Labs after switching to EOD schedule

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cigpk

Active Member
I was on a 2x per week schedule but decided I wanted more stability and less spikes.

I have been on the following for 11 weeks now EOD:
-23 mg test-c (80 mg per week)
-315 mg HCG (1100 mg per week)

Symptoms:
-insomnia
-sweating all the time
-fatigue (due to insomnia)
-Oily skin
-high(er) blood pressure

Testosterone total: 1089 (264-916)
Testosterone free: 20 (9-26)
Tru T calculation: 32
E2 sensitive: 31 (8-35)
Progesterone: .4 (0-0.5)
HCT: 48.5 (37-51)
HGB: 16 (13-17.7)
ALT: 50 (0-44)
SHBG not tested this time around but historically sits at 50-60

So I’m thinking about lowering my dosage of both T and HCG. My Tru T calculation of ~32 correlates with how I feel except for the fatigue from insomnia.

I was gonna move to 20 mg eod (70 mg test c per week) and maybe drop hcg to 310 mg eod.

Also, I’ve been taking 20 mg pregnenolone at night and likely gonna cut that to 10 mg every night. Waiting to hear back from the doc.

What do y’all think?
 
Last edited:
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sh1973

Well-Known Member
Personally I’d drop the dose as you said as well as quit the ancillaries such as the pregnenolone and hcg. I’m a high shbg guy as well and feel better with lower levels. Just my two cents.
 

cigpk

Active Member
Personally I’d drop the dose as you said as well as quit the ancillaries such as the pregnenolone and hcg. I’m a high shbg guy as well and feel better with lower levels. Just my two cents.

Thanks for the response -
Yeah I’m not big on pregnenolone but found it does help the sleep a little bit. I plan to phase that one out.

I take the hcg for fertility purposes as I’m getting married soon and likely going to be trying to have children in the next few years.
 
I would limit the change to just one thing so that you can narrow it down to what works. I'm unsure of the Tru T @ 32 where the lab range is there. 20mg EOD would be a fair reduction.
I like to see guys make one change at a time than upsetting the cart with HCG and Preg doses alongside the T.
 

cigpk

Active Member
I would limit the change to just one thing so that you can narrow it down to what works. I'm unsure of the Tru T @ 32 where the lab range is there. 20mg EOD would be a fair reduction.
I like to see guys make one change at a time than upsetting the cart with HCG and Preg doses alongside the T.
Tru T range: 16-31 ng/dl According to madman.

I have rarely had elevated liver enzymes like above. Not sure what is causing that. I do take Advil on occasion.

Supplements:
Multivitamin
Fish oil


Evening:
3-4 grams glycine
400 mg magnesiun
20 mg pregnenolone
5 mg melatonin
 

cigpk

Active Member
This is also the highest my hematocrit has ever been. I’ve never been above 47 I believe and my HCT is typically 44-45.

Could hcg contribute to that as well or is that more likely just the testosterone?

Would a dose reduction of just 10 mg per week be enough to reduce my HCT significantly?
 
Last edited:

cigpk

Active Member
Had labs checked again at PCP:

HCT: 45

My liver enzymes are still elevated though. Any ideas about what could be driving this? Does test-c drive up liver enzymes maybe more now that I’m on eod schedule?
 
Gym activity can possibly elevate liver AST/ALT, as could the Advil. I tend to never run those tests unless I'm off the gym for at least 3 days. I know in the past I had one set of elevated liver numbers but I had been sick and used a lot Nyquil and we blamed that. Never had an elevated set of liver numbers since then.
 

cigpk

Active Member
Gym activity can possibly elevate liver AST/ALT, as could the Advil. I tend to never run those tests unless I'm off the gym for at least 3 days. I know in the past I had one set of elevated liver numbers but I had been sick and used a lot Nyquil and we blamed that. Never had an elevated set of liver numbers since then.
I see. Yeah maybe I shouldn’t worry about it but two tests in a row had me a little concerned.

The only new supplements I’m taking are glycine and pregnenolone. I’m wondering if those could have possibly elevated them.

I read that test injections bypass the liver so going to eod schedule wouldn’t have been the cause right?
 

cigpk

Active Member
I wouldn't change anything unless you are going to just start over. WAY too many variables in what you are doing. The LAST thing you want to do is make a change to one of the drugs in your regimen that has a long half life.

