My numbers look dialed in, but I'm still not feeling great

[dfwo]

I've been on TRT since last October. I'm 44 and started with a test level of about 150.

My current routine is as follows;

Tue - 250 iu HCG
Wed - 250 iu HCG
Thu - 160 mg Test Cyp
Fri - .25 mg Arimidex

I also donate blood every eight weeks or so.

And my bloodwork I received today has my levels here;

Total Testosterone - 618 ng/dL (348-1197)
Eastradiol, Sensitive - 25 pg/mL (3-70)
(don't have free results yet)

Maybe I've just gotten used to being on the TRT and I'm not noticing the benefits as much? My energy level, libido and erections just aren't what they were a few months ago. I guess I'm at a 6/10 and I'd like to be at an 8/10.

[dfwo]

any thoughts?

[steroid.com 1]

You need to post complete bloodwork including Thyroid panels (all of them).

Not enough here to make any real evaluation.

[HRTstudent]

I've been on TRT since last October. I'm 44 and started with a test level of about 150.

My current routine is as follows;

Tue - 250 iu HCG
Wed - 250 iu HCG
Thu - 160 mg Test Cyp
Fri - .25 mg Arimidex

I also donate blood every eight weeks or so.

And my bloodwork I received today has my levels here;

Total Testosterone - 618 ng/dL (348-1197)
Eastradiol, Sensitive - 25 pg/mL (3-70)
(don't have free results yet)

Maybe I've just gotten used to being on the TRT and I'm not noticing the benefits as much? My energy level, libido and erections just aren't what they were a few months ago. I guess I'm at a 6/10 and I'd like to be at an 8/10.

What's your SHBG look like?

If its on the low end I would really think you should try more frequent shots.

Also, have you tried TRT without HCG? Some people feel worse on HCG believe it or not. It is not a positive well-being addition in a lot of people. Unless you are maintaining fertility then it might be worth considering dropping it off to test that out.

[dfwo]

This is the rest of what I have;

[dfwo]

[Vettester]

What's your SHBG look like?

If its on the low end I would really think you should try more frequent shots.

Curious on this one. As far as I know, having it (SHBG) on the lower end would reflect in some higher free testosterone values. If free test is the variable with why he isn't feeling "great", I would think it would be because it's too low, which would mean his SHBG is too high. Maybe you meant something else, not sure?

Anyways, 618 on total serum (IMO) is pretty darn good, and if you're holding a 2% to 3% (smack in the middle would be excellent) Free T score, then it would be safe to say (again, IMO) that testosterone isn't the culprit of your issues. E2 looks good, and from what I can of your thyroid panels, they look good as well.

Maybe go a little deeper into other panels, such as DHEA, B-12, Vitamin D-3, & Cortisol. Good chance you would benefit with back filling your pathways upstream with DHEA & Pregnenolone. If you haven't looked at B12 or D3, jump on it! I can't express how much both of these made a difference in my program, especially the B12 a few years ago when I was feeling similar to what you're experiencing. If given a choice, look at the methylcobalamin over the cyancobalamin for B12. A little more pricier, but WELL worth it. Your doc can even prescribe Drisdol for the Vit D, which is a 50,000iu/wk capsule. Great product if you're deficient and needing a boost, and I'll bet GD's Mercedes that you are!

[dfwo]

From my last two (not this one) blood draws, my free % were 3.58 and 3.70. So my free tends to run a little high.

(on my way out, but I'll look at the other stuff later this evening, thanks!)

[steroid.com 1]

What's your SHBG look like?

If its on the low end I would really think you should try more frequent shots.

Also, have you tried TRT without HCG? Some people feel worse on HCG believe it or not. It is not a positive well-being addition in a lot of people. Unless you are maintaining fertility then it might be worth considering dropping it off to test that out.

"...in a lot of people..."

Where you getting this from?

[steroid.com 1]

Vette said it all; I don't see anything here but a healthy man.

I would want to look at adrenals especially Cortisol next.

dfwo, have been under any life related stress lately?

[go2failure]

Vette said it all; I don't see anything here but a healthy man.

I would want to look at adrenals especially Cortisol next.

dfwo, have been under any life related stress lately?

He needs to get RT3 and Salivary Cortisol. With his numbers looking almost like mine did and still not feeling well, I'd bet his adrenals are fatigued.

[dfwo]

Vette said it all; I don't see anything here but a healthy man.

I would want to look at adrenals especially Cortisol next.

dfwo, have been under any life related stress lately?

nope, not particularly. it's odd, I know.

