Irritability and anxiety on Testosterone

#61
I don’t know. I didn’t get it done on that lab. All of this is out of pocket for me so I thought it wouldn’t be of great value when doing ultrafiltration FreeT.


No SHBG for this set of labs as you stated

4/2019 (40mg, 250iu, .125ai MWF) [labs done Tu 12pm]
Test (LC/MS) 972 [264.0-916.0]
FreeT (ultrafiltration) 30.62 [5.00-21.00]
E2 Sensitive 13 [8.0-35.0]
Free E2 Percent 3.6 [1.7-5.4]
Free E2 0.47 [0.2-1.5]





Most recent labs


6/2019 (40mg, 250iu, no ai MWF) [labs done Monday AM before shot]
Test 908 [26-916]
FreeT(direct) 17.5 [8.7-25.1]
Tru-T (Albumin 4.7) 28.65
E2 (Roche ECLIA) 41.5 [7.6-42.6] (I know wrong test but this test bundle was $100 cheaper than other options)
SHBG 42.4 [16.5-55.9]
HCT 52.5 [37.5-51.0] (haven't donated blood in ~6months)
DHT 19 [30-85]



On the same protocol minus use of a.i. on second set of labs (40mg, 250iu, no ai MWF)..... TT levels are not too far off between the 2 set of labs 4/2019 (TT 972), 6/2019 (TT 908).....although 1st set of labs you had blood drawn on Tuesday at 12 pm so if you are injecting M/W/F morning than 24+ hrs after your Monday injection (not sure what time you inject?) .You are testing peak.

Second set of labs you had blood drawn on Monday morning so since you are injecting M/W/F morning than 72 hrs after your Friday injection you are testing your trough (lowest point in the week).

Regardless 5 days out of the 7 your peak---> to trough levels would be higher during M--->W and W--->F (48 hrs between injections) as oppose to the peak--->trough levels from F--->M.

As you can see your FT trough levels are near the top end of the reference range using the newer calculated TruT method so your peak FT levels would be higher let alone your trough levels from M--->W and W--->F injections.

Mind you it is odd that on the 1st set of labs 4/2019 your TT 972 (peak) and 2nd set labs your TT 908 (trough).....was LC/MS-MS done on both labs?
 

fifty

Well-Known Member
Thread starter #62
Latest labs was not lcms for testosterone. I need a sponsorship to afford all the best tests every time :)

Do you think my low dht is cause for concern or a cause of some of my irritability or anxiety issues?
 
#63
Latest labs was not lcms for testosterone. I need a sponsorship to afford all the best tests every time:)

Do you think my low dht is cause for concern or a cause of some of my irritability or anxiety issues?[/QUOTE]



Would have been better to compare TT between both sets of labs using the same assay to get a more accurate result.....no big deal would been interesting to see the difference between peak/trough TT levels as I think it would have been a bigger difference than 972/908.



I would say DHT has a positive effect on mood/libido among other things as we know testosterones metabolites e2/DHT are critical to testosterones full spectrum of positive effects regarding mood/libido/erectile function/cardiovascular health/bone health/immune function.

Having healthy levels of e2/DHT are critical to the overall benefits of testosterone.


You stated:

Latest labs below. Biggest thing that stands out is DHT is still low. I have been using several topicals for hair loss (a .05% finasteride 6% minoxidil solution which I stopped in March), Lipogaine (topical minoxidil with saw palmetto, azelaic acid, etc), and nizoral shampoo ~4-5 days per week.

I feel a little better than last bloodwork period in March. Sex drive is good (probably a little too high). Mood is still not good though.

6/2019 (40mg, 250iu, no ai MWF) [labs done Monday AM before shot]
Test 908 [26-916]
FreeT(direct) 17.5 [8.7-25.1]
Tru-T (Albumin 4.7) 28.65
E2 (Roche ECLIA) 41.5 [7.6-42.6] (I know wrong test but this test bundle was $100 cheaper than other options)
SHBG 42.4 [16.5-55.9]
HCT 52.5 [37.5-51.0] (haven't donated blood in ~6months)
DHT 19 [30-85]

Personally I would avoid the use of any topical/oral pde-5 inhibitor.....would rather accept the hair loss (easier said than done.....mind you I am bald).

