Huge Improvement in Labs. Still Feel Like Crap

Pharma / TRT Testosterone Replacement
1

Labs from 2/17/20
Total Test - > 1500 (264-916 ng/dL)
Free Test - 41.9 (8.7-25.1pg/mL)
Estadiol sensitive 42.8 (8.0 - 35.0)
SHBG 57.9 (16.5 - 55.9)
Free T3 - 4.7 (2.2-4.4)
DHEA 150 (31 - 701)

Labs from 11/12/19
Total Test - 623.6 (264-916 ng/dL)
Free Test - 7.5 (8.7-25.1pg/mL)
Estadiol sensitive 7.9(8.0 - 35.0)
SHBG 91.1 (16.5 - 55.9)
Free T3 - 2.4 (2.2-4.4)

Current numbers look good, right? The issue is I still feel the same, if not worse. Unexpected weight gain, low libido, sleep sucks, low energy, low motivation. I would think that this dramatic of a change in labs would be noticeable? Between these labs, for 11 weeks, I began a protocol of 200mg/ml Test cyp .40ml 2x per week, HCG 400IU 2x per week. For thyroid I’m on 2grains armour/30mcg cytomel per day. I think it’s worth mentioning that before I started testosterone injections, over the last 2 years I tried clomid, which didn’t help. Until these latest labs, I’ve always had very low free test, very LOW estradiol, and very HIGH SHBG.

So I see the testosterone has skyrocketed. Perhaps too high?? My estradiol has been BELOW standard range for 2 years, but now is actually ABOVE range. SHBG seems to be surprisingly lower, although I’m not sure why? I take Boron, but I’ve done that for awhile, and it never had that big of impact.

My consultation with my provider is scheduled 2 weeks from now. Outside of telling him how I’m feeling, I want to be armed with the right questions. I also want to get some views from the community here.

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I guess it’s two potential reasons

  • symptoms are not related to T in the first place
  • overtreatment

I would considerably reduce the dose of T and hCG.
I don’t get why men strive to have twice the amount of T in their system compared to healthy and lean young men.

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Because it’s good for gains (jk… well… sort of)

I don’t think OP was targeting a number, I assume this was the amount he was prescribed thus it clocked him with a FT of 40.

Androgens dose dependently bind to and suppress SHBG

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Yes, I was doing as prescribed. This was not me stabbing away at myself to become superhuman. And I do believe the symptoms i mentioned line up with low T. Improvements in all of these things are documented everywhere of healthy T levels, yet I have not felt any of these improvements. I’d imagine my levels changing so dramatically in the course of 12 weeks, I would notice something different in the way I’m feeling??

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You’re allowed to overshoot the mark several times before getting it right. Your Free T3 looks like it’s in hyperthyroid territory. Good job getting the SHBG down, now you probably just need to dial things back, but that is a discussion you should have with your provider.

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How’s your diet?

What is your TDEE…if you don’t know what this is or what your number is then you can’t complain about weight gain on TRT.

I came to these forums to get advice from men where TRT was the last resort…Men that had their strength and diets dialed in…What I’m starting to realize is that most of the men on here have done very little if anything to control their own fate, and are now expecting TRT to save their asses…

Go watch the interview with Dr. Serrano…If you don’t have diet and strength training dialed in…you’re sunk with or without TRT.

7

Get rid of the hcg. Hcg causes many symptoms.

If that doesn’t work try 180mg . Leave hcg our of the picture for now.

Switch to daily dosing as well.

Thyroid is good stick with it. It’ll be worse if you got off.

This is just a phase all men go through. I can tell you hcg causes many issues like tiredness and brain fog. It’s the chemical of hcg that causes it.

Change one thing at a time and hang in there. I wouldn’t be surprised if removing hcg helps you a ton.

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It’s not hyper. Those labs have been lowered. I know people who are at 4.8 and 5. It’s not hyper .

