Help With Recent Bloodwork Results on TRT/ HcG

[JmAch]

Hello-
51 yo male here, been on TRT for several years using Cypionate, recently added HcG in past year for testicular atrophy. I currently follow this protocol: Test Cyp 50 mg combined with HcG 500 units both drawn up for 1 ml. total in a 29ga 1/2" syringe injected into shoulder area on M/Th each week. Been working great for me and I feel very well on this regimen.
Just had labs drawn (been 1 year) through discount labs (Quest) with the following results:
TEST Free (dialysis) and Total, MS = 1516 ng/dl and 327.5 free pg/ml
ESTRADIOL, ultrasensitive, LC/MS= 73 pg/ml
Prolactin= 8.0 ng/ml
Dihydrotestosterone= 124 ng/dl
Ferritin= 39 ng/ml

Did the "bodybuilder test panel" as I workout heavy and am on the muscular side....all kidney and liver tests back with normal numbers.
Only other parameters out of range were total cholesterol 236 and LDL 162 (nothing new for me), and Hematocrit and RBC just slightly on high range- will dontate blood in next day or two.

My questions are= Should I be concerned with the high range results of test/ free test (this is the highest level results I've ever had, but as I said I do feel very well).
Is my Estradiol too high at 73? No symptoms, but do get emotional with movies, etc. more than usual. Libido is very strong, and erection quality is fair to usual.
Lastly, Is DHT level that high concerning? What things can I do to bring this down?

Truly appreciate any help/ ideas/ suggestions as my doc offers very little input and I'm out here "on my own" with much of this!

 

[Systemlord]

I always say there's nothing wrong with slightly high T numbers as long as CBC markers are healthy.

The problem with HCT ranges is not all lab ranges are identical, seen 50, 52 and some top out at 55%.

The guidelines for TRT is <55%, but some doctors prefer it <52% due to long term consequences of thicker blood on the heart and vascular walls.

I'm one of the unfortunate ones that has to get phlebotomies every 2 months (HCT 57%) which drives my ferritin levels down.

I can feel my heart beating harder at 57% even though blood pressure is normal, long term this isn't going to be good.

I wish it were as simple as lowering my dosage, but I don't feel good on the 198 mg Jatenzo dosage because my levels drop <300 too early in the day.

 

[Systemlord]

Lastly, Is DHT level that high concerning?

No.

Is my Estradiol too high at 73? No symptoms

Not an issue, due to the fact you have no symptoms.

You might get better erections on a lower dosage though, the one complaint men mention when on cycles is poorer sexual parameters.

The question you have to ask yourself is do you need these levels above the normal range to relieve the symptoms of low testosterone.

 

[Cataceous]

I always say there's nothing wrong with slightly high T numbers as long as CBC markers are healthy.
...

Now there's an understatement. Free testosterone is more than twice the top of the reference range. That's almost eight standard deviations above the mean, a one-in-trillions outlier in a healthy normal population. The fact is we don't know the long-term safety of such levels. There can be dose- and exposure-dependent cardiovascular toxicity with AAS. The threshold for damage is uncertain. Why not at least see if you can also feel good at physiological levels?

Questions: Is your testosterone cypionate 200 mg/mL? What volume are you using? The numbers seem high for 100 mg per week, though it's possible you're getting an endogenous boost with the hCG. When was your blood test done relative to your last injection?

 

[tareload]

Just had labs drawn (been 1 year) through discount labs (Quest) with the following results:
TEST Free (dialysis) and Total, MS = 1516 ng/dl and 327.5 free pg/ml

I always say there's nothing wrong with slightly high T numbers as long as CBC markers are healthy.

Yeah, just your typical 18 yr right there .

OP: Are the numbers you shared above taken right before your next injection (trough)?

Please consider what cataceous has presented to you. How much risk are you willing to take on?

Truly appreciate any help/ ideas/ suggestions as my doc offers very little input and I'm out here "on my own" with much of this!

You truly are on your own. Make sure you get regular heart monitoring/Echos annually if you want to be responsible. Or you could titrate your dose down. What was your pre TRT baseline?

 

[JmAch]

Thanks all- Yes, I want to feel optimal, BUT I also absolutely want to be healthy in the long term! This is why I am posting out of concern and wanting experienced advice.
Cataceous= Yes, I am on 200mg/ml dosage of test cyp...I do .50 ml of that along with .50 ml of the HcG in my 1ml. syringe on the M/Th schedule.
Blood test was done approx. 30 hrs. after my Monday injection.
My baseline testosterone level (over 10 yrs ago) was mid 200's.
I absolutely would consider titrating down to achieve safer levels.....any suggestions for dosing/ timing/ titration?

 

[Cataceous]

Ok, your total dose is 200 mg per week of testosterone cypionate. Physiological dosing is more in the range of 50-100 mg. A slow downwards titration would likely be less disruptive than an immediate large drop. One possible plan is to drop 10 mg per week for a couple of months, then maintain for a couple more months, and then evaluate how you feel and get new lab work to see if you're still over-range with free testosterone. At that time you can decide if you're up for further reductions. You may give up a little at the gym, but it's a worthwhile tradeoff if your priority is long-term health.

 

[JmAch]

Sounds like a very reasonable plan to titrate dose down and recheck levels, I plan on doing this.
Last question- is my ferritin level ok at 39? This is just over the low end threshold....would it warrant iron supplementation to feel less tired, etc?
Again, thanks for all the responses and suggestions!

 

[Vince]

Thanks all- Yes, I want to feel optimal, BUT I also absolutely want to be healthy in the long term! This is why I am posting out of concern and wanting experienced advice.
Cataceous= Yes, I am on 200mg/ml dosage of test cyp...I do .50 ml of that along with .50 ml of the HcG in my 1ml. syringe on the M/Th schedule.
Blood test was done approx. 30 hrs. after my Monday injection.
My baseline testosterone level (over 10 yrs ago) was mid 200's.
I absolutely would consider titrating down to achieve safer levels.....any suggestions for dosing/ timing/ titration?

You didn't test at trough. You should do labs on injection day before you inject.