T serum level DOWN over three months on exact same protocol! What is going on? Any Insight?

Xerxes

New Member
35 y.o. 5'8'' 160 lbs, on TRT since May 2015. Gels for month, then shots.

So I went in to my urologist yesterday for my 3 month check up and to get blood to start up with Defy. I have everything else over to Chelsea except for the last few required pieces of bloodwork (of course uro did not request all the tests I asked for).

BUT, more importantly, my numbers from same lab

Oct 12, 2015 Jan 18, 2016 range
total T - 949 total T - 547.6 249-836
e2 - 14.52 e2 - 19.18 7.02-49.06
SHBG 16 SHBG - 19 10-57

there has been absolutely no change in my protocol - 120mg week, 40mg MWF. Both drawn at same time of day on a Monday before shot. Very sparing arimidex by symptom. Hadn't taken any for 3 weeks before this most recent draw.

The only other thing anomalous in the most recent blood was that non-fasting glucose was 111 with a range of 70-99.

I have had some very good stretches on TRT, but never more than a few weeks and then I also feel like crap again.

I feel terrible now. Bad sleep, anxiety, no libido, maybe slightly depressed at the whole deal.

I am really hoping Defy can help figure out what is going on with me. Primaries, Endos, and Urologists either have no clue or tell me to just stop the T cold turkey.

I might explore a restart protocol with Defy if they think it is appropriate.
 
You need a fresh set of labs; make sure to ask for more comprehensive Thyroid labs plus Prolactin and Cortisol as well.

Ask for Dr. John Crisler to do your assessment; he's the best in the industry in my personal opinion.

Something is off and he'll figure it out.
 
Anything from lab error to user error in dosing, a 400 point swing should be explainable. Perhaps a bad vial of TCyp. I wouldn't make it a health concern just yet, there's a range of reasons for that, I'd immediately retest as step one. Step two, get off that MWF stuff and go EOD. I'm the same type low SHBG and for me, I was back kinda low T (ish) on Sundays, that extra day was too much for me. Dr Saya actually told me to stop doing that; MWF. You can smooth out your Sunday and keep your T elevated better.

Assuming you feel downish on Sundays with the MWF routine.
 
I had a similar blood draw (497) drawn on 1/5/16. It's really insane. I do feel bad on Sundays, but I also feel pretty bad most days. That is an insane swing, though.

Hope to have all my bloodwork in order this week and consult with someone at Defy.

Of course my Endo didn;t request everything I had asked t request, so now still waiting to get the final pieces of blood. I am beyond frustrated with my whole TRT experience.

I wonder what Dr. Crisler or Saya will suggest...My wife and I are actually desiring the restart protocol b/c I am only 35...or to discover some underlying cause of what in the world is going on...
 
Xerxes, so far I haven't had any problems with Defy Medical, all of my testosterone levels has been good. I think going through Defy Medical will solve your problems.
P.S. I make a list of questions I have for my doctor and give it to my doctor when I enter their room.
 
Thanks for all the encouragement. I just want to get straightened out. I hope Defy can help. I sent as much of my old bloodwork as I had from the first time I tested low (250) before I ever started TRT in June 2014 until yesterday. I still need a few pieces of lab work that my uro neglected to run (but that I requested in writing to him in his office). Hopefully they'll figure out what is going on and help me.
 
Xerxes- my low(ish) SHBG guys are some of our most interesting (and challenging...in a good way) cases! Low SHBG guys are a "unique animal" and no two are the same. We will do our best for you. Look forward to your progress!
 
Xerxes,

There is light at the end of this tunnel. You're certainly tired of being told to be patient, to give everything time to work out. You're now working with capable doctors who, I'm confident, will help you determine a protocol to achieve good health. All the best.
 
Xerxes - I also have low(ish) SHBG and am a Defy patient. I work with Dr. Saya, and he's fantastic. I tend to do a LOT of research on all my labs, before each consult. Each time I'm done speaking with Dr. Saya, I feel like I've received a year's worth of education on how to interpret the test results.

He WILL be able to help! What I like the most about working with Defy is that I always feel like it's a partnership when making treatment decisions, not like a normal urologist or GP that simply tells you "what's best for you".
 

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Estradiol (E2)

A form of estrogen produced from testosterone. Important for bone health, mood, and libido. Too high can cause side effects; too low can affect well-being.

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Dihydrotestosterone is a potent androgen derived from testosterone. Affects hair growth, prostate health, and masculinization effects.

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The biologically active form of testosterone not bound to proteins. Directly available for cellular uptake and biological effects.

Scientific Reference

Lakshman KM, Kaplan B, Travison TG, Basaria S, Knapp PE, Singh AB, LaValley MP, Mazer NA, Bhasin S. The effects of injected testosterone dose and age on the conversion of testosterone to estradiol and dihydrotestosterone in young and older men. J Clin Endocrinol Metab. 2010 Aug;95(8):3955-64.

DOI: 10.1210/jc.2010-0102 | PMID: 20534765 | PMCID: PMC2913038

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