Am I where I need to be with these results on TRT?

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    Am I where I need to be with these results on TRT?


    I have been injecting once every 5 days .375ml of test/cyp (200 mg/ml) for about four months. My doc ordered some odd tests this time, they came back today, my question is, judging from the numbers here and the fact I am now 49, 6'2" and 248lbs. Am I in your opinion injecting enough test. (doctor prescribed) to be at my best. Here are the numbers.
    Prolactin (Serum) 9.8 ng/ml range 2.1-17.7
    Estradiol by TMS 28.2 pg/ml range Men over 18 10-42
    5-a-Dihydrotestosterone by Tandam Mass Spectrometry Serum
    Dihydrotestosterone, LC-MS/MS 328.0 pg/ml range 106.0-719.0
    Testosterone Serum 463 ng/dl range 300-890
    Testosterone Free Adult Male 114 pg/ml range 47-244
    This was a fasting blood draw at 8AM on the 5th day after test injection
    I am still fighting fatigue, depression, and ED
    Your thoughts and opinions are greatly appreciated

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    I don't think so. I'm starting at just 100 and if I'm not 700's by first blood draw, I'll be really working my doc to go to 150 at least. Especially if you are still struggling with symptoms of low T. But keep in my mind 463 at your age may not be causing those symptoms. Alcohol, antidepressants, sickness, infection, depression, and pain killers are just a few things that could 1. Be causing the low T
    2. Causing these symptoms.
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    Thanks so much for taking the time to post. No alcohol, but yes to all the others. Not really sure what you mean by how much you inject and how often. I am hoping he will up my test dose to .50ml every 5 days.
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    Zoloft is a good drug. It has helped me in the past and after 8 years of not needing it, I'm back on it, possibly for life. Up your test dose and a good antidepressant and you may feel a lot better. Wellbutrin is really popular but it made me jittery. 100mgs a week was what I meant.
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    Quote Originally Posted by Matthersby View Post
    I don't think so. I'm starting at just 100 and if I'm not 700's by first blood draw, I'll be really working my doc to go to 150 at least. Especially if you are still struggling with symptoms of low T. But keep in my mind 463 at your age may not be causing those symptoms. Alcohol, antidepressants, sickness, infection, depression, and pain killers are just a few things that could 1. Be causing the low T
    2. Causing these symptoms.
    Need proper DX history as well many other factors previously mentioned. Personally I do not think its your TRT your SHBG, thyroid parameters, and adrenals where not checked which could be a potential cause ...Look for the cause do not treat just the symptoms like many Drs do often masking the problem instead of correcting it
    I am not a medical Dr, please keep in mind that this answer is for information purposes only, and is not intended to diagnose, treat or replace sound medical advice from your physician or health care provider.
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    Quote Originally Posted by The Matrix View Post
    Need proper DX history as well many other factors previously mentioned. Personally I do not think its your TRT your SHBG, thyroid parameters, and adrenals where not checked which could be a potential cause ...Look for the cause do not treat just the symptoms like many Drs do often masking the problem instead of correcting it
    All the above tests have been done several times this year. Levothyroxine was prescribed for under active thyroid. Hydrocortisone was prescribed for adrenal insuff. MRI of brian was done to rule out pit. tumor. SHBG and growth hormone in normal range. I have had every test known to man this year, just wanted to know from some of the guys that give FREE advice from their own lifes experiences that are willing to share, if my test injection volume needed tweeking. Thanks to those that did.
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    Quote Originally Posted by The Matrix

