4 weeks into Testosterone. Have a few questions about current protocol and the reason why I started.

[DiegoG]

Bloods Right before beginning TRT.
Hematocrit - 44.9%
PSA - 1.220 ng/ml
Testosterone Total - 337 ng/dl
Free Testosterone - 74 pg/ml
SHBG - 22nmol/l
LH - 5.69 mIU/mL
FSH - 2.37 IU/L
E2 - 13.4 pg/ml
DHEA - 281 ug/dl
Growth Hormone - 0.06 ng/mL
Thyroid panels were normal.
Pituitary gland MRI - Normal

I am 34 years old male and weigh 170 pounds. 5'10 in height.

So here are the symptoms that led me to check my testosterone. Extreme Fatigue around mid day (2pm) I could barely walk to my office to work. Debilitating fatigue, PVCs, brain fog, concentrating issues, decreased libido, moodiness, and probably the worse symptom was I developed POIS - Post orgasmic illness syndrome. My POIS symptoms were as followed. Immediately after ejaculation I would get numbness in my hands, arms and head followed by some of the worse brain fog in my life and my mood would fluctuate heavily. I was prescribed 100mg of testosterone cypionate, once a week by my endocrinologist. I am injecting only 80mgs. I inject 20mgs every 2 days. The reason I am doing this as per my research so far it seems less in more. Start small and gradually go up. This is week 4 and I only checked my total testosterone on the trough day and it came back at 444 ng/dl. So after 4 weeks at this dose ive gained about 100 points on my T. Below is what has improved in so far.

mid day 2pm fatigue/crash - 80% Improved
PVCs - Gone 100%
General Brain fog - improved 40%
Concentration - improved 50%
Energy levels - Improved 50%
Decreased Libido - improved 40%
Mood - improved 50%
POIS symptoms - Improved 30% - Numbness after ejaculation is gone, but brain fog persists and increases slightly after ejaculation. The longer I sustained the more the brain fog improves.

I've done a lot a research on POIS and I know it sucks and is very difficult to heal. I've read the study on the 25 year old that resolved his symptoms by raising his T to the 900's via HCG therapy.

So my question. Am I being to conservative on my dose at 80mgs a week? Pinned 4 times a week at 20mgs a pin? Also, starting to think I should of added a small dose HCG to keep things alive downstairs. Not sure if it's a good idea or not.

Should I increase my dose to elevate my total T faster and possibly get more symptom relief quicker or should I continue with this protocol and continue the slow and steady increase? I can increase my dose up to 200 mgs/week if necessary. I am prescribed 200mg/1ml vials a week. My scripts gets me 4 vials a month. They instruct me to throw the left over away but I just use what's left for my next dose. Using new clean syringes of course. I appreciate any feedback and help. I am completely new to TRT and am using it for medical issues.

Thank you,

 

[Systemlord]

Am I being to conservative on my dose at 80mgs a week?

There's nothing wrong with starting low and going slow. You'll most likely need closer to 100 weekly to feel optimal.

A 200 mg weekly dosage would likely put your Total T and Free T levels supraphysiological and is a bit much for most men.

You should maintain at least a 550 ng/dL trough levels as this puts you at 30% reduced risk of heart attack and death from any cause.

 

[DiegoG]

There's nothing wrong with starting low and going slow. You'll most likely need closer to 100 weekly to feel optimal.

A 200 mg weekly dosage would likely put your Total T and Free T levels supraphysiological and is a bit much for most men.

You should maintain at least a 550 ng/dL trough levels as this puts you at 30% reduced risk of heart attack and death from any cause.

I guess that's part of my issues. Feels like things have leveled off. Not seeing much movement on symptoms currently.

 

[Systemlord]

Defining Healthly Testosterone Levels

Multiple peer-reviewed papers state that "testosterone deficiencies" are more prevalent and "desirable testosterone" levels in men are actually much higher than what is currently being considered as "normal" in doctors' practices across the country. Case in point: A cross-sectional study of Swedish men ages 69 to 80 years showed the risk for premature death from any cause and the risk for suffering a major cardiovascular event were inversely correlated with the total serum testosterone concentration (i.e., the higher the testosterone levels, the lower the risk of death).

Specifically with regards to cardiovascular events, men in the highest quartile of testosterone (at or higher than 550 ng/dL) had a lower risk of cardiovascular events compared with men with lower testosterone.

