These Are the Final Results. Nooot.
Testosterone up 56% measured at its floor. Estradiol up 215%. And six iron markers leaning the same way, which is the finding nobody would have flagged. Then, hours after the PDF landed, a message that made the word final premature.
Four days ago I published the partial results — lipids, liver, kidney, everything except the one number the whole protocol is named after. Testosterone was still in the machine.
It came back. So did the free testosterone, the SHBG, the full iron panel and the prostate marker. Ninety-four days, measured against a baseline drawn before I started anything.
So this is the final analysis.
Except it isn't, because a few hours after I opened the PDF, a message arrived that made the word "final" premature. More on that at the end — it's the best thing that happened this week and it has nothing to do with my blood.
First, the numbers.
Am I good? Yes. Genuinely, unambiguously yes. The protocol is working, and the numbers are not close or debatable about it.
Testosterone went from 455 to 713 — and that was measured at my lowest point of the cycle, so my floor now sits about where my old normal used to be. Triglycerides down 41%. Bad cholesterol down 18%. Blood sugar excellent. Liver perfect. Prostate quiet. Six kilos gone. Nothing on this panel is damaged, and nothing is heading anywhere bad.
There is one imperfection: iron. And it is the easy kind.
Nothing is diseased and nothing is broken. Testosterone told my body to build more red blood cells, building them costs iron, and I am simply spending it faster than I am eating it. That is a supply problem, not a health problem — the difference between a fuel gauge reading low and an engine fault.
And the fix is boring: more red meat, keep coffee away from meals, and if a test confirms it, a cheap supplement every other day. Weeks, not months. It is close to the most fixable finding in all of medicine. The only reason it gets a whole section below is that I found it by pattern rather than by any single alarming number — which is the entire argument for measuring instead of guessing.
Three small things to keep an eye on: estradiol at the top of its range (expected on testosterone, no symptoms, leave it alone), HDL one point low, creatinine slightly high — almost certainly because I am muscular and take creatine daily, not my kidneys.
Should the dose go up? I want it to, eventually — but not off this panel, and not before the estradiol and iron questions are settled. Explained below.
Testosterone: 455 → 713
455.52 → 712.60 ng/dL. Up 56 percent.
The number that matters isn't the size of the jump, it's where it was taken. This is the bottom of the cycle. The floor of the new normal sits roughly where the old baseline was at its best — and the baseline wasn't a trough, it was just a random Tuesday.
Which means the peak is higher than 713, and I don't know by how much. Reconstructing it would need the ester, the dose, the injection interval and the exact hours since the last shot. That's a question for the next panel, not a guess for this one.
To be clear about the direction of travel: I do want to push this further. I am not running this protocol to land in the middle of a reference range and stay there. Higher exposure is on the table, and it is a conversation I intend to have.
But not off this panel, and here is the honest reasoning:
1. The trough is already 713. The peak is meaningfully higher than that. Whatever the argument for more is, it is not that the current dose is weak.
2. Estradiol is sitting at the ceiling. More testosterone means more conversion. Raise the dose today and that number goes somewhere I would rather it did not, before I have even measured it on a trustworthy assay.
3. Red cell production is already outrunning my iron. More testosterone pushes harder on the one system currently under strain.
What would have to be true first: estradiol re-measured by LC-MS/MS and behaving; the iron picture confirmed and corrected; and free testosterone calculated from a real albumin value rather than an assumed one. Fix the constraints, then talk about the ceiling.
That is the discussion to have with the full dataset in hand and the doctors in the room — not a decision to make from a single panel and a hunch. If the low free-testosterone figure is what tempts you toward more, ignore it: see the next section.
Free testosterone: the number I'm not going to trust
Free testosterone came back at 12.27 pg/mL, up from 8.19 — a 50% rise, sitting in the lower half of its range. On its face that looks like a mismatch: strong total testosterone, perfectly normal SHBG at 29.63, and yet a mediocre free fraction.