    Need proper DX history as well many other factors previously mentioned. Personally I do not think its your TRT your SHBG, thyroid parameters, and adrenals where not checked which could be a potential cause ...Look for the cause do not treat just the symptoms like many Drs do often masking the problem instead of correcting it
    ^absolutely^ I fully agree and didn't start my Hrt personally until all of the other factors came back within range(or close enough) from my endo. It almost does sound like adrenal fatigue and depression but could be one of hundreds of other factors. The crappy part for me is my doc cannot get insurance to cover any treatment for hyperthyroidism until ALL lab ranges are within 'their' ranges indicating graves or hyperthyroidism. Until that day comes, my pcp is forced to treat symptoms only even though all three of us know why I am having the symptoms.
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    Quote Originally Posted by ratdog
    I am hoping he will up my test dose to .50ml every 5 days.
    Not nitpicking, but unless everyone has read your first post we would have no idea that you mean 100mg of test.
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    Quote Originally Posted by Matthersby View Post
    ^absolutely^ I fully agree and didn't start my Hrt personally until all of the other factors came back within range(or close enough) from my endo. It almost does sound like adrenal fatigue and depression but could be one of hundreds of other factors. The crappy part for me is my doc cannot get insurance to cover any treatment for hyperthyroidism until ALL lab ranges are within 'their' ranges indicating graves or hyperthyroidism. Until that day comes, my pcp is forced to treat symptoms only even though all three of us know why I am having the symptoms.
    Symptoms over lap making it a challenge for medical professionals to isolate the issue. Many times drs seem to put symptoms on a dart board then close their eyes throw a dart. Where ever it lands is what they treat. You need to isolate the variables one at a time, then look how the imbalances are connected to the other systems in the body. To many people are being bounced around from medical professionals to medical profession like a ping pong ball. One hand is not talking to the other. Why people do not get well, but only better in many cases.
    I am not a medical Dr, please keep in mind that this answer is for information purposes only, and is not intended to diagnose, treat or replace sound medical advice from your physician or health care provider.
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    Quote Originally Posted by Matthersby
    I don't think so. I'm starting at just 100 and if I'm not 700's by first blood draw, I'll be really working my doc to go to 150 at least. Especially if you are still struggling with symptoms of low T. But keep in my mind 463 at your age may not be causing those symptoms. Alcohol, antidepressants, sickness, infection, depression, and pain killers are just a few things that could 1. Be causing the low T
    2. Causing these symptoms.
    I've been on 200mg/wk for a couple of months now since starting TRT. Initial bloodwork indicated testosterone level of 222. My most recent bloodwork came back with a testosterone level of 709! My libido is way up and energy levels/mood have improved significantly.

    Only problem is estradiol came back high as well so my doc prescribed Arimidex. Hoping the E2 levels fall back within normal range on my next panel I'm 43 btw.
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    Quote Originally Posted by Ninjo View Post
    I've been on 200mg/wk for a couple of months now since starting TRT. Initial bloodwork indicated testosterone level of 222. My most recent bloodwork came back with a testosterone level of 709! My libido is way up and energy levels/mood have improved significantly.

    Only problem is estradiol came back high as well so my doc prescribed Arimidex. Hoping the E2 levels fall back within normal range on my next panel I'm 43 btw.
    Increasing adminstration of the shots will help e2 and reduce peaks and valleys to a more even plasma level. Its not the amount, but getting the proper ratio of balance of T:e2. I suggest Drs starting guys out on 60-80 mgs a week then go from there. The result has been less need for e2 and better over all response.
    I am not a medical Dr, please keep in mind that this answer is for information purposes only, and is not intended to diagnose, treat or replace sound medical advice from your physician or health care provider.
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    Ratdog, it sure sounds like you are addressing the other variables as best you can, and it sounds like you have a doc that is listening to you rather than just reading your labs and telling you "you are fine, you are within the ranges". That's fantastic and will get you a long way. Having said that, since you are not seeing an improvement in energy / mood / libido, you might want to push that Serum Test up around 800 - 900 and reevaluate yourself. Keep a close eye on your Estradiol (E2) though, since it looks like you will end up beyond the top of the range and need a blocker to control it.

    I'll bet if you ran that .375ml twice a week rather than twice every 10 days that you will see a difference. Just my .02...and I'm pretty new to this stuff.

    You are not on a blocker like Arimidex now are you? Some people are more sensitive to extra E2 than others and you might benefit by pushing that 28 down to 10 or so.
  

  
 

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