Why Has my T Level Dropped on TRT?!

Hi just had my 6 month blood test for my trt treatment. I am on 105mg per week with every other day Injections. I jab in delts with insulin pins.

I’ve been on same dose for 6 months but my t levels have dropped significantly from 957 to 651 … maybe my natural t stopped just seems to have taken a while for it to stop maybe ?

Prolactin also gone up but think that was because the day of the blood test I was very tired and had sex night before ?

Bloods below -

Serum vitamin B12 level 274 ng/L [120.0 -

900.0]; Adequate B12 stores.If the patient is on IM B12

therapy, it is not necessary to monitor B12 levels

Free androgen index

Free androgen index 113.0 % [24.0 -

110.0]; Above high reference limit

Serum testosterone level 18.2 mol/L [6.1

  • 27.1]

Serum sex hormone binding globulin level

20 nmol/L [13.0 - 90.0]

Full blood count

Haemoglobin concentration 158 g/L

[130.0 - 180.0]

Total white blood count 7.0 10*9/L [4.0 - 11.0]

Platelet count - observation 271 10*9/L

[150.0 - 400.0]

Haematocrit 0.47 L [0.4 - 0.52]

Red blood cell count 5.36 10*12/L [4.5 -

6.51

RDW 13.1 % [11.0 - 14.8]

Mean cell volume 87.0 fL [80.0 - 100.0]

Mean cell haemoglobin level 29.6 pg [27.0

-32.0]

Mean platelet volume 8.1 fL

Neutrophil count 3.40 10*9/L [1.7 - 7.5]

Lymphocyte count 2.51 10*9/L [1.0 - 4.5]

Monocyte count - observation 0.70 10*9/L

10.2 - 0.81

Eosinophil count - observation 0.34 10*9/L

10.0 - 0.4]

Basophil count 0.06 10*9/L [0.0 - 0.1]

Serum ferritin level 46 ng/mL [15.0 -

300.0]; Ferritin >15 and <100ng/mL.

Serum folate level 10.6 ug/L [2.5 - 9999.0]

Liver function tests

Serum total protein level 67 g/L [60.0 - 80.0]

Serum albumin level 42 g/L [35.0 - 50.0]

Serum globulin level 25 g/L [20.0 - 35.0]

Serum alkaline phosphatase level 42 u/L

[30.0 - 130.0]

Serum total bilirubin level 13 umol/L [0.0 - 21.0]

Serum alanine aminotransferase level 11 u/L [0.0 - 50.0]

Lipid level

Serum cholesterol level 5.9 mmol/L;

Target for secondary CHD prevention is total

cholesterol of <5, HDL >1 and LDL <3.0 mmol/L

Primary prevention - use risk tables.

Carm UAl chalerteral laurl 1 20 mmal/l Primary prevention - use risk tables.

Serum HDL cholesterol level 1.30 mmol/L

[0.9 - 3.0]

Serum cholesterol/HDL ratio 4.5

Serum triglyceride levels 0.98 mol/L [0.6

-2.3]

Serum LDL cholesterol level 4.15 mmol/L

[0.0 - 3.0]; Above high reference limit NON-HDL CHOLESTEROL 4.6 mmol/L;

Target non-HDL cholesterol reduction on treatment

40% from baseline.

Serum estradiol level 191 pmol/L [0.0 -

173.0]; Above high reference limit

Serum prolactin level 515 mu/L 0.0 -

278.0]; Above high reference limit

Serum progesterone level 1.4 mol/L

Serum prostate specific antigen level

Serum prostate specific antigen level 0.39 ug/L [0.0 - 3.0]

Serum total 25-hydroxy vitamin D level

109 mol/L [50.0 - 150.0]; Between 76 and

150nmol/L: Vitamin D sufficient.

Serum C reactive protein level 1 mg/L [0.0

  • 5.0]

Hi @blshaw hope your are well ? If you get a minute would you mind giving me your view on my 6 months bloods please ?

T Level gone down and prolactin gone up … not sure why same dose etc.

Was very tired and had sex night before bloods so might explain high prolactin. Was fine last blood test but was high before trt before…

TRT isn’t a set and forget therapy, your hormone levels will still fluctuate and mileage may vary time to time. For someone with a history of iron deficiency, I found my ferritin level greatly affects my mileage on TRT.

This is why you’re tired. Low iron, ferritin negatively affects thyroid function and will make TRT much less effective. Low thyroid function can lead to high prolactin.

You need iron supplements.

I would also test TSH, Free T3 and Free T4 after correcting the iron problem if symptoms are still present.

Prolactin peaks 10-20 minutes after sex, and starts declining thereafter. You only need to abstain from having sex 24 hours of a PSA test.

Anti-depressants, and estrogen affects prolactin.

What were your baseline, pre-TRT prolactin levels.

In cases of elevated C-reactive protein, only the sensitive estradiol test can be used, otherwise testing will lead to a falsely elevated estradiol level.

Hi thanks for the reply :slight_smile:

Since my last bloods 3 months ago - I took your advice and have been supplementing with iron. My levels have gone up slightly from 38 I think … I will continue to do so. I’m on 30mg per day.

My prolactin pre trt and at my last 3 month bloods were at 190,s or around that ball park.
I have however had elevated levels in past but they came back down with P5p and reducing stress. I work nights so don’t think that helps.

I get Trt is never set and forget and takes a good while to get dialed. But is it normal for it to take 6 months before my natural t stops ? Must be the reason it’s dropped so much ?

You natural test is mostly shutdown at 6 weeks, but will take decades to become completely shutdown.

Same things happened to me, at first a little went a long way, to the point of hyper-responding, then my body acclimated to the exogenous testosterone.

This is not enough. You need double of triple the dosage. I take 154 mg iron daily, or else TRT will push my ferritin levels into oblivion very quickly!

Chelate iron is best.

Ok I’ll double my Iron dose and retest

With regards to the c reactive protein sorry I’m not sure I understand? Is my c reactive level ok ?
If it helps my last test e2 was higher but prolactin was lower …

Also was smoking weed at a wknd away the other week .maybe that raised my prolactin

1 mg/L, a small elevation but an elevation none the less.

C-reactive protein is a marker for inflammation.

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@systemlord pretty much covered everything. There are a lot of explanation as to why your total testosterone levels could have dropped. Have you taken any meds that would have caused a fall in your SHBG? Were both of your labs taken on the same day of the week as well as your injection prior to those lab draws? Timing makes a big difference.

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Hi @blshaw thanks from the reply.

No meds take to lower shbg has always been low. It’s lowered since 3 month test but only from 22 to 20… maybe it’s from every other day injections ?

As systemlord said maybe it’s normal as natural slowly shuts down and we become more adapted to trt. ? Just seems to have dropped a fair bit …

Bloods was drawn same day and time