effects

[Watersedge1234]

Hello! Long time lurker, first time poster.

First and foremost - I wanted to thank all the TRT experts on this forum. I’ve benefited immensely from your knowledge and direction in this journey.

Current Protocol:
6’ tall, 260 lbs (overweight)
40MG E3D (0.2 ML test e 200/ml)
.075 Anastrole E3D (day after shot)

I tested back in Nov these numbers while taking 30MG E3D:
LABCORP
Total T: 498 (264-916)
Free T (Direct): 17 (8.7-25.1)
E2 Sensitive: 18 (8-35)
SHBG: 12 (16.5-55.9)

After these labs were taking I was instructed to up my dosage to 40MG E3D to bring up Free Testosterone to 21 and combat the somewhat lower than ideal E2.

Early Feb I retested at Quest:
Total T: 630 (250-1100)
Free T: 174.7 (35-155) HIGH
E2 Sensitive: 25 (<29)
SHBG: Didn’t test

My question is:
My understanding is the free t (direct) test from Labcorp is not accurate but that is the test my doctor is basing these decisions on.

With that said, should I pull my dosage back to counter this high Quest free testosterone result?

I ask because I was feeling good on this protocol but am now feeling pronounced symptoms of high estrogen after being on this protocol a couple months. I upped my AI to .1 E3D to hopefully combat these symptoms but would prefer to keep AI dosage to a minimum as much as possible.

Please let me know your thoughts and thank you in advance!

 

[Systemlord]

With that said, should I pull my dosage back to counter this high Quest free testosterone result?

If you feel better with less Free T and lower estrogen, reduce your dosage.

 

[Watersedge1234]

Appreciate the response and understood.

I’ve been at this for over a decade at very low dose (42mg a week) but can’t say I ever felt great. 42mg/wk was the level that I stopped having estrogen side effects with no AI (I am true hypo, test was in the low 100s when I began treatment).

The research I’ve compiled suggests the Quest method of dialysis is the most accurate methodology for Free T measurement, and given I’m out of range high it would seem I am pushing my protocol too far. However, this directly contradicts what I’ve been instructed to do at Defy (based on a “direct” Free T measurement) so just trying to be as educated as I can be next step wise.

Given my low SHBG and high test result, is it worth basing protocol revision on Quests dialysis method Free T range?

 

[Vince]

Hello! Long time lurker, first time poster.

First and foremost - I wanted to thank all the TRT experts on this forum. I’ve benefited immensely from your knowledge and direction in this journey.

Current Protocol:
6’ tall, 260 lbs (overweight)
40MG E3D (0.2 ML test e 200/ml)
.075 Anastrole E3D (day after shot)

I tested back in Nov these numbers while taking 30MG E3D:
LABCORP
Total T: 498 (264-916)
Free T (Direct): 17 (8.7-25.1)
E2 Sensitive: 18 (8-35)
SHBG: 12 (16.5-55.9)

After these labs were taking I was instructed to up my dosage to 40MG E3D to bring up Free Testosterone to 21 and combat the somewhat lower than ideal E2.

Early Feb I retested at Quest:
Total T: 630 (250-1100)
Free T: 174.7 (35-155) HIGH
E2 Sensitive: 25 (<29)
SHBG: Didn’t test

My question is:
My understanding is the free t (direct) test from Labcorp is not accurate but that is the test my doctor is basing these decisions on.

With that said, should I pull my dosage back to counter this high Quest free testosterone result?

I ask because I was feeling good on this protocol but am now feeling pronounced symptoms of high estrogen after being on this protocol a couple months. I upped my AI to .1 E3D to hopefully combat these symptoms but would prefer to keep AI dosage to a minimum as much as possible.

Please let me know your thoughts and thank you in advance!

Before you do anything, stop using the .075 Anastrole E3D (day after shot) that alone may be causing all of your issues. It's very common as some men should never lower their estrogen. No matter what level it goes to.

 

[Watersedge1234]

Thanks Vince. I actually spent all of last year titrating dosages to combat sides without an AI, but by the time I had titrated down enough to combat the E2 sides I was getting no benefit from TRT. I enrolled with Defy to explore my options and have been extremely conservative with dosages and do believe it helps me.

With that said, has the community gotten to the bottom of the debate of Quests lower Free T dialysis range of 35-155? Is this testing range worth basing protocol changes on or considered too conservative?

I ask because it seems a lot of members end up out of range with the Quest test and middle of the range of Labcorp testing methods. I’ve just found a lot of conflicting info here and was hoping for some clarity if there is any. Thank you.

 

[Deleted member 42882]

More important than which assay you use is that you use the same one every time. Blood results go hand in hand with symptoms. Even if you're using a piss poor assay, if you feel good at XX, bad at XXX, and terrible at X, you can figure things out.

 

[t_spacemonkey]

I'd drop the AI and re-asses in 1 week or so