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If you're including testosterone suspension in this then yes, I am using it as a form of TRT. As documented here, I recently tried measuring the response over time. My protocol has involved injecting a nominal 1.5 mg three times a day. But based on lab work I'm beginning to suspect the actual...

This is very much in line with my thinking, particularly the part about a longer HTPA shutdown being more problematic. In my case the addition of hCG was an improvement, but it never led to consistent libido and/or sexual function, and things still went downhill over the years. Dropping the hCG...

Lately I’ve been insinuating that some testosterone suspension products may qualify as fast-acting, and therefore be in the same league as testosterone nasal gels and buccal troches. The “fast-acting” quality is important if the goal is to retain HPTA function in the presence of exogenous...

I do believe that TRT in just about any form is preferable to hypogonadism. However, now that we have an increasing number of choices that are less disruptive of the overall hormonal milieu I would hope these eventually become the new standard of care.

These are all relatively short and with small N, as they acknowledge: "A large number of clinical trials with relatively small numbers of participants, have been conducted to investigate the effects of testosterone, for generally limited durations of intervention, on various cognitive function...

As noted, GnRH may play a role in adult neurogenesis. Also in the post I linked to: ”[1] Furthermore: “Multiple lines of evidence indicate that the expression of extrapituitary GnRH receptor is not limited to reproductive tissues. For instance, it has been demonstrated by RT-PCR and Southern...

Which studies evaluated the rates of dementia? Healthy controls or just untreated hypogonadal subjects? What's needed to answer this question more definitively is a study with large N that has matched eugonadal men as controls. The study needs to last long enough and/or have old enough subjects...

Regardless of whether the testosterone is endogenous or exogenous, the fraction that is aromatized is trivial, and you'd be unable to detect such an increase, subjectively, or even with current lab tests. On the other hand, knocking down a big fraction of estradiol is what can cause significant...

That's good to know and nice work by Maximus. It sounds like I may be able to add it to the list of short-acting testosterone treatments. I still don't like the use of the term "bioidentical" to differentiate it from products that in the end also yield bioidentical testosterone. "Non-esterified"...

DHT is created from free testosterone. The rate of creation is not expected to change with lower estradiol. This means free DHT should not change. But as with testosterone, if SHBG is driven down by the lower estradiol then total DHT may drop. I should add that I'm ignoring the tiny amount of...

In this situation an aromatase inhibitor should not affect your free testosterone. It could indirectly affect total testosterone by reducing estradiol. Lower estradiol can lead to lower SHBG and therefore lower total testosterone as well. Your dose of testosterone has likely suppressed LH and...

As I recall, all of the oral forms of testosterone have considerably longer half-lives than the nasal gels. Something like a few hours versus less than an hour. This makes the difference between significant and possibly complete suppression of the HPTA, versus relatively minor suppression. Over...

It's less common to have low-T symptoms with that level of free testosterone. I would steer you away from the three treatment options you're considering. They all come with some risk of doing more harm than good given that you're not firmly into hypogonadal territory. If you want to explore...

I’ve covered this issue in many posts, but I thought it would be helpful to put more information in one thread and expand on the topic. TL;DR: Under TRT, free testosterone is proportional to the dose rate and inversely proportional to the metabolic clearance rate. The liver accounts for most of...

This is false. The ratio varies and is highly dependent on the SHBG level. For a fixed free testosterone, which occurs at a fixed dose rate, as SHBG goes higher so does total testosterone, and this lowers the ratio of FT to TT. Using measurements of SHBG, albumin and total testosterone you can...

In the case of aromatization you're looking at converting 0.2 to 0.6% of testosterone. Even knocking it out entirely leads to a trivial increase in free testosterone. This myth that a decrease in SHBG leads to an increase in free testosterone may stem from a mistaken idea that total...

They are fooling themselves and others. The quality anecdotal evidence I've seen shows that when such steroids are added, free testosterone does not change if the TRT dose remains the same. You can see reduced SHBG, both real and effective, and effects on aromatization. But there is not a...

This highlights the confusion about whether total or free testosterone is the dependent variable. I've been arguing for years that total testosterone is the dependent variable, determined by free testosterone and the binding protein levels and other hormone levels. o The new data show that this...

I believe they are making this more complicated than necessary, and potentially reversing causes and effects. Under TRT the dose rate and metabolic clearance rate directly and proportionally determine free testosterone. In turn, total testosterone is driven primarily by free testosterone, SHBG...

We went through it again just last month, in this thread a few posts back. Being on TRT is not relevant. Free testosterone is driven by the rate of testosterone entering the system: https://www.excelmale.com/threads/what-it-the-purpose-of-sex-hormone-binding-globulin-shbg.24916/post-297524

We've been discussing this for years now. SHBG has little influence on free testosterone. The shift to lower SHBG under TRT does not change free testosterone at steady state. Free testosterone is determined by the dose rate and the metabolic clearance rate constant. The same applies when SHBG...

It depends on your dose. The thing about injections is that it's much too easy to overdose, and most men do. For example, the common starting dose of 100 mg of testosterone cypionate per week is well above typical healthy natural production, which is equivalent to more like 50-70 mg. Regarding...

The problem with HCT is still going to be primarily a function of dose. If you absorb a similar amount of testosterone via cream and serum levels are fairly steady then the results probably won't be much different. There is some complexity with respect to the pattern in serum testosterone. Based...

I didn't ask if you have ruled out fast absorption. To do this properly you need several samples of serum testosterone during the day to estimate area-under-the-curve. But it might suffice to see what your testosterone level is two to fours hours post-injection. If it is extremely high then you...

It's an interesting hypothesis, but I'm not aware of any supporting data, and there is some pointing against it. For example, in one of the testosterone dose-response trials free testosterone remained proportional to dose even at very high doses of testosterone. Now I guess you could argue that...

It only works that way if you're measuring total testosterone on an absolute basis, e.g. the total milligrams in plasma. But we're measuring the total concentration in blood, which is mostly bound to the effective reservoir of SHBG and albumin. This means the concentration of total testosterone...

Weight is probably related only indirectly to the observations. Obesity would be strongly correlated with metabolic syndrome and low SHBG. The low SHBG is what drives down total testosterone, but not free testosterone. Therefore it's unlikely that heavier men on TRT actually need higher doses...

In fact this is usually the case. 100 mg per week in divided doses puts my total testosterone over 1,200 ng/dL, and this is common. @Readalot shared data supporting this proposition. Your low SHBG suppresses total testosterone. Free testosterone is proportional to the dose rate. By what method...

The ibutamoren is taken at bedtime, hours after the last meal. I've been using a continuous glucose monitor and there's no evidence of negative effects in this regard. Which is to say that it didn't make things worse. But my Hba1c was already running high in the reference range in spite of good...

Fortunately this assessment appears to be overly pessimistic. Phase 3 of the Sprifermin trial is ongoing, and researchers envision public access to this treatment soon. [R] I can also report that I have overcome the hurdles and obtained FGF-18, basically using the techniques you mention above...

Opinions vary, but mine is that "real" TRT excludes going much over 100 mg of testosterone cypionate per week. That's because this is beyond the physiological production range. Your 200 mg is double this, and at 20 mg of testosterone per day that's giving you about triple what a healthy young...