More importantly, details from this study show that it did not matter if a man's total testosterone was very low (below 340 ng/dL ) or moderately low (up to 549 ng/dL ) – all men with T levels below 549 ng/dL had a similar increased risk for suffering a cardiovascular event. Only when total testosterone exceeded 550 ng/dL did cardiovascular risk drop.

This is truly alarming, as cardiovascular disease is the No. 1 killer of men in the United States and even more – this study was published in the Journal of the American College of Cardiology. These researchers documented a 30 percentreduction in cardiovascular events as well as a decrease in cerebrovascular disease incidence. Men with the highest total testosterone had a 24 percent reduced risk of transient ischemic attack or full-blown stroke. Clearly, based on this study, the only target for "healthy testosterone" is to maintain total testosterone at or above 550 ng/dL.

As a health care practitioner, please note the following:

According to LabCorp, the "healthy reference range" for total testosterone is 348–1,197 ng/dL. So, the lower part of this range completely ignores recent science that shows total testosterone levels need to be maintained above 550 ng/dL.
Subjectively, this broad range is ridiculous. As any 45-year-old man who has suffered with low normal testosterone knows,there is a world of difference in how a man feels and performs (both mentally and physically) when testosterone is "low normal" versus higher up the healthy "normal" reference range.

Giving Testosterone Levels a Boost | Dynamic Chiropractic

www.dynamicchiropractic.com

 

[Systemlord]

Not seeing much movement on symptoms currently.

Onset of effects of testosterone treatment and time span until maximum effects are achieved

Testosterone has a spectrum of effects on the male organism. This review attempts to determine, from published studies, the time-course of the effects induced by testosterone replacement therapy from their first manifestation until maximum effects are ...

www.ncbi.nlm.nih.gov

 

[DiegoG]

Onset of effects of testosterone treatment and time span until maximum effects are achieved

Testosterone has a spectrum of effects on the male organism. This review attempts to determine, from published studies, the time-course of the effects induced by testosterone replacement therapy from their first manifestation until maximum effects are ...

www.ncbi.nlm.nih.gov

Appreciate all the info. I am reading everything as it comes in.

 

[Systemlord]

Feels like things have leveled off.

For me at least when I was on injections (steady state 4-6 weeks), at 6 weeks it's like a light switch was flipped.

Now on Jatenzo, a new oral T gel capsule > 7 days to a steady state!

 

[Nelson Vergel]

Thyroid panels were normal.

Any chance for sleep apnea.

Do you have thyroid antibodies results?

I would not change a thing until you know where you are. Get something like this:

TRT Basic Monitoring Panel

TRT Basic Monitoring Panel This TRT basic panel includes essential tests (CBC, CMP, ultrasensitive estradiol, total and free testosterone) to monitor treatment in men on that have been testosterone replacement therapy for a few months. You can add PSA, DH

www.discountedlabs.com

20% off code: excelmalevip

 

[DiegoG]

Any chance for sleep apnea.

Do you have thyroid antibodies results?

I would not change a thing until you know where you are. Get something like this:

TRT Basic Monitoring Panel

TRT Basic Monitoring Panel This TRT basic panel includes essential tests (CBC, CMP, ultrasensitive estradiol, total and free testosterone) to monitor treatment in men on that have been testosterone replacement therapy for a few months. You can add PSA, DH

www.discountedlabs.com

20% off code: excelmalevip

Weird I guess my reply didn't come through?
I did have an sleep apena test and it came back normal. My doctor just ran bloods. Everything came back normal, except liver was elevated just slightly.

Testosterone - 636
E2 - 25
I'm injecting subq also.
I'll try to re-upload the full labs here shortly. Can we attach files or should I break everyrhing down?

 

[Nelson Vergel]

You can attach files. Just make sure your name is blocked out.

 

[DiegoG]

You can attach files. Just make sure your name is blocked out.

Ok incoming here in 5 mins. Going to log in via portal and screwnshot them.

 

[DiegoG]

You can attach files. Just make sure your name is blocked out.

Ok, personal info should all be removed. What do you think so far. Its missing a few things like free t and sensitive e2.

 

[DiegoG]

You can attach files. Just make sure your name is blocked out.

Think I got it this time.