It's not a mismatch. It's the assay. This was measured by direct ELISA, and direct or "analog" free-testosterone immunoassays are notoriously unreliable — they don't cleanly separate the tiny free fraction, and their numbers are method-dependent rather than physiological.
Run the standard calculation instead — total testosterone, SHBG and albumin through the Vermeulen equation — and you get roughly 16.5 ng/dL, about 2.3% of total. That is a completely normal free fraction and it's coherent with everything else on the panel. The ELISA number is the outlier, not my physiology.
Never change a dose on the strength of a direct free-testosterone ELISA. Ask instead for total testosterone by LC-MS/MS, SHBG, and a measured albumin — then calculate free testosterone properly. Equilibrium dialysis is the other good answer.
Albumin was not on this panel, so even my calculated figure rests on an assumed value. That is a gap, and it is now on the list.
Estradiol: the biggest mover on the whole panel
13.93 → 43.84 pg/mL. Up 215 percent, against a ceiling of 44.
That is not a surprise and it is not, by itself, a problem. More testosterone means more substrate for aromatase, and I'm carrying more body fat than I want to be — fat tissue is where a lot of that conversion happens. At trough. The peak is higher.
Men need estradiol. Libido, erections, mood, bone density, joints, cognition, vascular function — all of it runs partly on estradiol. A number near the top of the range is a number to watch, not a number to attack.
The wrong move here would be to reach for an aromatase inhibitor. Crushing estradiol buys joint pain, flattened libido, worse lipids and lost bone protection, and it treats a downstream number while leaving the upstream exposure untouched. The right sequence, if symptoms ever appear, is: verify with a proper assay, then look at dose and injection frequency, then the HCG, then keep losing fat. An AI is the last step, not the first.
Symptoms that would change my mind: persistent nipple tenderness, actual glandular tissue, fluid retention, blood pressure creeping up, or sexual function that reliably tracks the injection cycle. I have none of them. Feeling tired on a Tuesday doesn't count.
One caveat worth stating: standard estradiol immunoassays are genuinely unreliable at the low concentrations found in men. The next one gets measured by LC-MS/MS, at the same trough, or the number isn't worth arguing about.
The Finding That Actually Matters: Iron
This is the part I'd have missed if I'd only read the numbers that were flagged. Nothing here is dramatically out of range. The pattern is the finding.
Six markers. Every one of them pointing the same direction.
| Marker | 21 Apr | 30 Jul | Reference | What it means |
|---|---|---|---|---|
| Serum iron | 123.3 | 67.2 μg/dL | 65–175 | Down 45%. Sitting two points off the floor. |
| Transferrin saturation | 42.0% | 20.9% | 20–50% | Halved. Essentially at the floor. This is the headline. |
| UIBC | 170 | 255 μg/dL | 69–240 | Above range. Transport capacity sitting empty, waiting for iron that isn't arriving. |
| Ferritin | 129.1 | 78.4 ng/mL | 21.8–274.7 | Down 39% — and still technically 'normal', which is exactly the trap. |
| MCV | 85.3 | 84.7 fL | 86.0–96.0 | Below range — but it was below range in April too. See below. |
| Haemoglobin | 15.7 | 17.0 g/dL | 13.5–18.0 | Up 8%. Climbing regardless. |
Here's the mechanism. Testosterone drives red blood cell production — it raises erythropoietin and suppresses hepcidin, which means the marrow starts building cells faster and demanding more iron to do it. For a while the body simply spends its savings. Haemoglobin goes up, hematocrit goes up, everything on the blood count looks powerful.
Meanwhile the supply side quietly drains. Transferrin — the transport protein — carries less and less of its capacity filled, which is why saturation falls and UIBC climbs. Ferritin, the storage form, gets drawn down. And the newest red cells start coming out slightly smaller, because there wasn't quite enough iron to fill them.
Ferritin at 78 is inside the range, so a quick read calls it fine. But ferritin measures the warehouse, not what is actually reaching the factory floor — and it is pushed upward by inflammation, which can make a depleted person look stocked.
