TRT Dosage advice?

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Defy Medical TRT clinic doctor
OK, added Prolactin into the mix just because why not. Checking out of LEF.org and now it's talking about shipping everything to me? Are these tests not done at a LabCorp site?

Ya same thing happened to me at checkout. I’m in Massachusetts and they said they can’t send the requisition to anyone in mass. So I just put my mothers New Hampshire address during checkout, they emailed me the requisition, I printed it out, and then went to a labcorp location in New Hampshire. Got the results a couple days later
 
Hey all - got my results today. A few things piqued my attention for sure.

I'd like to report that in the last two weeks libido and sexual function have been better than at any point since starting TRT - I'd give function a solid 6/10 and libido maybe a 5. But I am hugely grateful that I am on the right track here!!!

And the numbers: I'll list what seems to be important but I did get full CBC/CMP, happy to share any of that.

Total T: 665 (264-916), was 526 8 weeks ago
Free T: 17.1 (8.7-25.1)
DHT: 70 (30-85)
DHEA: 281 (102.6-416.3)
Prolactin: 10.1 (4.0-15.2)
Estradiol: 15.8, Roche ECLIA methodology (7.6-42.6) (was 22 four months ago)
PSA: 1.3 (0.0-4.0)
SHBG: 20.4 (16.5-55.9) (one year ago it was 25 from a different lab (10-50))
Hematocrit: 44.8 (was 50 when I was still on that idiotic dose of 100mg TC x2/week)
Albumin: 4.4 (4.0-5.0)
Bilirubin, Total: 0.3 (0.0-1.2)

So I have several questions for you all! First and foremost what you think about any of this.

Then:

1. I've never had free T tested before - how is my number? As I feel like I'm making progress but don't feel as good as I'd like yet, does it makes sense to move up from 75mg TC x2 to 80mg x2?
2. I've never tested DHT/DHEA/Prolactin - could you tell me what to look for in these numbers?
3. SHBG looks to be on the lower end of normal - should I change in injection frequency? I currently inject x2/week but I'm happy to do it more or less often if that would be beneficial.
4. WHY is my E2 so low?? I knew I likely crashed it when my idiot urologist had me on 200mg TC/wk and 1mg Anastrazole/wk - then he wanted to push me up to 1.5mg!! Anyway, it was 22 back when I was off the AIs and on 70mg TC x2/wk - why would it be lower now??

Thanks a ton for the feedback, guys!
 
Directly measured free T isn't very useful. But you have everything you need for Tru-T free T, which is 23.7 ng/dL, nicely in the middle of the healthy normal range of 16-31. However, if these are trough measurements then peak measurements could be as much as a third higher.

Prolactin is probably fine. In rare cases men with symptoms—low libido, difficulty achieving orgasm, tried everything else—will do better with it less than 10.

I'm not sure if SHBG levels respond more to peak testosterone or to average. If to peak then increasing the injection frequency will work. Otherwise it's necessary to lower the total weekly dose regardless of frequency.

I'm not sure why your estradiol is low at this time. I do occasionally see unexpected variations in my own measurements, much more so than with testosterone.
 
You sound a lot like me with your labs and protocols you've tried. You have low'ish SHBG so more frequent doses may help. It did with me. My SHBG is 17 and I went to daily injections and feel better overall.

If it were me, I'd do the following....
- Preload 7 insulin syringes at the beginning of the week and inject daily. 29 gauge 1/2' insulin syringes work great.
- Up the dose to try and stay above 800 total T at all times. Free T would be higher as well.
- No AI ( I think you've already quit that)
 
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OK - many thanks, all. Since I'm making positive progress I'm going to slightly increase my dose to 80mg x2/week - I think I'd like to see how far the x2 regimen takes me, but if I get into the above-800 range and it's still not where I want it to be, I may try daily injections. I have read that it's a different deal having naturally low SHBG vs. low SHBG as a result of TRT; mine was 25 when I started TRT, and still having quite low E2 I think I'd like to wait at least until my next round of labs and monitor things. Thanks all!
 
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