Wait out the negative side effects. If those symptoms don't start to improve i the next few weeks I'd look at dropping some of the ancillaries AFTER you get relevant bloodwork to see what the before and after do.

I all you were taking is HCG and T with those numbers I'd say bump the dose UP 10%.
Bump the dose up even though my total T and Tru-T (which around here appears to be much more reliable than Free t) are above range at trough?

I already lowered the dose of T to 20 mg EOD.a few weeks after that change, im sleeping better than I did when I was on a higher dose for the past year.
 
Last edited:

cigpk

Active Member
yes those ranges include many unhealthy people.

you don’t even have stable levels until 6 weeks after a change. That’s the beginning of things leveling off. Anything before is transient.
I was on that dose for a year. I went to an EOD schedule with the same dose and waited another 11 weeks before getting lab work.

Edit - I see you’re talking about my new dose. Yeah I hope the sleep improvement sticks. We’ll see.

I am wary of increasing my dose primarily due to insomnia.
 

madman

Super Moderator
Bump the dose up even though my total T and Tru-T (which around here appears to be much more reliable than Free t) are above range at trough?

I already lowered the dose of T to 20 mg EOD.a few weeks after that change, im sleeping better than I did when I was on a higher dose for the past year.


Just so you understand the newer references ranges for TT let alone FT (TruT calculated method) are based off of more recent studies using more accurate assays.




Regarding Total Testosterone:

Harmonized Reference Ranges for Circulating Testosterone Levels in Men of Four Cohort Studies in the United States and Europe
Harmonized Reference Ranges for Circulating Testosterone Levels in Men of Four Cohort Studies in the United States and Europe


Results:
Harmonization procedure reduced intercohort variation between testosterone measurements in men of similar ages. In healthy nonobese men, 19 to 39 years, harmonized 2.5th, 5th, 50th, 95th, and 97.5th percentile values were 264, 303, 531, 852, and 916 ng/dL, respectively. Age-specific harmonized testosterone concentrations in nonobese men were similar across cohorts and greater than in all men.

Conclusion:
Harmonized normal range in a healthy nonobese population of European and American men, 19 to 39 years, is 264 to 916 ng/dL. A substantial proportion of intercohort variation in testosterone levels is due to assay differences. These data demonstrate the feasibility of generating harmonized reference ranges for testosterone that can be applied to assays, which have been calibrated to a reference method and calibrator



Regarding Free Testosterone using the newer calculated TruT model/algorithm:

"Based on the new data on the distribution of free testosterone levels in healthy men the target range of free testosterone has been determined to be 164 to 314 pg/ml (mean+/−1SD)"


Which would convert to 16-31 ng/dl








Now do understand that on trt we use these ranges as guidelines.....it is in no way set in stone that one needs to stay within such ranges.

Some may choose/need to run slightly higher TT/FT levels when on trt and as long as blood markers are healthy and one feels well overall so be it.

As we know symptom relief is what truly matters not numbers but again even than we most likely do not need to achieve/run absurd TT/FT levels to benefit from testosterone replacement!

Do what is best for you within being sensible regarding your overall health.
 

madman

Super Moderator
Bump the dose up even though my total T and Tru-T (which around here appears to be much more reliable than Free t) are above range at trough?

I already lowered the dose of T to 20 mg EOD.a few weeks after that change, im sleeping better than I did when I was on a higher dose for the past year.




Keep in my that when I state such that I am speaking in terms of TROUGH TT/FT levels of 1200 ng/dL / 30 ng/dL.


Now do understand that on trt we use these ranges as guidelines.....it is in no way set in stone that one needs to stay within such ranges.

Some may choose/need to run slightly higher TT/FT levels when on trt and as long as blood markers are healthy and one feels well overall so be it.

As we know symptom relief is what truly matters not numbers but again even than we most likely do not need to achieve/run absurd TT/FT levels to benefit from testosterone replacement!

Do what is best for you within being sensible regarding your overall health.
 
Tru T range: 16-31 ng/dl According to madman.

I have rarely had elevated liver enzymes like above. Not sure what is causing that. I do take Advil on occasion.

