First Blood Test at 12 Weeks

[evolution69]

Hi All,
I started TRT in August. I am doing daily SubQ .14ml of Test Cyp. I am 53.

I just went for my first blood test at 12 weeks and I was a little disappointed that my estradiol is showing as quite high, while my total T isn’t all that high. Here are the results:

Estradiol: 207pmol/L 56.39pg/ml
Testosterone Total: 30.2nmol/l 871 ng/dl
Testosterone Free: 678pmol/L
Testosterone Bioavailable: 15.9nmol/L
SHGB: 35.4nmol/L

PSA: 0.81ug/L
Hematocrit: .48L/L

I do have somewhat sensitive nipples, but I thought that is relatively common. Sometimes I do feel a little flushed. But I don’t feel much poor mood etc. Should I be concerned about this estradiol level? Seem super high. I had a poor sleep before this test, could this affect it?

I think if I have to take an AI I may bail on TRT because I don’t want to open up that can of worms and my natural levels weren’t super low for my age.

As far as how I feel on TRT I haven’t noticed much apart from the following:

Libido increased from almost zero to wanting sex a couple of times a week. Nothing crazy but it is definitely an improvement.

About a month ago I had a marked increase in strength in the gym. Only lasted a couple of weeks, must have been my natural production combined with the exogenous. Now I am back to being weak lol.

I notice a little more mental energy and intensity with work (computer based work).

Thanks for all the info on this forum, it has helped me a lot.

 

[Systemlord]

I may bail on TRT because I don’t want to open up that can of worms and my natural levels weren’t super low for my age.

Testosterone 14.7 8.4-28.8 nmol/L (424 ng/dl)

Testosterone Threshold for Increased Cardiovascular Risk in Middle-Aged and Elderly Men: A Locally Weighted Regression Analysis - PubMed

These data showed that a testosterone threshold of 440 ng/dL was associated with increased Framingham 10-year CVD risk in middle-aged and elderly men. Poor sexual performance, decreased morning erection, and loss of libido had an impact on the testosterone threshold for CVD risk. The threshold...

pubmed.ncbi.nlm.nih.gov

About a month ago I had a marked increase in strength in the gym. Only lasted a couple of weeks, must have been my natural production combined with the exogenous. Now I am back to being weak

This seems like a contradiction, saying your levels weren’t that low for your age, then saying you’re back to being weak. It stands to reason if you’re weak that your levels weren’t healthy.

Also the improvement in libido is very telling and you’re already thinking about quiting considering you’ve made so much progress in 3 months time?!

I mean some tweaking to your protocol is needed in order to dial-in.

You have to stop comparing yourself to everyone else and compare yourself to you, you don’t know what normal is for you and by going off where everyone else is may be self-defeating.

Maybe these levels are too high for you. The best thing to do is lower your dosage and find out.

 

[Systemlord]

Also, I felt horrible on sub Q injections, so maybe this is part of the problem. Certain guys will have higher estrogen on sub Q injection.

 

[evolution69]

I would rather not quit, I was ready to go in and ask my doc for an increase in dosage, because the benefits have been ok so far but nothing great. I was really enjoying the gym gains while they lasted, I would like to get back to that point at least. But then seeing my estradiol levels made me think an increase would be impossible without an AI. Seems AIs long term are not great for longevity so it doesn’t seem like a good idea to start on one.

Good point about the SubQ, maybe I will try IM. I was thinking of asking my doc to switch to twice a week IM since my hematocrit seems ok (it actually went down).

Also, maybe I will try Natesto. I asked for it originally but it was not available in Canada again until last month, not sure what effect this would have on estradiol.

 

[madman]

Hi All,
I started TRT in August. I am doing daily SubQ .14ml of Test Cyp. I am 53.

