My 3mo Labs were shocking. Looking for some feedback.

[johnnyd]

My pre-TRT labs results:

Testosterone: 548 ng/dL
Free T: 6.3 pg/mL (low)
Estradiol (Sensitive): 14.2 pg/mL​

I inject 0.35mL of T, and 0.4mL of HCG 2X a week. If I understand this correctly, this would be 140mg per week. Not that unusual of a dosage for someone starting on TRT.

Now after 3 months:

Testosterone: 1220 ng/dL (high)
Free T: 31.6 pg/mL (high)
Estradiol (Sensitive): 62.6 pg/mL (incredibly high)​

I've experienced puffy, sensitive nipples, night sweats, and although my morning erections are ok, although I thought they were better early in my treatment. I put on some muscle, but nothing to brag about, as I'm in the gym 5-6 days a week. Attitude is same, although food cravings seem stronger.

Before I got my lab results, I was going to ask to increase my dosage, as I haven't been impressed with the results so far. Now that I see where I'm at, I'm guessing they'll want to lower my dose. I have a consultation scheduled for next week with my Dr, but always appreciate the great insight that the forum provides on TRT topics.

• Do you think I'll need to lower my dose? I really just want to get my E2 down.
• I'm guessing that an AI will be the easiest solution. Maybe 0.25mg twice a week. Thoughts?
• The only other possible idea is going to sub-q for my injections, but I don't think that will lower my incredibly high E2 enough.

Any and all feedback is sincerely welcome.

 

[CoastWatcher]

My pre-TRT labs results:

Testosterone: 548 ng/dL
Free T: 6.3 pg/mL (low)
Estradiol (Sensitive): 14.2 pg/mL​

I inject 0.35mL of T, and 0.4mL of HCG 2X a week. If I understand this correctly, this would be 140mg per week. Not that unusual of a dosage for someone starting on TRT.

Now after 3 months:

Testosterone: 1220 ng/dL (high)
Free T: 31.6 pg/mL (high)
Estradiol (Sensitive): 62.6 pg/mL (incredibly high)​

I've experienced puffy, sensitive nipples, night sweats, and although my morning erections are ok, although I thought they were better early in my treatment. I put on some muscle, but nothing to brag about, as I'm in the gym 5-6 days a week. Attitude is same, although food cravings seem stronger.

Before I got my lab results, I was going to ask to increase my dosage, as I haven't been impressed with the results so far. Now that I see where I'm at, I'm guessing they'll want to lower my dose. I have a consultation scheduled for next week with my Dr, but always appreciate the great insight that the forum provides on TRT topics.

• Do you think I'll need to lower my dose? I really just want to get my E2 down.
• I'm guessing that an AI will be the easiest solution. Maybe 0.25mg twice a week. Thoughts?
• The only other possible idea is going to sub-q for my injections, but I don't think that will lower my incredibly high E2 enough.

Any and all feedback is sincerely welcome.

We're your labs taken at trough, just prior to an injection?

 

[johnnyd]

I guess the other critical question I forgot to ask... If I'm only doing 140mg of T per week, why is my T, Free T and E2 all so high?? That's what's really confusing me. Thanks.

 

[johnnyd]

I inject on Sun and Wed, and my labs were taken on Tue, the day before I inject.
(And I realize most people here aren't doctors... but are still better informed on TRT than the majority of the medical community.)

 

[CoastWatcher]

I inject on Sun and Wed, and my labs were taken on Tue, the day before I inject.
(And I realize most people here aren't doctors... but are still better informed on TRT than the majority of the medical community.)

Your trough would certainly have been lower had you injected the morning of an injection, Wednesday, presumably. Trough readings are the standard because it permits you and your doctor to determine how, over the course of a week, your serum levels sustain your protocol. As to why 140mg of testosterone resulted in such a robust response, we're all different. I inject 16mg every morning and sustain levels just over 1000. In the TRT game nothing should surprise any of us. Do you have any idea what your SHBG value is?

 

[johnnyd]

Thanks for the reply CoastWatcher. Good question.
I notice that my SHBG dropped. It was originally
Sex Horm Binding Glob, Serum 77.8 nmol/L (High)
and now it's down to:
Sex Horm Binding Glob, Serum 43.0 nmol/L (Normal)
I think that would mean that more of the total testosterone is bioavailable and not bound to SHBG. One reason why my free T increased.

 

[Vince]

I think your numbers look good, your estradiol levels don't look that high. You may want to try low dose AI .125 twice a week and see if that makes a difference.

