Initial Blood test and start of TRT

[MB]

So I had typical low T symptoms got tested here are the initial labs recommended by defy for the sake of not typing it all out here is the major stuff.



Testosterone 243 ng/dl (264-916)

Free T 6.8 pg/ml (9.3-26.5)

DHEA 201.2 ulU/ml (138.5-475.2)

TSH 2.870 ulU/ml (.450-4.500)

LH 4.2 mlU/ml (1.7-8.6)

IGF-1 133 ng/ml (115-355)

Estadiol,Sensitive 9.0 pg/ml (8.0-35.0)

SHBG 22.9 nmol/L (16.5-55.9)

Hemoglobin 14.6 g/dl (13.0-17.7)

Hematocrit 43.9 % (37.5-51.0)



Started TRT on Wednesday, protocol is as follows;

150mg of test per week split over 3 days per week.

300 IUs of HCG 3 days per week.

Does that look like a good start? is there anything that I might have over looked or should be taking in addition to the test and HCG?

25 years old; 177lbs; 5'10"

 

[HealthMan]

It looks good. You might consider adding DHEA and pregnenolone. I take 10mg each at night.

 

[Vince]

Suggested Lab Tests and Questions Before and After Initiation of Testosterone Replacement​

https://www.excelmale.com/forum/sho...-After-Initiation-of-Testosterone-Replacement

 

[CoastWatcher]

Good luck...more and more younger men joining us with clear-cut hypogonadism.

 

[MB]

It looks good. You might consider adding DHEA and pregnenolone. I take 10mg each at night.

Thanks I added it!

 

[MB]

Lol ya it's unfortunate and not ideal but it is what it is I guess!

 

[madman]

So I had typical low T symptoms got tested here are the initial labs recommended by defy for the sake of not typing it all out here is the major stuff.



Testosterone 243 ng/dl (264-916)

Free T 6.8 pg/ml (9.3-26.5)

DHEA 201.2 ulU/ml (138.5-475.2)

TSH 2.870 ulU/ml (.450-4.500)

LH 4.2 mlU/ml (1.7-8.6)

IGF-1 133 ng/ml (115-355)

Estadiol,Sensitive 9.0 pg/ml (8.0-35.0)

SHBG 22.9 nmol/L (16.5-55.9)

Hemoglobin 14.6 g/dl (13.0-17.7)

Hematocrit 43.9 % (37.5-51.0)



Started TRT on Wednesday, protocol is as follows;

150mg of test per week split over 3 days per week.

300 IUs of HCG 3 days per week.

Does that look like a good start? is there anything that I might have over looked or should be taking in addition to the test and HCG?

25 years old; 177lbs; 5'10"

Lower shbg...................150mg/week (50mg M/W/F) along with hcg

I bet your total t/free t will be too high, sure your e2 needs to come up but 150 mg/week is still a fairly high starting dose!

You will know in 6 weeks, you are in good hands though.

 

[MB]

Ya I guess we will find out then, Thanks for the reply!

 

[blitzen]

Lower shbg...................150mg/week (50mg M/W/F) along with hcg

I bet your total t/free t will be too high, sure your e2 needs to come up but 150 mg/week is still a fairly high starting dose!

You will know in 6 weeks, you are in good hands though.

My TT / FT and SHBG numbers were kinda close to the above (315/9/23 or something like this) before starting 150mg T (split M/W/) + 2*400IU HCG > afterwards 916/14/33 (labcorp values) ... while the TT was top of the range my FT improved only from 9>14 around lower midrange that was my first surprise and the second tha the SHGB increased 10 points
So my 150mg would have been considered (by you) probably at least fairly high too but didn't deliver the expected/planned/hoped for results (aka how I feel)

 

[MB]

Ya this just reaffirms everyone is different and cookie cutter approaches don't work!

 

[Systemlord]

My TT / FT and SHBG numbers were kinda close to the above (315/9/23 or something like this) before starting 150mg T (split M/W/) + 2*400IU HCG > afterwards 916/14/33 (labcorp values) ... while the TT was top of the range my FT improved only from 9>14 around lower midrange that was my first surprise and the second tha the SHGB increased 10 points
So my 150mg would have been considered (by you) probably at least fairly high too but didn't deliver the expected/planned/hoped for results (aka how I feel)

Experienced doctors can sometime see things we do not, like certain blood biomarkers. Hematocrit is towards the lower end.