I just went for my first blood test at 12 weeks and I was a little disappointed that my estradiol is showing as quite high, while my total T isn’t all that high. Here are the results:

Estradiol: 207pmol/L 56.39pg/ml
Testosterone Total: 30.2nmol/l 871 ng/dl
Testosterone Free: 678pmol/L
Testosterone Bioavailable: 15.9nmol/L
SHGB: 35.4nmol/L

PSA: 0.81ug/L
Hematocrit: .48L/L

I do have somewhat sensitive nipples, but I thought that is relatively common. Sometimes I do feel a little flushed. But I don’t feel much poor mood etc. Should I be concerned about this estradiol level? Seem super high. I had a poor sleep before this test, could this affect it?

I think if I have to take an AI I may bail on TRT because I don’t want to open up that can of worms and my natural levels weren’t super low for my age.

As far as how I feel on TRT I haven’t noticed much apart from the following:

Libido increased from almost zero to wanting sex a couple of times a week. Nothing crazy but it is definitely an improvement.

About a month ago I had a marked increase in strength in the gym. Only lasted a couple of weeks, must have been my natural production combined with the exogenous. Now I am back to being weak lol.

I notice a little more mental energy and intensity with work (computer based work).

Thanks for all the info on this forum, it has helped me a lot.

Trying to understand why you jumped right into injecting daily as you have normal SHBG.

Was your blood work done at Lifelabs or Dynacare?

Post the reference ranges.

Keep in mind that you are hitting a high-end TT close to 900 ng/dL and this is on 14 mg T daily (98 mg/week) as Depo-Testosterone (TC) only comes in the 100 mg/mL strength in Canada.

With a TT close to 900 ng/dL and normal SHBG 35.4 nmol/L then you would definitely have a healthy FT level.

Keep in mind that although TT is important to know FT is what truly matters as it is the active unbound fraction of testosterone responsible for the positive effects.

The only way to know where your FT level truly sits is to have it tested using an accurate assay such as the gold standard Equilibrium Dialysis or Ultrafiltration.

Most are relying upon the piss poor direct immunoassays or cFT which tend to overestimate FT.

Doubtful jacking up your TT 900--->1200 ng/dL is going to make a big difference in your overall symptoms and if anything you are just going to drive up your estradiol, hemoglobin/hematocrit further.

Would not put too much weight behind your estradiol results as you most likely never had it tested using an accurate assay (LC-MS/MS).

The standard immunoassays which are commonly used tend to overestimate estradiol, especially in cases of high CRP.

It may very well not be as high as you think.

Not sure which province you reside but if you live in Ontario you can get the estradiol-sensitive test through Dynacare.

Need to sit back and think this through before jacking up your dose!

 

[evolution69]

Thanks madman. I live in BC. The reasons I started with daily are because my hematocrit had been at the top of the range (50-51) for the past couple of years without any TRT. Also, I had a lowish SHBG reading before starting (23.4nmol/L). I had quite a poor sleep before that reading so this may have affected my levels. Also, I was just under the impression that daily was somehow better, it is just over the past few weeks that I am coming to see that this is not necessarily the case.

Another reason I went for daily is because I tried TRT back in 2017 and the doc told me to do a weekly shot of 100ml. I did the first shot and my prostate felt very swollen and painful for a few days. This gave me pause because I have friends who suffer from long term prostatitis so I decided to wait for a few years until I was in my 50s to try TRT again. At that point my libido was still decent so it wasn’t a priority for me. I thought maybe a daily would avoid this prostate swelling from happening again.

These labs are from Lifelabs. I live on an island which has a Dynacare lab but they won’t do any free T etc if my total T is in range, even if I am paying. So I have to travel off island to Lifelabs. Maybe I will try the local lab again and see if they can do the sensitive Estradiol test.

Maybe the estradiol test was off somehow. I am not holding any water and my mood is pretty good. Sensitive nipples seem common when starting TRT and there is no itching or other symptoms.

Here are the reference ranges:
Estradiol 207 Ref Range <162 pmol/L
Testosterone 30.2 Ref Range 8.4-28.8 nmol/L
Testosterone Free Calculated 678 Ref Range 115-577pmol/L Method of Vermeulen
Testosterone Bioavailable Calculated 15.9 Ref Range 2.7-13.5nmol/L Method of Vermeulen
Sex Hormone Binding Globulin 35.4 Ref Range 19.0-76.0nmol/L