Howdy folks,
Soliciting feedback on my first follow-up bloodwork after 10 weeks on TRT. After 10 weeks, I may have seen very minor improvements to symptoms but definitely not close to full resolution.
Background:
45 years old, generally good health with clean, lower carb eating (strong family history of diabetes) and consistent but not excessive exercise (mostly interval training and weight training, no chronic cardio). GP referred to an endo several months ago due to multiple classic low-T symptoms despite in-range TT. Onset of low-T symptoms has rolled on slowly over last 3-5 years.
My testosterone has been tested five times in the last 16 months. TT ranged from 353 ng/dL to 955 ng/dL (reference range 264 - 916), with an average result of 671.
SHBG has been tested three times over the last eight months. Average SHBG result was 69 [reference range 16.5 ā 55.9]. Highest result was 80. The last two test results (both in 60ās) were months after significant dietary modifications including eating more carbs, not being calorie-restricted, and supplementing with Zinc, Magnesium, Nettle Root, and Boron. The final SHBG result of the three (high 60ās) was higher than the one prior so although the diet and supplementing mods may have helped SHBG a little, the trend was in the wrong direction after some initial improvement and it seemed fairly clear I wasnāt going to see significant SHBG/Free T improvement via diet and supplementation alone.
Thyroid and liver panels all looked very normal.
Pre-TRT:
TT = 353 ng/dl to 955 ng/dl (5 tests over a year) (range 264 - 916)
Free and weakly bound T% = 8% (range 9% - 46%)
Free and weakly bound T absolute = 31 (range 40 - 250)
Estradiol 23.5 (range 7.6 - 42.6 pg/ml)
Hematocrit = 50.9 (range 37.5 -51.0%)
10 weeks into TRT (100 mg Test C IM once weekly; results below at trough):
TT = 804 ng/dl (range 264 - 916)
Free and weakly bound T% = 20.6% (range 9% - 46%)
Free and weakly bound T absolute = 165 (range 40 - 250)
Hematocrit = 52.3 (range 37.5 -51.0%)
Estradiol not tested
SHBG not tested
Lipids pre- and post- are essentially unchanged. My cholesterol has always been high (strong genetic history) but actually got a fair amount better after dietary changes to introduce more carbs (probably the oatmeal breakfasts since oat fiber lowers cholesterol).
Follow-up with endo is next week.
Free T is trending in right direction but given lack of symptom resolution, Free T thatās got some room to move up, and history of high SHBG Iām thinking an incremental bump up in dosage is likely called for.
Questions:
- I think Iāve read on here before but canāt remember for sure - is there a metric that gauges how āstickyā a personās SHBG is?
- Whatās your read on prudence of bumping up dose?
- If you were in my shoes, what would you advocate to bump the dose up to (if you think an increase is called for)?
- What other questions or considerations to discuss with my endo?
Thanks much!