Ferritin down 39%, saturation halved to the floor, UIBC above range and cells getting smaller is a coherent story. The blood count looking strong is not evidence against it. It is the thing doing the draining.
The nuance I only have because I baselined
MCV was already below range in April — 85.3, before I started anything. So the small red cells are not new, and I should not pin them entirely on the protocol.
That matters, because a mild microcytosis that predates treatment opens a different question — an inherited pattern like thalassemia trait can look exactly like this and would need a haemoglobin electrophoresis to settle, not iron tablets.
But the supply collapse is unambiguously new. Saturation of 42% does not fall to 20.9% on its own. Iron doesn't drop 45% by coincidence. Those moved on my watch, and they moved because of what I'm doing.
Not the estradiol. Not the creatinine. Not the HDL. Iron.
Nothing here is dangerous today and nothing needs emergency treatment. But it is the only finding that gets worse on its own if I do nothing, because the thing driving it — testosterone building red blood cells — is running every single day.
Left alone, the sequence is predictable: smaller red cells, then falling endurance and slower recovery, then fatigue that no amount of sleep fixes, then eventually haemoglobin itself starts to drop. I would feel it in the gym long before a number looked alarming.
What I'm actually going to do about it
| Action | Why | |
|---|---|---|
| 1 | Confirm it with the right test — reticulocyte haemoglobin content, plus soluble transferrin receptor | Reticulocyte haemoglobin shows directly whether the cells being built right now are getting enough iron. It settles the question that ferritin can only gesture at. |
| 2 | Tick the boring box: confirm I'm not losing blood | Standard practice whenever an adult man's iron falls — a checkbox, not a suspicion. And in my case the numbers already argue against it: slow blood loss makes haemoglobin fall, and mine went UP, 15.7 to 17.0, alongside a rising red cell count. That is a body building blood, not leaking it. It stays on the list because it is cheap to exclude and the one thing you would not want to miss — not because anything suggests it. |
| 3 | Do not donate blood. No phlebotomy. | Hematocrit is 47.5% — nowhere near the threshold where TRT-driven erythrocytosis forces intervention. Draining blood from someone with falling iron makes the actual problem worse while treating a problem I don't have. |
| 4 | Check hs-CRP alongside ferritin | If inflammation is elevated, ferritin is being propped up and my iron stores are worse than 78 suggests. That test is on tomorrow's list. |
| 5 | Audit the inputs | Red meat, total dietary iron, and the calorie deficit I'm running. Cutting 10 kg while building red cells is a demanding combination. |
| 6 | Iron only if it's confirmed, and only with monitoring | Clinician-directed, alternate-day dosing, away from coffee and calcium. And repeat the blood count, because fixing iron can let testosterone-driven production accelerate again. |
And how you actually fix it
Rule one: confirm before you supplement. Iron is not a vitamin — the body has no route to excrete a surplus, and loading it into someone who doesn't need it causes real harm. My MCV was already low before I started anything, which leaves an inherited pattern genuinely on the table, and in that scenario iron tablets do nothing useful and something actively bad. Test first. Every time.
With that said, here is the plan once it's confirmed:
| Lever | What it looks like in practice |
|---|---|
| Food first | Red meat and organ meat. Haem iron — the form in animal tissue — is absorbed several times better than the iron in plants or a multivitamin. This is the cheapest fix and I am under-eating it while cutting. |
| Absorption timing | Vitamin C alongside, coffee and tea away from it. The tannins in coffee and tea and the calcium in dairy meaningfully block iron absorption. Same food, different hour, different result — my coffee habit is not helping here. |
| Alternate days, not daily | If supplementation is confirmed: 40–65 mg elemental iron every other day, clinician-directed. A daily dose spikes hepcidin, the hormone that blocks absorption, so you paradoxically absorb more total iron by dosing less often. |
| Mind the deficit | I am eating at a 500 kcal deficit while asking my marrow to build red cells at an accelerated rate. Less food in means less iron in. The cut and the iron demand are pulling against each other, and that tension is mine to manage. |
| What NOT to do | No blood donation. No phlebotomy. Hematocrit is 47.5%, nowhere near the threshold that would justify it. Draining blood from someone whose iron is already falling makes the real problem worse while treating one I don't have. |
| Then re-measure | Repeat the full iron panel and blood count after 6–8 weeks. And watch hematocrit while repleting, because fixing the iron supply lets testosterone-driven production accelerate again. Fix one thing, re-check the other. |
Timeline: nothing happens until the results come back. Confirm with the right test, clear the routine checkbox, then act. In the meantime the only free move is the obvious one — more red meat, and my coffee somewhere other than on top of it.