Supplements:
Multivitamin
Fish oil


Evening:
3-4 grams glycine
400 mg magnesiun
20 mg pregnenolone
5 mg melatonin

Hello! Wanted to send you some thoughts on your ALT level. ALT is one of several liver enzymes and ALT helps the liver convert protein into energy. Your ALT level is outside the top range, and while an ALT of 50 it is not at an immediately dangerous level, it does bear watching.

First, you will find that some labs high range for ALT is 55. It depends on the lab and the calibration of their equipment. Having said that, do not ignore an ALT of 50, for reasons I list below.

Typically, medication that is injected into the body via intravenous, intramuscular or subcutaneous routes is much easier on the liver than when you take it orally. When injected, medicine avoids what is known as the first hepatic pass. As with everything, there are exceptions, but it's a good general rule.

Ibuprofen (Advil, Motrin) and other NSAIDs like Naproxen (Aleeve), Aspirin, Mobic, Celebrex and the like, typically are concerning for renal damage, not liver.

Acetaminophen (Tylenol), on the other hand, is in many over the counter medications, and is extremely liver toxic. Drinking even a small amount of alcohol when taking anything with acetaminophen, and your liver enzymes will rise a bit.

Amoxicillin can temporarily elevate liver enzymes AFTER a course is completed.

What concerns me a bit, is that you supplement with glycine. Glycine is actually liver protective, so your level may actually be higher without the glycine.

Some questions for you:

Are you taking the glycine for it's hepato-protective action, or for some other reason?

Do you consume a lot of fruit or consume products with a lot of fructose or products that contain high-fructose corn syrup? Fructose is a sugar that is very stressful on the liver and can cause non-alcoholic fatty liver disease.

Do you take a statin of any kind? Statins are very stressful on the whole body, especially the liver, the brain, the muscles. In my opinion, there are few people who actually need statins, but that is a discussion for another day.

You should most certainly get follow up lab work, and make sure you don't take the glycine for a week or possibly more before the test to get the most accurate numbers. I would recommend Complete Metabolic Panel and Hepatic Panel including ammonia level.

There's a multitude of reasons why your ALT could be somewhat elevated, and it may have been a one time occurrence.

Fortunately, our livers are extremely resilient and can bounce back from a shocking amount of damage.

Definitely check into it and let us know how you're doing. Hope everything turns out fine!
 

cigpk

Active Member
Hello! Wanted to send you some thoughts on your ALT level. ALT is one of several liver enzymes and ALT helps the liver convert protein into energy. Your ALT level is outside the top range, and while an ALT of 50 it is not at an immediately dangerous level, it does bear watching.

First, you will find that some labs high range for ALT is 55. It depends on the lab and the calibration of their equipment. Having said that, do not ignore an ALT of 50, for reasons I list below.

Typically, medication that is injected into the body via intravenous, intramuscular or subcutaneous routes is much easier on the liver than when you take it orally. When injected, medicine avoids what is known as the first hepatic pass. As with everything, there are exceptions, but it's a good general rule.

Ibuprofen (Advil, Motrin) and other NSAIDs like Naproxen (Aleeve), Aspirin, Mobic, Celebrex and the like, typically are concerning for renal damage, not liver.

Acetaminophen (Tylenol), on the other hand, is in many over the counter medications, and is extremely liver toxic. Drinking even a small amount of alcohol when taking anything with acetaminophen, and your liver enzymes will rise a bit.

Amoxicillin can temporarily elevate liver enzymes AFTER a course is completed.

What concerns me a bit, is that you supplement with glycine. Glycine is actually liver protective, so your level may actually be higher without the glycine.

Some questions for you:

Are you taking the glycine for it's hepato-protective action, or for some other reason?

Do you consume a lot of fruit or consume products with a lot of fructose or products that contain high-fructose corn syrup? Fructose is a sugar that is very stressful on the liver and can cause non-alcoholic fatty liver disease.

Do you take a statin of any kind? Statins are very stressful on the whole body, especially the liver, the brain, the muscles. In my opinion, there are few people who actually need statins, but that is a discussion for another day.

You should most certainly get follow up lab work, and make sure you don't take the glycine for a week or possibly more before the test to get the most accurate numbers. I would recommend Complete Metabolic Panel and Hepatic Panel including ammonia level.

