1st 6-week labs. T much better, but estradiol climbing. AI advice? Feedback?

Labs drawn right before starting TRT:

Code:

Lipid Panel Cholesterol, Total 257 [100-199] Triglycerides 282 [0-149] HDL Cholesterol 42 [>39] VLDL Cholesterol Cal 56 [5-40] LDL Cholesterol Cal 159 [0-99] Thyroid Panel TSH 2.060 [0.450-4.500] Thyroxine (T4) 8.8 [4.5-12.0] T3 Uptake 31 [24-39] Free Thyroxine Index 2.7 [1.2-4.9] Testosterone, Serum 236 [348-1197] Testosterone, Free 10.45 [5.00-21.00] % Free Testosterone 4.43 [1.50-4.20] PSA 0.4 [0.0-4.0] IGF-1 177 [64-210] Estradiol, Sensitive 13 [3-70]

Doc didn't want to see me for 3 months, so I decided to get my own labs. The labs below were exactly 6 weeks after starting treatment and 3.5 days after one of my injections (I'm injecting 50mg Test C 2x/week - Sun PM/Thu AM). Lipids look a little better. I did have a couple weeks of Red Yeast Rice in there, but had to stop due to pretty severe muscle aches. I've had problems taking statins in the past. Have been cleaning up diet and have been back to exercising regularly for about the past 4 weeks. Started 3 weeks ago going to Bikram Yoga 3x/week + walking a few miles 2x/week.

Overall, I feel a LOT better. Depression, mental fog, lethargy are gone. Hopefully all of this will help me to get back on track with improving my whole diet/exercise situation. Libido and bedroom activities have improved some.

RBC's seem to be creeping back up fairly quickly after donating blood... I'm technically not "eligible" to donate again until 2/14. I went ahead and donated some blood yesterday at a different blood bank.

My current protocol:

50mg Test C every 3.5 days (Sun PM/Thu AM)
250u HCG every M-W-F
5000 u Vit D 2x/day
2400 mg Fish Oil 2x/day (recently "upgraded" to better quality fish oil)
500mg Extended Release Niacin 2x/d
300mg COQ10 1x/d
50mg DHEA 1x/d
50mg Pregnenolone 1x/d

Code:

WBC 5.8 [4.0-10.5] RBC 5.64 [4.14-5.80] Hgb 15.8 [12.6-17.7] Hct 48.4 [37.5-51.0] Chol, Tot 191 [100-199] Trig 158 [0-149] HDL 35 [> 39] VLDL 32 [5-40] LDL 124 [0-99] Test, Total 631 [348-1197] Test, Free 29.09 [5.0-21.00] %Free 4.61 [1.50-4.20] Estradiol 46 [3-70] SHBG 10.4 [16.5-55.9]

My main concern at this point is that my estradiol went from 13 to 46 in just 6 weeks. What would you guys recommend here? Also, it doesn't look like the estradiol was a significant contributor to my arthritis issues. Even though it's come up, some of my joints still hurt like hell.

These labs were drawn last Thursday and I felt better the week before that. I feel OK now. Definitely better than before I started TRT, but not as good as I felt a couple of weeks ago...

So what would you guys recommend? I have Liquidex on hand. 0.25 mg 2x/week?

Torqued good job on getting your cholesterol down like you did!

High e2 can make your joints hurt as well as low.

and I would say .25 2 times per week would be a good place to start.As i learned here its better to start low and increase dose if need be than to crash your estrogen!

Agree with the above, keep an eye on your RBC, Hgb and Hct.. They will creep up on you so go donate blood asap to keep those numbers in the normal range.. You can also try SubQ injections at your love handle area to keep E2 levels down too.. Possibly switch off between IM and SubQ..

Personally I don't believe that sub q injections keeps E2 down. From what I can tell, a lot of people are getting lower test levels from sub Q injections, which is probably why people are noticing less E2 symptoms (since having less test will result in less E2). If, you are injecting 150mg a week IM, and getting Test=800ng/dl, and E2=40, and then go to 150mg a week Sub-q and are getting Test= 500ng/dl, and E2=25, that is not exactly a fair comparison. I would bet in that case that if you were to take whatever sub Q dose is neccesary to produce a 800ng/dl test level, you are going to end up with the same amount of E2.