Everything That Moved
Lipids and cardiovascular
Covered in more depth in the last piece, and the picture holds: triglycerides down 41%, VLDL down 43%, non-HDL down 18%. Total cholesterol 158, LDL 102, fasting glucose 89.
Two blemishes, both small and both honest. HDL is 39 against a floor of 40 — one point under, and testosterone is known to push HDL down. And the atherogenic index is 4.1 against a target under 4, which is simply total cholesterol divided by HDL, so it's flagged for the same single reason.
The number I should actually be tracking isn't on this panel at all: ApoB. Every plaque-forming particle carries exactly one ApoB molecule, so ApoB counts particles directly, where LDL only measures how much cholesterol those particles happen to be carrying. Non-HDL at 119 is the best proxy this panel offers. Lp(a) belongs on the list too — measured once, for life, because it's largely inherited and completely invisible to a standard panel.
Kidney: the number that looks worse than it is
Creatinine 1.24, slightly over the 1.18 ceiling. eGFR 74, down from 80.
Creatinine is a breakdown product of creatine in muscle. I lift six days a week, I carry a lot of muscle, and I take creatine every single day. All three of those raise serum creatinine without anything being wrong with my kidneys — and the eGFR equation can't tell the difference between producing more creatinine and clearing less of it.
Cystatin C is the answer, and it's on tomorrow's list. It's produced at a steady rate by nucleated cells and barely cares about muscle mass. If cystatin C comes back normal while creatinine-based eGFR stays low, the creatinine number was an artifact of how I train. If both are down, that's real and I deal with it.
Liver and prostate: nothing to report, which is the point
| Marker | 21 Apr | 30 Jul | Reference | Status |
|---|---|---|---|---|
| ALT | 19 | 21 U/L | 0–45 | NORMAL |
| AST | 18 | 28 U/L | 11–34 | NORMAL |
| Alkaline phosphatase | 59 | 63 U/L | 50–116 | NORMAL |
| Bilirubin, total | 1.00 | 1.01 mg/dL | 0.3–1.2 | NORMAL |
| Bilirubin, direct | 0.28 | 0.35 mg/dL | 0.0–0.5 | NORMAL |
| PSA | 0.65 | 0.89 ng/mL | 0.00–2.50 | NORMAL |
Ninety-four days of injected testosterone, peptides, a GLP-class compound and NAD+, and every liver marker is normal — as it was at baseline. Not rescued. Never damaged.
AST moved 18 → 28, the biggest-looking jump in the table, and it's still comfortably in range. AST also lives in skeletal muscle. With a completely normal ALT, that pattern points at training, not the liver.
PSA 0.89, up from 0.65 and sitting at about a third of its range. Testosterone nudging PSA upward is expected. This is a number to trend, not to react to.
