Are high total T levels dangerous?

cprt123

New Member
Protocol:
25 mg cypionate every 3.5 days
500 iu hcg 2x a week
.25 Anastrozole 3x a week

Ive been on trt 6 years. On this very small amount of testosterone I've had total T labs ranging from 957-2200 ng/dl.

Most of the time my total T is off the chart while my free T hangs out in the mid to high teens. Rarely has my free T hit the 20+ ng/dl level.

My last lab total T was 1400 free T 17

I get my labs right before a testosterone injection is due.

My baseline levels were:
Total T 805
Free T 8
Shbg 105 nmol (way off range)

The 25mg twice a week has not affected a positive change. It's only produced screwy labs. Though I'm sure a higher dose would create higher total T and the doctor would not agree to an increase

Any thoughts as to why total should be so high?
 

Cataceous

Super Moderator
This is as expected with high SHBG. Basically, the injected testosterone is directly driving free testosterone. If your SHBG were to drop by a lot then free testosterone wouldn't change, but total testosterone would drop. This can be understood through a fluid flow analogy.

Your question about the risks of high testosterone levels is a good one. In general the risks should be driven by free testosterone more than total. But you're such an outlier with respect to SHBG that the resulting high total testosterone is going to scare away most doctors. It's unknown territory for TRT, meaning you get put in the box with steroid abusers, who have known risks. Rather than taking more testosterone, a back door way to the same result could possibly be found in other medications, such as danazol or a SARM like ostarine.
 

cprt123

New Member
This is as expected with high SHBG. Basically, the injected testosterone is directly driving free testosterone. If your SHBG were to drop by a lot then free testosterone wouldn't change, but total testosterone would drop. This can be understood through a fluid flow analogy.

Your question about the risks of high testosterone levels is a good one. In general the risks should be driven by free testosterone more than total. But you're such an outlier with respect to SHBG that the resulting high total testosterone is going to scare away most doctors. It's unknown territory for TRT, meaning you get put in the box with steroid abusers, who have known risks. Rather than taking more testosterone, a back door way to the same result could possibly be found in other medications, such as danazol or a SARM like ostarine.
Thank you for your thoughtful response! I will research the information you have provided.
 

Nelson Vergel

Founder, ExcelMale.com
The right dose (or blood level) of testosterone is one that makes you feel well, keeps you from donating blood more than 3-4 times per year, and keeps your HDL and blood pressure within normal ranges.

Anastrozole will enhance the negative effects of testosterone on lowering HDL. One of estradiol's main roles is to keep good lipid levels.
 

madman

Super Moderator
Protocol:
25 mg cypionate every 3.5 days
500 iu hcg 2x a week
.25 Anastrozole 3x a week

Ive been on trt 6 years. On this very small amount of testosterone I've had total T labs ranging from 957-2200 ng/dl.

Most of the time my total T is off the chart while my free T hangs out in the mid to high teens. Rarely has my free T hit the 20+ ng/dl level.

My last lab total T was 1400 free T 17

I get my labs right before a testosterone injection is due.

My baseline levels were:
Total T 805
Free T 8
Shbg 105 nmol (way off range)

The 25mg twice a week has not affected a positive change. It's only produced screwy labs. Though I'm sure a higher dose would create higher total T and the doctor would not agree to an increase

Any thoughts as to why total should be so high?
Protocol:
25 mg cypionate every 3.5 days
500 iu hcg 2x a week
.25 Anastrozole 3x a week

Ive been on trt 6 years. On this very small amount of testosterone I've had total T labs ranging from 957-2200 ng/dl.

Most of the time my total T is off the chart while my free T hangs out in the mid to high teens. Rarely has my free T hit the 20+ ng/dl level.

My last lab total T was 1400 free T 17

I get my labs right before a testosterone injection is due.

My baseline levels were:
Total T 805
Free T 8
Shbg 105 nmol (way off range)

The 25mg twice a week has not affected a positive change.
It's only produced screwy labs. Though I'm sure a higher dose would create higher total T and the doctor would not agree to an increase

Any thoughts as to why total should be so high?




Herein lies the issue.

Although TT is important to know FT is what truly matters as it is the active unbound fraction of testosterone responsible for the beneficial effects.


