Initial blood tests for TRT and future updates

[Vince]

$400 per month? Is that a normal cost for TRT?

$400 a month is too much to pay for trt, I would look at prices from Prime Body and from Defy Medical.

 

[Vince]

Would it be okay to add an AI in my routine in the mean time for about a month to lower my estrogen? looking to take some Arimidex 25 mg tablets can anyone recommend a good protocol? either thinking half tablet everyday or 1 tablet EOD or either taking 1 tablet on the twice a week on the days of my injections? I'm also reducing my test injections from 250 mg to 200 mg a week starting next week.

Your estrogen is running High, also your testosterone is very high. Have you consider lowering your testosterone dose and if you were to add an AI. I wouldn't go higher then .125 twice a week.

 

[ronpaek100]

Your estrogen is running High, also your testosterone is very high. Have you consider lowering your testosterone dose and if you were to add an AI. I wouldn't go higher then .125 twice a week.

Vince I made 2 replies, yes I'm going to lower my test cyp injections to 200 mg per week now instead of 250 mg starting next week, but wasn't sure if I should just wait and see how much my estrogen levels drop before using an AI? I was also thinking of just using a small dose of AI temporarily maybe for a month just to lower my estrogen to get it closer to the normal range i'm suppose to be at.

Also had a question if I change my dosage protocal to 200 mg per week, do I need to wait another 6-8 weeks before my levels normalize again to know how that dose is working for me?

 

[ronpaek100]

$400 a month is too much to pay for trt, I would look at prices from Prime Body and from Defy Medical.

thanks, i'll look into these

 

[fifty]

Agree with vince. Try .125mg with your injections. Assuming twice a week...

 

[Vince]

Vince I made 2 replies, yes I'm going to lower my test cyp injections to 200 mg per week now instead of 250 mg starting next week, but wasn't sure if I should just wait and see how much my estrogen levels drop before using an AI? I was also thinking of just using a small dose of AI temporarily maybe for a month just to lower my estrogen to get it closer to the normal range i'm suppose to be at.

Also had a question if I change my dosage protocal to 200 mg per week, do I need to wait another 6-8 weeks before my levels normalize again to know how that dose is working for me?

200 mg of T is still a pretty high dose. If you want to get your estrogen to a good level without adding an AI, you're going to have to go a lot lower.

 

[ronpaek100]

200 mg of T is still a pretty high dose. If you want to get your estrogen to a good level without adding an AI, you're going to have to go a lot lower.

I will try 200 mg for now then if it's still too high i'll adjust from there, so how many weeks from my new protocol should I wait to get my next blood draw? 6-8 weeks?

 

[Vince]

You need to wait at least 6 weeks, when I change my protocol I usually need 12 weeks before all my levels stabilize.

 

[Gman86]

Ok. Just reviewed ALL your bloodwork. For people wondering, prior to TRT his SHBG was 44 (16-55). Then 33 (14-94), which is a range we normally don’t see. So not sure if you’re a low, mid, or high SHBG guy, so definitely get that retested. It could of possibly dropped now that you’re on TRT anyways.

You had blood work done at 3.5 weeks on 250mg per week. Which is 24 days. It takes 35-40 days for testosterone to reach steady state. So your numbers were clearly insanely high, and they were actually all still going to increase for another 11-16 days roughly. So test and E2 were going to end up even higher than what that blood test showed.

Your cholesterol levels are not that bad. HDL looks pretty good, triglycerides are perfect, and LDL is obviously a little high, I would continue working on getting your cholesterol down naturally. I’m a nurse, and whatever you do, DO NOT go on a statin! I would only recommend a statin to someone if they had a genetic component that puts them at extreme risk for having a cardiovascular event. Other than that, avoid statins like the plague! Trust me. In your case, I promise you don’t need to be on one. LDL isn’t the monster it’s been made out to be, and even tho yours seems high. It’s not that bad. Definitely nothing to worry about in regards to your health. TRT can help improve your cholesterol numbers. But only if you keep your numbers within a healthy range. If you continue to have levels that are too high, it’s going to be the opposite. You are gojng to have a hard time getting your cholesterol levels where you want them.

