Just Got Bloodwork Done. Need Advice

Pharma / TRT Testosterone Replacement
1

I have been on trt for about 3 months. Been taking 170mg once per week for most of it. recently switched to 90mg on monday and 80mg on thursday still making it 170mg a week. I am also taking 500 iu hcg every monday and .25 (1/4 pill) Anastrozole on monday and thursday

So i took my thursday shot on 8-15 and had all this blood work done the following day just out of curiosity. My LH was flagged as abnormal and I want to know what you guys think about my labs. I feel like my sex drive was way better before starting trt. i could go 3 times a day no problem and now i dont have much of a sex drive.

sorry if it is hard to read. It is how it came out.

|TESTOSTERONE, TOTAL,$LC/MS/MS|8/18/2019|792.00|NG/DL|250-1100|
||REPORT COMMENT: FASTING:YES|
|TESTOSTERONE, FREE|8/18/2019|206.70|PG/ML|46.0-224.0|
||REPORT COMMENT: FASTING:YES|
|TESTOSTERONE,BIOAVAILABLE|8/18/2019|407.10|NG/DL|110.0-575.0|
||REPORT COMMENT: FASTING:YES|
|ALBUMIN|8/18/2019|4.30|G/DL|3.6-5.1|

TSH, 3RD GENERATION$W/REFLEX TO FT4 8/16/2019 3.23 MIU/L 0.40-4.50

PSA, TOTAL 8/16/2019 0.40 NG/ML < OR = 4.0

LH 8/16/2019 <0.2 1.5-9.3

DHEA SULFATE 8/16/2019 367.00 MCG/DL 106-464

WHITE BLOOD CELL COUNT 8/16/2019 7.00 THOUS/UL 3.8-10.8
RED BLOOD CELL COUNT 8/16/2019 5.57 MIL/UL 4.20-5.80
HEMOGLOBIN 8/16/2019 16.70 G/DL 13.2-17.1
HEMATOCRIT 8/16/2019 47.30 % 38.5-50.0
MCV 8/16/2019 84.90 FL 80.0-100.0
MCH 8/16/2019 30.00 PG 27.0-33.0
MCHC 8/16/2019 35.30 G/DL 32.0-36.0
RDW 8/16/2019 13.40 % 11.0-15.0
MPV 8/16/2019 12.30 FL 7.5-12.5
PLATELET COUNT 8/16/2019 183.00 THOUS/UL 140-400
NEUTROPHILS 8/16/2019 61.50 %
LYMPHOCYTES 8/16/2019 29.80 %
ABSOLUTE NEUTROPHILS 8/16/2019 4305.00 CELLS/UL 1500-7800
ABSOLUTE LYMPHOCYTES 8/16/2019 2086.00 CELLS/UL 850-3900
ABSOLUTE MONOCYTES 8/16/2019 518.00 CELLS/UL 200-950
ABSOLUTE EOSINOPHILS 8/16/2019 70.00 CELLS/UL 15-500
ABSOLUTE BASOPHILS 8/16/2019 21.00 CELLS/UL 0-200
ABSOLUTE NUCLEATED RBC 8/16/2019 0.00 CELLS/UL 0
MONOCYTES 8/16/2019 7.40 %
EOSINOPHILS 8/16/2019 1.00 %
BASOPHILS 8/16/2019 0.30 %

|IGF I, LC/MS |8/18/2019 |194.00 |NG/ML |53-331 |
|Z SCORE (MALE) |8/18/2019 |0.70 |SD |-2.0 - +2.0|

GLUCOSE 8/16/2019 94.00 MG/DL 65-99
|UREA NITROGEN (BUN) |8/16/2019 |11.00 |MG/DL |7-25 |
|CREATININE |8/16/2019 |1.40 |MG/DL |0.60-1.35 |
|eGFR NON-AFR. AMERICAN |8/16/2019 |65.00 |ML/MIN/1.7 |> OR = 60 |
|eGFR AFRICAN AMERICAN |8/16/2019 |75.00 |ML/MIN/1.7 |> OR = 60 |
|BUN/CREATININE RATIO |8/16/2019 |8.00 |(CALC) |6-22 |
|SODIUM |8/16/2019 |140.00 |MMOL/L |135-146 |
|POTASSIUM |8/16/2019 |4.70 |MMOL/L |3.5-5.3 |
|CHLORIDE |8/16/2019 |105.00 |MMOL/L |98-110 |
|CARBON DIOXIDE |8/16/2019 |29.00 |MMOL/L |20-32 |
|CALCIUM |8/16/2019 |9.40 |MG/DL |8.6-10.3 |
|PROTEIN, TOTAL |8/16/2019 |7.00 |G/DL |6.1-8.1 |
|ALBUMIN |8/16/2019 |4.30 |G/DL |3.6-5.1 |
|GLOBULIN |8/16/2019 |2.70 |G/DL (CALC |1.9-3.7 |
|ALBUMIN/GLOBULIN RATIO |8/16/2019 |1.60 |(CALC) |1.0-2.5 |
|BILIRUBIN, TOTAL |8/16/2019 |0.70 |MG/DL |0.2-1.2 |
|ALKALINE PHOSPHATASE |8/16/2019 |70.00 |U/L |40-115 |
|AST |8/16/2019 |24.00 |U/L |10-40 |
|ALT |8/16/2019 |22.00 |U/L |9-46|

CHOLESTEROL, TOTAL 8/16/2019 119.00 MG/DL <200
HDL CHOLESTEROL 8/16/2019 47.00 MG/DL >40
TRIGLYCERIDES 8/16/2019 89.00 MG/DL <150
LDL-CHOLESTEROL 8/16/2019 55.00 MG/DL (CAL
CHOL/HDLC RATIO 8/16/2019 2.50 (CALC) <5.0
NON-HDL CHOLESTEROL 8/16/2019 72.00 MG/DL (CAL <130
2

LH will bottom out when on TRT, so no point in checking it.