You stated that:

Ive been on trt 6 years. On this very small amount of testosterone I've had total T labs ranging from 957-2200 ng/dl.

Most of the time my total T is off the chart while my free T hangs out in the mid to high teens. Rarely has my free T hit the 20+ ng/dl level.


Without posting labs we have absolutely no idea where your SHBG has sat when you were running a TT 957-2200 ng/dL as you only posted the most recent lab which shows an absurdly high SHBG 105 nmol/L.

Even more concerning is where your FT level truly sat on such protocol and unless you had your FT tested using the most accurate assay such as the gold standard Equilibrium Dialysis or Ultrafiltration then I would not rely on the results.




25 mg cypionate every 3.5 days
500 iu hcg 2x a week
.25 Anastrozole 3x a week

Ive been on trt 6 years. On this very small amount of testosterone I've had total T labs ranging from 957-2200 ng/dl.


Even then the protocol you have been put on is horrible and with such a low weekly dose of T (50 mg split 25 mg every 3.5 days + 500 iu hCG every 3.5 days), I would find it hard to believe that anyone could achieve a healthy FT level (upper end) and top it off with the fact that you are using an AI.....go figure!

How could anyone with high SHBG feel-good on such protocol?

Post any labs with reference ranges and the assays used to test your TT/FT?

If your FT was not tested using an accurate assay then you would be wise to get it done.




The most accurate assay for TT (LC-MS/MS) and FT (Equilibrium Dialysis or Ultrafiltration).

Especially in cases of altered SHBG, I would not rely on any other testing method other than ED or UF when it comes to testing free testosterone.


Use Nelsons DiscountedLabs.


Any of these will suffice: (kill 2 birds with one stone)

1

2
 

cprt123

New Member
The right dose (or blood level) of testosterone is one that makes you feel well, keeps you from donating blood more than 3-4 times per year, and keeps your HDL and blood pressure within normal ranges.

Anastrozole will enhance the negative effects of testosterone on lowering HDL. One of estradiol's main roles is to keep good lipid levels.
Interesting. I'm ok with 3 out of the 4 you've mention. The tangible Health markers are good. However, regarding mood I'm either short fused or have a flat affect personality. Neither of which I displayed when I was younger.

Lately, I've come across a lot of Youtubers decrying the use of AIs. Their reasoned arguments Do concern me that I've been popping these for 6 years. I don't know if the anastrozole is causing this but my joints sound like a bowl of rice krispies.
 

Nelson Vergel

Founder, ExcelMale.com
I would read these:



I have been preaching to deaf ears about not obsessing about estradiol while on TRT but there is no way I can make a dent on years of programming and brainwashing. I predict it will take 5 to 10 more years before the anastrozole craze and blaming every side effect on estradiol stop.

 

cprt123

New Member
Herein lies the issue.

Although TT is important to know FT is what truly matters as it is the active unbound fraction of testosterone responsible for the beneficial effects.


You stated that:

Ive been on trt 6 years. On this very small amount of testosterone I've had total T labs ranging from 957-2200 ng/dl.

Most of the time my total T is off the chart while my free T hangs out in the mid to high teens. Rarely has my free T hit the 20+ ng/dl level.


Without posting labs we have absolutely no idea where your SHBG has sat when you were running a TT 957-2200 ng/dL as you only posted the most recent lab which shows an absurdly high SHBG 105 nmol/L.

Even more concerning is where your FT level truly sat on such protocol and unless you had your FT tested using the most accurate assay such as the gold standard Equilibrium Dialysis or Ultrafiltration then I would not rely on the results.




25 mg cypionate every 3.5 days
500 iu hcg 2x a week
.25 Anastrozole 3x a week

Ive been on trt 6 years. On this very small amount of testosterone I've had total T labs ranging from 957-2200 ng/dl.


Even then the protocol you have been put on is horrible and with such a low weekly dose of T (50 mg split 25 mg every 3.5 days + 500 iu hCG every 3.5 days), I would find it hard to believe that anyone could achieve a healthy FT level (upper end) and top it off with the fact that you are using an AI.....go figure!

