I was wondering if I could ask about my labs. Current 46 years old. Started feeling symptoms that could be associated with low t. I was also overweight at the time, my first set of labs was in March, I was 193 lbs, 5’11”, total T 566, free T 8.6, Estradiol 15.6, SHBG 59, A1c 5.7. I stopped drinking all alcohol (was a couple of beers a day guy), started exercising and eating cleaner with lower carb, more protein, salads, etc I have gotten my weight down to 153, I could certainly stand to build muscle though. Repeat labs a week ago have total test 923 (higher than I expected), but free T is 6.0, and SHBG is 103, A1c is 5.8 (no better with the weight loss) I’m sure the SHBG is why the Free T is still low and contributing to me still having symptoms. Other labs were within normal ranges other than DHEA is 117. I supplement with Boron 10 mg daily, DHEA 25 mg daily, calcium, D3 5000 iu, zinc, magnesium, Vit C, B complex, and Lysine. I was prescribed Test cyp 100 mg twice a week, HCG 500 twice a week. I am somewhat hesitant to start as my total is so high. They feel this will improve my free T and lower my SHBG along with helping me build some muscle which should help my A1c. I am still having symptoms, some actually worse. The weight loss has been nice though. Any thoughts on my labs and starting down this road would be greatly appreciated. Thank you.

Question

I was wondering if I could ask about my labs. Current 46 years old. Started feeling symptoms that could be associated with low t. I was also overweight at the time, my first set of labs was in March, I was 193 lbs, 5’11”, total T 566, free T 8.6, Estradiol 15.6, SHBG 59, A1c 5.7. I stopped drinking all alcohol (was a couple of beers a day guy), started exercising and eating cleaner with lower carb, more protein, salads, etc I have gotten my weight down to 153, I could certainly stand to build muscle though. Repeat labs a week ago have total test 923 (higher than I expected), but free T is 6.0, and SHBG is 103, A1c is 5.8 (no better with the weight loss) I’m sure the SHBG is why the Free T is still low and contributing to me still having symptoms.  Other labs were within normal ranges other than DHEA is 117. I supplement with Boron 10 mg daily, DHEA 25 mg daily, calcium, D3 5000 iu, zinc, magnesium, Vit C, B complex, and Lysine.  I was prescribed Test cyp 100 mg twice a week, HCG 500 twice a week.  I am somewhat hesitant to start as my total is so high. They feel this will improve my free T and lower my SHBG along with helping me build some muscle which should help my A1c. I am still having symptoms, some actually worse. The weight loss has been nice though.  Any thoughts on my labs and starting down this road would be greatly appreciated. Thank you.

Alpha MD · Accepted Answer

First, awesome job losing the weight and making lifestyle changes.

You have a good selection of supplements.

The labs on paper look good, you wouldn't be classified as primary or secondary hypogonadism but could be classified as relative hypogonadism.

Normally the addition of the HCG might not do much, but with such high base production is may do more than normal. Is your dose 100mg total weekly or 200mg total weekly split into 2 doses of 100mg? I am a bit unsure with the wording. If it is 200mg total weekly, that's a dose providers often consider appropriate for someone at your T level. If it's 100mg total weekly then it may work out with the HCG as well, though the provider overseeing your care may consider it a bit low for you.

For 100mg total weekly, you'd want to re-test around weeks 7 or 8 to make sure it's not actually lowering your production by more than it's adding. For 200mg it should be fine overcoming suppression usually.

Keep an eye out for Estrogen symptoms at that HCG + Test dosage combined with your higher base, any nipple sensitivity and you should let your provider know so they can give you an AI.

You'd be the kind of gentleman who could benefit from stand alone Enclomiphene if you didn't want injections, since again your base is high, but there's no reason you couldn't use normal TRT to great result to treat low T symptoms.

Hope that helps!

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