Some success, some challenges w/ daily protocol

[stx359]

On the advice of Defy I switched to a daily protocol 12 weeks ago. I was on 140 mg of test (70 mg twice a week) and 150 IU/day of HCG. I now inject 18 mg of test daily w/ no change to HCG dose. I just ran my first labs after 12 weeks. In terms of side effect management it has been a complete success. My main issues were terrible body acne which is completely resolved and hematocrit which is now 48.7. Without the need for blood draw my ferritin is coming back and reads 48 now (last test was 19). Also sleep issues have subsided and I get a solid 7 hours a night which was not the case before.

The curious part is blood levels. Despite the decrease to 126 mg a week from 140 my total test is up to 1140 although free test is 19.7 (7.2-24) which I consider adequate but not optimal, and my E2 is up at 73 (7.6-42.6 ECLIA). Other levels:

DHT - 70 (30-85)
DHEA - 136 (71-375)
Pregnenalone - 44
TSH - 1.4 (.4-4.5)
T3 - 3.7 (2.0-4.4)
SHBG - 36.9 (19.3-76.4)

The obvious move appears to be a drop to 16 mg a day (112 mg/week). Of course I will check with Dr. S before I do so. The confounding part is I would normally want to push my free test up a bit as well as DHEA and DHT but that is obviously not an option with that E2. I am not suffering any obvious E2 symptoms although libido and erectile function have suffered a bit. At this point those are the only two things I would tweak. Just thought I would solicit opinion from the board.

 

[Cataceous]

I'd disregard that measured free testosterone. The Tru-T calculated value is around 41 ng/dL, which is well above the top of the healthy normal range (31 ng/dL).

If you're measuring trough testosterone then it's expected that switching to more frequent injections with the same weekly total should yield higher levels. It appears this effect more than offset the dose decrease.

 

[Blackhawk]

I'd disregard that measured free testosterone. The Tru-T calculated value is around 41 ng/dL, which is well above the top of the healthy normal range (31 ng/dL).

I appreciate the Tru-T method, but when working with Defy/Dr Saya, he goes with measured Free T. So while Tru-T provides a different and potentially better reference, practically, it's moot when talking and working things out with the good Doctor.

That STX359's new protocol is working is enough for me, i.e.more relevant than the free T test method.

How do you deal with this methodological discrepancy with your doc Cat?

 

[TestOneTwo]

On the advice of Defy I switched to a daily protocol 12 weeks ago. I was on 140 mg of test (70 mg twice a week) and 150 IU/day of HCG. I now inject 18 mg of test daily w/ no change to HCG dose. I just ran my first labs after 12 weeks. In terms of side effect management it has been a complete success. My main issues were terrible body acne which is completely resolved and hematocrit which is now 48.7. Without the need for blood draw my ferritin is coming back and reads 48 now (last test was 19). Also sleep issues have subsided and I get a solid 7 hours a night which was not the case before.

The curious part is blood levels. Despite the decrease to 126 mg a week from 140 my total test is up to 1140 although free test is 19.7 (7.2-24) which I consider adequate but not optimal, and my E2 is up at 73 (7.6-42.6 ECLIA). Other levels:

DHT - 70 (30-85)
DHEA - 136 (71-375)
Pregnenalone - 44
TSH - 1.4 (.4-4.5)
T3 - 3.7 (2.0-4.4)
SHBG - 36.9 (19.3-76.4)

The obvious move appears to be a drop to 16 mg a day (112 mg/week). Of course I will check with Dr. S before I do so. The confounding part is I would normally want to push my free test up a bit as well as DHEA and DHT but that is obviously not an option with that E2. I am not suffering any obvious E2 symptoms although libido and erectile function have suffered a bit. At this point those are the only two things I would tweak. Just thought I would solicit opinion from the board.

Interesting. Can you please post your levels on 140mg (70mg E3.5D)week?
Also, was there any particular reason they recommended to go right into ED and not try EOD first? You said side effects have subsided but how do you feel compare to E3.5D?

 

[Cataceous]

I appreciate the Tru-T method, but when working with Defy/Dr Saya, he goes with measured Free T. So while Tru-T provides a different and potentially better reference, practically, it's moot when talking and working things out with the good Doctor.
...
How do you deal with this methodological discrepancy with your doc Cat?

I also use Defy, mostly dealing with Jill lately. At least with me they haven't emphasized the directly measured free T results. In fact, for my most recent consultation I didn't have it in my test results and nobody said anything. It is possible they are more laissez-faire with me than is typical. If they ever want to discuss the issue then I'll point to my data showing almost perfect linearity in Tru-T versus injected testosterone dose. In contrast, direct free T versus dose is pretty rough.