 

[johnnyd]

I think your numbers look good, your estradiol levels don't look that high. You may want to try low dose AI .125 twice a week and see if that makes a difference.

Thanks for the feedback Vince. I thought 62.6 pg/ml was pretty high for Estradiol. Expecting it to be somewhere in the low to mid 20's.
Definitely looking to cut back on my T. Seems like going from 140mg/wk to 50mg/wk is pretty significant drop. I think I'd definitely notice a difference, but am a little concerned it might not be all good.
I know that high E is also affected by body fat, so I should probably mention that I'm 5'9" and 165#. Not very heavy, with a good BMI.
If anyone has any additional tips for lowering E levels, I'm open to suggestions.
Thanks

 

[HealthMan]

Thanks for the feedback Vince. I thought 62.6 pg/ml was pretty high for Estradiol. Expecting it to be somewhere in the low to mid 20's.
Definitely looking to cut back on my T. Seems like going from 140mg/wk to 50mg/wk is pretty significant drop. I think I'd definitely notice a difference, but am a little concerned it might not be all good.
I know that high E is also affected by body fat, so I should probably mention that I'm 5'9" and 165#. Not very heavy, with a good BMI.
If anyone has any additional tips for lowering E levels, I'm open to suggestions.
Thanks

Like Coast mentioned these levels are not trough levels. Your levels look good and the estradiol can be taken care of with a low dose AI twice a week like Vince said.
To drop your dosage to 50mg a week makes no sense. That is probably enough only to shut you down.
What I would do is. Get blood work done again right before injection (on injection) day. See how your numbers look like. If you are not a big fan of AI you can try to decrease your dosage a bit or even try more frequent injections (a lot of guys here were successful reducing estradiol with daily injections for example).

 

[johnnyd]

Like Coast mentioned these levels are not trough levels. Your levels look good and the estradiol can be taken care of with a low dose AI twice a week like Vince said.
To drop your dosage to 50mg a week makes no sense. That is probably enough only to shut you down.
What I would do is. Get blood work done again right before injection (on injection) day. See how your numbers look like. If you are not a big fan of AI you can try to decrease your dosage a bit or even try more frequent injections (a lot of guys here were successful reducing estradiol with daily injections for example).

Thanks HealthMan. I think it would be helpful to redo my labs. Hate the expense, but if it get's me more accurate info, it's worth it. Until I talk to my doc I was thinking of dropping from 140mg/wk down to 100mg/wk. I don't want to develop gyno. I've read a lot about AI, but have never tried any, so don't have any personal experience. I just know the dosage is tricky. I was thinking of requesting pills, with a dose of 0.25mg EOD or 2X week.
I know that it takes some work to get all your levels optimized, so I realize this comes with the territory.
Thanks!

 

[HealthMan]

Thanks HealthMan. I think it would be helpful to redo my labs. Hate the expense, but if it get's me more accurate info, it's worth it. Until I talk to my doc I was thinking of dropping from 140mg/wk down to 100mg/wk. I don't want to develop gyno. I've read a lot about AI, but have never tried any, so don't have any personal experience. I just know the dosage is tricky. I was thinking of requesting pills, with a dose of 0.25mg EOD or 2X week.
I know that it takes some work to get all your levels optimized, so I realize this comes with the territory.
Thanks!

Why the concern about gyno? Are you having any sumptoms? Anastrozole is tricky to find the right dosage indeed. Always good to start on a small dosage and go from there. 0.125-0.25mg 2x a week is a good start.
Have you discussed about adding an AI with you doctor?
Again I would get another bloodwork done to see what your trough levels are. You might end up having a 900-1000 TT at trough which are good numbers to aim for the average Joe. Again. Everyone is different. Some people only feel good above 1000 (my case). Some feel great around 700-800. You will only know by trying. In your case the high estradiol might not be helping to make you feel your best. Just make sure you try to move only one variable at a time.
So get those labs done again. And then you and your doctor can decide to either reduce your testosterone dosage or add an AI to bring estradiol down.

 

[Vince]

I really don't think your testosterone is too high. Be careful about using an AI, low symptoms of estrogen I believe are worse than high symptoms.

 

[JPB]

I would reduce the hcg before adding an AI

 

[johnnyd]

Why the concern about gyno? Are you having any sumptoms? Anastrozole is tricky to find the right dosage indeed. Always good to start on a small dosage and go from there. 0.125-0.25mg 2x a week is a good start.
Have you discussed about adding an AI with you doctor?
Again I would get another bloodwork done to see what your trough levels are. You might end up having a 900-1000 TT at trough which are good numbers to aim for the average Joe. Again. Everyone is different. Some people only feel good above 1000 (my case). Some feel great around 700-800. You will only know by trying. In your case the high estradiol might not be helping to make you feel your best. Just make sure you try to move only one variable at a time.
So get those labs done again. And then you and your doctor can decide to either reduce your testosterone dosage or add an AI to bring estradiol down.