Luckily your libido is as you state "Sex drive is good (probably a little too high)".....even with you having low DHT"

I would definitely look into trying to increase your DHT through scrotal application of a t-cream (low dose)......I know this may counter productive as you are trying to avoid further hair loss/maintaining what you already have but there is much more involved than just DHT regarding MPB and you should very well know ones genetics plays a strong role.

In the long run it will be more beneficial to have healthy levels of DHT as oppose to the low level you have now.

Also glad to hear you dropped the a.i. and lowering your overall T-dose would have a big impact as your FT levels were way too high when your TT was 1400+.
 
#64
Our patent protected, novel TruT™ companion diagnostic framework provides accurate determination of free testosterone concentrations. This algorithm is based on experimental data demonstrating that testosterone’s binding to SHBG is a multi-step process involving an allosteric interaction between the two binding sites on the SHBG dimer. Estimates of free testosterone derived incorporating the allosteric coupling of SHBG monomers within the dimer provide accurate determination of free testosterone without systematic deviation from values obtained using equilibrium dialysis.



Now getting back to your FT levels as you can see if we take your labs from 4/2019 when you had FT tested using Ultrafiltration which is the next best testing method when compared to the gold standard Equilibrium Dialysis and than if we use the new calculated method using the TruT Free Testosterone Calculator by FPT (which will be comparable in accuracy when matched against Equilibrium Dialysis or Ultrafiltration)

Although you did not have SHBG tested on the (4/2019 labs) if we assume that your SHBG level would be somewhat similar to when it was tested on the( 6/2019 labs) 42.4 nmol/L (2 months later).....than if we take your TT 972 ng/dL (4/2019 labs), SHBG 42.4 nmol/L (6/2019 labs) and Albumin 4.7 g/dL and use the newer calculated method TruT than your FT level would be 30.92 ng/dL (top end of the reference range 16-31 ng/dL) and than compare it to your FT level 30.62 ng/dL using the Ultrafiltration method they are an extremely close match compared to the dismal underestimation when using the Free T direct immunoassay which is know to be inaccurate testing method that almost everyone on the forum relies on.
Screenshot (255).png






4/2019 (40mg, 250iu, .125ai MWF) [labs done Tu 12pm]
Test (LC/MS) 972 [264.0-916.0]
FreeT (ultrafiltration) 30.62 [5.00-21.00]
E2 Sensitive 13 [8.0-35.0]
Free E2 Percent 3.6 [1.7-5.4]
Free E2 0.47 [0.2-1.5]





Most recent labs:

6/2019 (40mg, 250iu, no ai MWF) [labs done Monday AM before shot]
Test 908 [26-916]
FreeT(direct) 17.5 [8.7-25.1]
Tru-T (Albumin 4.7) 28.65
E2 (Roche ECLIA) 41.5 [7.6-42.6] (I know wrong test but this test bundle was $100 cheaper than other options)
SHBG 42.4 [16.5-55.9]
HCT 52.5 [37.5-51.0] (haven't donated blood in ~6months)
DHT 19 [30-85]





Even when looking at your most recent labs above TT levels not drastically different 4/2019 -TT 972 and 6/2019-TT 908 notice the big difference between your FT levels using the Free T direct immunoassay (known to be inaccurate) 17.5 [8.7-25.1] and the Free T (ultrafiltration) 30.62 [5.00-21.00] (comparable to the gold standard equilibrium dialysis).....the Free T direct immunoassay underestimates your levels which would have a huge impact on the effectiveness or lack thereof on ones protocol!
 

sh1973

Active Member
#65
Madman if this calculator is in fact correct, then it definitely explains why many like myself feel much better with lower doses of testosterone. I have SHBG usually in the 60-70 range and even doing 100mg per week is just much too high for me. I'm really glad you posted this, thanks.
 