 

[Blackhawk]

I also use Defy, mostly dealing with Jill lately. At least with me they haven't emphasized the directly measured free T results. In fact, for my most recent consultation I didn't have it in my test results and nobody said anything. It is possible they are more laissez-faire with me than is typical. If they ever want to discuss the issue then I'll point to my data showing almost perfect linearity in Tru-T versus injected testosterone dose. In contrast, direct free T versus dose is pretty rough.

Not so different I think. If you are in an intended overal numerical zone and feeling well, the actual number or methodology isn't the most important thing.

 

[stx359]

I'd disregard that measured free testosterone. The Tru-T calculated value is around 41 ng/dL, which is well above the top of the healthy normal range (31 ng/dL).

If you're measuring trough testosterone then it's expected that switching to more frequent injections with the same weekly total should yield higher levels. It appears this effect more than offset the dose decrease.

At my current albumin level the calculator gave me a free test of 38 - literally twice my free test reading. This is fascinating. I was not aware of the Tru-T calculator so I thank you.

 

[stx359]

Interesting. Can you please post your levels on 140mg (70mg E3.5D)week?
Also, was there any particular reason they recommended to go right into ED and not try EOD first? You said side effects have subsided but how do you feel compare to E3.5D?

My numbers are 70 twice a week were much the same. Last labs were 1040 total, 22 free, 73 sensitive E2, 32 SHBG. Interesting to me that I can reach the same numbers on so much less testosterone.

As for ED vs EOD Dr. Saya seemed to be just a big believer in the ED regimen, and I have no issue with the additional needle sticks so I agreed to try it. I would like to say that I feel better but there are so may confounding factors its hard to say. With the pandemic I am getting tons of sun and working out like crazy, plus I since started ipamorelin/cjc1295 and BPC-157. One thing that is definitive though is my acne which I waged a multi-year war with since starting trt is completely resolved, my hematocrit appears to be under control without the need for blood draws and I am not waking up at 3:00 every morning. Based on those things alone I would say its a rousing success.

 

[TestOneTwo]

My numbers are 70 twice a week were much the same. Last labs were 1040 total, 22 free, 73 sensitive E2, 32 SHBG. Interesting to me that I can reach the same numbers on so much less testosterone.

As for ED vs EOD Dr. Saya seemed to be just a big believer in the ED regimen, and I have no issue with the additional needle sticks so I agreed to try it. I would like to say that I feel better but there are so may confounding factors its hard to say. With the pandemic I am getting tons of sun and working out like crazy, plus I since started ipamorelin/cjc1295 and BPC-157. One thing that is definitive though is my acne which I waged a multi-year war with since starting trt is completely resolved, my hematocrit appears to be under control without the need for blood draws and I am not waking up at 3:00 every morning. Based on those things alone I would say its a rousing success.

Your lowered HCT gives me hope. How long did it take you to feel normal again? It took me a bumpy 5-6 weeks from E3.5D to EOD.

 

[Cataceous]

At my current albumin level the calculator gave me a free test of 38 - literally twice my free test reading. This is fascinating. I was not aware of the Tru-T calculator so I thank you.

They are not even using the same units. The LabCorp test you had gives results in pg/mL. This is 10 times less than actual hormone concentrations, which are in ng/dL, the units for Tru-T. There's a long thread on Tru-T in which "madman" has posted some of the supporting research:

Calculate Free Testosterone with TruT by FPT

:D About TruT Current problems with accurate free testosterone determination Current methods for measuring free testosterone (fT) are technically challenging and not accurate. The widely used direct immunoassay and tracer analog techniques for measuring fT have been shown to be inaccurate...

www.excelmale.com

 

[stx359]

Your lowered HCT gives me hope. How long did it take you to feel normal again? It took me a bumpy 5-6 weeks from E3.5D to EOD.

In terms of how I "feel" I'd have to say there was little difference. Aside from the aforementioned side effects I have always been extremely active and high energy. I will say that one of the reasons I moved to Defy in the first place was what I considered a lower libido, for me anyway, and lack of sensitivity and ability to enjoy intimacy, but those things seem highly independent of any specific lab reading and honestly I wonder if that is just a result of being 50 and yearning for my 30 year old libido. In that area I am better and expect to feel more so as I induce my E2 to lower levels but there are so many things I have done to impact that that it would be hard to attribute it to going to an ED regimen.