New to TRT - quick labs after start

[hotdog]

Hi,
I am new to TRT and started with Defy a few weeks ago. Age 56.
Test Cyp 60mg twice per week (delts IM), 350IU HCG twice per week (abs subq).

PRE-TRT (Defy baseline) - taken 1/13/16
Hematocrit 43.4 (37.5-51)
Test 270 (348-1197)
Free Test 10.1 (7.2-24)
Estradiol Sens. 13.1 (8-35)

After consult I delayed starting for a while.

POST-TRT 1.5 weeks (3 sets of injections, 4/16, 4/19 and 4/23) - DiscountedLabs (to try them out and I was curious) - taken 4/26/16
Hematocrit 39.5 (37.5-51)
Test 1496 (348-1197)
Free Test 22.9 (7.2-24)
Estradiol Sens. 47.4 (8-35)
RBC 4.23 (4.14 - 5.80)

Now after 3 weeks I feel more energized with improved libido but certainly not as good as I felt say a decade ago.
So I figured that things would build up over time and I am quite surprised to find the very high level of T. And the hematocrit seems oddly to have dropped - although I have tried to stay well hydrated.
I'm intrigued that I was heading into the 4th injection day with the levels so high.
Labs are not usually done so early but I thought it might be an interesting thing to look at.
Your thoughts?

 

[ERO]

It typically takes 5-6 weeks for your body to adjust to a new protocol so you look like you are going in the right direction. You are likely to continue to feel better for the next few weeks until you reach you new baseline. (and continue to feel good after that, of course) I would not adjust anything between now and your next consult with Defy.

 

[CoastWatcher]

You're right, three weeks is a very short time on a protocol. That said, there's certainly activity and your system will continue to sort things out over the next three weeks. ERO is right - no changes until your first follow-up conference.

 

[Jackie Treehorn]

Hot Dog,

When exactly did you draw that blood for the post-TRT results? Was it the day of your injections...before or after you pinned the Test?

Other than that, concur with ERO and Coastie. You just started this protocol...it may take a bit longer than 3 weeks for your serum levels to settle down. I would have waited a good 6 weeks before checking your progress. Give it another few weeks, and recheck.

 

[hotdog]

Hot Dog,

When exactly did you draw that blood for the post-TRT results? Was it the day of your injections...before or after you pinned the Test?

Other than that, concur with ERO and Coastie. You just started this protocol...it may take a bit longer than 3 weeks for your serum levels to settle down. I would have waited a good 6 weeks before checking your progress. Give it another few weeks, and recheck.

The blood draw was prior to the pin so I had received nothing for 3.5 days. Hence my surprise at the levels.
I Was expecting to see something low. Compared to the protocols of others I had thought I was on the conservative side.

 

[CoastWatcher]

The blood draw was prior to the pin so I had received nothing for 3.5 days. Hence my surprise at the levels.
I Was expecting to see something low. Compared to the protocols of others I had thought I was on the conservative side.

You're right on both counts - surprisingly high levels, and you are on a reasonable, pragmatic protocol. Curious: what's your SHBG?

 

[hotdog]

You're right on both counts - surprisingly high levels, and you are on a reasonable, pragmatic protocol. Curious: what's your SHBG?

Sex Horm Binding Glob, Serum 46.1 nmol/L 19.3 - 76.4

 

[Jackie Treehorn]

The blood draw was prior to the pin so I had received nothing for 3.5 days. Hence my surprise at the levels.
I Was expecting to see something low. Compared to the protocols of others I had thought I was on the conservative side.

Your protocol IS on the conservative side. I just think that it was a little too soon to check your serum levels. If after a good 6 weeks your total Test is still that high in the trough, then it might be time for some adjustments. I wouldn't worry about it right now...it's too early in your protocol.

You're in great hands with Defy, and they will take good care of you.

 

[hotdog]

Jackie,
I am just wondering whether the "adjusting" should be taking place at supraphysiological hormone levels? I've not found anything that is for or against this.
When you are in the trough with T at 1496 and E2 (sens) at 47 it seems counter-intuitive to add a further Test Cyp/HCG round to your system. Do we know if that's good or bad for sure?
With a half life of 8-10 days would you guess that my T will be at 750 after 10 days with no injections or do the early days not follow the same pattern as a body that has reached steady state?
Do you know if the topic of hormone levels during the first few weeks has been discussed before in the forum?

