TRT Serum increase post Varicocele Surgery

[DJMikeT]

Hey guys,

So it's been a little over 7 weeks since I had my surgery for a really large Varicocele done. Last week I had an extensive blood panel ran independently of my doctor and I've noticed a significant spike in my Test Serum levels. Listed below are blood work results before and after.

Blood work 05-03-2018 (Doctors Office Labs)

Test Level ng/dp = 904 (Std Range 300-890)
Free Test pg/ml = 170.5 (Std Range 47.0-244.0)
IGF-1 = 96 (Std Range 55-168)
Estradiol = <17.0 (Std Range <=60.7)


Blood work 07-11-2018 (PrivateMd Labs)

Test Serum = 1321 (Ranges = 264-916)
Free Test = 42.14 (Ranges = 5.00-21.00)
% Free Test = 3.19 (Ranges = 1.50-4.20%)
IGF-1 = 210 (Ranges = (67-205)
Estradiol Sensitive = 48.1 (Ranges = 8.0-35.0)
Growth Hormone Serum = 1.2 (Ranges = 0.0-10.0)

My TRT dosage has not changed since I've started on 04-23-2018.

My dosage is .3ml / E3D which comes out to approximately 165mg / week of Test Cyp. 200mg/ml

My HCG dose is 300ui / E3D

The only thing that has changed outside of the surgery is that I started taking a low dose of HGH on 06-05-2018 @ 2ui / ED

So two things have happened, one my Test went from
904 to 1321 and my Estrogen has gone up as well. My Estrogen was in range prior to this spike.

So my main question is, did the repair of the Varicocele have that much impact or is the HGH causing the spike or a combo of both?

I'm going to cut back my TRT dosage to .25ml / E3D which would put me at 150mg / week versus the current 165mg / week and then have another blood panel ran in a few weeks.

Also going to start the Adex my doctor prescribed, just waiting on my eye droppers and bottles to come in tomorrow so that I can use YouthfulGuys vodka method.

If any of you Veterans have any insight on what caused the Test Level spike, I really appreciate the feedback.

Thanks in advance as always,
DJ

[Youthful55guy]

I have no idea if the surgery affects response from HCG. It's certainly not endogenous production due to LH, as your LH should be zero on TRT.

Be VERY carful about combining an AI with a dose cut back. Personally, I'd layer in the dose cut back and then the AI if it is still needed. That way, you'll know approximately how much is due to each variable if in the future you need to make further adjustments.

[DJMikeT]

I have no idea if the surgery affects response from HCG. It's certainly not endogenous production due to LH, as your LH should be zero on TRT.

Be VERY carful about combining an AI with a dose cut back. Personally, I'd layer in the dose cut back and then the AI if it is still needed. That way, you'll know approximately how much is due to each variable if in the future you need to make further adjustments.

That's sound advice, as I was fine on Estrogen before my Test went from 904 to 1341. I will drop dosage and then run another blood panel to see where I'm at.
My Doctor said there would be some improvement on Test Production on the affected testicle but man a jump of 437 is pretty significant.

Do you think the HGH is playing a role in that, just curious as I'm only running 2ui per day?

[Youthful55guy]

That's sound advice, as I was fine on Estrogen before my Test went from 904 to 1341. I will drop dosage and then run another blood panel to see where I'm at.
My Doctor said there would be some improvement on Test Production on the affected testicle but man a jump of 437 is pretty significant.

Do you think the HGH is playing a role in that, just curious as I'm only running 2ui per day?

I can see only two possibilities:

1) Your testicles are responding better to HCG, which makes me wonder if you even need TRT anymore. Food for thought.


2) For some reason I can fathom, your SHBG increased and the increased Total T is a result of it being protected better form liver metabolism. If that's the case, your Free T might not have changed much, or even gone down.


Of the two, I think #1 is the most likely.

[DJMikeT]

I can see only two possibilities:

1) Your testicles are responding better to HCG, which makes me wonder if you even need TRT anymore. Food for thought.


2) For some reason I can fathom, your SHBG increased and the increased Total T is a result of it being protected better form liver metabolism. If that's the case, your Free T might not have changed much, or even gone down.


Of the two, I think #1 is the most likely.

Thanks for the input YouthfulGuy, I'm not sure about going off TRT though. I haven't seen my Test Levels at 500 or higher since I was about 44 and I'm 49 now. I don't have all my records on hand but here's the last several years.

04-18-2018 = 202 ng/dL
09-20-2017 = 360 ng/dL
11-16-2016 = 352 ng/dL

As you can see I've been at the low end of the spectrum for several years before it got down to 202 and I really felt like crap. I recall about 5 years ago that my wife ask me to get checked because we weren't having sex as often.