Concerned about gyno because I don't have the best chest to start with, and was experiencing some tenderness, as well as nipple puffiness. Tenderness went away, and I thought that was simply a stage of being on TRT, but now that I see my E levels, it makes me paranoid.
I don't worry about how high my T levels are, but I am concerned about how high my E level is.
Now I'm wondering if I should redo my labs before my consultation, as I pay for each one. Might not make sense to do a consultation, only to have them say... yep, you should get more labs done, and talk to us again. $$

 

[johnnyd]

Concerned about gyno because I don't have the best chest to start with, and was experiencing some tenderness, as well as nipple puffiness. Tenderness went away, and I thought that was simply a stage of being on TRT, but now that I see my E levels, it makes me paranoid.
I don't worry about how high my T levels are, but I am concerned about how high my E level is.
Now I'm wondering if I should redo my labs before my consultation, as I pay for each one. Might not make sense to do a consultation, only to have them say... yep, you should get more labs done, and talk to us again. $$

I think the bigger question now is if I lower my dosage as planned... or schedule another lab first.

 

[HealthMan]

Concerned about gyno because I don't have the best chest to start with, and was experiencing some tenderness, as well as nipple puffiness. Tenderness went away, and I thought that was simply a stage of being on TRT, but now that I see my E levels, it makes me paranoid.
I don't worry about how high my T levels are, but I am concerned about how high my E level is.
Now I'm wondering if I should redo my labs before my consultation, as I pay for each one. Might not make sense to do a consultation, only to have them say... yep, you should get more labs done, and talk to us again. $$

Well if you are getting tenderness and puffyness in your nipples I would speak to your doctor and add an AI right away. I dont think that a testosterone dosage reduction will be enough to bring down your estradiol to within range (unless you are ok with having you TT levels to drop considerably too).
I had gyno a few times and can’t be without an AI. I take 0.25mg E3D.

 

[HealthMan]

I think the bigger question now is if I lower my dosage as planned... or schedule another lab first.

I would get another bloodwork done and add anastrozole right after that. You TT is probably well within range if you measure at trough. I wouldn’t reduce your testosterone dosage if i were you.

 

[johnnyd]

I would get another bloodwork done and add anastrozole right after that. You TT is probably well within range if you measure at trough. I wouldn’t reduce your testosterone dosage if i were you.

Great point... It doesn't make sense to get new bloodwork to confirm my levels if I'm messing with my dosage.

 

[CoastWatcher]

Great point... It doesn't make sense to get new bloodwork to confirm my levels if I'm messing with my dosage.

One change at a time - that's the rule my doctor follows and it makes sense. Add anastrozole, and drop your dose and eliminate the HCG...all are possibilities. How will you make any sense of what was efficacious if you adopt two or more of these options? Test at trough, make a prudent decision based on those results. As for gyno, it's something many men fear, most of those fears are unreasonable. The idea that estradiol should be maintained in the low to mid 20s is not sensible. Mine floats around 33 and I feel great. Gene Devine, another senior member feels at his best when it is above 40. It all depends...because in this game each of is different.

Estradiol is is a critical hormone necessary for erectile function and skeletal health.

 

[johnnyd]

One change at a time - that's the rule my doctor follows and it makes sense. Add anastrozole, and drop your dose and eliminate the HCG...all are possibilities. How will you make any sense of what was efficacious if you adopt two or more of these options? Test at trough, make a prudent decision based on those results. As for gyno, it's something many men fear, most of those fears are unreasonable. The idea that estradiol should be maintained in the low to mid 20s is not sensible. Mine floats around 33 and I feel great. Gene Devine, another senior member feels at his best when it is above 40. It all depends...because in this game each of is different.

Estradiol is is a critical hormone necessary for erectile function and skeletal health.

Thanks CoastWatcher. I appreciate everyone's feedback. Although a bit concerned, I realize there's no need for panic. I see too many threads where someone on TRT changes too much, exactly as you'd warned.
I'm going to do the consultation this week as planned, and see which what we do next: More labs, or change 1 variable. This is a long term commitment, and I want to insure I do it in a sensible fashion. But having the feedback from the group on this forum is invaluable to making sure I can do my consultation as an informed patient.
Thanks again everyone!