TRT 5-6 week update. Need advice.

smashed25 · Feb 22, 2017

I just now got 5 week results back, but I didn't actually get the "real" test which upset me a little bit. I just got updates on what improved / didn't. This isn't the first time this place has been slow/slacking with patient portal, email information. That's not acceptable to me. I asked for the actual test results. I'm confident I will get them tomorrow to post here they are very nice and professional otherwise.

Anyways. Last I posted I was started on 140 mg of trt and 1 mg anistrazole per week. I put 130 because I'm an idiot .7 = 140 3ml syringe

. Here are the results without reference range until tomorrow. I'm pretty sure they use lab corp though. I actually looked up the lab corp ranges which you can do on their website for now.

Total T. 348−1197 pg/ml
free 9.3−26.5 pg/ml
e2 7.6−42.6 pg/mL

TT-327 to 533- The 533 is at the trough with he last injection being a week prior. I thought this would be way higher. They want me to go up to 180 mg from 140
FT-7.3 to 13.5
EST- is at 11.7 - Seems low from what I've read. They want me to stay on 1 mg anistrazole....

I guess the most important is how I feel not the numbers as much. And I haven't really noticed a big difference yet. I would love to hear your opinions on this thank you very much! Also, would splitting up my dose to twice a week from once keep my test higher?

johndoesmith · Feb 22, 2017

smashed25 said:
I just now got 5 week results back, but I didn't actually get the "real" test which upset me a little bit. I just got updates on what improved / didn't. This isn't the first time this place has been slow/slacking with patient portal, email information. That's not acceptable to me. I asked for the actual test results. I'm confident I will get them tomorrow to post here they are very nice and professional otherwise.

Anyways. Last I posted I was started on 140 mg of trt and 1 mg anistrazole per week. I put 130 because I'm an idiot .7 = 140 3ml syringe . Here are the results without reference range until tomorrow. I'm pretty sure they use lab corp though. I actually looked up the lab corp ranges which you can do on their website for now.

Total T. 48−1197 pg/ml
free 9.3−26.5 pg/ml
e2 7.6−42.6 pg/mL

TT-327 to 533- I thought this would be way higher. They want me to go up to 180 mg from 140
FT-7.3 to 13.5
EST- is at 11.7 - Seems low from what I've read. They want me to stay on 1 mg anistrazole....

I guess the most important is how I feel not the numbers as much. And I haven't really noticed a big difference yet. I would love to hear your opinions on this thank you very much! Also, would splitting up my dose to twice a week from once keep my test higher?

Terrible results honestly, E2 is too low, and so is free and total.

Seems like a cookie cutter protocol with included AI, which is never a good thing.

The lack of care for patients is also a concern, sounds like you're not getting the care you need.

A good practice will automatically send you your results, assuming they're not severely out of range or dangerous, in which case they'd contact you directly, or should.

It is not surprising you haven't noticed a difference.

CoastWatcher · Feb 22, 2017

smashed25 said:
I just now got 5 week results back, but I didn't actually get the "real" test which upset me a little bit. I just got updates on what improved / didn't. This isn't the first time this place has been slow/slacking with patient portal, email information. That's not acceptable to me. I asked for the actual test results. I'm confident I will get them tomorrow to post here they are very nice and professional otherwise.

Anyways. Last I posted I was started on 140 mg of trt and 1 mg anistrazole per week. I put 130 because I'm an idiot .7 = 140 3ml syringe . Here are the results without reference range until tomorrow. I'm pretty sure they use lab corp though. I actually looked up the lab corp ranges which you can do on their website for now.

Total T. 48−1197 pg/ml
free 9.3−26.5 pg/ml
e2 7.6−42.6 pg/mL

TT-327 to 533- I thought this would be way higher. They want me to go up to 180 mg from 140
FT-7.3 to 13.5
EST- is at 11.7 - Seems low from what I've read. They want me to stay on 1 mg anistrazole....

I guess the most important is how I feel not the numbers as much. And I haven't really noticed a big difference yet. I would love to hear your opinions on this thank you very much! Also, would splitting up my dose to twice a week from once keep my test higher?

What johndoeamith noted is absolutely accurate - it's not the sort of response you'd expect to see at the five week point of therapy. Nothing looks good, and the use of anastrozole - in the absence of confirmed, elevated estradiol levels (on the sensitive lab test), and symptoms of elevated e2 - well, it simply makes no sense at all.

Splitting your dose, as you asked, might well result in more robust levels. Do you know what your SHBG is?

smashed25 · Feb 22, 2017

CoastWatcher said:
What johndoeamith noted is absolutely accurate - it's not the sort of response you'd expect to see at the five week point of therapy. Nothing looks good, and the use of anastrozole - in the absence of confirmed, elevated estradiol levels (on the sensitive lab test), and symptoms of elevated e2 - well, it simply makes no sense at all.