Mr S

Active Member
#66
Madman if this calculator is in fact correct, then it definitely explains why many like myself feel much better with lower doses of testosterone. I have SHBG usually in the 60-70 range and even doing 100mg per week is just much too high for me. I'm really glad you posted this, thanks.
If I may ask, better in what sense?
 

sh1973

Active Member
#67
In every regard. Better energy, libido, erections, sleep, acne and so on. I only do 60-70mg per week with shbg of 70 which puts my total t trough at 650ng or so. Been struggling with trt nearly a decade and Dr Saya states he has many men like me that just do much better with lower doses, some lower than me. Been in this range for the last 1.5 years or so and no way in hell would I ever go higher.
 

Mr S

Active Member
#68
In every regard. Better energy, libido, erections, sleep, acne and so on. I only do 60-70mg per week with shbg of 70 which puts my total t trough at 650ng or so. Been struggling with trt nearly a decade and Dr Saya states he has many men like me that just do much better with lower doses, some lower than me. Been in this range for the last 1.5 years or so and no way in hell would I ever go higher.
Thank you for explaining. I don’t think my urologist has ever tested my shbg. I’m relatively new to TRT. So I still have a long journey ahead of me I presume. My lack of libido sort of amazes me. Like I became a different person.
 

Mr S

Active Member
#70
At higher levels I have zero libido and feel like crap.
My lack of libido is the main reason why I started TRT at 140mg/week of Cypionate. My trough was 700 seven weeks later (test done the morning before my injection) but no major change libido wise. Dr says it takes time. We’ll see
 

fifty

Well-Known Member
Thread starter #71
Coming off on restart protocol. Stopped trt then 4 days later started hcg 300iu/day for 2 weeks.

week 1- felt no different
week 2- felt pretty good. a little tired but that’s almost a relief. able to sleep better. resting hr down ~10bpm. bp down a bit (5-10pts on each). good libido, etc.
week 3- stopped hcg after 15 days. start clomid 12.5mg/day. no issues so far through day 8 of clomid only.
 

Mr S

Active Member
#72
Coming off on restart protocol. Stopped trt then 4 days later started hcg 300iu/day for 2 weeks.

week 1- felt no different
week 2- felt pretty good. a little tired but that’s almost a relief. able to sleep better. resting hr down ~10bpm. bp down a bit (5-10pts on each). good libido, etc.
week 3- stopped hcg after 15 days. start clomid 12.5mg/day. no issues so far through day 8 of clomid only.
Why did you drop the HCG and start Clomid?
 

fifty

Well-Known Member
Thread starter #73
That was my prescription. Hcg still keeps you shut down. Clomid is an attempt to get your body to make everything on its own once again.
 

fifty

Well-Known Member
Thread starter #76
End of week 4- Got a little bit of a cold. Very tired. Lower libido. Nothing bad just a noticeable difference.
 
#77
Coming off on restart protocol. Stopped trt then 4 days later started hcg 300iu/day for 2 weeks.

week 1- felt no different
week 2- felt pretty good. a little tired but that’s almost a relief. able to sleep better. resting hr down ~10bpm. bp down a bit (5-10pts on each). good libido, etc.
week 3- stopped hcg after 15 days. start clomid 12.5mg/day. no issues so far through day 8 of clomid only.
Are you doing this under doctor's care or on your own? Just curious. I am on week 2 cold turkey. yesterday was day 13 and I was super fatigued at dinner time.
 

fifty

Well-Known Member
Thread starter #80
Labs from the morning after the last day of 4wks of 12.5mg clomid per day:

Lh 15.6 [1.7-8.6]
Shbg 68.2 [16.5-55.9]
T 970 [264-916]
FT 13.3 [8.7-25.1]
E2 sensitive 52.5 [8-35]
Dht 67 [30-85]

Direct Free T is a joke. Peace
 
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