How could anyone with high SHBG feel-good on such protocol?

Post any labs with reference ranges and the assays used to test your TT/FT?

If your FT was not tested using an accurate assay then you would be wise to get it done.




The most accurate assay for TT (LC-MS/MS) and FT (Equilibrium Dialysis or Ultrafiltration).

Especially in cases of altered SHBG, I would not rely on any other testing method other than ED or UF when it comes to testing free testosterone.


Use Nelsons DiscountedLabs.


Any of these will suffice: (kill 2 birds with one stone)

1

2
shbg was tested once 6 years ago. That test was prior to starting trt. No
labs since starting trt have included shgb.

As stated previously, the lab for shbg
Herein lies the issue.

Although TT is important to know FT is what truly matters as it is the active unbound fraction of testosterone responsible for the beneficial effects.


You stated that:

Ive been on trt 6 years. On this very small amount of testosterone I've had total T labs ranging from 957-2200 ng/dl.

Most of the time my total T is off the chart while my free T hangs out in the mid to high teens. Rarely has my free T hit the 20+ ng/dl level.


Without posting labs we have absolutely no idea where your SHBG has sat when you were running a TT 957-2200 ng/dL as you only posted the most recent lab which shows an absurdly high SHBG 105 nmol/L.

Even more concerning is where your FT level truly sat on such protocol and unless you had your FT tested using the most accurate assay such as the gold standard Equilibrium Dialysis or Ultrafiltration then I would not rely on the results.




25 mg cypionate every 3.5 days
500 iu hcg 2x a week
.25 Anastrozole 3x a week

Ive been on trt 6 years. On this very small amount of testosterone I've had total T labs ranging from 957-2200 ng/dl.


Even then the protocol you have been put on is horrible and with such a low weekly dose of T (50 mg split 25 mg every 3.5 days + 500 iu hCG every 3.5 days), I would find it hard to believe that anyone could achieve a healthy FT level (upper end) and top it off with the fact that you are using an AI.....go figure!

How could anyone with high SHBG feel-good on such protocol?

Post any labs with reference ranges and the assays used to test your TT/FT?

If your FT was not tested using an accurate assay then you would be wise to get it done.




The most accurate assay for TT (LC-MS/MS) and FT (Equilibrium Dialysis or Ultrafiltration).

Especially in cases of altered SHBG, I would not rely on any other testing method other than ED or UF when it comes to testing free testosterone.


Use Nelsons DiscountedLabs.


Any of these will suffice: (kill 2 birds with one stone)

1

2

Herein lies the issue.

Although TT is important to know FT is what truly matters as it is the active unbound fraction of testosterone responsible for the beneficial effects.


You stated that:

Ive been on trt 6 years. On this very small amount of testosterone I've had total T labs ranging from 957-2200 ng/dl.

Most of the time my total T is off the chart while my free T hangs out in the mid to high teens. Rarely has my free T hit the 20+ ng/dl level.


Without posting labs we have absolutely no idea where your SHBG has sat when you were running a TT 957-2200 ng/dL as you only posted the most recent lab which shows an absurdly high SHBG 105 nmol/L.

Even more concerning is where your FT level truly sat on such protocol and unless you had your FT tested using the most accurate assay such as the gold standard Equilibrium Dialysis or Ultrafiltration then I would not rely on the results.




25 mg cypionate every 3.5 days
500 iu hcg 2x a week
.25 Anastrozole 3x a week

Ive been on trt 6 years. On this very small amount of testosterone I've had total T labs ranging from 957-2200 ng/dl.


Even then the protocol you have been put on is horrible and with such a low weekly dose of T (50 mg split 25 mg every 3.5 days + 500 iu hCG every 3.5 days), I would find it hard to believe that anyone could achieve a healthy FT level (upper end) and top it off with the fact that you are using an AI.....go figure!

How could anyone with high SHBG feel-good on such protocol?

Post any labs with reference ranges and the assays used to test your TT/FT?

If your FT was not tested using an accurate assay then you would be wise to get it done.




The most accurate assay for TT (LC-MS/MS) and FT (Equilibrium Dialysis or Ultrafiltration).

