TRT for 4 months - No change in labs

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So I started TRT about 4 months ago. My protocol I was put on was .25ml of test cyp 200 3 x a week with HCG 500 iu 2 x a week. Additionally, I take anastrozole 2 x a week.

My lab work came back and my levels are as follows:

Total test: 317
Free Test: 7.3
Estrogen: 2.9
SHGB: 24.2


I am confused as to why my test levels would not have come up. Note, I do subq injections. I have a call with the PA but just wanted to get others opinions. It seems at 150mg of Cyp a week, my test levels would be a little higher?

Let me know if you want to know any other lab values. I tried to include the important ones.

 

[Systemlord]

We see men who go from IM injections over to SQ injections see T levels decrease. It could also be because you are a hyper T metabolizer or hyper excreter or a combination of both.

You shouldn't be on an AI unless labs confirm high estrogen and symptoms are present.

Do you have pre-TRT labs?

 

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We see men who go from IM injections over to SQ injections see T levels decrease. It could also be because you are a hyper T metabolizer or hyper excreter or a combination of all.

This is my first time on TRT so I haven't done IM before. I haven't really noticed much of a change in my well being, except for a 24-36 hrs window after the HCG. I feel pretty good after my HCG on Mon and Wed.

 

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Does body habitus play a role in TRT levels? I am 6'3 ~250lbs around 18% bf

 

[mooseman109]

I think what system lord is saying, is some folks do not do as well with sub q as with IM. Most of us do shallow IM with a 27-30 gauge needle 1/2" long. Into leg, glue, shoulder.
Yes body weight can effect testosterone, usually in big guys, like overweight significantly.
Did you get your SHBG tested as well?

 

[Nelson Vergel]

Where are you getting your testosterone cypionate? Does the vial contain 100 mg/ml or 200 mg/ml?
As Systemlord said, you may be a hyper metabolizer. No data exists on body weight and T levels, but I would assume that bigger guys indeed need a higher dose.

 

[stick_figure]

I think what system lord is saying, is some folks do not do as well with sub q as with IM. Most of us do shallow IM with a 27-30 gauge needle 1/2" long. Into leg, glue, shoulder.
Yes body weight can effect testosterone, usually in big guys, like overweight significantly.
Did you get your SHBG tested as well?

SHGB is in my post. 24.2

 

[stick_figure]

Where are you getting your testosterone cypionate? Does the vial contain 100 mg/ml or 200 mg/ml?
As Systemlord said, you may be a hyper metabolizer. No data exists on body weight and T levels, but I would assume that bigger guys indeed need a higher dose.

I get my Cyp from Empower, I currently get my treatment from Defy. It is 200mg/ml.

 

[Sean Mosher]

Your estrogen level is non existent, which is no bueno.
Upping the dose or going to every day and getting that fixed I would think needs to be priority #1 at the moment.
How much anastrozole are you taking?
Twice a week at what dose?

 

[stick_figure]

We see men who go from IM injections over to SQ injections see T levels decrease. It could also be because you are a hyper T metabolizer or hyper excreter or a combination of both.

You shouldn't be on an AI unless labs confirm high estrogen and symptoms are present.

Do you have pre-TRT labs?

Sorry I missed this. Yes I had pre-TRT labs.

Pre-TRT Labs:

Total T: 357
Free T: 8.9
LH: 5.1
Estrogen: 24.7
SHGB: 26.6

Let me know if you want to know any other labs.

 

[stick_figure]

Your estrogen level is non existent, which is no bueno.
Upping the dose or going to every day and getting that fixed I would think needs to be priority #1 at the moment.
How much anastrozole are you taking?
Twice a week at what dose?

I believe it is .125mg

 

[stick_figure]

So I just got off the phone with my PA and he believes the Estrogen lab wasn't correct and it may be part of the LabCorp problem. My lab draw was on 09.12.18.

He raised my test to .3mls 3 x week and suggested another lab draw for my testosterone in 4 weeks to ensure that level was correct as well.

 

[Systemlord]

I believe it is .125mg

You are an AI over-responder like myself, I dissolve my 0.050 anastrozole (Defy Medical/Hallandale) in 5mls of vodka and dose .2mls using glass graduated droppers I got off Amazon. I'm going to be creating a thread that shows how to do it in about a week.

If it was the standard E2 testing, you can bet estrogen is even lower.

 

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H

You are an AI over-responder like myself, I dissolve my 0.050 anastrozole (Defy Medical/Hallandale) in 5mls of vodka and dose .2mls using glass graduated droppers I got off Amazon. I'm going to be creating a thread that shows how to do it in about a week.

If it was the standard E2 testing, you can bet estrogen is even lower.

Honestly I dont believe the labs results are accurate. I am going to get more lab work down in 4 weeks and we will find out if those numbers are true or not.

I have a hard time believing that i could function and still get an erection with my estrogen being thay low. I dont have any joint pain or moodiness, i just feel a little tired.

 

[captainbud30]

I get my Cyp from Empower, I currently get my treatment from Defy. It is 200mg/ml.

Do these sites check your blood cell count and platelets?
How much for test cyp?

 

[fifty]

Yes.
And about $120

 

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Do these sites check your blood cell count and platelets?
How much for test cyp?

Hemo was 47

 

[Vince Carter]

Id move from 3x per week to EOD with the SHBG @ 24. Same cumulative dose just split it up more and stop any AI use. At your next set of labs if it's affordable for you run the Sensitive E2 LC/MS/MS, AND, run "Estradiol, Free". Ultimately your dosing should get your trough Free T to the lab rang and not much over that.

 

[stick_figure]

Id move from 3x per week to EOD with the SHBG @ 24. Same cumulative dose just split it up more and stop any AI use. At your next set of labs if it's affordable for you run the Sensitive E2 LC/MS/MS, AND, run "Estradiol, Free". Ultimately your dosing should get your trough Free T to the lab rang and not much over that.

Thanks for the advice. When I spoke to the PA yesterday he expected my Free T to be around 800 and was quite shocked it was so low. So he bumped up my dosing. I also have a Free T and Total T lab on file at the lab from my PCP, before I started with Defy.

I am planning on getting my labs redrawn tomorrow to see if my last lab results were even accurate.

 

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I just wanted to update this. To recap -> My first labs after starting TRT were:

Total test: 317
Free Test: 7.3
Estrogen: 2.9
SHGB: 24.2

The protocol was:
.25ml cyp 200m/ml 3 x week m/w/f
hcg 500iu 2 x week m/f
anastrozole 2 x week

After that I had my consult and he changed my protocol to:
.3ml cyp 200m/ml 3 x week m/w/f
hcg 500iu 2 x week m/f

My estrogen was super low, so I stopped taking the anastrozole all together. I have been on this protocol for about 60 days now and my recent labs came back as this:

TT: 468
Free T: 11.1
estrodial, sensative: 18.1

I am still a little suprised at the TT being only at 468. I am currently taking everything subq. I might try and switch to IM injections to see if that helps at all. Just wanted to know your guy's thoughts on this..

** Edit: I know Vince mentioned to trying moving to EOD inj. Do you think that would help? like .25ml EOD? That should put me at a similar dose.

Also, I forgot to mention, I am finally starting to feel a little better. After years being in the low 200s, it is nice to start to feel a little normal.