Six Week Check In

BBaller · Dec 28, 2015

Hey guys,

Here's some blood-work at around 6 weeks after starting TRT. My current protocol is

70mg Test cyp
400IU HCG

2x/week subcutaneously. I inject Tuesday nights and Saturday morning, and drew this blood Tuesday afternoon before my evening injection.

Waiting on my estradiol results and will return with a follow up once received, but here are my free/total T test results via DiscountedLabs.com:

Testosterone Serum- 683 ng/DL - 348-1197
Testosterone Free- 23.6 pg/mL- 8.7- 25.1

A few questions:
1- How long does it take for blood serum levels to reach their peak? In other words, is this roughly where I'll be at on current dosage, or will it still be climbing to its peak steady level over the next 6+ weeks?

2- Can you help me understand again the role of free T? I see calculations sometimes about 2-3% of total T, and also mentions of bio-available T vs free T, and it's still hazy for me.

Thanks in advance

Vince · Dec 28, 2015

Free - testosterone is the portion of testosterone (T) that is available to enter a cell and bind to the androgen receptor to turn on a variety of anabolic genes to synthesize a variety of T dependent proteins. These tissues include muscle, brain, penis, bone, heart and other tissues.

Free T is the active form of T that can enter the cell. The main binding of T is to SHBG and albumin. There are different ways to determine FT. Some use free androgen index method, which is done by a calculation formula. Recently the LC/MS-MS (liquid chromatography / mass spectroscopy) has become the most widely and easy to use method.

There is an epidemic around the world of men with insufficient FT levels of less than 15-20 pg/mL and excess E2 levels greater than 35 to 40 pg/ml. When there is excess E2 it may indicate excess aromataze enzyme activity.
https://www.excelmale.com/forum/sho...adiol-and-Sex-Hormone-Binding-Globulin-in-Men

BBaller · Dec 28, 2015

Vince said:
There is an epidemic around the world of men with insufficient FT levels of less than 15-20 pg/mL and excess E2 levels greater than 35 to 40 pg/ml. When there is excess E2 it may indicate excess aromataze enzyme activity.
https://www.excelmale.com/forum/sho...adiol-and-Sex-Hormone-Binding-Globulin-in-Men

Thank you Vince. A follow up question: if less than 15-20pg/mL is insufficiently low, does that shift the entire reference range up? Or does it just make it tighter?

In other words does it shift 8.7-25.1---> 15-25.1, or 15-33 or so?

BBaller · Dec 31, 2015

Hey everyone,

I received back my results from the Ultra-Sensitive Estradiol test, and it was
27pg/mL - 8.0-35.0pg/mL (Total T at 683 T:E Ratio ~ 25)

Previous non-sensitive test results:
Nov 2014
26.7pg/mL- 7.6-46.2pg/mL (Total T at 566 T:E Ratio ~21)

April 2015
15.5pg/mL- 7.6-46.2pg/mL (Total T at 288 T:E Ratio ~19 )

Sept 2015
17.3pg/mL- 7.6-46.2pg/mL (Total T at 337 T:E Ratio ~19)

Can anyone weigh in and help me understand these results?
1- My T:E ratio has gone up from between 19-21 pre-TRT --> 25. Is this significant? Is there an optimal ratio?
2- How much of this is confounded by the fact that this is the first ultra-sensitive test, versus the ECLIA non-sensitive test used previously?

ERO · Dec 31, 2015

Optimal T/E Ratio is between 14 and 20, but most important is how you feel. Your ratio of 25 means that you are a bit low on E2 but nothing to worry about. There is no good way to compare the ultra sensitive test to the regular test and its just a rabbit hole trying to go there. Just call these test results your 6 week TRT baseline and ignore previous tests.

Your total T level is decent but could be higher. See what your doc says, but consider going to 80 mg twice a week instead of the 70 you are using now.

How do you feel? Good libido? Good energy?

BBaller · Dec 31, 2015

Thanks ERO.

I've heard that many guys don't really start to "feel" TRT until they're 700+. I would say that my experience mimics this. My energy is still a little low, and my gym consistency has been off. I aim for 3-4x/week, but the last few months have been closer to 1-3x/week. I do however have enough energy for 5-15+ hours of recreational basketball each week, which is an important physical outlet for me. Libido is good- no ED issues either to date, and thankfully both of those were fine to begin with.

In general, I think I'm still in the 'wait and see' stage, and have official follow up bloodwork, with a consulation I am to schedule for around 12 weeks. I'm working with Defy and I think Dr Saya said the goal is to get in the upper quartile+ in terms of total T levels. Still in the healthy normal range, but on the higher end of it. I'll have to ask, and suspect that titrating up will be in order if things don't improve by 12 weeks.

ERO · Dec 31, 2015

Excellent! You are in great hands with Dr Saya, and if you can play 15 hours of basketball a week, I'd say your energy is pretty darn good as well

Dr Saya may very well titrate you up a bit if your numbers are the same at the 12 week mark as the upper quartile (assuming 1100 is upper limit - different tests have differing upper limits) is going to be between 825 and 1100.

BBaller · Dec 31, 2015

ERO said:
Excellent! You are in great hands with Dr Saya, and if you can play 15 hours of basketball a week, I'd say your energy is pretty darn good as well Dr Saya may very well titrate you up a bit if your numbers are the same at the 12 week mark as the upper quartile (assuming 1100 is upper limit - different tests have differing upper limits) is going to be between 825 and 1100.

Thank you! It's not 15 hours every week, but almost always 5+; appreciate the reminder not to take that for granted.

And yes, I have lots of confidence and every reason to trust the good care of Dr Saya. I will be sure to ask about my T:E ratio next time, and to confirm the goal range.

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