100mg Cypionate every 2 weeks

[Cali965]

I am 58 years old and my Dr wanted me to inject Cypionate 100mg 1x weekly, but with recommendations from this forum I injected Cypionate 50mg two times a week with 29g Insulin syringe into my delts.

After 7 weeks my Testosterone is 941 ng/dl (Reference Range: 250 ng/dL - 1100 ng/dL) and Free testosterone is 243.9 pg/dl (Reference Range: 35.0 pg/dL - 155.0pg/dL)

Now she wants me to drop to 1x 100mg every two weeks. I tried to get her to adjust the dosage to 80mg weekly but she wants to try this first.
I feel good overall and definately have more energy but the brain fog, concentration & motivation has not gotten better, hopefully my depression meds can fix that with dosage adjustment.
The test was done on monday morning before my 50mg shot on mondays as I do thursday & monday shots

What do recommend I do:

1. Inject 100mg every 2 weeks
2. Inject 50mg weekly
3. Inject 25 mg twice a week

Thank you in advance.

 

[tareload]

See this table...

And links attached. Your mean TT probably a little above range given the trough you shared. I like your suggestion of 80 mg/week total and you should see about a 20% reduction in T levels.

40 mg twice weekly and see how you are doing in 12 weeks if she is really pushing for a reduction. You are smart. Find minimum effective dose using thoughtful changes.

What other blood work did she pull? How's your other markers?

Some labs out of range -- would you change anything?

Hi All, My question is: Given my data below -- would you change anything? Me: 61yo, 5'10", 165lbs, TRT for nearly 2 years. I've titrated up over that time up to current .10mg test cyp SQ daily (last 6 months). Good body composition, good energy, good cognitive function, good libido/sexual...

www.excelmale.com

 

[Cali965]

Other results were:
RBC = 6.23 M/uL (Range:4.20 M/uL - 5.80 M/uL)
HGB = 17.5 gm/dL (Range:13.2 gm/dL - 17.1 gm/dL)
HCT = 53% (Range:38.5 % - 50.0 %)

She wasn't concerned with anything but 941 ng/dl & HCT 53%

With her ration of Cypionate 100mg every 2 weeks I only have the following options for now and evaluate in 4 weeks:
1. Inject 100mg every 2 weeks
2. Inject 50mg weekly
3. Inject 25 mg twice a week

 

[tareload]

Other results were:
RBC = 6.23 M/uL (Range:4.20 M/uL - 5.80 M/uL)
HGB = 17.5 gm/dL (Range:13.2 gm/dL - 17.1 gm/dL)
HCT = 53% (Range:38.5 % - 50.0 %)

She wasn't concerned with anything but 941 ng/dl & HCT 53%

With her ration of Cypionate 100mg every 2 weeks I only have the following options for now and evaluate in 4 weeks:
1. Inject 100mg every 2 weeks
2. Inject 50mg weekly
3. Inject 25 mg twice a week

What was your baseline Hct?

In 4 weeks you won't see a big move on Hct.

I still vote for Door #4. One of the pillars of medical ethics is patient autonomy. You may end up at lower than 80 mg/week but dropping 50% in one step is a big step change.

 

[Systemlord]

Now she wants me to drop to 1x 100mg every two weeks.

All you have to do is lower your dosage, it's as simple as that!

Diagnosis and management of testosterone deficiency

Testosterone supplementation therapy (TST) use has dramatically increased over the past decade, due to the availability of newer agents, aggressive marketing, and an increasing incidence of testosterone deficiency (TD). Despite the increase in TST, a ...

www.ncbi.nlm.nih.gov

Slightly longer but still relatively short-acting agents testosterone enanthate and testosterone cypionate require injections every 1–2 weeks due to half-lives of 5–7 days, respectively. All of the short-acting agents are plagued by a “roller coaster” effect by achieving supraphysiologic levels within 2–4 days after injection followed by sub-therapeutic levels by 10–14 days. A rapid decline in serum levels around 10–14 days has been called “testosterone crash” and is associated with sudden recurrence of TD symptoms. To minimize these effects, more frequent dosing from once to twice weekly has been suggested as is preferred by these authors.