The Scorecard
| System | Verdict | The one thing to do |
|---|---|---|
| Hormonal | Strong — trough testosterone high-normal, free fraction normal once calculated properly | Stop using the direct free-T ELISA. Get LC-MS/MS total T, SHBG and measured albumin. |
| Estradiol | At the ceiling, no symptoms | Re-measure by LC-MS/MS at trough. Do not reach for an aromatase inhibitor. |
| Blood & iron | The real finding — no erythrocytosis, but a clear early iron-restriction pattern | Reticulocyte haemoglobin content. No phlebotomy, no blood donation. |
| Metabolic | Excellent — glucose 89, triglycerides 87 | Confirm with insulin, HOMA-IR and a repeat HbA1c against the 5.7% baseline. |
| Cardiovascular | Improving, mild HDL blemish | Measure ApoB and Lp(a). Track ApoB, not LDL. |
| Kidney | Probably an artifact — muscular, lifting, daily creatine | Cystatin C. Then read the two together. |
| Liver | Clean — normal in both panels | Nothing. Keep monitoring. |
| Prostate | Reassuring — PSA 0.89 | Trend it. Don't react to a single value. |
And Now the Part Where "Final" Stops Being True
I had this article mostly written. Full panel, full comparison, scorecard done, a tidy list of everything I couldn't answer because it wasn't measured this round — IGF-1, thyroid, insulin, HbA1c, inflammation, cystatin C, the whole pituitary axis.
Then TRT Colombia messaged me.
Not to sell me anything. To tell me they want the complete dataset — the same comprehensive panel I did at the very start — so they can compare like against like instead of guessing across a gap. And that they're covering the cost.
Every marker missing from this panel, drawn tomorrow at 7:00am. Fasted, at home, arranged end to end by them.
Laboratory value: COP $1,270,000. Roughly 300 US dollars.
Cost to me: zero. Their words: to ensure we complete the same comprehensive evaluation and can accurately compare the results against the original baseline.
Thank you, Adriana, and thank you to the team at TRT Colombia. That kind of thing is worth writing down.
So the numbers above are real, complete and analysed — and they are not the final word, because sixteen more measurements land within the week.
What's being drawn tomorrow, and what each one answers
| Test | The question it answers |
|---|---|
| LH & FSH | How suppressed is my own pituitary signal on TRT — and is the HCG doing what it's meant to? Neither proves fertility; only a semen analysis does that. |
| IGF-1 | The one I most want to see. It was 251 against a ceiling of 230 before I started any growth-hormone peptides. Already above range, unmedicated. What has CJC-1295 and ipamorelin done on top of that? |
| Fasting insulin + HOMA-IR | Glucose of 89 is excellent — but how much insulin is it costing me to hold it there? That's the difference between metabolically healthy and metabolically compensating. |
| HbA1c | Baseline was 5.7% — the first tick of the prediabetic band. Ninety-four days of deficit and a GLP-class compound should have moved it. Did they? |
| hs-CRP | Systemic inflammation. Also the check on whether my ferritin of 78 is real or propped up. |
| Cystatin C | Settles the kidney question: artifact of muscle and creatine, or genuine. |
| Full thyroid — TSH, free T3, free T4 | Whether sustained calorie restriction has started throttling thyroid output. Free T3 is where that shows up first. |
| Morning cortisol | Six training days a week, a deficit, and a stack of hormone-active compounds. Is the stress axis coping? |
| Prolactin | Was 16.07 against a ceiling of 19.40 — high-normal at baseline. Worth watching. |
| DHEA-S | Adrenal androgen output alongside everything being administered. |
| Homocysteine | A vascular risk marker the standard panel misses entirely. |
| Vitamin D (25-OH) | Was 35 — sufficient, not optimal. Bone, muscle, immune, endocrine. |
| ECG | Rhythm and conduction, before the protocol goes any further. The one that isn't a blood test. |
Twelve-hour fast starting at 7pm tonight. Hydrated, rested, no training beforehand. Seven in the morning.
And what is still missing from that list
That panel is comprehensive. It is not quite complete — and since the needle goes in at seven tomorrow morning, this is worth saying out loud rather than discovering in a month.
