Need help interpreting blood tests

[lovedajuice]

Ok, so I started TRT about a year ago 200mg pw test c split in two injections, after a month or two on it I added arimidex cause E2 was too high,
then noticed I crushed E2 and reduced dosage to 0.25mg twice weekly, then E2 still crashed and reduced to to 0.25mg once weekly and still kinda crashed but if I don't take it for longer my nipples start to feel weird so I'm gonna switch to aromasin so I will avoid E2 rebound and take it even less frequently.
Now the blood test comparison between november last year after a few months on test c 200mg pw and now after increasing test dose to 250pw for almost 6 months.

Nov 2021
total test 1806 ng/dl
SHBG 64.3 nmol/L
free t index 97.4%
E2 5 pg/ml
total cholesterol 132 mg/dl
HDL 33.6 mg/dl
LDL 88.9 mg/dl
HDLC ratio 3.93
triglycerides 49.5 mg/dl

Now
total test 2141.9 ng/dl
SHBG 24.4 nmol/l
free t index 304%
E2 6.15 pg/ml
total cholesterol 212.2 mg/dl
HDL 42.5 mg/dl
LDL 155 mg/dl
HDLC ration 4.99
triglycerides 74.34 mg/dl

As you can see my lipid profile is being negatively affected now and I'm at higher risk of cardiac events with the current levels, I'm trying to understand what is causing it, is it the arimidex, is it too high testosterone, is it the duration of the TRT or simply changes to diet, supplements, lifestyle?
Also what is causing SHBG levels to be lower and what are the optimal levels for it?
What could I do to improve my lipid profile?

 

[jtmarlin]

Ok, so I started TRT about a year ago 200mg pw test c split in two injections, after a month or two on it I added arimidex cause E2 was too high,
then noticed I crushed E2 and reduced dosage to 0.25mg twice weekly, then E2 still crashed and reduced to to 0.25mg once weekly and still kinda crashed but if I don't take it for longer my nipples start to feel weird so I'm gonna switch to aromasin so I will avoid E2 rebound and take it even less frequently.
Now the blood test comparison between november last year after a few months on test c 200mg pw and now after increasing test dose to 250pw for almost 6 months.

Nov 2021
total test 1806 ng/dl
SHBG 64.3 nmol/L
free t index 97.4%
E2 5 pg/ml
total cholesterol 132 mg/dl
HDL 33.6 mg/dl
LDL 88.9 mg/dl
HDLC ratio 3.93
triglycerides 49.5 mg/dl

Now
total test 2141.9 ng/dl
SHBG 24.4 nmol/l
free t index 304%
E2 6.15 pg/ml
total cholesterol 212.2 mg/dl
HDL 42.5 mg/dl
LDL 155 mg/dl
HDLC ration 4.99
triglycerides 74.34 mg/dl

As you can see my lipid profile is being negatively affected now and I'm at higher risk of cardiac events with the current levels, I'm trying to understand what is causing it, is it the arimidex, is it too high testosterone, is it the duration of the TRT or simply changes to diet, supplements, lifestyle?
Also what is causing SHBG levels to be lower and what are the optimal levels for it?
What could I do to improve my lipid profile?

Why don't you try cutting the dose to something like 140mg and then you don't need to worry about an AI and your other numbers should probably improve. You've also crushed your SHBG... are you taking anything else like proviron or anavar?

 

[The-Optimist]

Your test dose is too high for TRT. I had a HDL of 64 mg/dl on 125mg Test E / week with no AI. You shouldn't normally need one on 125mg/week. I'd half your TRT dose and ditch the Adex.

 

[lovedajuice]

Why don't you try cutting the dose to something like 140mg and then you don't need to worry about an AI and your other numbers should probably improve. You've also crushed your SHBG... are you taking anything else like proviron or anavar?

I've done a few anavar cycles, first one was probably shortly after the first cycle, current one is after two months, so I don't think it would show

 

[lovedajuice]

So @The-Optimist and @jtmarlin , you guys think the test is messing up my lipids? But I have to say it feels even better at 250mg than 200mg, and all the other levels are within normal range, BP, RBC, you name it.

 

[Rido]

E2 is very important.,.. idk why you are keeping it that low. It provides plenty of benefits.

You shouldn't need an AI on trt... Especially if your weight is under control...


Are you sure the nipple issue isn't in your head?

 

[lovedajuice]

E2 is very important.,.. idk why you are keeping it that low. It provides plenty of benefits.

You shouldn't need an AI on trt... Especially if your weight is under control...


Are you sure the nipple issue isn't in your head?

I don't voluntarily keep E2 that low, it's that before taking arimidex it was over 200 and I was feeling ok, I tried just one tablet of tbol once and my nipples started to feel weird so I checked blood levels and it was that high, that was after about a month of beginning on test, so I started taking arimidex, and never touched tbol again, the problem is I'm very sensitive to arimidex if just 0.25mg per week can crash my E2 like that, but if I don't take it my nipples start to feel weird, I can't really tell if it's in my head or not, but the only explanation I can think of is that after a while that I took arimidex there is a rebound and E2 starts shooting up like crazy, while on aromasin this should not happen since it kills the enzymes completely instead of blocking them, so I guess it would be safer to take like half a tablet per month.