Splitting your dose, as you asked, might well result in more robust levels. Do you know what your SHBG is?

No, I don't know SHBG. I will tomorrow. I got this email about 20 minutes before closing, so my email asking for the real test was late. They are usually good at answering back and immediately answer questions I ask so that's a positive I guess. I expect the test tomorrow morning. I probably should have waited but I was really antsy as tomorrow is my weekly self administered shot.

smashed25 · Feb 22, 2017

johndoesmith said:
Terrible results honestly, E2 is too low, and so is free and total.

Seems like a cookie cutter protocol with included AI, which is never a good thing.

The lack of care for patients is also a concern, sounds like you're not getting the care you need.

A good practice will automatically send you your results, assuming they're not severely out of range or dangerous, in which case they'd contact you directly, or should.

It is not surprising you haven't noticed a difference.

Thanks for the response. Should I cut out the ai entirely, I'm doing 0.5 every 3-3.5 days atm. Or should I go down to like .25 once a week.

CoastWatcher · Feb 22, 2017

smashed25 said:
No, I don't know SHBG. I will tomorrow. I got this email about 20 minutes before closing, so my email asking for the real test was late. They are usually good at answering back and immediately answer questions I ask so that's a positive I guess. I expect the test tomorrow morning. I probably should have waited but I was really antsy as tomorrow is my weekly self administered shot.

Split-dosing is a sound policy unless one has extremely high SHBG. In your case I'd GUESS that you may have (somewhat) lower SHBG and you are clearing testosterone too quickly to find success on a weekly protocol. Injecting every 3.5 days would then be a sensible modification.

The anastrozole, however, is such a puzzle. Were your levels tested, with the proper test, prior to the initiation of therapy?

smashed25 · Feb 22, 2017

CoastWatcher said:
Split-dosing is a sound policy unless one has extremely high SHBG. In your case I'd GUESS that you may have (somewhat) lower SHBG and you are clearing testosterone too quickly to find success on a weekly protocol. Injecting every 3.5 days would then be a sensible modification.

The anastrozole, however, is such a puzzle. Were your levels tested, with the proper test, prior to the initiation of therapy?

I remember my estradiol was in the 20's I want to say it was 24. Which is making me think I should stop taking it. From what I've figured out recently 20's is where it should be anyway. I'm thinking as you guys have said I was just given a cookie cutter dose.

CoastWatcher · Feb 22, 2017

smashed25 said:
I remember my estradiol was in the 20's I want to say it was 24. Which is making me think I should stop taking it. From what I've figured out recently 20's is where it should be anyway. I'm thinking as you guys have said I was just given a cookie cutter dose.

There's no magic, perfect value for estradiol. In my case, I'm comfortable when it's in the 30s. Gene Devine, another of our moderators, feels his best if it's in the low 40s. Estradiol is not to be feared, it's an essential hormone for male health, the goal is to manage it. One manages it by measuring it with the proper lab test, the sensitive test which was not ordered for you, and monitoring subjective response/symptoms. You are very close to crushing your estradiol - a place you really don't want to go. Don't misunderstand, anastrozole is a good drug, but never prescribed in the absence of high numbers and symptoms.

One size does not fit all in the world of TRT.

smashed25 · Feb 22, 2017

CoastWatcher said:
There's no magic, perfect value for estradiol. In my case, I'm comfortable when it's in the 30s. Gene Devine, another of our moderators, feels his best if it's in the low 40s. Estradiol is not to be feared, it's an essential hormone for male health, the goal is to manage it. One manages it by measuring it with the proper lab test, the sensitive test which was not ordered for you, and monitoring subjective response/symptoms. You are very close to crushing your estradiol - a place you really don't want to go. Don't misunderstand, anastrozole is a good drug, but never prescribed in the absence of high numbers and symptoms.

One size does not fit all in the world of TRT.

I'm thinking of switching to split dosing. But I will wait for my test to see what my SHBG is and I will re-post tomorrow. Thanks for the help. It's much appreciated.

smashed25 · Feb 23, 2017

After getting my actual test results back I want to update the thread with my SHSB result which is 22.9 in a range of 16.5 - 55. Everything else I posted still stands. Thanks for the help!

CoastWatcher · Feb 23, 2017

smashed25 said:
After getting my actual test results back I want to update the thread with my SHSB result which is 22.9 in a range of 16.5 - 55. Everything else I posted still stands. Thanks for the help!

Many of us have lower SHBG, but you are on the low end, no question. Split-dosing would, I believe, be something to adopt.