Been looking at getting tested for a while and finally did. Here are the results:
TSH 1.930 uIU/ml
T4 7.1 ug/dL
T3 28 %
Free Thyroxine Index 2.0
IGF-1 137 ng/mL
IGF-1 Z score -0.3 S.D.
Testosterone, Serum 277 ng/dL
Free Testosterone 7.7 pg/mL
PSA 0.7 ng/mL
Estradiol 32.7 pg/mL
B12 1072 pg/mL
Progesterone 0.3 ng/mL
Definitely following up with clinic for HRT protocol, but any additional thoughts are appreciated.
Testing is limited and not nearly enough to get a complete picture, according to your total testosterone and free testosterone SHBG is low. Low SHBG men need to inject testosterone more frequently, every day or EOD or you will experience large swing in hormone levels.
My original numbers were 225 Total T and Free T 7.7, lower SHBG means you excrete testosterone quickly which is why it’s important to inject as frequently as possible. Controlling estrogen production will depend on it, you will require an estrogen blocker because estrogen is already at the top of the range and will only climb higher once total testosterone is higher.
You shouldn’t be targeting high normal total testosterone, low SHBG men have a lot of free hormones so we don’t need a high total T to achieve healthy free testosterone levels. IGF-1 is low and TRT may fix it.
TSH isn’t optimal, T4 should be mid range, Free T3 midrange or better, Free T4 midrange and Reverse T3 under 15 ng/dL. Most of these tests were skipped, painting less than half of a complete picture of thyroid function. You can evaluate thyroid function by measuring morning and afternoon body temperatures, 97.8 upon waking and 98.6 by 2 p.m.
Good body temperatures support fat burning ability, low body temperatures one can expext fat gain around the midsection.
I thought I had said this, but thank you for your insight.
Just over a week in. Protocol that was prescribed is as follows:
100 mg test-c twice a week (Mondays and Thursdays). I did ask about more frequent injections and he recommended starting here.
1 mg anastrozole EOD
Daily injection of HCG (can’t remember dosage right off)
Notes so far: A little better on the energy front- nothing ground breaking. I have returned to waking up with a friend to greet me almost every day. The libido increase is there. Not quite what it was when I was 20 or so, but definitely an increase. It’s not back to ADIDAS, but that’s probably for the better.
Lifting-wise: Too early to see anything for sure. I had a real sub standard day in the gym a couple of days ago and couldn’t even get a single on something that I can do doubles on easily, but there’s a lot of factors in play with work and nutrition due to being offshore at the moment that can also be contributing. I have noticed a little bit of vascularity (which at 350+ lbs is pretty cool), but nothing groundbreaking.
This is probably very bad and WILL crash your e2 causing damage to joints, libido , and more.
It’s way to much. You should probably stop taking it.
If anything 1mg total for the week is reasonable. But many guys do not take any AI until labs AND symptoms suggest it.
These TRT clinics who usually staff incompetence need to stop heavily prescribing AI’s, it’s clear they are attempting to sell the largest dosages of drugs possible to make a profit without an care in the world for their patients. I knocked my estrogen down to 12.5 pg/mL on only .125mg AI EOD, that’s almost a tenth of a mg and you have been prescribe a whopper of a dose.
Everything prescribed is at the limit for weekly doses, whenever I see 200mg weekly and an AI 1mg EOD, if it quacks like a duck and walks like a duck, it’s a duck. You don’t even have the proper tests to start TRT, I can tell you right now with the Total T and Free T numbers you’re presenting you’re low SHBG like myself and this protocol is expected to cause trouble.
Lower SHBG men do much better on smaller more frequent dosing, ideally you want to keep levels as stable as possible with the least amount of fluctuations. My first blood test show a Total T of 225 with a free T of 7.7 and SHBG was 20 nmol/L.
So your SHBG is somewhere around the low to mid 20’s and you best chance of success lies in injecting 20-25mg EOD, larger doses twice weekly will produce higher estrogen peaks and can ruin the feeling of being on TRT.
I recommend 20-25mg EOD with no AI, not at least until there are symptoms and labs indicating high estrogen. If you proceed with this clinics recommendation you will learn a new level of suffering that will last several weeks if not months.
A lot of these clinics (T-mills) should be shut down!
Thyroid labs are inadequate, no Free T3, Reverse T3 or antibodies tested. There are no Free T4 receptors in the body, your body responds to Free T3.
@systemlord and @anon10230041 thanks for the insight. I’ll cut back the anastrozole. Would it be too soon to repeat a blood panel and get more comprehensive testing? What would you recommend as screening questions to a potential TRT physician? I’m sure there are plenty more to go to, and some that would work remote (as this one does).
Is 200mg/week the max dose you typically see for TRT for test?
Forgot to mention only use the LC/MS/MS sensitive method for E2 testing, the standard test is for females and a lot of clinics are doctors are still using the wrong E2 labs and basing their AI dosing on incorrect lab testing.
The standard E2 labs can overstate E2 in males.