 

[Rido]

I'm siding with @The-Optimist . You need to cut your TRT dose

 

[lovedajuice]

I'm siding with @The-Optimist . You need to cut your TRT dose

I agree, just afraid I would lose strength, muscle, etc

 

[Rido]

I agree, just afraid I would lose strength, muscle, etc

Then it wasn't size/strength you were not meant to keep.

Drop it to 150. If you wanna run a cycle, then do so.

What's your bodyfat at?

 

[lovedajuice]

Then it wasn't size/strength you were not meant to keep.

Drop it to 150. If you wanna run a cycle, then do so.

What's your bodyfat at?

Current body fat around 12% I have abs and some vascularization but not super shredded, I was actually thinking of adding some primo but not before putting E2 and cholesterol levels in check.

 

[Rido]

Current body fat around 12% I have abs and some vascularization but not super shredded, I was actually thinking of adding some primo but not before putting E2 and cholesterol levels in check.

That's fine but then you start Entering the world of "sports trt".

Your cholesterol levels are fine overall..

 

[The-Optimist]

So @The-Optimist and @jtmarlin , you guys think the test is messing up my lipids? But I have to say it feels even better at 250mg than 200mg, and all the other levels are within normal range, BP, RBC, you name it.

I'd say so. North of about 150mg test / week, my HDL drops to just barely in range, about 40.

 

[lovedajuice]

That's fine but then you start Entering the world of "sports trt".

Your cholesterol levels are fine overall..

Yep that was the idea, the way I see it is blasting gear like crazy and then either going off and losing a lot of it or on low dose test and if not losing much definitely not gaining anything is less healthy, and at the same time slow and steady gains year-round are more real and safer for the joints, etc. Of course I wanna reduce risk while doing it so if I see something off I wanna fix it, yeah my cholesterol is not too bad and it can probably be corrected even with just diet and more cardio, but still if I used to have perfect levels without much effort before I want to keep that, I will start by reducing my test dosage for sure.

 

[lovedajuice]

I'd say so. North of about 150mg test / week, my HDL drops to just barely in range, about 40.

There actually are studies that say testosterone improves cholesterol levels, I guess besides having subjective side effects when taken past a certain dose it starts backfiring.

 

[HB_22]

There actually are studies that say testosterone improves cholesterol levels, I guess besides having subjective side effects when taken past a certain dose it starts backfiring.

That is correct. Too low as well as too high of testosterone, but also estrogen, can screw lipids.

 

[The-Optimist]

There actually are studies that say testosterone improves cholesterol levels, I guess besides having subjective side effects when taken past a certain dose it starts backfiring.

The golden rule of toxicology is the dose makes the poison. 125mgs / week should be fine on your HDL, as well as all your other lipids but if your serum test levels are supraphysiological, you're no longer doing TRT. I would even say that anything over 150mgs / week is pushing it.

I've just noticed your E2 levels are low as well. I'm in the UK so I have to do the unit conversions to understand. Tanking your E2 will generally make you feel pretty miserable.

I agree, just afraid I would lose strength, muscle, etc

Depends on your size but I know very big guys who can not just maintain but cut just fine on TRT. If it's a more aggressive cut they go a shade above at 200mg.

 

[lovedajuice]

The golden rule of toxicology is the dose makes the poison. 125mgs / week should be fine on your HDL, as well as all your other lipids but if your serum test levels are supraphysiological, you're no longer doing TRT. I would even say that anything over 150mgs / week is pushing it.

I've just noticed your E2 levels are low as well. I'm in the UK so I have to do the unit conversions to understand. Tanking your E2 will generally make you feel pretty miserable.



Depends on your size but I know very big guys who can not just maintain but cut just fine on TRT. If it's a more aggressive cut they go a shade above at 200mg.

Yep I'm trying to correct the low E2 levels, I explained why it happens a few posts above, I have zero low E2 symptoms though, but yeah it's important to keep it within normal range.

 

[jtmarlin]

Current body fat around 12% I have abs and some vascularization but not super shredded, I was actually thinking of adding some primo but not before putting E2 and cholesterol levels in check.

You can carry a lot of muscle on 150mg of test cyp/e per week. It's not comparable to any sort of natural level because your testosterone levels don't really vary all that much on this dose. They are high around the clock.

Naturals have high levels in the morning and then declines throughout the day. 150mg is supraphysiological full stop for most people unless they are outlier. If you can have 800-1000 total T and 25-35 free T ALL THE TIME ALL DAY AND ALL NIGHT LONG, you are well above natty.

 

[hudson98]

E2 is very important.,.. idk why you are keeping it that low. It provides plenty of benefits.

You shouldn't need an AI on trt... Especially if your weight is under control...


Are you sure the nipple issue isn't in your head?

again for once we agree

bf?
you never needed an ai
diet?

if you think you need an anti e on TRT you need to look at the big picture and ask why? using an AI trying to make these little numbers perfect when your lifestyle probably isn't healthy is what they call majoring in the minors