High dose low total

[thejyd]

Hey guys I had a few questions. My drs. Have been useless!!!!

original total t- 159 and 213
He started me on 100mg a week total t came back after being on 100mg at 133 so it dropped

since November I have been on 200mg a week... total t always comes back at 430-480 injecting at home doing .33 mwf

asked for estradiol and it came back at 51. Prescribing doctor doesn’t understand t so sent me to talk to an endo.

this guy might even be a bigger idiot. He wanted me to consider clomid instead of injections. Said if I need to donate blood or get armidex for estradiol then my dose is too high. Tried to talk me into going to 100mg a week. I refused and said doing that makes my test lower than pre t. He asked me to try 150 and I said I would try it but if my t drops I am going back to 200mg. Needless to say I won’t be going back to him.

so went back to my and he read endos notes and said he couldn’t continue prescribing me 200mg.

so my question is why does it take so much testosterone to get my levels up? I am not having any estradiol issues with nips ect. Feel like my labido was better on the 200 vs 150....

So I am just curious if anyone has any ideas of what I should do next? Yes I am overweight.

any help or thoughts would be appreciated.

 

[madman]

Hey guys I had a few questions. My drs. Have been useless!!!!

original total t- 159 and 213
He started me on 100mg a week total t came back after being on 100mg at 133 so it dropped

since November I have been on 200mg a week... total t always comes back at 430-480 injecting at home doing .33 mwf

asked for estradiol and it came back at 51. Prescribing doctor doesn’t understand t so sent me to talk to an endo.

this guy might even be a bigger idiot. He wanted me to consider clomid instead of injections. Said if I need to donate blood or get armidex for estradiol then my dose is too high. Tried to talk me into going to 100mg a week. I refused and said doing that makes my test lower than pre t. He asked me to try 150 and I said I would try it but if my t drops I am going back to 200mg. Needless to say I won’t be going back to him.

so went back to my and he read endos notes and said he couldn’t continue prescribing me 200mg.

so my question is why does it take so much testosterone to get my levels up? I am not having any estradiol issues with nips ect. Feel like my labido was better on the 200 vs 150....

So I am just curious if anyone has any ideas of what I should do next? Yes I am overweight.

any help or thoughts would be appreciated.

He started me on 100mg a week total t came back after being on 100mg at 133 so it dropped

since November I have been on 200mg a week... total t always comes back at 430-480 injecting at home doing .33 mwf

Nothing to work with here without posting full labs?

Although TT is important to know you are overlooking the most important fraction.....FT which is the active unbound fraction of testosterone responsible for the positive effects.

Too many get caught up on TT.

The kicker here is SHBG which is also critical to know as it will have a significant impact on TT/FT let alone can dictate what injection frequency may suit one best.

Another thing to keep in mind is peak/trough as we always want to have blood work done at a trough (lowest point).


Said if I need to donate blood or get armidex for estradiol then my dose is too high.

The use of exogenous testosterone will increase RBCs/hemoglobin/hematocrit within the first month and can take up to 9-12months to reach peak levels.

Also, keep in keep in mind T formulation, the dose of T, genetics (polymorphism of the AR), age all play a role in the impact a trt protocol will have on blood markers (RBCs/hemoglobin/hematocrit).

Other factors such as sleep apnea, smoking can have a negative impact on hematocrit.

Increasing T will increase E.

T formulation, the dose of T, body fat levels (aromatase), genetics (polymorphism of the AR), liver function, age all play a role in the impact T will have on E.

Running to a high FT level let alone extremes in the peak--->trough (once/twice weekly protocol) can result in elevated RBCs/hemoglobin/hematocrit and estradiol.

In such cases, many can struggle with sides and unfortunately end up jumping on an AI to control e2 let alone get caught up in that frequent blood donations merry go round to control elevated RBCs/hemoglobin/hematocrit.


so my question is why does it take so much testosterone to get my levels up? I am not having any estradiol issues with nips ect. Feel like my labido was better on the 200 vs 150....

So I am just curious if anyone has any ideas of what I should do next? Yes I am overweight.

Again would need to see full labs posted before jumping to any conclusions and for all, we know seeing as you are overweight you may very well have low SHBG.

Seeing as you stated:

He started me on 100mg a week total t came back after being on 100mg at 133 so it dropped

You most likely have low SHBG and even then if you are only hitting a trough (7 days post-injection) TT 133 ng/dL it is extremely hypogonadal!

Keep in mind there will be an extreme difference in peak--->trough levels when using once-weekly IM injections.

Post-injection T levels will start rising within 2 hrs and reach peak levels (8-12 hrs) later/remain elevated during the following days only to be much lower come weeks end.

This can have a negative impact on energy/mood/libido/erections/recovery throughout the week.


since November I have been on 200mg a week... total t always comes back at 430-480 injecting at home doing .33 mwf

Again although your trough TT 430-480 ng/dL may seem sub-par keep in mind that peak levels will be higher and top it all of with the fact that if you have low SHBG your FT would not be absurdly low.

Mind you it would be hard to believe that anyone would feel great at such levels.

 

[madman]

Regarding testosterone levels.

The average young healthy male produces 5-7 mg/day.

When using exogenous T many factors can come into play when it comes to what dose of T is needed to achieve a healthy FT level.

The dose T, SHBG level, injection frequency, metabolism, the sensitivity of the AR, polymorphism of the AR, and CAG repeat length (long/short), bodyweight.

Effect of Weight on Serum T with Sub-Q TE in Men with TD

Effect of Weight on Serum Testosterone with Subcutaneous Testosterone Enanthate in Men with Testosterone Deficiency (2020) SAT-037 Background: In men, obesity is often associated with low testosterone (T) levels, but the information is limited as to how body weight affects the pharmacokinetic...

www.excelmale.com

 

[madman]

Strictly IM.

Variance in Peak and Trough T Levels in Men Using Intramuscular T Injections

MP85-14 VARIANCE IN PEAK AND TROUGH TESTOSTERONE LEVELS IN MEN USING INTRAMUSCULAR TESTOSTERONE Bruno Nascimento*, Helen L Bernie, Elizabeth Schofield, John P. Mulhall, New York, NY INTRODUCTION AND OBJECTIVES In men using intramuscular testosterone (IM T), clinical experience shows us that...

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