Regarding E2 control. If you are feeling good mentally, energy wise, in the bedroom, etc... it is not neccessary to do anything. You don't have to shoot for a number on a piece of paper just because other people say a certain number is best. Different numbers can be best for different people.

Now, if there is a problem in some of those areas then the best E2 control imo is liquid Aromasin. I've tried just about every type of E2 control out there, and Aromasin seems to be the easiest to control because it is a suicidal inhibitor. The problem with arimidex is that if you go to low in E2, and reduce your dose, or stop it for a couple days, you get a flood of aromatase, which can send you on a roller coaster ride. But, if you go too low on Aromasin, you can easily transition to a different dose without worrying about E2 rebound.

The dosing of Aromasin kind of depends on frequency of injections imo. Personally I have frequent injections, so I elect to take aromasin every day. Easiest way I found is to start very small (1mg a day) and go with that for a bit, then increase it to 2mg a day, etc... untill you find a good dose.

Quote:

Originally Posted by 38onTRT

Agree with the above, keep an eye on your RBC, Hgb and Hct.. They will creep up on you so go donate blood asap to keep those numbers in the normal range..

I am. I donated yesterday afternoon. Based on how my HCT recovered since the last donation, I'm going to put myself on a schedule to donate every 5 weeks.

I wish my free test was that high

What stands out most to me is that your SHBG is extremely low. While there are some links with why this happens in some men, it definitely is not 100% figured out. The most common cause that pops up is insulin resistance. It's worth considering at the very least.

But from a practical standpoint, this might indicate more frequent injections because I believe very low SHBG like yours might put you at a greater risk for aromatizing that testosterone. It's worth considering 3 times a week injections. Whether or not you want to trial subQ is up to you of course, but it works well for many men, including myself.

You might be able to lower the dose with more frequent injects, although for the time being, id probably just leave the dose/week the same because you're FEELING much better, which is what this is all about.

Donating blood so often would raise my concern about your iron stores being run too low. Personally, I would be monitoring my ferritin and iron.

Quote:

Originally Posted by HRTstudent

What stands out most to me is that your SHBG is extremely low. While there are some links with why this happens in some men, it definitely is not 100% figured out. The most common cause that pops up is insulin resistance. It's worth considering at the very least.

Bro, am I correct in saying that Diet "could" be a culprit in this situation? My SHBG was low too, however have since made DRASTIC changes in my diet.. Am going to test my SHBG in my next BW so hopefully it works...

Quote:

Originally Posted by HRTstudent

What stands out most to me is that your SHBG is extremely low. While there are some links with why this happens in some men, it definitely is not 100% figured out. The most common cause that pops up is insulin resistance. It's worth considering at the very least.

But from a practical standpoint, this might indicate more frequent injections because I believe very low SHBG like yours might put you at a greater risk for aromatizing that testosterone. It's worth considering 3 times a week injections. Whether or not you want to trial subQ is up to you of course, but it works well for many men, including myself.

You might be able to lower the dose with more frequent injects, although for the time being, id probably just leave the dose/week the same because you're FEELING much better, which is what this is all about.

Donating blood so often would raise my concern about your iron stores being run too low. Personally, I would be monitoring my ferritin and iron.

It very likely could be related to insulin resistance. I'm a candidate for metabolic syndrome - obese w/ belly fat, elevated BP, elevated lipids. A big part of my problem with exercising was that I just felt like crap and had no motivation... that lack of motivation also manifested itself in my diet. Even if I forced myself to exercise, I just couldn't seem to make any gains/improvement. With just getting started on TRT several weeks ago and exercising regularly for about the past month, I can already tell it's making a difference. Have only lost a couple of pounds, but my clothes are fitting a little better and people are asking me if I've lost weight... I got started back to Bikram Yoga 3x/week (90 minutes of hot yoga) a few weeks ago and the rate of improvement since I started back has been pretty surprising.

I'll keep an eye on my iron. Reviewing past labs, it looks like my Hct and Hgb tend to hang out on the upper end of the range. In 6 weeks, my blood counts were back to where they were before I donated blood the last time. Last Thurday, HCT was 48.4. When I donated yesterday, I was already back up to 50 and I was well hydrated. I actually feel better after having donated blood yesterday - less mental fog.