I could go on for days about your blood work and what you should do in regards to your testosterone and ai dosage. But I’ll keep things simple. DO NOT TAKE AN AI RIGHT NOW. I can’t be any clearer. Anyone that suggested it or encourages you to take one right now, even at a low dose, must not have reviewed your blood work or story enough.

Second thing, LOWER DOSE TO 150MG PER WEEK MAX! Getting dialed in can be a very lengthy process, even longer when you don’t know what you’re doing. Trust me on this one. 200mg is going to be WAY too high still. You are going to end up lowering your dose again after you get blood work on 200mg. I promise you this. Looking at your numbers, 150mg is still probably going to be too high, but it will be a lot closer to your ideal dose than 200mg. 200 I promise you will be WAY too high. On 250mg per week your free test was >65.85 (5-21). I think a lot of people missed this. You only need 1/3 of that free t to be at the top of the range. So say you took 1/3 of 250mg, that would be only 83mg per week. Yes, testosterone doesn’t work this linearly, but just goes to show you that you are only going to require 150mg or less of testosterone per week, I PROMISE YOU THIS. Again, just trying to save you time, money on labs, and make this process as quick and as easy for you as possible. Learn from others mistakes. No need for you to make them too when we are all here to guide you.

So long story short. Don’t take a statin. Lower dosage to 150mg/ week max. Do not start taking an ai. Get blood drawn the morning of your biweekly injection. Add SHBG to your next set of labs. And wait at least 40 days between changing your dose and when you get lab work done. Good luck man. If I came off harsh, I apologize. But I know what I’m talking about. I promise you will thank me later if you just trust me on this. Again, just trying to save you time and money and frustration. It’s not easy starting off, but it’s a lot easier when you listen to other guys that have been through it and know what they’re doing.

Also no offense to anyone that recommended he take the ai. It’s just that it’s extremely obvious that he just needs to drastically lower his dose. I’m not against ai’s, I take one myself. But just wait until you get your total and free test where you want them. And then if you still have high E2, that would be the point where you can consider using one.

 

[ronpaek100]

Ok. Just reviewed ALL your bloodwork. For people wondering, prior to TRT his SHBG was 44 (16-55). Then 33 (14-94), which is a range we normally don’t see. So not sure if you’re a low, mid, or high SHBG guy, so definitely get that retested. It could of possibly dropped now that you’re on TRT anyways.

You had blood work done at 3.5 weeks on 250mg per week. Which is 24 days. It takes 35-40 days for testosterone to reach steady state. So your numbers were clearly insanely high, and they were actually all still going to increase for another 11-16 days roughly. So test and E2 were going to end up even higher than what that blood test showed.

Your cholesterol levels are not that bad. HDL looks pretty good, triglycerides are perfect, and LDL is obviously a little high, I would continue working on getting your cholesterol down naturally. I’m a nurse, and whatever you do, DO NOT go on a statin! I would only recommend a statin to someone if they had a genetic component that puts them at extreme risk for having a cardiovascular event. Other than that, avoid statins like the plague! Trust me. In your case, I promise you don’t need to be on one. LDL isn’t the monster it’s been made out to be, and even tho yours seems high. It’s not that bad. Definitely nothing to worry about in regards to your health. TRT can help improve your cholesterol numbers. But only if you keep your numbers within a healthy range. If you continue to have levels that are too high, it’s going to be the opposite. You are gojng to have a hard time getting your cholesterol levels where you want them.

I could go on for days about your blood work and what you should do in regards to your testosterone and ai dosage. But I’ll keep things simple. DO NOT TAKE AN AI RIGHT NOW. I can’t be any clearer. Anyone that suggested it or encourages you to take one right now, even at a low dose, must not have reviewed your blood work or story enough.

