islandtime50 said:
Alright, I had a crazy week but thought I would update this thread for those who may be considering TRT so you know what to do if it goes a little awry.
My blood work results were the following:
Total testosterone: 32.6nmol/L is 940 ng/dL high but not crazy solid TRT upper level
Free testosterone: 678 pmol/L is 19.6 ng/dL decently high
Estradiol (E2): 170 pmol/L is 46.3 pg/ml which is notably high for this T level. At 940 total T you want around 25-35 pg/mL. 46 means I am aromatizing.
Hematocrit: 0.52L/L (52%) - this is the most concerning number. 54 is the ceiling
Hemoglobin: 173g/L is 17.3 g/dL - is elevated in line with HCT and expected
RBC: 5.77 - elevated, textbook test-induced erythrocytosis
SHBG: 43.1 - right in range
Rest of CBC: clean WBC, platelets, differentials all normal
So, now for what this likely means. I am currently on 15mg pharma testosterone cypionate ED for a total of 105mg/week. I was at 20mg ED for a total of 140mg/week when I started to experience tingly tits.
First of all, this is not a high dose and I experienced sides at about 8 weeks which is definitely into full saturation period.
Secondly, I fell apart during that week living out of a hotel room. 3am wake ups for early flights, poor sleep in the hotel bed, shitty diet (this is relative but I have had most of my colon removed from cancer surgery in December and food away from home is a definite struggle for me now), no exercise, and also got pretty dehydrated (this I also have to work at a bit - I have to be careful with coffee, I don't think I absorb as well as I used to (working on hydration) and tirz is kicking my ass still. I lost 4.1 kg over that week.
Third, I also was not able to get blood work right away due to changing TRT providers, busy at work and just not having a plan to get a requisition. In BC, you have to get a requisition from someone to get blood work, then you have to fight your way into LifeLabs around your work schedule (there was no way I could get an appointment and I ended going on Saturday morning). My point here is the timeline skews the results that you are looking at. I felt tingly tits for sure on Friday night, I flew home on Saturday, dropped my dose from 20mg/ED to 15mg/ED on Moday (and felt immediate relief) but could not get a blood test until the following Saturday.
Lastly, hindsight is 20/20 and I just made some dumb mistakes.
1. I possibly could have had an AI on hand - both UpGuys and Teletest seem to be tightfisted with the AIs. I am in a couple of TG groups now and some guys with these providers have gotten AIs. I did not. It seems to come down to the individual doctor doing your assessment with the online TRT provider. I am going to procure my own but I could have done that before all of this and that is what I would recommend for anyone else. Even if you have to fight for it a bit.
2. I used to live out of hotel rooms for a living as a utility arborist and I used to be pretty good at it. I knew I was not going to eat out at restaurants, upgraded my room to a kitchenette and went grocery shopping the first day I was there. However, I underestimated my needs here and it did not go well with the long days. I also did not have a rental car and got trapped during 10 hour training days and could not get back to my room.
3. Someone told me not to especially hydrate before your blood work because you want to know your baseline without skewing your results (esp. HCT) so that you see how you are really doing. Sounds good in theory but doesn't work in practice. I had to wait quite a while at the clinic, trt blood work is fasted so you also don't eat and the fact is I was dehydrated again during my draw, no question. Don't do this as your HCT will look elevated like mine. I usually get up at 4:45am to fit work outs or running in before breakfast and rushing to work. Getting delayed at the clinic until 11am for a blood draw is way too long to go without hydrating.
The blood work numbers above are at least partially impacted by the higher dose I was taking before I dropped my dose.
Another red herring that I had to ask about was just my tits in general. Fun story, I was drunk and bored about 25 years ago and pierced my nipples with a sewing needle. I didn't have anything but some earring hoops to put in there (curved not straight) and it took some doing both to get the piercing done and then to get the hoops in there afterward. Shortly afterward, they started to react there a lot more than they ever did in my ear lobes so I replaced them a few days later with the correct hardware before they were healed and it took some doing again. Long story short, I've got pretty sensitive nips. I notice the slightest breeze, any temperature drop, and rubbing of any kind is definitely prohibited. I may or may not be equipped with extremely distant early warning gyno tits.
Despite the shitty week I had and my sensitive nips ... I experienced gyno, dropped my dose, and it went away right away - pretty straight up evidence that my Estradiol went too high.
So ...
My understanding is the following (I had help from the Rick bot at Anabolic Atlas with the following):
My testosterone numbers are likely accurate - the interval between dropping my dose and the test is probably long enough to see the change in the blood work. I am likely top of range for TRT. Frankly, I am okay with this. I was just trying to dial in TRT with an eye to TRT+ in the future but I just got there a lot faster than intended because I have a pretty good response to exogenous test.
My elevated Estradiol is likely not accurate right now because changes to those levels will take longer. E2 at 46is a lagging indicator from before the dose adjustment plus travel stress/dehydration. Even if it was accurate, my tits stopped hurting right away and you want to pay more attention to experiencing side effects than the number anyway. This number could well drop into the 30s by the next draw.
HCT is likely not accurate. Dehydration alone is a factor + tirz weight dump + travel. I need to retest in a couple of weeks to see where that really is.
Tirz really matters. A 9lb weight loss in a week is aggressive. That pulls fluid out, concentrates blood markers, adds metabolic stress and raises cortisol. This blood work could easily reflect poor snapshot timing.
Colon cancer recovery is also a factor. I'm 9 months out from very poor health and likely nowhere near decent homeostasis. I also had single digit ferritin which required me to have a blood transfusion right before surgery. So I might be over-responding to erythropoiesis and my HCT tolerance may lower than most.
The above may sound like a pile of cope. If you disagree, feel free to let me know. Like I said I had some help with it. Discourse breeds understanding and and even just reading damages ignorance. I have no real reason to want to damage my own health.
What I'm going to do: Nothing with my dose right now. I'm going to get ancillaries and some aromasin (though I don't expect to need it any time soon). I already take a lot of the correct vitamins (omega 3, magnesium, zinc, k2+d3, berberine and coq10) but I'm going to quiz the bot on whether they are actually good ones in particular and whether I am taking the right amounts. I also already daily dose low level Tylenol as that is a thing post colon surgery. I already have some suggestions on others to add.
Additional notes: I am now on TRT with Teletest. The $49 referral fee covers basic blood work, a doctor looking over results and you get your 12 week prescription of test. The included blood work package is probably not sufficient. I had to pay $90 additional to LifeLabs just to get SHBG added to the panel. I have a test prescription waiting for me at my pharmacy but I am not done with the original vials I got from UpGuys. Teletest has an AAS 'harm reduction' panel that looks much more complete (but still does not contain igf-1 and other markers I may be interested in). I was worried that they would take a dim view of me being on TRT and requesting an AAS panel at the same time but other Canadians have reassured me that they will simply take my money. There is a big caveat that the AAS panel still has numerous user pay portions in addition to the $79 sticker price. I'll update when it is actually time for more blood work. Apparently, if there was a Dynacare lab available, they have much more competitive pricing than LifeLabs. There are no Dynacare clinics even in the lower mainland, much less the island.
TL;DR disaster averted, TRT good, blood work good-ish, lessons learned
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