 

[Systemlord]

With her ration of Cypionate 100mg every 2 weeks I only have the following options for now and evaluate in 4 weeks:
1. Inject 100mg every 2 weeks
2. Inject 50mg weekly
3. Inject 25 mg twice a week

You can look at it like this, first week 50% of Test is eliminated, by end of week two, 75% of Test is eliminated.

That second week is going to be brutal!

Your prescriber isn't skilled enough to be managing anyone on TRT!

 

[Cali965]

I am surprised my T level was 941 ng/dl as I injected 0.5ml on Thursday morning and got the lab work done Monday at 10.30am.......shouldn't it have been lower?
Also, since my trough level was 941 ng/dl on 0.5ml twice a week what might it be if I did as she wanted and injected 1ml every 2 weeks on a Monday and tested on a Monday in 4 weeks?
I already know that it's not gonna be fun etc.....just kinda wondering what to expect.

 

[tareload]

I am surprised my T level was 941 ng/dl as I injected 0.5ml on Thursday morning and got the lab work done Monday at 10.30am.......shouldn't it have been lower?
Also, since my trough level was 941 ng/dl on 0.5ml twice a week what might it be if I did as she wanted and injected 1ml every 2 weeks on a Monday and tested on a Monday in 4 weeks?
I already know that it's not gonna be fun etc.....just kinda wondering what to expect.

100mg Cypionate every 2 weeks

I am 58 years old and my Dr wanted me to inject Cypionate 100mg 1x weekly, but with recommendations from this forum I injected Cypionate 50mg two times a week with 29g Insulin syringe into my delts. After 7 weeks my Testosterone is 941 ng/dl (Reference Range: 250 ng/dL - 1100 ng/dL) and Free...

www.excelmale.com

My next blood test

I will go see my doctor in about 4 weeks . Brief history and areas of concern: * 750mg testosterone undeconoate every 12 weeks January 2017 RBC - 5.65 Hemoglobin - 16.8 Hematocrit - 50.9 TESTOSTERONE, TOTAL, RGA MALES (ADULT), IA - 772 * 750mg testosterone undeconoate every 4 weeks March...

www.excelmale.com

Tool to Assess your TT Dose Response -- Percentile Curves

Summary: Tools to estimate your individual dose response for injectable testosterone ester in comparison to a normal distribution (95 percentile confidence estimate) of adult males (Ref). Plot below shows a summary of data from (1) clinical trials gathered from the literature + (2)...

forums.t-nation.com

 

[Systemlord]

1ml every 2 weeks on a Monday and tested on a Monday in 4 weeks?
I already know that it's not gonna be fun etc.....just kinda wondering what to expect?

Considering the advice you’ve been given, the studies showing what a piss poor protocol your prescriber has suggested, your just going to roll over and not put your foot down and demand better or at least start looking for another doctor?

You have enough information to make your own decisions.

 

[Mastodont]

I am surprised my T level was 941 ng/dl as I injected 0.5ml on Thursday morning and got the lab work done Monday at 10.30am.......shouldn't it have been lower?
Also, since my trough level was 941 ng/dl on 0.5ml twice a week what might it be if I did as she wanted and injected 1ml every 2 weeks on a Monday and tested on a Monday in 4 weeks?
I already know that it's not gonna be fun etc.....just kinda wondering what to expect.

I thought you were doing 100mg per week, if you are doing 0.5ml twice a week you are doing 200mg per week, that cypionate must be 200mg/ml right?

 

[Cali965]

I thought you were doing 100mg per week, if you are doing 0.5ml twice a week you are doing 200mg per week, that cypionate must be 200mg/ml right?

