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TRT Bloodwork

Abzilla

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Hello All.
I went on prescribed TRT a month ago (my urologist, not an online clinic). Doc put me on 200 mg Cyp. I just got one month blood:
Total: 1238
Free: 9.2
Estradiol: 78 !!!!!
Hematocrit/Hemoglobin/Liver: All good
Before the Test #'s came in I asked for Adex since I'm holding a ton of water (puffy ankles). He prescribed: 1 mg M/W/F (seems really high). Then, the PA called saying reduce the shot to .8 ml (160mg).
I'm curious what you guys think. Reducing the shot might put me at 1000 or so that they want but I'm mostly worried that my Free is only 9 and may drop below "normal" range?
For now I'm following to the letter. It took over a year to get approved and picking up my pharma test covered by insurance is awesome and don't wanna blow it. That said, I'd love to have some feedback.
Thanks
 

Abzilla

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For TRT purposes of being on trt. Blood work showing 1000 is optimal. And lowering your trt dose to be in that optimal range doesn’t necessarily mean that your free T will go down with it . You can have high free or low free T with a wide range of total T numbers.
 

BBBG

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PS: it's been 3 months now. Blood each month. They only ran a full panel the first time, now just the testosterone and estradiol.
Was free testosterone the same all 3 bloods?

Blood tests are a snapshot at a specific moment in time. It’s helpful to look at the overall data.

And btw, your free test is in the “normal” range… which is the goal of TRT. High free test isn’t necessarily “better”. SHBG and albumin is what carries testosterone throughout your body.

The crushed e2 should concern you more.
 

Middleage

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Was free testosterone the same all 3 bloods?

Blood tests are a snapshot at a specific moment in time. It’s helpful to look at the overall data.

And btw, your free test is in the “normal” range… which is the goal of TRT. High free test isn’t necessarily “better”. SHBG and albumin is what carries testosterone throughout your body.

The crushed e2 should concern you more.
You're absolutely right. I guess maybe I'm over reacting about the Free. I'm just a bit paranoid that reducing total will push free under the line.
It wasn't the same all 3 but was directly related to the total. Obviously the first everything was crushed.
Second blood, total was 1228 and free 9.1. Estradiol was 78. Now this.
As a FYI; first panel: Prolactin was high, 20.6 ng/ml. LH (Luteinizing) Estradiol in range at 27.
My Pre injection numbers, Free 1.3 and Total about 300. BUT, I had been cruising on my own for a long while. I stopped everything two months before initial testing. Maybe that has something to do with it? Body still trying to stabilize?
Thanks so much for the help
 

Middleage

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Was free testosterone the same all 3 bloods?

Blood tests are a snapshot at a specific moment in time. It’s helpful to look at the overall data.

And btw, your free test is in the “normal” range… which is the goal of TRT. High free test isn’t necessarily “better”. SHBG and albumin is what carries testosterone throughout your body.

The crushed e2 should concern you more.
Just got my reply.
She's saying they like patients to be 500-800. Said also for symptoms it can be a little higher but 950-1000 is far too high. She added, they do not base supplementation on Free testosterone because it fluctuates to much to be a reliable reference.
Repeated to reduce Adex and so blood again in a month. The tone of the message was not good at all. I felt she was scolding me like a child for my attitude that 1000 was good. She told me anything further I should talk to the doctor when I see him in January.
Do you think I'm being unreasonable? I always felt better at 1000-1200. Maybe some is placebo effect? But wanting me at 500 seems crazy. I was 800 naturally when I was 43 years old (10 years ago).
Well thank you for the help. I really appreciate the input
 

BBBG

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Just got my reply.
She's saying they like patients to be 500-800. Said also for symptoms it can be a little higher but 950-1000 is far too high. She added, they do not base supplementation on Free testosterone because it fluctuates to much to be a reliable reference.
Repeated to reduce Adex and so blood again in a month. The tone of the message was not good at all. I felt she was scolding me like a child for my attitude that 1000 was good. She told me anything further I should talk to the doctor when I see him in January.
Do you think I'm being unreasonable? I always felt better at 1000-1200. Maybe some is placebo effect? But wanting me at 500 seems crazy. I was 800 naturally when I was 43 years old (10 years ago).
Well thank you for the help. I really appreciate the input
TRT is Testosterone Replacement Therapy. That's a long-term solution. It balances everything out. 1,000 would be awesome, but it's not going to be healthy long-term. And you are absolutely correct that it's placebo. There's no way you can "FEEL" the difference between 800 and 1,000.