My next endo appointment is in early March. I think I'll add a little AI and not change anything else for now. I want to see what the next set of labs says, what the endo has to say, and what the guys checking out the new Low T clinic in Houston have to say before I decide what my next step is going to be. Maybe with an AI in the mix, I can back off of my test dose some and switch to SubQ. I'm just a little wary of switching after just one set of data points/labs.

Quote:

Originally Posted by 38onTRT

Bro, am I correct in saying that Diet "could" be a culprit in this situation? My SHBG was low too, however have since made DRASTIC changes in my diet.. Am going to test my SHBG in my next BW so hopefully it works...

I'm curious... what changes did you make to your diet? And what info did you find that led you to give these changes a try?

Thanks for the feedback, guys. I really appreciate it.

Your hematocrit can still be elevated despite low iron stores, so if you can afford it, it's worth (IMO) checking serum iron and ferritin.

And yes, diet could be a culprit in SHBG. For what its worth, though, diet is probably the biggest culprit/player in most of our health. Its just a lot harder to make it "right".

Quote:

Originally Posted by Torqued

Labs drawn right before starting TRT:

Code:

Lipid Panel Cholesterol, Total 257 [100-199] Triglycerides 282 [0-149] HDL Cholesterol 42 [>39] VLDL Cholesterol Cal 56 [5-40] LDL Cholesterol Cal 159 [0-99] Thyroid Panel TSH 2.060 [0.450-4.500] Thyroxine (T4) 8.8 [4.5-12.0] T3 Uptake 31 [24-39] Free Thyroxine Index 2.7 [1.2-4.9] Testosterone, Serum 236 [348-1197] Testosterone, Free 10.45 [5.00-21.00] % Free Testosterone 4.43 [1.50-4.20] PSA 0.4 [0.0-4.0] IGF-1 177 [64-210] Estradiol, Sensitive 13 [3-70]

Doc didn't want to see me for 3 months, so I decided to get my own labs. The labs below were exactly 6 weeks after starting treatment and 3.5 days after one of my injections (I'm injecting 50mg Test C 2x/week - Sun PM/Thu AM). Lipids look a little better. I did have a couple weeks of Red Yeast Rice in there, but had to stop due to pretty severe muscle aches. I've had problems taking statins in the past. Have been cleaning up diet and have been back to exercising regularly for about the past 4 weeks. Started 3 weeks ago going to Bikram Yoga 3x/week + walking a few miles 2x/week.

Overall, I feel a LOT better. Depression, mental fog, lethargy are gone. Hopefully all of this will help me to get back on track with improving my whole diet/exercise situation. Libido and bedroom activities have improved some.

RBC's seem to be creeping back up fairly quickly after donating blood... I'm technically not "eligible" to donate again until 2/14. I went ahead and donated some blood yesterday at a different blood bank.

My current protocol:

50mg Test C every 3.5 days (Sun PM/Thu AM)
250u HCG every M-W-F
5000 u Vit D 2x/day
2400 mg Fish Oil 2x/day (recently "upgraded" to better quality fish oil)
500mg Extended Release Niacin 2x/d
300mg COQ10 1x/d
50mg DHEA 1x/d
50mg Pregnenolone 1x/d

Code:

WBC 5.8 [4.0-10.5] RBC 5.64 [4.14-5.80] Hgb 15.8 [12.6-17.7] Hct 48.4 [37.5-51.0] Chol, Tot 191 [100-199] Trig 158 [0-149] HDL 35 [> 39] VLDL 32 [5-40] LDL 124 [0-99] Test, Total 631 [348-1197] Test, Free 29.09 [5.0-21.00] %Free 4.61 [1.50-4.20] Estradiol 46 [3-70] SHBG 10.4 [16.5-55.9]

My main concern at this point is that my estradiol went from 13 to 46 in just 6 weeks. What would you guys recommend here? Also, it doesn't look like the estradiol was a significant contributor to my arthritis issues. Even though it's come up, some of my joints still hurt like hell.

These labs were drawn last Thursday and I felt better the week before that. I feel OK now. Definitely better than before I started TRT, but not as good as I felt a couple of weeks ago...

So what would you guys recommend? I have Liquidex on hand. 0.25 mg 2x/week?

Bro your labs are almost identical to mine except your 2 test results. I can only wish my was like your second one. Got a bump of 70-80 in total test. E2 is 12