CoastWatcher,
As an extra thought my SHBG has risen from 39 to 46 as a result of the TRT which as I understand it is likely caused by the rise in estrogen.

 

[CoastWatcher]

Jackie,
I am just wondering whether the "adjusting" should be taking place at supraphysiological hormone levels? I've not found anything that is for or against this.
When you are in the trough with T at 1496 and E2 (sens) at 47 it seems counter-intuitive to add a further Test Cyp/HCG round to your system. Do we know if that's good or bad for sure?
With a half life of 8-10 days would you guess that my T will be at 750 after 10 days with no injections or do the early days not follow the same pattern as a body that has reached steady state?
Do you know if the topic of hormone levels during the first few weeks has been discussed before in the forum?

CoastWatcher,
As an extra thought my SHBG has risen from 39 to 46 as a result of the TRT which as I understand it is likely caused by the rise in estrogen.

I would wait the additional three weeks and discuss it when you have your first follow-up conference. When I started TRT my labs were wildly out of sync for over seven weeks. However, if anxiety is mounting, and it seems as if it is, why not send the lab data to Defy and schedule a quick call with Jill, Dr. Saya's nurse? In a few minutes you'll have some answers. If there is a real issue here that needs attention, she will escalate it to Dr. Saya.

 

[hotdog]

I would wait the additional three weeks and discuss it when you have your first follow-up conference. When I started TRT Mmy labs were wildly out of sync for over seven weeks. However, if anxiety is mounting, and it seems as if it is, why not send the lab data to Defy and schedule a quick call with Jill, Dr. Saya's nurse? In a few minutes you'll have some answers. If there is a real issue here that needs attention, she will escalate it.

CoastWatcher,
I feel fine and I am talking to Defy about my levels, I am interested in what the forum members know for my education.

 

[CoastWatcher]

CoastWatcher,
I feel fine and I am talking to Defy about my levels, I am interested in what the forum members know for my education.

What sort of subjective feelings are you noting? Your estradiol is up - any libido or erectile issues?

 

[Dr Justin Saya MD]

I would give it more time hotdog.

In the first few weeks of treatment, your own LH is still being produced (not suppressed yet) in addition to the T + HCG. It takes at least approx 5 weeks for reliable steady state levels to be achieved. Anything prior to that is unreliable and making changes prior would create the "chasing your tail" phenomenon.

You are indeed on a relatively conservative regimen...and you may indeed need some dosage titration downward coming up, but cannot determine just yet.

 

[hotdog]

What sort of subjective feelings are you noting? Your estradiol is up - any libido or erectile issues?

Libido is certainly better, my interest has gone from zero to quite interested. That feels very good I am happy to tell you.
Nighttime and morning wood is back to something from my youth which is very pleasing. The interesting thing is that the libido and the erections seem somewhat disconnected. Hard to describe unless you've experienced it as I am sure quite a few have. It's like both are working now but they're not speaking?

 

[CoastWatcher]

Libido is certainly better, my interest has gone from zero to quite interested. That feels very good I am happy to tell you.
Nighttime and morning wood is back to something from my youth which is very pleasing. The interesting thing is that the libido and the erections seem somewhat disconnected. Hard to describe unless you've experienced it as I am sure quite a few have. It's like both are working now but they're not speaking?

I get your point on libido and erections being less than in sync. For me, that did clear up within two months or so.

 

[hotdog]

I would give it more time hotdog.

In the first few weeks of treatment, your own LH is still being produced (not suppressed yet) in addition to the T + HCG. It takes at least approx 5 weeks for reliable steady state levels to be achieved. Anything prior to that is unreliable and making changes prior would create the "chasing your tail" phenomenon.

You are indeed on a relatively conservative regimen...and you may indeed need some dosage titration downward coming up, but cannot determine just yet.

Hi Dr Saya,
First of all I have to say you have an excellent team at Defy and they are both responsive and helpful. Well done. I was expecting a call from Sam later today but I am happy to accept your advice here. Thanks.
The changes in my body are intriguing and go beyond the sexual side, I already feel a big mental shift. I am intrigued to see how things shape out and will update this thread.