Especially in cases of altered SHBG, I would not rely on any other testing method other than ED or UF when it comes to testing free testosterone.


Use Nelsons DiscountedLabs.


Any of these will suffice: (kill 2 birds with one stone)

1

2
the shbg level posted was a baseline level from 6 years ago and prior to commencing trt.
shbg has not been tested since.

below are recent total and free
testosterone along with the type of test used to perform the labs.

TESTOSTERONE, FREE (DIALYSIS) AND TOTAL,MS

TESTOSTERONE, TOTAL, MS

1412 H

Reference Range: 250-1100 ng/dL

TESTOSTERONE, FREE

163.8 H

Reference Range: 35.0-155.0 pg/mL

the free T is above the range. Though I have come across others stating free T in the mid 20s (ng/dl) and even as high 30s (ng/dl) was desirable.
 

Cataceous

Super Moderator
TESTOSTERONE, FREE (DIALYSIS) AND TOTAL,MS

TESTOSTERONE, TOTAL, MS

1412 H

Reference Range: 250-1100 ng/dL

TESTOSTERONE, FREE

163.8 H

Reference Range: 35.0-155.0 pg/mL

the free T is above the range. Though I have come across others stating free T in the mid 20s (ng/dl) and even as high 30s (ng/dl) was desirable.
It's interesting that on the gold standard free T test you are measuring high. Was this a trough measurement? What I would do is retest and measure SHBG too. If measured and calculated free T are still both coming up high then I would consider a dose reduction. For me the flat personality trait is tied to high—free—testosterone levels and/or low estradiol.
 

madman

Super Moderator
shbg was tested once 6 years ago. That test was prior to starting trt. No
labs since starting trt have included shgb
.

As stated previously, the lab for shbg



the shbg level posted was a baseline level from 6 years ago and prior to commencing trt.
shbg has not been tested since.

below are recent total and free
testosterone along with the type of test used to perform the labs.

TESTOSTERONE, FREE (DIALYSIS) AND TOTAL,MS

TESTOSTERONE, TOTAL, MS

1412 H

Reference Range: 250-1100 ng/dL

TESTOSTERONE, FREE

163.8 H

Reference Range: 35.0-155.0 pg/mL

the free T is above the range. Though I have come across others stating free T in the mid 20s (ng/dl) and even as high 30s (ng/dl) was desirable.

6 years in and you have no clue where your SHBG sits let alone your doctor has you injecting 50 mg/week of T (25 mg every 3.5 days) and to add insult to injury put you on an AI.

You need to know where your SHBG sits as it will have a big impact on the overall effectiveness of a protocol.

I would be looking for a new doctor.

Regarding your FT level keep in mind that these are your trough levels (84 hrs post-injection) and your peak levels will be higher 8-12 hrs post-injection.

So your FT has been over the 20 ng/dL range.

Unfortunately, when it comes to the reference ranges for measured or calculated FT they vary between different labs, and as of now, there is no standardization let alone a harmonized reference range.

Efforts are underway to standardize the procedures for FT and to generate a harmonized reference range.

Patiently waiting I am!

Most men on trt will do well with a FT 20-30 ng/dL and many tend to aim for the higher end.

Even then some may choose to run higher levels but it comes down to the individual and what is best for them.

FT of 16-31 ng would be considered healthy and yes some men will feel great with a FT 16 ng/dL!

Highly doubtful most would ever need to run a trough FT in the 50-60 ng/dL range.

The goal is to achieve a healthy FT level which results in relief/improvement of low-t symptoms/ increased overall well-being while at the same time avoiding/minimizing any potential side-effects.

Some men can not tolerate running higher FT levels due to sides so the goal would be to find the lowest level you can run while maintaining the beneficial effects.

If you want to be nitpicky when it comes to the reference ranges then retest your FT using Labcorp Equilibrium Dialysis.

I prefer this one which uses a reference range of 52-280 pg/mL (5.2-28.0 ng/dL) and % FT 1.5-3.2

 
Last edited:

M.J

Active Member
Used to take AI, not anymore....,

accept the estrogen let it be part of you :)
Unless u have serious side affect for me .25 is craaaaazy high dose and 3 times a week will turn me to 0 estrogen for sure
 

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