No it is 100mg

 

[Cali965]

Considering the advice you’ve been given, the studies showing what a piss poor protocol your prescriber has suggested, your just going to roll over and not put your foot down and demand better or at least start looking for another doctor?

You have enough information to make your own decisions.

I have seen 2 Urologists and both said they would start off at 100mg every 2 weeks as Cypionate shot is recommended every 2 - 4 weeks from 50mg-400mg

 

[Systemlord]

I have seen 2 Urologists and both said they would start off at 100mg every 2 weeks as Cypionate shot is recommended every 2 - 4 weeks from 50mg-400mg

I just gave you a study showing why an every 2 week protocol isn't ideal. The endocrine society recommends 75-100 mg weekly.

Your doctors are out to lunch!

 

[Systemlord]

The treatment for anxiety and depression, you don't see protocols that allow the medicine to reach a therapeutic concentration, wait for the medicine half-lives to decline to the point where the anxiety see's a vigorous resurgence, and then take another pill 2 weeks after your last pill and the roller-coaster repeats.

This is what they do to men on TRT and this is no way to treat a patient!

The ivy league people that wrote these guidelines decades ago had no idea what they were doing. If you look at the half-life of cypionate (5-7 days), with hypogonadal levels by the second week and a 75% reduction in Test by 3 weeks.

Any doctor that doesn't see a problem here wasn't paying attention when they were learning about pharmacokinetics, which all doctors are required to learn in medical school.

 

[Cali965]

I just gave you a study showing why an every 2 week protocol isn't ideal. The endocrine society recommends 75-100 mg weekly.

Your doctors are out to lunch!

I totally agree with you and have listened to your advice and and I even got her to let me go with 100 mg every week versus every two week in the beginning, unfortunately with the high testosterone level of 941 she is concerned about my health. I said to her it would be better to do 80 mg a week instead of 100 every 2 weeks but she disagrees and wants to do it her way. By the time I go through another few doctors and hopefully find someone that will give me the right regimen the month would have passed at least, so I'm thinking I just bite the bullet do the 100 mg every 2 weeks and get retested on the 27th, hopefully my T level is low enough for her to put me back to weekly at 80 mg to start with.
I understand there's going to be problems in the second week but I think I just got to do it as I'm not going to get anywhere better within one month unless I go private clinic.

 

[t_spacemonkey]

another shitty doctor. reminds me of my beginnings. dude insisted on 100mg every 2 weeks. did not even bother checking SHBG which is ultra low. thankfully i found a proper clinic quickly

 

[Systemlord]

I totally agree with you and have listened to your advice and and I even got her to let me go with 100 mg every week versus every two week in the beginning, unfortunately with the high testosterone level of 941 she is concerned about my health.

You should just show your doctor that study and maybe she will just lower your weekly dosage to 80 mg (40 mg x2 weekly).

 

[TRT15+]

Other results were:
RBC = 6.23 M/uL (Range:4.20 M/uL - 5.80 M/uL)
HGB = 17.5 gm/dL (Range:13.2 gm/dL - 17.1 gm/dL)
HCT = 53% (Range:38.5 % - 50.0 %)

She wasn't concerned with anything but 941 ng/dl & HCT 53%

With her ration of Cypionate 100mg every 2 weeks I only have the following options for now and evaluate in 4 weeks:
1. Inject 100mg every 2 weeks
2. Inject 50mg weekly
3. Inject 25 mg twice a week

What was her recommendation for the high HCT and RBC? I have similar problem

 

[MarcoFL]

I drink a ton of spring water, L citrulline and baby aspirin. My blood flows like CRAZY!

 

[tropicaldaze1950]

You can look at it like this, first week 50% of Test is eliminated, by end of week two, 75% of Test is eliminated.

That second week is going to be brutal!

Your prescriber isn't skilled enough to be managing anyone on TRT!

Agree! She's treating by numbers, a recipe for failure, not how the OP is feeling/functioning, even if it's early in treatment.