Struggling with bloodwork consistency. TRT bloodwork included.

[BeardedButcher55]

Started TRT through a clinic and I didn’t have much if any guidance on dose. Was put on 200mg Test Cyp a week and .5mg Arimidex 2x a week. I followed this for about 2 years. Bloodwork numbers were hard to follow because each doctor through the clinic basically just said “everything looks good” but when I looked at my numbers nothing looked good. I felt like starting at 200mg a week was high but found this was the dose all their patients get regardless. (Probably a bad sign). I ultimately dropped down to 160mg.

I decided paying the clinic so much wasn’t worth it so I consulted with my primary doctor who suggested I go through him as my insurance covered it. He’s not an expert but willing to listen to my concerns and work with me to be optimal for how I should be feeling as well as being safe.

Note: I feel like that I definitely convert more to estrogen and have suffered the side effects more so than others.

Current TRT protocol:

-140mg a week of Test Cyp. Single IM dose on Mondays.
-1mg Arimidex on Mondays. 1mg Arimidex or Thursday.
-No processed foods. Low carbohydrate with high fat and moderate protein from meat. High water intake. 7-8 hours of quality sleep every night.
-Blood donations as needed to maintain RBC, hematacrit, etc. Was doing double reds every 6months but switches to full donations as I can do them more often.


Bloodwork timing question: I can’t seem to get my timing right as far as when I should get my blood test.

Bloodwork timing as of the last blood test: TRT injection (140mg) on Monday early morning. Bloodwork test on Thursday early morning.



I was doing 2x a week of a split dose but injections so often was annoying. I do understand it might help level my numbers better and help with estradiol.

 

[WhiteMale]

I have low SHBG and I like my E2 number to mirror my SHBG value. You stated E symptoms and you're still bothered by whatever you're feeling so push it a little lower. I don't think your numbers or dosing is otherwise troubling, keep it simple and just push your E2 a little lower. Ideally you want to time your bloods on Monday morning for your trough and then do your injection, since you're injecting once per week.

 

[BeardedButcher55]

My symptoms are not so bad but I don’t feel amazing like I did before. Sex drive is not particularly high.

 

[Vince]

I would inject 50 mg of testosterone twice a week. And that's it, no ai. See how you feel in about 12 weeks. Also, I would donate blood at least once to keep your HCT in range

 

[BeardedButcher55]

I would inject 50 mg of testosterone twice a week. And that's it, no ai. See how you feel in about 12 weeks. Also, I would donate blood at least once to keep your HCT in range

I was thinking I could lower it and be able to drop AI. When do you suggest the bloodwork to be done as far as injection schedule

 

[Systemlord]

The AI can deceive you into thinking your estrogen is fine, when in reality, serum E2 means very little. Estrogen is converted, made in tissues (50 x higher than serum levels) which can't be measured and this it's where estrogen exerts its effects and you're blocking estrogen inside the tissues.

You can have a magneesium, or potassium deficiency and still have normal serum levels. The tissues is where the magic happens.

Also, depending on the location in the body, the brain converts estrogen at a higher rate than other areas of the body, yet you're blocking estrogen eveningly through the body.

 

[Vince]

I was thinking I could lower it and be able to drop AI. When do you suggest the bloodwork to be done as far as injection schedule

When I change my protocol, I like to wait at least 12 weeks before I get labs. That's how long it takes me to actually feel my results.