Defy Medical Blood Test Results - 11 Week Follow Up

[DrSilkWater]

Hi EM Community,

I just got my blood test results after 11 weeks on TRT @ 150mg/week, HCG 800iu/week and Arimidex 1mg/week.

so I am really happy with the results.

Main Tests:

Total Test 341 ---> 1093ng/dl
Free Test 6.8 ---> 27.2 pg/dl
E2, Sensitive Assay 19.9 ---> 18.7 pg/ml
SHBG 31.5 ---> 27.5 nmol/ll
Total/LDL Cholesterol dropped by 50 pts each.
Hematocrit stayed stable.
Liver values are fine.

I'm very happy with my results. I feel I dialed in quickly. Everything got better. I lift pretty hard, total body, 3-5x per week, use intermittent fasting and track my macros so I lost a bunch of fat and added muscle.

My only questions are the following:

1) My E2 dropped by 1 pg/ML. I had itchy nipples so I went from .75mg prescribed for my routine to 1MG per week and this stopped the itchy nipples, but notice my joints pop more. Is my E2 low? It isn't crashed, but not sure if I should have kept my E2 essentially flat to pre TRT despite increasing my Total T/Free T by a few mulitples. Thinking about it letting it go up a few points by dropping my AI to .75mg/week

2) Whenever I inject (Every 3.5Days, Monday PM and Friday AM), I get puffy nipples and a funny sensation, not itchy, but just feel them more. Is this due to HCG? I can't imagine i can feel the test immediately. FYI, I inject subQ.

3) I take my AI 24 hours after my test, is this still the SOP regarding AI dosing while on TRT.

4) I took my blood test the 6 hours after my Friday AM injection which is 3.5 days after my Monday AM injection. Does this mean my average test is higher or lower than what is shown in the labcorp result?

Thanks,

Alan

PS - Bloodwork is attached.

 

[ERO]

Glad to hear you are dialing-in quickly!

A couple things: 1) You need to do your blood draw the day of your injection but BEFORE you inject, not after you inject. 2) When you are injecting twice weekly you can take your AI the same day as your shots. Day after is OK, but that protocol is from the days of the once a week T shot. Not a big deal, its just easier to do everything the same day.

 

[CoastWatcher]

If all you had were itchy nipples, you needn't have made any adjustment with your AI. Nipple sensations are typical presentations for men on TRT. Serum levels are more volatile. Three years in I still itch and "notice" my nipples on occasion. Never taken an AI.

I'd reconsider that aspect of your protocol.

 

[DrSilkWater]

If all you had were itchy nipples, you needn't have made any adjustment with your AI. Nipple sensations are typical presentations for men on TRT. Serum levels are more volatile. Three years in I still itch and "notice" my nipples on occasion. Never taken an AI.

I'd reconsider that aspect of your protocol.

Thanks CW! What do you think of my curent E2 level in relation to my total and free test?

 

[Vince Carter]

Most of us in the know are going to advise you that ~18 is broaching the low side of E2, of note is you mentioned clicky joints which is a low E symptom. I would advise a small reduction in the AI to .25mg with your shots 2XW, not making a major change, small change followed with labs. I agree with my friends above that some nipple issues are normal and otherwise benign in TRT.

 

[DrSilkWater]

Most of us in the know are going to advise you that ~18 is broaching the low side of E2, of note is you mentioned clicky joints which is a low E symptom. I would advise a small reduction in the AI to .25mg with your shots 2XW, not making a major change, small change followed with labs. I agree with my friends above that some nipple issues are normal and otherwise benign in TRT.

Thanks. I was planning on reducing it by .25mg. You mentioned "with your shots", do you mean st the same time I inject or still adhere to 24 hours post injection?

Also, since I took my blood test 6-8 hours after my Friday AM shot, how much would this have affected my total and free test results? I am trying to decipher where I sit testwise day to day.

Thanks

 

[CoastWatcher]

Thanks. I was planning on reducing it by .25mg. You mentioned "with your shots", do you mean st the same time I inject or still adhere to 24 hours post injection?

Also, since I took my blood test 6-8 hours after my Friday AM shot, how much would this have affected my total and free test results? I am trying to decipher where I sit testwise day to day.

Thanks

Always test immediately before an injection of testosterone. Your doctor should have pointed out that estradiol follow testosterone, your trough testosterone gives you something close to a peak look at your e2.

 

[Vince Carter]

Sometimes more advanced guys can do some more introspective testing like 24hrs post injection but for the most part bloods are always taken jsut prior to injection and changes are based on trough numbers. 6-8hrs probably isn't going to make it unusable but it's just not done that way.

 

[RLW]

I think I'm at 11 weeks this coming week. I figured around 12 weeks is when I would be getting follow up labs done. Did Defy contact you, or did you contact them? Not sure how that works.

 

[JMP]

I recently came up to my first 12 weeks with Defy and called them in the 11th week to ask when my bloodwork was due and when I could refill test/hcg. They told me and then a few days later I received a automated call reminding me of both.

 

[sebco]

DrSilkWater congrats on your results. That is awesome they got you to optimal so fast. How far in advance did you schedule your lab work? I have my first follow up with them coming, but i know it takes forever to get an appointment with them and on top of that they won't schedule an appointment until you get the lab work results.