Just got bloods back for the first time since starting TRT, test is a little low for the dose I'm on. Thoughts?

[BrodTT]

(please let me know if this is the wrong place to post this)

Hey guys, I had my first set of bloodwork done which included hormones + lipid panel, CMP, TSH, T3/T4, Hemoglobin A1C, CBC, SHBG, Iron, PSA, etc. Most everything came back in normal ranges except for my iron levels and HDL, and I had some general questions about my protocol and how to tell if I can optimize this. I'm 6'5 and 279 lbs - I've actually been able to lose weight easier since starting this six weeks ago (I started at 290).

I had these bloods done at the beginning of week 6, about 48 hours after my last injection. I'm prescribed 160mg/week of test cyp injected every 3.5 days so this is pharma grade stuff here. I have noticed a bigger boost in mood/confidence and a bit higher energy levels, and have seen some of my lifts go up at the gym but at 160mg a week I'm really surprised that my test is rather low comparitively.

Hormones:
Total Test: 741 ng/dl (was 354 ng/dl)
Testo Free: 139 pg/ml (was 67.3
Estradiol: 44.4 pg/ml (was 17.3 pg/ml)
SHBG: 28 (was 23)
Prolactin 10.8 ng/ml (was 9.1 ng/ml)

CBC:
RBC: 5.69 (was 5.45)
HGB: 16.6 (was 15.8)
HCT: 52% (was 46%) -> cause of concern?
Platelets: 301 (was 267)

Lipids:
Cholesterol: 148 mg/dl (was 157)
HDL: 37 mg/dl (was 45 mg/dl) ref range is >40
LDL: 95 mg/dl (was 88 mg/dl)

Iron:
Iron: 60 ug/dl (was 87 ug/dl)
Iron Sat: 17% (no ref for before) ref range is 20-55%



I can post the full labs here if needed but everything else is in range. What I am a little concerned about is my HCT and my low iron. I do take 3g of Kratom a day to unwind and I've heard that sometimes Kratom can cause iron deficiency. I cut it out of my diet already so we'll see how that goes.

Do you think based on my estrodiol/SHBG and CBC that I may be able to try and increase to 180mg a week? I'd like to try and optimize my TRT dosage if I'm only getting 750 total test.

 

[psauce]

Smart man getting bloodwork done. Just as a general thing, it is helpful to know the reference range for that particular lab. Ideally, they calibrate their testing to their protocol, including reagents and machines, so each lab varies a little bit and that’s expected ( even good). Going from book values, though, you’re good to go.

CBC is good. Tiny bit high on RBC, but nothing to worry about. Donate if you want to drop it and safe a few lives… win-win. Iron isn’t low, but you could try more red meat or a small supplement every other day. E2 is not something to worry about unless you have symptoms. It helps prevent arterial plaque buildup and actually protects several tissues in the heart… its probably good to be on the higher side, especially while trying to establish a healthier weight.

On the same note as estrogen, remember than TRT is about symptoms. If you get relief from the symptoms of hypogonadism at 750, you don’t need to push past that. Everyone here recognizes the utility of anabolics, especially testosterone, but there is a real price tag that comes with them. If you feel good at your current level, I wouldn’t fuck with it.

The tricky situation is when you still have some symptoms of low testosterone within reference. Bumping up your dose may resolve those problems, but induce other symptoms in the process, like a problematically high estrogen. Then you find yourself chasing the E2, which requires more drugs, more blood work, and more tuning of dosages. You can follow it down a rabbit hole for years and end up wasting tons of time and money, as well as exposing yourself to drugs you don’t need to be taking.

If you feel good — relief from low T symptoms — you need to give your body some time to respond to the training and diet in the newly-healthy hormonal environment. The changes can be profound, but they do take time. If you push drugs in an effort to get to an ideal state right away, you can overshoot and fuck yourself up. That said, a tiny bit more test is not very risky, and if you notice negative symptoms you just revert back to the lower dose.

 

[BrodTT]

Smart man getting bloodwork done. Just as a general thing, it is helpful to know the reference range for that particular lab. Ideally, they calibrate their testing to their protocol, including reagents and machines, so each lab varies a little bit and that’s expected ( even good). Going from book values, though, you’re good to go.

CBC is good. Tiny bit high on RBC, but nothing to worry about. Donate if you want to drop it and safe a few lives… win-win. Iron isn’t low, but you could try more red meat or a small supplement every other day. E2 is not something to worry about unless you have symptoms. It helps prevent arterial plaque buildup and actually protects several tissues in the heart… its probably good to be on the higher side, especially while trying to establish a healthier weight.

On the same note as estrogen, remember than TRT is about symptoms. If you get relief from the symptoms of hypogonadism at 750, you don’t need to push past that. Everyone here recognizes the utility of anabolics, especially testosterone, but there is a real price tag that comes with them. If you feel good at your current level, I wouldn’t fuck with it.

The tricky situation is when you still have some symptoms of low testosterone within reference. Bumping up your dose may resolve those problems, but induce other symptoms in the process, like a problematically high estrogen. Then you find yourself chasing the E2, which requires more drugs, more blood work, and more tuning of dosages. You can follow it down a rabbit hole for years and end up wasting tons of time and money, as well as exposing yourself to drugs you don’t need to be taking.

If you feel good — relief from low T symptoms — you need to give your body some time to respond to the training and diet in the newly-healthy hormonal environment. The changes can be profound, but they do take time. If you push drugs in an effort to get to an ideal state right away, you can overshoot and fuck yourself up. That said, a tiny bit more test is not very risky, and if you notice negative symptoms you just revert back to the lower dose.

Sorry I forgot to like this last month, thank you for taking the time to write all of this man. It's about a month later and I'm going to go back for another round of bloods just to see how I'm adjusting in my first 12 weeks. If everything goes well I'll probably introduce HCG and Semaglutide to help with the weight loss and overall mood.

 

[Deucalion]

RBC and HCT trend together, HCT is the volume % of RBC in your blood. Iron is fine I would NOT try and correct iron with a supplement... Change diet first. What is your MCH,MCV, MCHC? THIS will let us know with better accuracy if you iron is a problem.

I would be more concerned with lifestyle and diet changes to negate the negative effects of test on your HDL and RBC. Do you have a history of blood clots? Smoke, obesity, eat unhealthy fats?

As far as optimizing your TRT like the other person said it is symptom based. How do you feel after 6 weeks?

I am assuming blood tests were 6 weeks apart?