Second thing, LOWER DOSE TO 150MG PER WEEK MAX! Getting dialed in can be a very lengthy process, even longer when you don’t know what you’re doing. Trust me on this one. 200mg is going to be WAY too high still. You are going to end up lowering your dose again after you get blood work on 200mg. I promise you this. Looking at your numbers, 150mg is still probably going to be too high, but it will be a lot closer to your ideal dose than 200mg. 200 I promise you will be WAY too high. On 250mg per week your free test was >65.85 (5-21). I think a lot of people missed this. You only need 1/3 of that free t to be at the top of the range. So say you took 1/3 of 250mg, that would be only 83mg per week. Yes, testosterone doesn’t work this linearly, but just goes to show you that you are only going to require 150mg or less of testosterone per week, I PROMISE YOU THIS. Again, just trying to save you time, money on labs, and make this process as quick and as easy for you as possible. Learn from others mistakes. No need for you to make them too when we are all here to guide you.

So long story short. Don’t take a statin. Lower dosage to 150mg/ week max. Do not start taking an ai. Get blood drawn the morning of your biweekly injection. Add SHBG to your next set of labs. And wait at least 40 days between changing your dose and when you get lab work done. Good luck man. If I came off harsh, I apologize. But I know what I’m talking about. I promise you will thank me later if you just trust me on this. Again, just trying to save you time and money and frustration. It’s not easy starting off, but it’s a lot easier when you listen to other guys that have been through it and know what they’re doing.

Also no offense to anyone that recommended he take the ai. It’s just that it’s extremely obvious that he just needs to drastically lower his dose. I’m not against ai’s, I take one myself. But just wait until you get your total and free test where you want them. And then if you still have high E2, that would be the point where you can consider using one.

Wow, thank you for this beautifully detailed long response, no offense taken, I have been worry about my cholesterol as well my doctor even tried to put me on statin but I told him I didn't want to be on it, that I would try to lower it myself, I also think I eat pretty healthy in terms of I been buying and cooking my own foods lately since I'm more focused on trying to be healthier as well as I been exercising with weights and doing cardio 4 times a week after weight training for a year now without missing a workout. Once I lower my test injection to either 200mg or 150mg per week does the estradiol automatically follow and lower as well?

Another question I had is I see a lot of people here taking HCG around 500 IU twice a week or either 250 IU twice a week, should I follow this protocol as well, I heard taking this can always effect either SHBG or either estradiol so i'm not sure when to add this, I was trying to add each thing in 1 at a time.

Also I will have a really detailed blood panel for my next test with all things i'm suppose to have, I will be planning to get my blood drawn around the 3rd week of December, Also I guess i'll opt not to take AI right now, I have heard that most people don't need it and that AI are just adding more complication to the mix.

Any recommendations on what can help lower cholesterol levels, is eating red meat really the cause of high cholesterol?

 

[Gman86]

God I'm really glad you took my post the right way, I'm always worried how people are going to react to things. But ya, estradiol will decrease once your total and free testosterone decrease. You might end up not needing an ai in the end. You have to just get your free testosterone to where you would like it, and then see where your E2 sits and if you have any high E2 symptoms. If an ai is necessary at that point, it's no big deal to start using one at a very low dose. Just go down to 150mg/ week though. Trust me. With 200mg your blood work is going to come back all elevated again. Then you're going to have to lower your dose, and get blood work done again. And even after that set of blood work, you're just going to be in the ballpark of where you need to be. It's going to take one more set of labs to really get dialed in. So just save yourself time and money, and go down to 150mg/ week now. I honestly think that's going to still be a little high, but it should get you close enough to where you have a chance of getting your free T dialed in after one more set of labs after your next set in December. With 150mg/ week, your free T is still going to be over the top of the range for free T, so you'll still be able to build plenty of muscle and keep fat storage at a minimum. But I don't want to force anyone to do anything they don't want to, so if you want to try 200mg first, it's really not that big of an issue. Nothing bad is going to come from it. It's just going to cost you a little extra time and money. So if those things don't bother you, try 200mg. Not being sarcastic at all by the way.