BTW, I also got back my free test numbers;

testosterone, free - 21/69 ng/dL (5.00-21.00)
% free testosterone - 3.51 % (1.50-4.20)

[Allaaro]

Yeah, looks okay overall....

I'd also say get DHEA/Vitamin D levels checked.

You could try shooting the test twice per week and see if that changes anything. But I have a feeling you just need more testosterone....some people need the higher range or even just slightly above to feel the best. Most docs are fine with this long term if everything else is coming back fine for bloods.

[dfwo]

But I have a feeling you just need more testosterone....some people need the higher range or even just slightly above to feel the best. Most docs are fine with this long term if everything else is coming back fine for bloods.

I hear you, but my free testosterone is already off the high end (21.69 and the range is 5.00-21.00)

[Allaaro]

I hear you, but my free testosterone is already off the high end (21.69 and the range is 5.00-21.00)

Have you ever been higher? Like ran a blast/cycle before? Be something to compare to if so.....if not, still possible you need it higher, although unlikely to get the o-k from doc on that.

Also, I notice your just taking adex once per week? It should be minimum twice....that could be causing some problems. I'd split the adex twice per week and test shots to twice per week as first try to fix things....since it would keep all dosages the same. I doubt it is DHEA since that would lead to a lower free if it was low....but I still think Vitamin D/B could be the cause.

[dfwo]

Vette said it all; I don't see anything here but a healthy man.

I would want to look at adrenals especially Cortisol next.

just browsing at what privatemdlabs.com has to offer, I see the following tests;

Cortisol Serum AM & PM $119.99
Cortisol, AM $44.49
Cortisol, Serum $49.99
Cortisol, Urinary Free (24 Hour) $79.99

any thoughts on choosing one?

[xtitan1]

just browsing at what privatemdlabs.com has to offer, I see the following tests;

Cortisol Serum AM & PM $119.99
Cortisol, AM $44.49
Cortisol, Serum $49.99
Cortisol, Urinary Free (24 Hour) $79.99

any thoughts on choosing one?

I would suggest a 4 sample 24 hour saliva cortisol test. The reason being, your total amount of cortisol for 24 hours, which is what you get with something like the urine test, won't show you snapshots throughout the day of where your levels are. You may be low in the morning, and high in the night, and come up normal with the urine one!

From STTM:
**Go here to directly order a saliva test, and type in STTM10 to get a discount. Or here to view known facilities elsewhere where you can order the 24 hour adrenal cortisol saliva test. This test can be crucial to share with your doctor.


I personally have used the ASI from Diagnos-Techs but STTM doesn't seem to like that one for some reason. That one is here.

[xtitan1]

sorry for double post

[bass]

yup i too see a healthy man here, the only thing i can think of is SHBG and Vitamin D as Vette noted. are you getting enough sleep?

[HRTstudent]

"...in a lot of people..."

Where you getting this from?

Forums and a few doctor's personal accounts.

Like many things in TRT, clinical judgment and trial and error are the only real way to know whats the best route to take...

[HRTstudent]

Curious on this one. As far as I know, having it (SHBG) on the lower end would reflect in some higher free testosterone values. If free test is the variable with why he isn't feeling "great", I would think it would be because it's too low, which would mean his SHBG is too high. Maybe you meant something else, not sure?

Well, SHBG interests me and I believe being too low could be a very strong cause to potential roller coasters with HRT. I think we are going to see a lot more talk about SHBG in the future and not simply test numbers. But we are seeing more frequent injection protocols, which is probably good all around, regardless of SHBG status.

Additionally, free test is, well... of debatable value. Sure it is almost heresy to say that, but there are some respected doctors who don't give it much CLINICAL value. I believe Dr Mariano is one of these, and he uses total testosterone (as of a couple years ago he liked that to be >600). So what does that mean to me? Well, you might have good free test, but your total test could be low or "lower" meanwhile your free test is ok or even good.

The thing with SHBG is that its going to bind up our sex hormones and, if it is high, will keep these hormones in the body longer. But if SHBG is too low then your testosterone will probably be peaking high and early and dropping off too soon. Not only is that bad for maintaining a youthful testosterone number, but it is also going to lead to more aromatization. As far as I know, the best solution here is to do a more frequent injection of a smaller quantity.

For what it's worth, when I was on 1 shot per week, my total testosterone was low-normal to normal, but my free T was almost out of range.

[Renholder]

Maybe your testosterone could be higher?

FWIW, I also doubled my testosterone without any improvement of symptoms. As of writing this, I`m feeling very good, but on average I don`t. I`m now looking into my thyroid and I suggest you do the same. You lack a full panel.

Without a properly functioning thyroid, I do not think you will reap the benefits of increased testosterone.