TRT really shouldn't require arimidex. You didn't need that while you were natural, even in your 20s and 30s. You are overthinking all of this. Get on TRT for MONTHS and then look to reevaluate. It's a process. While the doctor does their thing, read up on TRT specifically, not just steroids in general. We would all like to be superhuman 24/7/365 for decades. That's not reality though.
 

huethemanatee11

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Yes pg/ml. The medical portal that posts my results lists the Free Testosterone Normal Range as 7.2 - 24 pg/ml. They didn't run SHBG so I can only guess it's high.
I'm really trying to find ways to raise this
i think something is up with your portal man those are female ranges. perhaps they have confused pg/ml with nmol/l or its in ng/ml . normal male range is 47-244pg/ml or round abouts. it should look something like 871ng/dl TT 245 pg/ml FT shbg 22.4nmol/l. thats right off the page of some labs i had done a few years ago.
the conversion table i used shows 8.5 ng/ml to be equal to 85pg/ml. that would be on the low side. calculated shbg would be about 122 which is pretty high.
 

huethemanatee11

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You're absolutely right. I guess maybe I'm over reacting about the Free. I'm just a bit paranoid that reducing total will push free under the line.
It wasn't the same all 3 but was directly related to the total. Obviously the first everything was crushed.
Second blood, total was 1228 and free 9.1. Estradiol was 78. Now this.
As a FYI; first panel: Prolactin was high, 20.6 ng/ml. LH (Luteinizing) Estradiol in range at 27.
My Pre injection numbers, Free 1.3 and Total about 300. BUT, I had been cruising on my own for a long while. I stopped everything two months before initial testing. Maybe that has something to do with it? Body still trying to stabilize?
Thanks so much for the help
you were on gear before? what were you on for how long and do you have bloods from that? stopping abruptly can jack shbg up. might explain the low free t. if thats the case things should level back out with time on.
 

Middleage

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you were on gear before? what were you on for how long and do you have bloods from that? stopping abruptly can jack shbg up. might explain the low free t. if thats the case things should level back out with time on.
Thanks Brother. IDK why I didn't get notification back when this posted. I'm thankful for the reply and sorry I missed it, but here we go...
I ran cycles many times. The last few years I cruised on my own. Decided I wanted a legit source. I intentionally stopped it all to crash and get approval.
Long story but basically I took Winstrol (only) to crash LH /Test to make sure I'm qualified and insurance approved. (Without that I was still 250 which would allow it).
Now it's a mess. I've lost all trust in this urologist. Saying 1000 is way way too high, putting me on 3 mg Adex/wk crashing me (felt horrible). Now 1 mg Adex/wk and he's saying reduce my shot and I should be around 500.
WHAT?!
I was always naturally very high. I had symptoms and checked 15 years ago and was 700+. Still, I felt like something was off. I got in shape, ate better, etc and felt fine. Till recently.
I don't get why he's so focused on keeping a low normal total instead of working with my symptoms?
Anyway... I spoke to my PCP. He's willing to take over the script. Of course he'll keep an eye on things, but not this insane micro management. I felt and was great when cruising on my own. Test 200 mg/wk, Adex 1 mg/wk. Blood was about 1200 Total, Estradiol 40. (75 without Adex).
Thanks.... I promised myself and my wife I was going to follow the doc's orders and get stable. Now, IDK... I'm all over the place. Doing blood monthly for the last 5 months.
Worst part; now, I need to wait 8-10 days after shot to go for blood so I can show I'm in range. Then go right back to my thing again.
Many Thanks ..
HAPPY NEW YEAR!!!
 
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