Newest lab results. It's a doozy. Need seasoned advice

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I was 180mg/week broken up into m/w/f no AI.

I was starting to feel like warmed over shit. I suspect my E2 was high, as on 150mg it was low 40s. My test was increased because we dropped hcg

Before starting TRT my SHBG was low

I changed my protocol to a lower weekly dose, given everyday. I currently pin 20mg/day for a total of 140 mg/week. Rationale was low SHBG, I would benefit more from smaller, more frequent. I didn't want to change it without consulting defy but at 180mg/60mg(mwf) my heart felt like it was going to jump out of my chest and I was going to be out weeks anyway until I could get an appointment.

I have a consult coming up here in a few weeks. This new protocol has been running for at least 3-4 weeks.

And here she is, free t is way above normal, 904 total and 62 E2. My only symptom is sometimes I sleep like shit

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Test dose is too high for a daily dose, no wonder you are having problems. An EOD protocol would have worked, but an everyday protocol will help control estrogen better.

A 10-12mg daily protocol is a good starting point, it is a moderate dose without going over the top.

Too much Total T = very high Free T = very high free estrogen. Total T is nice to look at but I'm more interested in free testosterone for determining where I am and where I need to go.
Thank you
Only problem so far has been occasional piss poor sleeping. Am I gaining ANY benefit from a 27 free test level? I take it the general consensus is avoid AI, lower dosing, right?
Only problem so far has been occasional piss poor sleeping. Am I gaining ANY benefit from a 27 free test level? I take it the general consensus is avoid AI, lower dosing, right?

It's doubtful there's any benefit of very high Free T, downside is very high Free estrogen which you must throw absurd amount of anastrozole at the problem. Most will tell you they feel better when the AI is taken out of the equation, I do for awhile until estrogen is high again.
Keep this in mind being a low SHBG guy (20.6). You have less T being bound by SHBG which means you have high Free T and high Free E2. Most lower SHBG individuals do better with Total T in the 700 range and Free T in the 16 to 20 range verse being over the top of the range. When you bring your Total T down that will bring the Free T as well as the E2 and Free E2 down.

Some people with E2 at your level (62) say they have no symptoms and feel great. One school of thought is if you don't have symptoms then don't worry about it and don't treat it. Another school of thought is that you might not have symptoms but E2 high at 62 is not good for you and could be doing harm to your body.

Some say that our bodies self regulate themselves and that as long as your Testosterone to Estradiol ratio (T:E) is in check then you are in a healthy ratio. A rule of thumb out there is a ratio between 14 and 20. With Total T of 904 and E2 of 62 you have a ratio of 14.6. When we are young and have testosterone levels naturally near 1,000 and high E2 levels we dont think twice about it but we start worrying about it when we are older and have healthy levels of T and our E2 goes up. Others say that an optimal level of E2 is between 20 and 30.

It is a fact that some people can not handle even what some may consider moderate levels of E2 and I am sure others can handle levels of E2 significantly higher than others or the "norm".

Finally, there is a thought that your E2 should be relatively close to your SHBG, especially for low SHBG individuals.

Just sharing with your various schools of thought. I see merit in all sides and haven't really taken a hard core position one way or the other. I tend to lean with if you aren't having symptoms leave it alone, but if having symptoms then treat it.

You have room to lower your dose a little bit which will help and something you may want to try first after having your consult in a few weeks.

Thanks Mark, so should I keep this protocol (20mg/day - 140g/week) until my consult? My thinking is, so far it has been changed once since my last consult, I don't want to keep changing it and have this convoluted mess when I speak with the health care professional.

The only negative I have noticed is occasional sleep like shit, but I work third shift and I dont know if high E2 affects sleep.

I do know my libido is insatiable and I am killing it in the gym.
Is it 3, 4, or more weeks? Makes a hell of a difference. Even at 5 weeks with the new protocol e2 may not be settled exactly where it’s going to stay.

I want to say 3, I work third shift so my days all blur together. It definitely hasn't been long.


I feel worlds better than I did on 180mg (60mg) m/w/f, which was what the transpired from my last consult.

20mg/day for a total of 140mg a week, I feel more normal but as I said above my sleep is sometimes shit but I also work third shift and am probably slowing killing myself with the unnatural sleep patterns anyhow
You've only been on this protocol 3 to 4 weeks based on your original post so I'd leave the dose alone until your consult, especially since you have minor symptoms (occasional sleep issues). It takes 40 days to reach a steady state so your body is still adjusting. Labs could look much different in a few more weeks.
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