There's a multitude of reasons why your ALT could be somewhat elevated, and it may have been a one time occurrence.

Fortunately, our livers are extremely resilient and can bounce back from a shocking amount of damage.

Definitely check into it and let us know how you're doing. Hope everything turns out fine!
I take glycine for the benefit of deeper sleep at ~3 grams per night. I haven’t ever supplemented glycine until this most recent round of lab work I had been taking glycine for about 5 weeks.

I have only had liver enzymes elevated on two tests in the >5 years I’ve been on TRT.

It has been when I was taking Ibuprofen for my knee and this most recent test.

I do eat a lot of fruit - I eat the following every day:
1-2 bananas
1 apple
1 cup blueberries

The other supplement i recently have been taking prior to this recent bloodwork was pregnenolone. I discontinued that and will re test liver enzymes in a month or so to see if it’s still elevated.
 
I take glycine for the benefit of deeper sleep at ~3 grams per night. I haven’t ever supplemented glycine until this most recent round of lab work I had been taking glycine for about 5 weeks.

I have only had liver enzymes elevated on two tests in the >5 years I’ve been on TRT.

It has been when I was taking Ibuprofen for my knee and this most recent test.

I do eat a lot of fruit - I eat the following every day:
1-2 bananas
1 apple
1 cup blueberries

The other supplement i recently have been taking prior to this recent bloodwork was pregnenolone. I discontinued that and will re test liver enzymes in a month or so to see if it’s still elevated.

Since this happened before while you were taking ibuprofen, it's possible you are in the very small percentage of people who will show higher liver enzymes when using ibuprofen.

How much ibuprofen do you take?

The amount of fruit you're eating shouldn't be large enough to put that much of a strain on your liver, especially a blueberries are one of the lower sugar/carb fruits, and bananas contain a resistant starch.

If you're in a lot of pain, try a different pain medication like naproxen or even aspirin.

There's also supplements that help tremendously with pain and inflammation.

Steady use of a good curcumin supplement will also help with pain. It also helps keep your liver in top shape. Here's the brand I use for the multitude of benefits can get from turmeric. https://smile.amazon.com/Turmeric-C...sc=1&qid=1570827503&sprefix=sports+re,aps,147

For arthritic or joint pain, Boswellia has proven to be quite effective. Boswellia serrata Supplement - Science-based Review on Benefits, Dosage, Side Effects

Here's a link for a brand I bought for my Dad, he is a retired electric company lineman and he was recently diagnosed with osteoarthritis in his feet from wearing steel toe/shank boots for 41 years and this and the Curcumin supplement REALLY helps his pain. https://smile.amazon.com/Pure-Encap...=1570828228&s=hpc&sprefix=bosw,hpc,145&sr=1-9

I know you're taking an Omega-3, be sure it's got high levels of EPA/DHA.

Also, find a certified organic Milk Thistle supplement you like. Milk Thistle is powerful liver protector and healer. Here's what I take: https://smile.amazon.com/Concentrat...uPWNsaWNrUmVkaXJlY3QmZG9Ob3RMb2dDbGljaz10cnVl
 

cigpk

Active Member
Since this happened before while you were taking ibuprofen, it's possible you are in the very small percentage of people who will show higher liver enzymes when using ibuprofen.

How much ibuprofen do you take?

The amount of fruit you're eating shouldn't be large enough to put that much of a strain on your liver, especially a blueberries are one of the lower sugar/carb fruits, and bananas contain a resistant starch.

If you're in a lot of pain, try a different pain medication like naproxen or even aspirin.

There's also supplements that help tremendously with pain and inflammation.