Five things are not on it, and between them they close the two questions this whole article had to leave open:
| Missing test | What it would settle | Priority |
|---|---|---|
| Reticulocyte haemoglobin (Ret-He / CHr) | The one that ends the iron argument. It measures whether the red cells being built right now are actually receiving iron. Everything above is inference; this is measurement. | HIGH |
| Albumin | Free testosterone cannot be calculated properly without it. It is the reason my free-T figure still rests on an assumed value. Routine, cheap, and it fixes the single weakest number on the panel. | HIGH |
| ApoB | The best cardiovascular risk number available — it counts the actual plaque-forming particles instead of estimating what they contain. Better than every lipid value I already have. | HIGH |
| Lp(a) | Measured once in a lifetime. Largely inherited, completely invisible to a standard lipid panel, and it changes how aggressive the ApoB target should be. | MEDIUM |
| Soluble transferrin receptor | Corroborates the iron picture and, unlike ferritin, is not distorted by inflammation. | MEDIUM |
Five additions to tomorrow's draw, in the order I care about them:
1. Reticulocyte haemoglobin (Ret-He or CHr) — the test that ends the iron question instead of inferring it.
2. Albumin — routine and cheap, and free testosterone cannot be calculated properly without it.
3. ApoB — a better cardiovascular number than anything already on the panel.
4. Lp(a) — once in a lifetime, and it changes the ApoB target.
5. Soluble transferrin receptor — backs up the iron picture without ferritin's inflammation problem.
The first two are the ones that matter. They turn two educated inferences into two measurements, and both are trivial next to what is already being run. If the lab can't add them at this notice, they go on the next draw — but the asking costs nothing and the answer is worth a month.
Which is the whole point of auditing the list before the needle goes in: a panel nobody checks is a panel that quietly answers the wrong questions. They offered a complete workup in good faith. Working out what "complete" should mean is my job, not theirs.
Where This Leaves Me
Ninety-four days in: testosterone up 56% measured at its floor, triglycerides down 41%, non-HDL down 18%, liver untouched, prostate quiet, glucose excellent. That's the protocol working.
One genuine problem, and it isn't the one anybody would have flagged. Not the estradiol at the ceiling, not the creatinine, not the HDL a single point low. It's iron — found not because any single value screamed, but because six of them leaned the same way at once.
That's the entire argument for measuring instead of feeling. I feel great. I would have told you everything was perfect. The blood says one system is quietly running down its reserves to keep another one impressive.
Sixteen more numbers on Monday or Tuesday. Then the comprehensive review, then a new protocol built on all of it rather than most of it.
That one will be the final results. Probably.
The protocol is working. That is the headline and it is not a close call.
1. Testosterone +56%, measured at its lowest point of the cycle. My floor is now roughly my old ceiling.
2. Triglycerides −41%, non-HDL −18%, glucose 89, liver spotless in both panels, prostate fine, six kilos gone. Ninety-four days of injecting a lot of compounds and nothing is damaged. That was the thing actually worth checking, and it came back clean.
3. One imperfection, and it is the easy kind: iron. Not a disease, not damage, and nothing to worry about — I am using iron faster than I am eating it, because building extra blood costs iron. A supply problem with a boring fix: more red meat, coffee away from meals, and a cheap supplement every other day if a test confirms it. Weeks, not months.
4. The only reason it gets a whole section is that no single number screamed — six of them just leaned the same way at once. That is what measuring buys you. I feel great. I would have told you everything was perfect.
5. The dose does not go up yet. I want more eventually — fix the constraints first, then talk about the ceiling.
6. Sixteen more tests within days, plus five I asked to add. Then the real protocol rebuild.
Ninety-four days in: substantially better across the board, one small and entirely solvable thing to tidy up. I would take that trade every single time.
Related Reading
- The Numbers Came Back — the partial panel this completes.
- Five Tubes of Blood and a 688-Page Manual — where the baseline came from.
- MONSTER 2.0 — The Blueprint — the training block these numbers set the target for.
- The Sword Goes Back in the Sheath — the recovery week around the draw.
- Mapping SmartFit Inventory with AI — the same measure-don't-guess habit, pointed at a room.
- Twenty-One Markers and an ECG — the extended draw that closes the gaps this panel left open.