Those levels seem low for the day following injection, I’d be more interested in knowing where you are on the day of injection, prior to it, at trough. SHBG is likely fairly low as you are at 2.6% free testosterone.

Did you check E2? Before or after starting TRT? I’m wondering if you have low estrogen.

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3

When i was doing it once a week my labs were done on the trough and my test was 996 but they lowered my dose and the next time around it was at 600 on trough. My clinic says I am probably peaking at 1000+ but i don’t really believe them. I am in the process of switching to defy.

My shbg should have been done but i didnt get the results. I will look in to that and thanks for the feedback. What is the point of hcg and can i take more or less to feel better?

4

The point of hCG is to maintain fertility if you are actively attempting to conceive, to prevent testicular atrophy if that is of concern, or to generate income for the clinic.

5

Realize by being on HCG will increase estrogen and the AI will suppress estrogen and dosing the AI isnt always easy because some men are AI over-responders lowering estrogen to low.

Libido and erectile strength is dependent on testosterone and estrogen levels, I could never find a lower enough AI dosage without crushing my estrogen to low. AI’s was chemical castration for me.

6

my shbg is 16 and they say the normal range is 10-50. What are your thoughts?

7

Your SHBG is low, I’m sure you’ve read about other low SHBG men on this forum. The low SHBG men do better on more frequent dosing, daily and EOD. Then there are those who don’t have low SHBG that do very well on daily and EOD dosing.

8

I have not read about that yet but will look in to it. So with it being on the very low end of the range what the issues most run in to?

9

People overall feel better on HCG. I had guys, friends on the forum, swear it was all about money.

But now they swear by it themselves, it only took 2 years of convincing them lol. I have a friend who used AAS for like the last 20 years, he just takes HCG sometimes for long stretches, a year or more at time, because he says his sex drive has never been better, and he has never been leaner.

I never believed in the HCG diet, but it is hard to argue with user reports, and people lose fat on HCG and report a general sense of well being. Its the 500 cal diet I don’t agree with.

The whole high E2 thing is not substantiated, in the study I posted where hypo men took 5,000 IU a week they noted that E2 barely rose.

So I don’t think it is fair to say it is all about money.

Another thing to think about is things change. Someone may be all into TRT and then a year or 2 down the road they are not into it and they will always wonder if they should have taken HCG the whole time would they not be so shut-down.

So it definitely has its benefits, the biggest problem is people don’t take enough of it and then blame the HCG for not doing anything. I don’t know where this whole 250IU rumor started but its not enough, for men on TRT that are simultaneously desensitizing their gonads with T.

It may be enough to keep some sperm alive, but it is not enough to get the full benefit of HCG.

There were forums dedicated to HCG mono therapy, one guy had a ton of followers. I used to post there. Only issue they ever ran into was they couldn’t keep SHBG down on HCG (some of them). So they switched to injections and that increased their free t.

Maybe thats why some of you guys have such low SHBG? We do not see these problems in our practice often, it is very rare. I see it here in almost every thread though. :slight_smile:

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10

That sounds right given your free test percentage of 2.6. By far, the majority of guys on TRT use 150-200mg once a week. Of the hundreds of thousands on TRT, both underground and medically supervised, very few show up here. Those that are, like you, are experiencing less than ideal results. Think of the thousands of underground meathead guys in local gyms taking test that are doing great with no idea what SHBG is.

Given your dose, I think your levels seem low. I’d lean toward increasing your dose. I think twice a week is fine. I also do not think it would hurt if you want to inject more frequently. Many here like it that way. I do wonder if every other day is good, and every day is better, why not twice a day? Maybe every six hours? Where do you draw the line, so your levels are within 10ng/dL all day? But who am I to say? Whatever works for you, I just think its overthinking it.

I’d like to know your E2. I wonder how you are over responding to the anastrozole. Many here, most notably systemlord, report problems with even the smallest dose.

Good luck finding your solution. I take 200mg once a week and that puts me at 900 total and 220 free at trough. Have been on that for six years and feeling very good. That’s with a SHBG of 19. I’ve thought about trying every day dosing just out of curiosity, but I’m doing very well and don’t wish to mess with it right now. Point being, we are all different.

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11

Especially with the sublingual. Hell, on 500cal, you could dissolve an almond under your tongue and lose weight.

Maybe not always, but sometimes. However, when guys are sold stuff and they do not even know what it is, when a hot, augmented sales girl tells them it is to keep their balls functioning and keep their fertility (when they are 52 y/o and finished having children), when told it is so their testicles won’t dry up and disappear, when it is part of a cookie cutter protocol given to every patient, it is.

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