Feedback on Blood Labs - 8 Months TRT

[LC66]

Hello Gentlemen, 53 year old, 6 ft, 205 lbs, have been on Testosterone Cypionate 200 mg/mL 100 mg (0.5 ml) intramuscularly once a week since April 2019. No HCG or AI, Dr. is not very receptive. Any feedback on latest LABS would be appreciated. Feeling pretty good currently. Currently injecting once per week. Labs were drawn 36 hours after injection.

Concerns:

-Cholesterol has always been borderline high but inside normal range, LAB done three days after Thanksgiving, may have skewed it up. Need to boost HDL.​

-Same for Triglycerides​

-Estradiol, Sensitive too high?​

-SHBG low?​

-Would going to a 3.5 day injection schedule help? Realize this would lessen trough, what impact on other numbers?​

Baseline:
Testosterone, Serum 292 ng/dL
Free Testosterone (Direct) 6.1 pg/mL Low
PSA: 2.1 ng/mL

 

[DixieWrecked]

yeah man. I am not trying to scare you or anything but you got to get your lipids in order. I would be worried if mine came back like that. I got my bloodwork done before Thanksgiving so that I could see what I normally walk around at. Lips tests are cheap on discounted labs.

Your SHBG is low. You need to inject more frequently. It should give a little boost in test and decrease Estradiol a bit.

 

[Vince Carter]

Labs were drawn 36 hours after injection.

you always draw blood just before an injection not after.

 

[Vince Carter]

Feeling pretty good currently.

besides as noted about your lipids there's no reason to change something given you say you're feeling pretty good.

 

[Joey786]

Total and free test seem low for 36hr post injection. How do you feel at the end of the week?

 

[Systemlord]

Your SHBG is low. You need to inject more frequently. It should give a little boost in test and decrease Estradiol a bit.

This^^^ and welcome to the low SHBG club where very frequent injections are needed in most cases. There is a trend with low SHBG and very high free estrogen even when estrogen is in range. The fact you are asking your doctor for an AI tells me there is room for improvement. You might actually feel even better on more frequent dosing and trough levels will be higher and estrogen lower which is actually what you need.

 

[SilverSurfer]

Your lipids need serious attention! What does your liver function look like? AST/ALT?

With a SHBG of 18.8 your free testosterone is almost 3% which is great. I need triple that total T to get close to that. If you’re feeling good, I’d leave it alone.

 

[LC66]

Thanks everyone for the replies:

1. Feel pretty good at the end of the week, don't really notice a large crash.
2. Lipids are a concern. Labs in mid June were normal: 189 mg/dL Total Cholesterol, 131 mg/dL Triglycerides, 44 mg/dL HDL. I did cut back on Niacin recently as my wife talked me into Intermittent Fasting Diet, and Niacin on an empty stomach equals severe flushing, maybe that contributed. Stopped morning 500mg dose, kept 1000 mg evening dose.
3. Liver Function is normal: AST 27 IU/L [0 - 40], ALT 29 IU/L [0 - 44].

 

[madman]

Hello Gentlemen, 53 year old, 6 ft, 205 lbs, have been on Testosterone Cypionate 200 mg/mL 100 mg (0.5 ml) intramuscularly once a week since April 2019. No HCG or AI, Dr. is not very receptive. Any feedback on latest LABS would be appreciated. Feeling pretty good currently. Currently injecting once per week. Labs were drawn 36 hours after injection.

Concerns:

-Cholesterol has always been borderline high but inside normal range, LAB done three days after Thanksgiving, may have skewed it up. Need to boost HDL.​

-Same for Triglycerides​

-Estradiol, Sensitive too high?​

-SHBG low?​

-Would going to a 3.5 day injection schedule help? Realize this would lessen trough, what impact on other numbers?​

Baseline:
Testosterone, Serum 292 ng/dL
Free Testosterone (Direct) 6.1 pg/mL Low
PSA: 2.1 ng/mL

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View attachment 8823

As VC stated your labs were taken at the wrong time.....labs should always be done at trough just before your next injection.

Seeing as you are only injecting once weekly and your labs were done 36 hours later than you can clearly see that your TT/FT levels are not that high and would be much lower on day 7 (before next injection which would be your true trough).....your TT/FT levels would definitely be sub-par by than!

Top it off with the fact that the direct immunoassay is inaccurate so if you truly want to know where your FT sits on such protocol you would need to have it tested using most accurate testing methods such as the gold standard Equilibrium Dialysis or Ultrafiltration.

Or you can use the most accurate calculated method TruT Free Testosterone Calculator by FPT

If we calculate your FT using TruT.....with a TT 616 ng/dL, SHBG 18.8 nmol/L, Albumin 4.3 g/dL (mean) than your FT would be 22.42 ng/dL. (almost mid-range of the reference range 16-31 ng/dL).

Most men do well having FT in the 30+ ng/dL range.....others may need to run higher levels and others may do well running lower levels as it depends on the individual and how they react to said FT level.

Ideally we want to feel great overall regarding energy/mood/libido/erectile function/body composition/recovery while keeping blood markers healthy and minimizing/preventing and potential negative effects.

Although you state that your feeling pretty good on such protocol 100 mg once weekly.....with a lower SHBG 18.8 nmol/L you may very well feel even better injecting smaller doses more frequently as your TT/FT levels are not that high 36 hours post injection.....let alone they would most likely be sub-par by day 7 before your next injection (true trough).

You have room to bring up your TT/FT levels and because your SHBG is on the lower end you would most likely benefit from more frequent injections.

I would not even worry about your slightly elevated e2.....as you stated you are feeling pretty good.....mind you free e2 is what you should also be testing.

You definitely need to work on improving your lipids/triglycerides.

I would not change anything if you truly feel well overall although if you feel there could be room for improvement than you have room to bring up your TT/FT levels some.....let alone you may feel even better injecting lower doses more frequently.

 

[LC66]

Great insight madmen, thanks!

 

[xqfq]

Your non-HDL is high which means your LDL particle count is probably high. Niacin may help (the Slo Niacin has been the most tolerable for me in my experience). But you should look into other options as well.

ezetimibe is a non-statin option to lower LDL. I’ve been taking it for the past six weeks. Statins are also a good option. Some such as Crestor are widely tolerated and do a lot at low doses. I would use niacin to lower LDL only if all other options had failed.

niacin’s “boost” to HDL-C does NOT help for heart disease prevention. It’s lowering of LDL may help though. But for that there are usually better drugs unless they cannot be tolerated.