If you plan on having children, I would recommend starting with HCG. Only because it should be in your protocol if you are trying to remain fertile. So since it's going to be part of your protocol regardless, you might as well put it in now and get things dialed in with it. The only time I would recommend not starting off with HCG, is if fertility and your testicles possibly shrinking are not a concern to you, and also if that man has no plans to have it in his protocol. For those men, I would get dialed in without it. I would only recommend guys to start off with it if they already know it's going to be part of their protocol basically. I personally do 1000iu's per week, because I have no children and fertility is very important to me. For guys that just want to do HCG to keep their testicles from shrinking, I think 500iu's should suffice in accomplishing that for most men. Some men will require more. Everyone's different. I inject HCG EOD personally. But you can do ED, or twice per week. I wouldn't do HCG once per week. And HCG has been known to increase estrogen more so than testosterone. So that's something to be aware of. So the chances of needing an ai do increase when using HCG. But there are still plenty of guys that use HCG that don't take an ai. It just increases your chances of needing one, that's all.

Does HCG effect SHBG? Not 100% sure on that one. It might though. Going by my personal lab work, it looks like it does for me. I was on HCG monotherapy for a while and had 3 blood tests done while on HCG mono. They were all 2 months apart. My baseline SHBG is around 47-53 by the way. On HCG mono, my SHBG came back at 38, two months later at 38, and two months later at 39, all while taking just HCG. On testosterone with HCG, my SHBG stays around 47-51. So maybe there's something to it. The only other thing that lowers my SHBG, is Exemestane (Aromasin). It's an ai. Not all ai's lower SHBG though. Anastrozole, for me at least, didn't lower SHBG at all.

And no, it's a basically a myth that red meat, or eating cholesterol raises cholesterol in the blood. Cholesterol and triglycerides are raised by having excess inflammation in the body. So to balance cholesterol levels, just keep your sugar intake low, cut out dairy (unless it's organic, grass-fed and preferably raw). The only dairy I consume is some organic grass-fed raw cheese that I get from whole foods. Most dairy is highly inflammatory. Also, cut out gluten as much as possible. The other main way to keep down inflammation, and maintain healthy cholesterol levels is to exercise, preferably with weights, on a regular basis. So to answer your question, no. You can eat red meat daily if you would like. Same thing with egg yolks. I eat 3-4 whole eggs everyday, and red meat almost daily, and my cholesterol numbers are stellar. I get them checked regularly. Just make sure your red meat is grass fed. If it is grain fed beef, it is going to be inflammatory to your system. Same thing with the eggs. Make sure they are pasture raised and feed off of grass, not grain fed. Any beef that comes from cows that are fed grain are going to be inflammatory to you, and then yes, that type of red meat can cause cholesterol levels to go out of balance. So it's a bit confusing. Yes red meat can be bad for your cholesterol, people that say that are right. Only if you're talking about grain fed beef though. If you're talking about organic grass fed beef, then no, it should actually improve your cholesterol markers. When people talk about red meat and cholesterol, they don't specify, and therefore it can get confusing.

 

[ronpaek100]

God I'm really glad you took my post the right way, I'm always worried how people are going to react to things. But ya, estradiol will decrease once your total and free testosterone decrease. You might end up not needing an ai in the end. You have to just get your free testosterone to where you would like it, and then see where your E2 sits and if you have any high E2 symptoms. If an ai is necessary at that point, it's no big deal to start using one at a very low dose. Just go down to 150mg/ week though. Trust me. With 200mg your blood work is going to come back all elevated again. Then you're going to have to lower your dose, and get blood work done again. And even after that set of blood work, you're just going to be in the ballpark of where you need to be. It's going to take one more set of labs to really get dialed in. So just save yourself time and money, and go down to 150mg/ week now. I honestly think that's going to still be a little high, but it should get you close enough to where you have a chance of getting your free T dialed in after one more set of labs after your next set in December. With 150mg/ week, your free T is still going to be over the top of the range for free T, so you'll still be able to build plenty of muscle and keep fat storage at a minimum. But I don't want to force anyone to do anything they don't want to, so if you want to try 200mg first, it's really not that big of an issue. Nothing bad is going to come from it. It's just going to cost you a little extra time and money. So if those things don't bother you, try 200mg. Not being sarcastic at all by the way.