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You have low cortisol. TRT, Thyroid, GH, etc. will NOT work until your adrenal function is normalized. Have you taken antibiotics in the past? How are your stools/digestion? Gas, bloating, constipation/diarrhea, poorly formed stools?
-Do a 24-Hour Saliva Cortisol kit test Amazon/Life Extension has them, or your provider)
-You should do a Genova Comprehensive Digestive Stool Analysis. A Naturopath provider can order it for you. Research brain-gut axis, serotonin/cortisol and ACTH. You will NEVER get better until your gut is healed. Your high SHBG is an indicator that you body is not getting hormones into its cells, so in a futile effort your liver is pumping out SHBG to try and preserve/transport hormones. Also, intestinal dysbiosis causes liver dysfunction from all the LPS/toxins/inflammation.

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@enackers - I am pairing the TRT with HCG to remain fertile, which is important to me. And why daily injections? Given currently doing .40 ml 2x per week, you’re suggesting ~.10 every day? What is the reason behind this? SubQ or IM?

@TRT_Phoenix - What indicator is there for low cortisol? And what is done to address this? If anything, I thought my cortisol would be high, as I often wonder if I’m overtraining.

SHBG seems to be moving the right direction. Estrogen seems to be heading the wrong direction. I still have an AI from 2 years ago, when I was prescribed clomid/AI. even though my estradial sensetive was low (BELOW normal ranges).

Should I be concerned my estrogen went from 7.9 to 42.8 in 12 weeks, from this protocol? Should I be concerned my testosterone went from low to WAY HIGH as well?

I will be out of the country, so I won’t speak with my provider for a couple weeks. It would be good to know what questions I should ask or bring up with my provider when I speak to them. Also, it seems alarming how much some things are out of range.

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@Stealthforce This. Give it a couple months and get blood retested and I’ll bet your numbers are significantly lower and you feel better. HCG makes many men feel like crap which is why you should do testosterone only at first, get that where you feel good and then introduce HCG (if you want).

It’s very weird that your E2 is not much higher considering your T levels. Mine is double yours at the same levels.

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You could be sensitive to E2 (like me). That would explain feeling like crap and weight gain (despite having high T3).

Which brings me to possibility number two (or it could very well be both): High free T3. When my thyroid drifts into higher than normal range, I feel like shit, get high anxiety, and lose muscle tone.

As mentioned, I would consider dropping the HCG for now (since your numbers are high enough) just to minimize the variables, and I’d start an AI (despite the anti-AI cult that has sprung up here these days), and bring your E2 down to at.least mid-normal range, and see how you feel then. Your high levels of total and free T are not why you are feeling crappy, so I’d leave all that alone. Also, lower your thyroid med dose to get you back into normal range. Testosterone is fine to be over the range, but that’s not the case with thyroid.

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You just wont stop distributing this nonsense.

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It’s copy and paste at this point

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@gtron Previous to TRT, all my labs showed my E2 very LOW (below standard range). Was yours like this as well?

My provider starting me on an AI back when my E2 was low probably wasn’t necessary (this was done to combat clomid raising it). However, now that my SHBG seems to be going the right direction, as the SHBG lowering, the T levels really high, my E2 will be next to raise dramatically.

There are several people saying to drop the HCG. But what if I want to remain fertile? I am going to talk to my provider about this, estrogen, thyroid protocol moving forward. Anything else?

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@Stealthforce
You can use HCG (and or HMG etc if necessary) once your ready to conceive.

There’s a lot more going on in the body than just estrogen that can make you feel like crap. The higher your testosterone goes the higher estrogen will get. The body will balance it out. Drop the HCG and give it time and I’d bet you’ll feel remarkably better.

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Your hormone levels are now high normal. The indicators are what you said, “The issue is I still feel the same, if not worse. Unexpected weight gain, low libido, sleep sucks, low energy, low motivation.”

TRT and thyroid will not work until your low cortisol is addressed. Thyroid CANNOT enter the cells without cortisol, hence the weight gain. Testosterone suppresses cortisol production, in which case only worsens your situation (As you are currently experiencing). Get the tests that I recommended done. Save yourself years of needless suffering.

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You want to feel like crap to retain fertility or do you want to feel good? You can always regain fertility at a later date if you lose it at all.

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In this case, do you supplement cortisol or what exactly is done to help with this reduction in cortisol production?

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17mg/day intra-anusly

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