Newbie with Newbie First Lab Questions

Pharma / TRT Testosterone Replacement
1

Hey everyone,

I’m new to both this board and to TRT, and going through some learning curves and the inevitable adjustment period. I’ll give some background and highlight my main questions, but if more information is required I’m happy to post more. I have a ton of tests, but provided the one’s I believe to be most important. Someone can correct me if I’m wrong…

Baseline Measurements (May, 2016):
TESTOSTERONE, TOTAL 285 (250-1100 ng/dL)
TESTOSTERONE, FREE 63 (46.0-224.0 pg/mL)
TESTOSTERONE,BIOAVAILABLE 128 (110.0-575.0 ng/dL)
SEX HORMONE BINDING GLOBULIN 15 (10-50 nmol/L)
ESTRADIOL, FREE .27 pg/mL (< OR = 0.45)
ESTRADIOL 11 pg/mL (< OR = 29)
ESTRONE, SERUM 18 (< OR = 68 pg/mL)
PSA, TOTAL 1.6 (< OR = 4.0 ng/mL)
PSA, FREE 0.6 ng/mL
PSA, % FREE 38 (>25)
HEMOGLOBIN 15.8 (13.2-17.1 g/dL)
HEMATOCRIT 48.4 (38.5-50.0 %)

I’ll also throw in my most recent thyroid/Iodine tests (these were done in December):
TSH 0.87 (0.40-4.50 mIU/L NW)
T4, FREE 0.9 (0.8-1.8 ng/dL NW)
T3, FREE 3.3 (2.3-4.2 pg/mL NW)
IODINE, SERUM/PLASMA 31 L (52-109 mcg/L AMD)

Based on this, it was suggested I start dosing with 2 drops of nascent iodine daily, along with 200mcg of Selenium. I’ve got my iodine levels up to 47 as of May, but still need to recheck TSH/T4T3.

5 week follow up labs (June 2016)

Dosing schedule during these 5 weeks:
• 200 mg / testosterone cypionate once per week on Mondays
• .25mg Arimidex on Mondays & Thursdays
• 250 HCG IU on Mondays and Thursdays

TESTOSTERONE, TOTAL 890 (250-1100 ng/dL)
TESTOSTERONE, FREE 280.6 H (46.0-224.0 pg/mL)
TESTOSTERONE,BIOAVAILABLE 577.1 H (110.0-575.0 ng/dL)
SEX HORMONE BINDING GLOBULIN 11 (10-50 nmol/L)
ESTRADIOL, FREE 1.24 H pg/mL (< OR = 0.45)
ESTRADIOL 47 H pg/mL (< OR = 29)
ESTRONE, SERUM 51 (< OR = 68 pg/mL)
CORTISOL, TOTAL, LC/MS/MS 16.0
CORTISOL, FREE, LC/MS/MS 0.87
PSA, TOTAL 2.0 (< OR = 4.0 ng/mL)
PSA, FREE 0.8 ng/mL
PSA, % FREE 40 (>25)
HEMOGLOBIN 16.2 (13.2-17.1 g/dL)
HEMATOCRIT 48.7 (38.5-50.0 %)

Based on these numbers, my doctor suggested the following dosages with a six week follow up:

• 75 mg / testosterone cypionate twice per week (Monday and Thursday)
• .5mg Arimidex on Mondays & Thursdays
• 250 HCG IU on Mondays and Thursdays

I definitely didn’t like how I felt the first two days after the 200 mg injection… Lots of anxiety types of symptoms, then I would feel okay for the rest of the week. I don’t know if that was being too high on testosterone, or too high on Estrogen… or both.

My main question is on the Estrogen. Do you guys think with the 25% reduction in dosage, dividing the dose to 2X per week, and the double of the Arimidex will cut my Estrodiol enough?
Also, I’ve read lots that Estrodiol should be between 25-35, but is that the total, or the free… I’m kind of confused on that target.

Thanks again for all the help! This is all new to me so I’m just trying to come up to speed and really appreciate all the experience and insight.

Scott

2

Need your vitals. Age, height, weight, etc. also symptoms both before and during treatment.

In general, and I repeat, in general. The average guy uses 1mg of Adex for 100mg of T cyp to control E2. Having said that, there are lots of exceptions to this rule.

A formula guys on here use is as follows:

New Adex dose = old Adex dose X 47/22 X .75

The 47/22 comes from your current E2 and the target E2

The .75 is the reduction in T

So…,

New Adex dose = 0.5 X 2.13 X 0.75 = 0.8

0.8 mg of Adex twice weekly.

3

Thanks Nash!

Sorry I should have included that. I’m 43, 6’, and 195lbs.

I had always been very active and try like the best of us to lead a healthy lifestyle. About 3 years ago, I met a “real” virus that darn near killed me. Pancreatitis, plural effusions, blood clots… The list goes on. After about a year and a half of very slow recovery they tested my testosterone levels several times. I had lows of around 230 total to highs of about 310.

I was incredibly fatigued, was suffering from anxiety and a non-existant sex drive.

While they never did find the actual virus (late life EBV was suggested by a couple of doctors), they hypothesis was that a combination of the virus and aging was contributing to the low T values.

Hope this helps. And I really appreciate the formula. As a guide!

4

Glad to help. Just keep in mind that getting your E2 optimized will make or break TRT. And… Everyone is different. The number 22 is just a target. You might feel better a little higher or lower.

You’ll know when you have it right. Morning wood, strong libido, more energy, positive attitude, clearer thinking, etc

5

Great feedback and thank you again.

One last question… Since I’m so high right now, is it wise to front load the AI to try to drop quickly (like take an extra .5mg this week), or just do the half pill + 1/4 pill twice a week and let it do its thing over time?

6

When mine was 35, I took 0.7mg of Adex twice weekly for about two weeks before going to my maintenance dose of 0.5mg because I wasn’t patient enough. You do run the risk of crashing your E2, but I didn’t think a small increase would be detrimental and I turned out to be correct. So if you decide to slightly increase your dose, it will speed up the process. Just don’t get too aggressive or do it for too long. Again everyone is different. Tread lightly.