Steady use of a good curcumin supplement will also help with pain. It also helps keep your liver in top shape. Here's the brand I use for the multitude of benefits can get from turmeric. https://smile.amazon.com/Turmeric-Curcumin-Complex-Enhanced-Absorption/dp/B00A39MPNI/ref=sxin_3_ac_d_rm?ac_md=0-0-c3BvcnRzIHJlc2VhcmNoIHR1cm1lcmljIGN1cmN1bWluIGM=-ac_d_rm&crid=3LSF0GC3FH10B&keywords=sports+research+turmeric+curcumin+c3+complex&pd_rd_i=B00A39MPNI&pd_rd_r=f72538c7-bd37-490c-9bcd-15f9b246213e&pd_rd_w=IYj7c&pd_rd_wg=yqiqL&pf_rd_p=983984df-2ad2-4c97-ba7f-4c5a90291c2b&pf_rd_r=79GR7JT8Y1TGMGP517AV&psc=1&qid=1570827503&sprefix=sports+re,aps,147

For arthritic or joint pain, Boswellia has proven to be quite effective. Boswellia serrata Supplement - Science-based Review on Benefits, Dosage, Side Effects

Here's a link for a brand I bought for my Dad, he is a retired electric company lineman and he was recently diagnosed with osteoarthritis in his feet from wearing steel toe/shank boots for 41 years and this and the Curcumin supplement REALLY helps his pain. https://smile.amazon.com/Pure-Encapsulations-Boswellia-Discomfort-Capsules/dp/B0016LPOIK/ref=sr_1_9?crid=2LF28DFLOUJCE&keywords=boswellia+serrata+capsules&qid=1570828228&s=hpc&sprefix=bosw,hpc,145&sr=1-9

I know you're taking an Omega-3, be sure it's got high levels of EPA/DHA.

Also, find a certified organic Milk Thistle supplement you like. Milk Thistle is powerful liver protector and healer. Here's what I take: https://smile.amazon.com/Concentrated-Silymarin-Flavonoids-All-Natural-Certified/dp/B07CCK6VRS/ref=sr_1_1_sspa?crid=37E3YYTY68I8H&keywords=organic+milk+thistle&qid=1570828664&s=hpc&sprefix=organic+milk,hpc,141&sr=1-1-spons&psc=1&spLa=ZW5jcnlwdGVkUXVhbGlmaWVyPUFGWkhYVzk5UzdIRjkmZW5jcnlwdGVkSWQ9QTA5MzcwMTExODhEOU9WRE5KVzMmZW5jcnlwdGVkQWRJZD1BMDcxMTAwNzE3RzdZSDNUQkI0TVQmd2lkZ2V0TmFtZT1zcF9hdGYmYWN0aW9uPWNsaWNrUmVkaXJlY3QmZG9Ob3RMb2dDbGljaz10cnVl
Thanks. I have knee issues from previous ACL reconstruction and a recent meniscus arthroscopy so was taking Advil after running. May have to give Aleve/naproxen a try.

I tried curcumin in the past but remember it had an odd effect on me, maybe I’ll try it again. I’m taking vitamin shoppe brand milk thistle at the moment so I will re test liver enzymes in a month or so and if it’s still high maybe I’ll try the above brand you mentioned.

One thing I was thinking about - I eat a PB&J almost every day for lunch. Weird, I know, but I work in a hospital and need something easy and fast and filling. The jelly I use has glucose-fructose corn syrup in it which could lead to more liver enzymes if I’m eating it almost every single day... I’ll discontinue this and see if it helps.


On the upside, I’m sleeping much better now on a lower T dose of 20 mg EOD. However I have noticed a little more body soreness/joint pain which may be related to lower e2. I’m hoping this levels off but will have to keep an eye on it.

I recently had an appointment with a new PCP and he immediately was put off by me being on testosterone at my age (about to turn 29). Stating the increase in stroke risk, blood clotting, heart disease, etc.

He referred me to an endo who I agreed to meet with just to hear her out. I’m hoping she can take a look at thyroid health in depth as well and maybe give me a good picture of complete hormone health.
 

Cataceous

Super Moderator
...
Regarding Free Testosterone using the newer calculated TruT model/algorithm:

"Based on the new data on the distribution of free testosterone levels in healthy men the target range of free testosterone has been determined to be 164 to 314 pg/ml (mean+/−1SD)"

Which would convert to 16-31 ng/dl
...
Is it reasonable to assume these are peak readings? If so we should take that into account when looking at our trough measurements.
 

MYTVC15

New Member
I'm just wondering how you guys hit such high numbers on such low doses. I was given 200mg. the first week followed by 140mg. for the next 5 weeks and only got to 533 total T with an SHBG of 32
 
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