Is too high, almost double of the reference range top, free T a thing?

[Gusamaso]

So I got back to TRT 8 weeks ago with my previous protocol. 100mg Test E and 1000iu HCG/wk + 5mg tadalafil everyday. Only difference is that I'm doing IM (MWF) rather than SubQ. I also started Retatrutide and HGH 3 weeks ago. Been also on levothyroxin due to hashimoto.

Bloods taken friday before shot:

HEMATOCRIT: 48,5% (39,2 to 49,0%)
LDL-COLESTEROL 158 mg/dL (optimal under 100 mg/dl)
COLESTEROL TOTAL 212 mg/dL (optimal under 190 mg/dl)
HDL-COLESTEROL 33 mg/dL (optimal above 40 mg/dl)
TRIGLICERIDES 97 mg/dl (optimal under 150 mg/dl)
ALBUMIN 4,6 g/dl (3,5 to 5,2 g/dl)
TSH 2,8 mUI/L (0,45 to 4,5 mUI/L)
FREE T4 1,6 ng/dl (0,9 to 1,7 ng/dl)
FREE T3 0,26 ng/dl (0,20 to 0,44 ng/dl)
PROLACTIN 21 microg/L (for Men up to 20 microg/L)
ESTRADIOL 6,0 ng/dl (1,1 to 4,3 ng/dl)
TESTOSTERONE 1190 ng/dL (240 to 816 ng/dl)
FREE TESTOSTERONE 1029,7 pmol/L (131 to 640 pmol/L)
SHBG 34 nmol/L (18 to 54)
DHT: no Reading yet but my baseline is close to the top.

How I'm feeling: Weight: On the scale, I've lost only 2 kg even on Reta, good diet and deficit. I see more prominent muscles, but still a lot of fat (I believe I'm between 15 and 20% of BF) Bloating, especially around the waist and face.

Libido and erection: I wake up most days with a strong morning erection. My flaccid penis is larger and more sensitive, and my testicles are hanging very low. However, my libido is still relatively low. I can get an erection with stimulation, but it's not as strong as my morning erection. The glans feels a little "soft," as if it hasn't filled with blood. Orgarsms not very pleasuble.

Skin and hair: My face is very oily and it flushes often, like I'm permanently tanned. No matter what I do (I use a top-notch La Roche-Posay product), and a little while later I'm already oily and shiny. Interestingly, hair is growing back where there were patches (I'm not prone to MPB).

Other: Having trouble urinating especially when I wake up. I have to make a pressure on the lower part of the abdomen. I also feel that it doesn't really empty the bladder. Fatigue during the day.

How can I adjust my protocol to feel better? I understand T:E ratio is fine in theory. IM injections resulted in fewer 30 points of E2 compared to when I did SubQ. Is my Free T too high? What might be causing my excessive oiliness? Thanks, guys.

 

[BigDadd7]

Hcg

 

[Ghoul]

How can I adjust my protocol to feel better?

Don't worry about it. With those lipids you won't be feeling anything sooner or later.

 

[Gusamaso]

Don't worry about it. With those lipids you won't be feeling anything sooner or later.

I was on keto diet for a month before the labs, it might have contributed.

 

[Ghoul]

I was on keto diet for a month before the labs, it might have contributed.

Should've normalized by now, and LDL is mostly genetic anyway. At most diet and lifestyle is 25%. You would be wise to get it below 70 to halt further damage, and below 55 if you want to reverse it to some degree. Ezetimebe, and Pitavastatin would do that with a near 0% risk of side effects.

Drop the HCG and you'll likely be near the top of the physiological T and free T range, skin will normalize, and you'll feel better. You may need to bump the Test dose slightly, or not. Retest in a month and make adjustment to Test dose based on those results. That oily skin could start to manifest as persistent, scarring back acne if this continues for long.

Everyone has a limit for how much free T feels good. Beyond that, it's essentially a constant state of overstimulation that leads to exhaustion.

 

[Gusamaso]

Should've normalized by now, and LDL is mostly genetic anyway. At most diet and lifestyle is 25%. You would be wise to get it below 70 to halt further damage, and below 55 if you want to reverse it to some degree. Ezetimebe, and Pitavastatin would do that with a near 0% risk of side effects.

Drop the HCG and you'll likely be near the top of the physiological T and free T range, skin will normalize, and you'll feel better. You may need to bump the Test dose slightly, or not. Retest in a month and make adjustment to Test dose based on those results. That oily skin could start to manifest as persistent, scarring back acne if this continues for long.

Everyone has a limit for how much free T feels good. Beyond that, it's essentially a constant state of overstimulation that leads to exhaustion.

Thank you for the input. I've always had good lipids even doing DHT derivs, so I don't really understand it now. The thing about HCG is that I'm reaping it's benefits, so it would be sad to drop it. Is my E2 too high to consider dropping it?

 

[Ghoul]

Thank you for the input. I've always had good lipids even doing DHT derivs, so I don't really understand it now. The thing about HCG is that I'm reaping it's benefits, so it would be sad to drop it. Is my E2 too high to consider dropping it?

You could drop the T dose to 75mg week instead. I just defaulted to eliminating one compound entirely for easier management. You'll need 6 weeks for that to stabilize before testing. It's a slower change than eliminating the HCG.

 

[Gusamaso]

You could drop the T dose to 75mg week instead. I just defaulted to eliminating one compound entirely for easier management. You'll need 6 weeks for that to stabilize before testing. It's a slower change than eliminating the HCG.

I will probably do that. Thank you again.

As for the Ezetimebe, would you consider it just for a short time, given my good lipids history.

 

[Ghoul]

I will probably do that. Thank you again.

As for the Ezetimebe, would you consider it just for a short time, given my good lipids history.

Unless by "good lipid history" you mean LDL has been consistently below 70, consider the Ezetimibe like any other vitamin or supplement you take daily. An investment in your long term health and longevity. There is no downside, only benefit.

If the idea of a "pharmaceutical" taken for a lifetime turns you off, consider Ezetimebe is essentially a synthetic, highly concentrated form of the sterols found in plants that compete in your gut for the same transporters that are used to absorb cholesterol, the end result of which is improving lipids. Nuts, seeds, beans, fruits and vegetables that naturally improve lipids, but impossible to consume in amounts sufficient to do what Ezetimebe does.

Science isolated the essential part of those plants that does the good work of improving lipids, found a way to make a pure version in a lab, and provide a huge dose in a tiny pill. Equivalent to consuming 10 pounds of those healthy plants daily.

 

[hankreal]

Other: Having trouble urinating especially when I wake up. I have to make a pressure on the lower part of the abdomen. I also feel that it doesn't really empty the bladder.

This might be an issue with the prostate. But maybe not, I'm not expert, but it might be worth adding in a psa at the next draw. Good labs has them for 5 usd. Hope you get everything sorted out.