Lab Work - Can't Get Better It Seems

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psaufan

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I am going to post my most recent lab work and an bit of history of where I am and how I feel. I was with Low T Nation for three years before switching to Defy Medical summer of 2019.

When I left Low-T. this was my regiment: .35ml test cyp twice a week IM...HCG 200iu twice a week...Ipamorelin CJC 1295 daily, at night...felt kinda blah and was not impressed with the care I was receiving.

Upon moving to Defy, my regiment changed to: .35ml test cyp twice a week subq...HCG 250iu twice a week...discontinued Ipamoreline CJC 1295...started Anastrozole .125 twice a week...started T3/T4 each morning.

All was going well physically and mentally until three months ago. I felt like I hit a wall...hard to concentrate...PMSing...hard to focus...no sex drive...hard to stay interested in things, etc. I called Defy and I had a return call to speak with a PA, though I cannot recall her name. She changed my protocol as follows:

Increase test cyp slightly by injecting .25ml three times a week rather than .35ml twice a week...stay subq...increase HCG from 200iu to 500iu twice a week...start injecting B-12 twice a week...one ml each time...everything else stays the same. The PA stated that increasing the HCG might help with the loss of sex drive?

So, now jump forward to now. I had my consult a couple of back with a lady by the name of Michelle (?) and I explained that my symptoms had not really improved since the changes mentioned in the paragraph prior to this consult, which was 90 days prior to the blood work being done.

So, my protocol has now been changed to the following: decrease test cyp from .25ml three times a week to .20ml three times a week...reduce HCG from 500iu twice a week to 250iu twice a week...discontinue the anastrozole...continue with T3/T4 and B-12.

My estradiol had decreased fro 37.1 to 31.3, so I'm uncertain as to why I am going to stop taking it, but I have to assume they have a reason.

Attached is my most recent blood work, The last set of changes I wrote about occurred after the results if this lab work was obtained. You will see - written in red - the levels of those items when I had blood work drawn earlier in 2020. I thought it might be helpful for y'all to see some of the changes.

I mentioned to Michelle that i cannot say I feel any better than I did when I stopped using pellets. I'm paying more money, sticking myself seven times a week and introducing a lot of substances into my body and just don't feel good. I felt great for six months when I started with Defy and I'm looking to get back there. In her opinion, my blood work 'looks great' and I should be feeling great.

Do y'all mind taking a look at the attached? Does anything jump out that might give a clue as to what is going on? Any tips, suggestions, etc would be much appreciated!
 

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Defy Medical TRT clinic doctor
The only thing I can think of, maybe you need to lower your dose of testosterone even more. Other than that, your labs look pretty good. But for some reason, some men just do better at lower levels.
 
Thanks for the reply! How would you feel about dropping the anastrozole? Before I started taking it, I was at 37 and my last labs showed 31. I know everyone reacts differently, just curios what your thoughts might be. Thanks again for the input...
 
Whew, I know I would not feel good at those high of T levels and E2. I do MUCH better in the 550-800 range. My FT and E2 are in range as well with no need of an AI. You definitely have some room to lower your dose and see if that helps.
 
Thanks for the reply! How would you feel about dropping the anastrozole? Before I started taking it, I was at 37 and my last labs showed 31. I know everyone reacts differently, just curios what your thoughts might be. Thanks again for the input...
Yes I agree, I would drop the anastrozole.
 
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I am going to post my most recent lab work and an bit of history of where I am and how I feel. I was with Low T Nation for three years before switching to Defy Medical summer of 2019.

When I left Low-T. this was my regiment: .35ml test cyp twice a week IM...HCG 200iu twice a week...Ipamorelin CJC 1295 daily, at night...felt kinda blah and was not impressed with the care I was receiving.

Upon moving to Defy, my regiment changed to: .35ml test cyp twice a week subq...HCG 250iu twice a week...discontinued Ipamoreline CJC 1295...started Anastrozole .125 twice a week...started T3/T4 each morning.

All was going well physically and mentally until three months ago. I felt like I hit a wall...hard to concentrate...PMSing...hard to focus...no sex drive...hard to stay interested in things, etc. I called Defy and I had a return call to speak with a PA, though I cannot recall her name. She changed my protocol as follows:

Increase test cyp slightly by injecting .25ml three times a week rather than .35ml twice a week...stay subq...increase HCG from 200iu to 500iu twice a week...start injecting B-12 twice a week...one ml each time...everything else stays the same. The PA stated that increasing the HCG might help with the loss of sex drive?

So, now jump forward to now. I had my consult a couple of back with a lady by the name of Michelle (?) and I explained that my symptoms had not really improved since the changes mentioned in the paragraph prior to this consult, which was 90 days prior to the blood work being done.

So, my protocol has now been changed to the following: decrease test cyp from .25ml three times a week to .20ml three times a week...reduce HCG from 500iu twice a week to 250iu twice a week...discontinue the anastrozole...continue with T3/T4 and B-12.

My estradiol had decreased fro 37.1 to 31.3, so I'm uncertain as to why I am going to stop taking it, but I have to assume they have a reason.

Attached is my most recent blood work, The last set of changes I wrote about occurred after the results if this lab work was obtained. You will see - written in red - the levels of those items when I had blood work drawn earlier in 2020. I thought it might be helpful for y'all to see some of the changes.

I mentioned to Michelle that i cannot say I feel any better than I did when I stopped using pellets. I'm paying more money, sticking myself seven times a week and introducing a lot of substances into my body and just don't feel good. I felt great for six months when I started with Defy and I'm looking to get back there. In her opinion, my blood work 'looks great' and I should be feeling great.

Do y'all mind taking a look at the attached? Does anything jump out that might give a clue as to what is going on? Any tips, suggestions, etc would be much appreciated!


First off I would not rely on the direct FT assay and you should be getting the most accurate assay such as the gold standard Equilibrium Dialysis or Ultrafiltration if you want to know where your FT trough truly sits on such protocol (dose T/injection frequency).

Seeing as your trough TT 1483 ng/dL is absurdly high and your SHBG is average 33.4 nmol/L along with albumin 4.4 g/dL right around the mean (4.3) than your FT levels at the trough would be very high.

I would definitely retest FT using an accurate assay and you most likely have room to decrease your dose let alone possibly drop the use of an AI which can also be causing issues.

Most men do well having FT in the 20-30 ng/dL range and many tend to aim for the top end mind you others feel much better running lower levels.

I would say your FT levels are well over the top end of such protocol (dose T/injection frequency).



Retest your FT (ED or UF):


 
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