 

[madman]

My TT / FT and SHBG numbers were kinda close to the above (315/9/23 or something like this) before starting 150mg T (split M/W/) + 2*400IU HCG > afterwards 916/14/33 (labcorp values) ... while the TT was top of the range my FT improved only from 9>14 around lower midrange that was my first surprise and the second tha the SHGB increased 10 points
So my 150mg would have been considered (by you) probably at least fairly high too but didn't deliver the expected/planned/hoped for results (aka how I feel)

In many cases men with lower shbg can attain healthy levels of free t with lower overall weekly testosterone doses, and as I stated it is a fairly high starting dose.

 

[MB]

So here is the next update and blood draw with lab results. Defy and I decided to test thyroid function with these labs as well.

Testosterone 724 ng/dl (264-916)

Free T 19.9 pg/ml (9.3-26.5)

DHEA 199.7 ulU/ml (138.5-475.2)

TSH 1.820 ulU/ml (.450-4.500)

LH not tested

IGF-1 190 ng/ml (98-282)

Estadiol,Sensitive 38.2 pg/ml (8.0-35.0)

SHBG 24.2 nmol/L (16.5-55.9)

Hemoglobin 16.6 g/dl (13.0-17.7)

Hematocrit 48.2 % (37.5-51.0)

T4, free (direct) 1.02 ng/dL (0.82-1.77)

T3, free 3.8 pg/ml (2.0-4.4)

Overall I feel better, not as good as I did when I was a teenager but better from the initial lab test. I'm not as tired more energy, libido is good. I am scheduling my next consult with defy tomorrow morning. Ideally I would like to see my total T in the 900 range and free T closer to the top of range.

 

[madman]

So here is the next update and blood draw with lab results. Defy and I decided to test thyroid function with these labs as well.

Testosterone 724 ng/dl (264-916)

Free T 19.9 pg/ml (9.3-26.5)

DHEA 199.7 ulU/ml (138.5-475.2)

TSH 1.820 ulU/ml (.450-4.500)

LH not tested

IGF-1 190 ng/ml (98-282)

Estadiol,Sensitive 38.2 pg/ml (8.0-35.0)

SHBG 24.2 nmol/L (16.5-55.9)

Hemoglobin 16.6 g/dl (13.0-17.7)

Hematocrit 48.2 % (37.5-51.0)

T4, free (direct) 1.02 ng/dL (0.82-1.77)

T3, free 3.8 pg/ml (2.0-4.4)

Overall I feel better, not as good as I did when I was a teenager but better from the initial lab test. I'm not as tired more energy, libido is good. I am scheduling my next consult with defy tomorrow morning. Ideally I would like to see my total T in the 900 range and free T closer to the top of range.

If you feel good overall at these levels I would ride it out for a while.

Ideally most need FT in the 2-3% range of TT.

Your FT is at a good level and if you calculate it using the Free & Bioavailable Testosterone calculator using your TT 724 ng/dL and SHBG 24.2 nmol/L

http://www.issam.ch/freetesto.htm


Your FT is 2.64% and your BT is 62%.

Lower SHBG men tend to struggle with e2/free estradiol if FT gets too high and you may run into problems.....sure one can add an aromatase inhibitor but why if need not be.

As you can see from your most recent labs your e2 (sensitive assay) has risen significantly from pre-trt at 9.0 pg/ml (range 8.0-35.0) to 38.2 pg/ml (slightly high now) and your hemoglobin/hematocrit has also increased from pre-trt Hemoglobin 14.6 g/dl (13.0-17.7) to 16.6 g/dl and Hematocrit 43.9 % (37.5-51.0) to 48.2%.

I would not even worry about your TT numbers as sure it is good to know but FT is what really matters as it is the active fraction of testosterone responsible for the positive effects.

Just understand that if you plan on increasing your dose than your are going to drive your e2 up a lot more and may need to start using an a.i.

You will more than likely have high hemoglobin/hematocrit than you may need to start donating blood.

Personally I would rather avoid the use of an aromatase inhibitor and having to donate blood.

If FT gets too high than high e2, hemoglobin/hematocrit can become problematic.

Your pre-trt Free T was 6.8 pg/ml (9.3-26.5) now it is 19.9 almost triple of what your pre-trt levels are!

Just giving you a heads up!