Very Odd blood results. advice. Kel?

[PJS19]

Got my results, blood taken 24 days post clomid. (On clomid my LH was 8 and T 600's.) Currently not on any sort of T therapy. That was my second attempt at a clomid restart.

Total test. 730 (250-1100) Awesome right?

Free Test. 53.5 (46-224) Way lower in relation to my Total T. Not good!

Bio available T. 107 (110-575) LOW

SHBG 69 (10-50) HIGH. Clomid really rises my SHBG I think.

Estradiol ultrasensitive 28 (<29) Good, especially since Ive had e2 at 6 and 7 in the past.

DHEA Sulfate 363 (110-510)

LH 2.7 (1.5-9.3) I expect this to keep dropping.

Prolactin 10 (2-18)

Vit D3 67 (30-100)

Vit D2 <4 (no range given)

Total Vit D 67 (30-100)

All blood counts were in range so I wont post them.

I expect for LH to drop further, as last time I tried clomid it took 3 months post clomid to drop down to below range. This test was only 24 days post clomid. Also, I am on wellbutrin, which can indirectly raise total T levels.

Also, Quest always seems to come up high for total T for me. On blood work 2 weeks apart, one from my local hospital, one from quest, quest came in at 600 while hospital lab was high 380. (This was months ago before any T therapy). Free T always comes up low.

Symptoms. Depression/lack of motivation/emotional numbness. BACK PAIN. JOINT weakness. Low libido. Hard to get an erection, but can. Overall weakness/ Lack of energy.

Advice?

[FRDave]

Free test is most important, regardless of total test. I would re-test again in another 4-6 weeks and see if the SHBG drops. If so, your free test should go up a bit, but most likely not enough.

Looks like TRT may be your best bet.

[kelkel]

Read this: (shbg/E2 correlation)

The effect of clomiphene citrate on sex hormone... [Int J Androl. 1981] - PubMed - NCBI

How old are you PJS?
What was ruled out initially for the doc to put you on clomid?

[slates]

Given your LH of 2.7, I expect your total T to keep dropping and probably settle in the 300-400 range.

Unless your hypgonadism is due to AAS usage, I don't see how a Clomid restart would actually work. Sure Clomid can boost T while you're taking it, but once you stop, your body goes back to its genetically programmed hormone levels. You need to keep taking Clomid for it to work.

[PJS19]

Age 23. 5'9". 165. MRI was fine. Will going on TRT lower my shbg? . All the results are bad, free bio lh, except total is very good. Im still gonna give trt a shot. LH will just keep sinking. Im not doing clomid again, it doesnt make me feel better and LH drops once i stop it

[PJS19]

I meant to ask.. Will Test shots lower SHBG? I heard once a week shots are best for lowering shbg because the large dose. Is this true?

[kelkel]

As test rises it suppresses shbg. Once per week shot better to lower it? Only BW would really show how you respond to this. The larger shot will definitely lower it more but then it has more time to rise throughout the rest of the week. Or would twice per week keep it at a more consistent, moderate level? BW, BW, BW.

[PJS19]

Ok thanks Kel, I just thought I saw austinate say somewhere that front loading T lowers shbg better. I could have read it wrong.

I am going to request to start at 100mg once a week. and then go to two a week after seeing blood work, if need me, before starting an AI.

is 100 mg a good starting dose? IM best?

my appt is next week Im basically going to say, look I feel horrible, my bio and free T are in the gutter, LH is going to keep dropping, lets just try TRT now because last time I went off clomid LH eventually tanked too.

I will suggest... 250 IU HCG tuesday. 250 IU HCG wednesday 100 mg Test cyp Thursday.

If needs to be split up after blood work. I will go hcg MWG test cyp 50mg mon thurs

thoughts? good start?

[kelkel]

Ok thanks Kel, I just thought I saw austinate say somewhere that front loading T lowers shbg better. I could have read it wrong.
Austin's sharp but I do not know the context of the conversation. Front loading would lower it simply due to it being a larger dose of T. You need stability, not large swings.

I am going to request to start at 100mg once a week. and then go to two a week after seeing blood work, if need me, before starting an AI.
100's a great starting point.

is 100 mg a good starting dose? IM best?
I prefer IM but SQ is proven effective as well. Personal preference.

my appt is next week Im basically going to say, look I feel horrible, my bio and free T are in the gutter, LH is going to keep dropping, lets just try TRT now because last time I went off clomid LH eventually tanked too.

I will suggest... 250 IU HCG tuesday. 250 IU HCG wednesday 100 mg Test cyp Thursday.

If needs to be split up after blood work. I will go hcg MWG test cyp 50mg mon thurs

thoughts? good start?

Sounds good.

[PJS19]

Thanks Kel for the quick reply. I am going to start IM, I have a family member who is a nurse who can administor shots for me until I get the hang of it. If I split up into doses, I will probably do both sub Q. I just feel like IM is where most start with, and see if sub q works for them after feeling better . I dont have time to waste to expirement with sub q, I just need to feel better as soon as possible, as I can barely function and its been almost a year ive felt this way.

Thanks again Kel, we all appreciate the time you take to help out the less knowledgable.