Just got my labs back from being on E3.5D of 100mg Test C for about 20 weeks. I am 29 years old and have spent a number of years dealing with tremendous “issues” that I associated with degraded health due to Crohns Disease. From suicidal tendencies, lost libido, no motivation, hot flashes, terrible sleep, literally feeling like I was shrinking in stature and my feet were as well, and horrible depression.
It was a lot to handle and I was convinced I would be ending things soon. I did some research and decided to have my levels tested as a possible cause.
Prior to TRT, over 4 months we did three labs, all came back with similar results:
Free T: 1.0
Total T: 75ng/dL
After being on 200mg a week for 20 weeks or so, my 2.5 days post injection numbers came back as follows in the image.
How do I feel? Remarkable. My motivation is back, my libido has returned after literally being dead for so long, my depression has virtually disappeared, my sleep is normalizing, and my passion for living is back. I feel again… in the most literally sense… before I was numb to everything, but now I just feel… and it is amazing to experience again.
All other values came back within normal ranges, we did not check estrogen
The important thing is you feel great. A lot of doctors don’t test for estrogen, it can cause BP issues if too high and shouldn’t be ignored, low estrogen can cause osteoporosis and so there must be a balance because either end of the spectrum has consequences.
The standard of care for TRT says nothing about testing estrogen, so doctors see no reason to do so.
The educated doctors that went to the appropriate medical school are more informed.
Many TRT doctors do not check estrogen because they do not believe in blocking it. As his doctor is not following the “standard of care” in prescribing 100mg twice weekly instead of 200mg twice monthly, it does not follow that he would follow the standard of care regarding estrogen management. He might consider asking the doctor about it, if he has not already done so.
As you have mentioned on multiple occasions, hormone optimization is not taught in medical schools, regardless of whether or not the school is appropriate or inappropriate. HRT docs picked this up on their own and through post grad continuing education seminars and conferences. There are thousands of doctors who have been trained by Neal Rouzier and if they follow him estrogen is never blocked.
You are dealing with a provider that isn’t competent enough to manage you properly on TRT, your FT is well within normal range, TT is not the active hormone and doesn’t influence anything in the body until it comes bioavailable.
You need to seek care outside of Kaiser or you will always have suboptimal FT levels, if anything you need a dosage increase. These Kaiser guidelines need to be thrown out and rewritten.
My email is in bio. If needed I’ll put you in touch with my doc. All done over the phone, $150/month including 10ml of 200mg T sent via mail. There’s a ton of docs just like mine but if you need mine hit me up.
OK, point out that your free testosterone is barely over mid-range and emphasize how well you have responded. Hopefully, he’ll think through this and not go solely off the number. Good luck.
You need to shop around, you can get TRT for $150 monthly, only other choice is have suboptimal FT with Kaiser.
The truth is everyones needs will be different especially with high SHBG levels, it greatly complicates TRT when doctors have procedures to follow.
I have Kaiser and once my TT was 829 and the canceled my TRT and denied further refills until I brought levels down below 800.
By the time Kaiser doctors are satisfied with your levels, you’ll be symptomatic because your FT levels are barely midrange and soon with be on the lower end.
Just read about Kaiser guidelines wanting to lower your dose. That’s bullcrap dude. This is 2.5 days after your shot, meaning this is around peak level. Your trough levels probably are not around this level, meaning lowering your dose will make you feel quite crappy. Like many have said here, you need to seek care outside of Kaiser, my advice would be to pay for your Test vials out of pocket, this way they cannot dictate your dosage. I dunno if it is the insurance company or the kaiser office doing this too you, but if its the insurance company, I would pay for it out of pocket.
It worked out for me because even when TT at 696 ng/dL, FT was 29 pg/mL (6.8-21.5 pg/mL) putting my FT supraphysiological and no one said a thing because TT is in range, then I hear cases like the OP and I can’t help but see how lopsided things are.
System, that’s crazy bro. Why are they so obsessed with TT? LOL it makes no sense too me. This is why I pay for my medicine out of pocket. It costs me 40 bucks every two months for a 10ml vial of Test Cyp. My insurance company will not be dictating my care.
Also ask for a second round of blood work. You took this when your levels were at peak man. Make sure he knows that. My TT levels were at 1276 because I took my bloods at peak. Take them at the end of the week before your next shot, I bet you will be below 800 and they wont say shit.
Doctors can’t do whatever they want, even if they know their right, they must follow procedure. The guidelines are always evolving, it’s just not happening fast enough.
If you think about it it’s not the doctors fault, someone higher up is responsible.
Yeah but, it is common knowledge that FT is what matters over TT. So like OP my TT is in the 1000’s at peak but my FT is middle of the road because of SHBG. How do they not see that and know that lowering the dose isn’t the answer? Its poor care. That’s why my doctor told me I could stay at my dose, or lower it if I felt I needed too. I mean does TT ever become bio available eventually? Does it slowly release it in the blood stream? What is the huge concern over TT if it doesn’t have a direct effect on you in the interm?