I'm really feeling great now, more energy than I've had in a long time, better overall mood, and my sex is back to where it was when my wife and I first met when I was 39.

It is something to think about and perhaps discuss with my doctor but I'd hate to come off and my levels crash and then have to start all over. When my levels got into the 200s I felt really bad and had no desire to even get off the couch if I wasn't working.

One other variable is that a few weeks prior to the last blood panel I did switch brands of HCG. I had some vials that I ordered from overseas and decided to use those up before refilling my Rx from the doctor. Dosage was the same but perhaps it was stronger HCG, or is that not even a possibility?

[DJMikeT]

One last question, on my blood work from 05-03-2018, I had only been on TRT for 2 weeks. Is it possible that my Test levels were still rising and hadn't had enough time to stabilize?

[Youthful55guy]

It is something to think about and perhaps discuss with my doctor but I'd hate to come off and my levels crash and then have to start all over. When my levels got into the 200s I felt really bad and had no desire to even get off the couch if I wasn't working.

One other variable is that a few weeks prior to the last blood panel I did switch brands of HCG. I had some vials that I ordered from overseas and decided to use those up before refilling my Rx from the doctor. Dosage was the same but perhaps it was stronger HCG, or is that not even a possibility?

I can certainly relate to the first comment.

I don't think there's a difference in the manufacturing of the HCG, but perhaps the storage. I too have switched 100% from overseas to scripted HCG. Can't say I've noticed a difference or have seen a change in labs, but it is possible. When you purchase overseas, it's often 3-4 weeks in transit and in uncontrolled storage conditions. Even in it's lyophilized state, that's got to have some impact on the potency of the hormone. I came to that realization the last time I ordered overseas and walked out to my mailbox in 100+ degree weather to get my stuff. Also, I've calculated that over the long run it doesn't cost me any more than the scripted stuff (I don't submit it to insurance). That's because I've been stiffed twice by an overseas supplier that shall remain nameless. When you factor that into the cost equation, the two sources come out about the same.

[DJMikeT]

I can certainly relate to the first comment.

I don't think there's a difference in the manufacturing of the HCG, but perhaps the storage. I too have switched 100% from overseas to scripted HCG. Can't say I've noticed a difference or have seen a change in labs, but it is possible. When you purchase overseas, it's often 3-4 weeks in transit and in uncontrolled storage conditions. Even in it's lyophilized state, that's got to have some impact on the potency of the hormone. I came to that realization the last time I ordered overseas and walked out to my mailbox in 100+ degree weather to get my stuff. Also, I've calculated that over the long run it doesn't cost me any more than the scripted stuff (I don't submit it to insurance). That's because I've been stiffed twice by an overseas supplier that shall remain nameless. When you factor that into the cost equation, the two sources come out about the same.

I'm going to stick with the scripted HCG as well. Just have a couple of vials of the ordered stuff to use.

Do you think my Test levels could have still been rising and had not stababilzed and that why I'm seeing the jump now in the most recent blood work??

[kelkel]

Mike were both blood tests (pre and post surgery) done in the same time frame related to your injections?
Yes, levels could be rising after only two weeks.
GH can effect T levels for those not on TRT by stimulating the pituitary and thus leydig cell function.
Agree with 55, don't start any AI at this time.

[DJMikeT]

Mike were both blood tests (pre and post surgery) done in the same time frame related to your injections?
Yes, levels could be rising after only two weeks.
GH can effect T levels for those not on TRT by stimulating the pituitary and thus leydig cell function.
Agree with 55, don't start any AI at this time.

Pre Surgery Blood Test - Injection that day of the blood test.
Post Surgery Blood Test - Injection the day before the blood test.

So not exact but pretty close to the same.

Can the GH still have an impact one those who are already on TRT?

I'm just going to cut dosage on my Test and get blood work done in about 3-4 weeks and see where everything is then.

[kelkel]

Pre Surgery Blood Test - Injection that day of the blood test.
Post Surgery Blood Test - Injection the day before the blood test.

So not exact but pretty close to the same.

Can the GH still have an impact one those who are already on TRT?

I'm just going to cut dosage on my Test and get blood work done in about 3-4 weeks and see where everything is then.

Before or after the BW?

[DJMikeT]

Before or after the BW?

Both TRT injections prior to the blood work.

Pre surgery I did an injection that morning and then went to the doctor and he pulled blood work.

Post surgery I did an injection the day before getting the blood work.

Hope that's what you meant.