T dose is high, TT is high.
FT is not high, so T dose is appropriate
FT is been reduced by:
- FT–>E2
- FT–>FT+SHBG which is not bioavailable
High FT+SHBG inflates TT so that TT overstates your T status. Do not expect doc to understand.
Your high SHBG is easily inferred from your labs and higher E2 causes liver to produce more SHBG.
As E2 is not high, FT–>E2 rates should not be high. Then we are left with the prospect that E2 may be high from impaired liver clearance. Liver problems can do this and AST/ALT labs may be useful. Some medications, Rx or OTC, supplements, weed etc can impair E2 clearance.
Anastrozole is needed and one could be tempted to suggest 1mg twice a week at time of injections. But this should be tempered with the fact that FT is not high. Ypu can try 3/4mg at time of injections and should feel profound benefits in 5-7 days. Do not make short term adjustments on how you feel because the delays and half-life will bite you. If you feel better then crash, or crash and/or joints ache, your E2 has crashed and we then assume that you are an anastrozole over-responder and then you stop for 5-6 days and resume at 1/4th the dose and go from there.
If you get near E2=22pg/ml, we would expect to see FT increase from less FT–>E2. But SHBG will also reduce, but that can be slow and that will also increase FT. So this may all take time. SHBG does in some guys refuse to obey the rules.
Prolactin is a concern as it can drive secondary hypogonadism. Test again to confirm. Avoid orgasm for a few days as well as cuddling {babies | kittens | puppies} as these also cause prolactin release. Some drugs can do this too.
Cholesterol?
Do not waste time+$ testing LH/FSH as we expect -->zero.
More CBC? RBC, MCV, ferritin
Blood pressure changed?
Hematocrit=50 needs to be watched. Do not take vitamins listing iron, those are suited to cycling women who have iron losses. Note that many breads, cereals, pasta, flour, pancake mixes etc are iron fortified.
Get 25mg DHEA from USA vitamin shelves. Do not take with high fiber foods, better with meals that have more fats and oils. Ditto fish oils and Vit-D3. Most need 5000iu Vit-D3 to get optimal VitD-25 labs.
TSH is clearly a problem, should be closer to 1.0
Problem may be from not using iodized salt and/or vitamins listing 150mcg iodine and 150-200mcg selenium.
Eval your thyroid function via oral body temps, see below.
Low thyroid function has most of the same effects as low T.
Training with low-T and low thyroid function typically means that adrenalin is compensating for low energy and adrenal fatigue can be expected from this stress. Then rT3 is elevated and rT3 block some effect of fT3. fT3 is the only active thyroid hormone.
Low thyroid can also lead to:
- feeling cold easier
- fat gain
- lethargy
- sparse outer eyebrows
- thyroid nodules and other problems in future
- dry skin
I would expect that getting near target of E2=22pg/ml will over time reduce PSA a bit. E2 is a risk factor for prostate problems.
Post your body temperatures.