If you plan on having children, I would recommend starting with HCG. Only because it should be in your protocol if you are trying to remain fertile. So since it's going to be part of your protocol regardless, you might as well put it in now and get things dialed in with it. The only time I would recommend not starting off with HCG, is if fertility and your testicles possibly shrinking are not a concern to you, and also if that man has no plans to have it in his protocol. For those men, I would get dialed in without it. I would only recommend guys to start off with it if they already know it's going to be part of their protocol basically. I personally do 1000iu's per week, because I have no children and fertility is very important to me. For guys that just want to do HCG to keep their testicles from shrinking, I think 500iu's should suffice in accomplishing that for most men. Some men will require more. Everyone's different. I inject HCG EOD personally. But you can do ED, or twice per week. I wouldn't do HCG once per week. And HCG has been known to increase estrogen more so than testosterone. So that's something to be aware of. So the chances of needing an ai do increase when using HCG. But there are still plenty of guys that use HCG that don't take an ai. It just increases your chances of needing one, that's all.

Does HCG effect SHBG? Not 100% sure on that one. It might though. Going by my personal lab work, it looks like it does for me. I was on HCG monotherapy for a while and had 3 blood tests done while on HCG mono. They were all 2 months apart. My baseline SHBG is around 47-53 by the way. On HCG mono, my SHBG came back at 38, two months later at 38, and two months later at 39, all while taking just HCG. On testosterone with HCG, my SHBG stays around 47-51. So maybe there's something to it. The only other thing that lowers my SHBG, is Exemestane (Aromasin). It's an ai. Not all ai's lower SHBG though. Anastrozole, for me at least, didn't lower SHBG at all.

And no, it's a basically a myth that red meat, or eating cholesterol raises cholesterol in the blood. Cholesterol and triglycerides are raised by having excess inflammation in the body. So to balance cholesterol levels, just keep your sugar intake low, cut out dairy (unless it's organic, grass-fed and preferably raw). The only dairy I consume is some organic grass-fed raw cheese that I get from whole foods. Most dairy is highly inflammatory. Also, cut out gluten as much as possible. The other main way to keep down inflammation, and maintain healthy cholesterol levels is to exercise, preferably with weights, on a regular basis. So to answer your question, no. You can eat red meat daily if you would like. Same thing with egg yolks. I eat 3-4 whole eggs everyday, and red meat almost daily, and my cholesterol numbers are stellar. I get them checked regularly. Just make sure your red meat is grass fed. If it is grain fed beef, it is going to be inflammatory to your system. Same thing with the eggs. Make sure they are pasture raised and feed off of grass, not grain fed. Any beef that comes from cows that are fed grain are going to be inflammatory to you, and then yes, that type of red meat can cause cholesterol levels to go out of balance. So it's a bit confusing. Yes red meat can be bad for your cholesterol, people that say that are right. Only if you're talking about grain fed beef though. If you're talking about organic grass fed beef, then no, it should actually improve your cholesterol markers. When people talk about red meat and cholesterol, they don't specify, and therefore it can get confusing.

Alright thanks for responding again, I didn't realize the organic / grass fed stuff made such a big impact, I just thought they were more expensive, but I will buy the organic / grass fed eggs / beef next time and see if that helps, I have been reading up on the vertical diet trying to implement something close to that. I think I have the exercising portion down perfect I lift heavy weights 4 times a week and also do 30 minutes of elliptical on the days I lift as well. Hopefully my cholesterol shows signs of improvement in the next 6 weeks. I'll keep you updated, thanks!

Also I can't really tell if I experienced shrinkage but I think my testicles have shrinked some or maybe they will shrink more in in the coming months, I don't have any children but i'm not really thinking about having children but I would like to keep my testicles size normal if possible so would 500 IU a week of HCG be good? I would split it into x 2 injections to make it easy for me to remember, also I saw a post where Nelson puts test and HCG in both the same syringe do you combine the syringe or do separate injections? also do you have specific areas you prefer to inject your test and hcg?