TT: 1100+ E2: 95+ on 150mg/week MWF. Sensitive/standard assay results compared.

[Seas and Mulberry]

11 weeks in. IM VG injections. No adjuncts of any kind.

TT 1141.2 ng/dl (LC/MS-MS)
FT 347 (ordered the sensitive assay, labeled as MS/Dialysis? Mentions LC/MS-MS in the details, units not listed)
E2 97.1 pg/ml (sensitive, details state LC/MS-MS)
SHBG 25.1 nmol/L
HCT 49.6%

I also ordered the standard assays to compare, and to my total shock there wasn't much difference--definitely not enough to justify the cost of the sensitive assays. Given how vocal some forum members are about getting the sensitive assays, I assumed there'd be a big discrepency.

TT 1251 (standard)
FT 35.8 pg/ml (so I assume the sensitive FT result above converts to 34.7 pg/ml?)
E2 95.1 pg/ml (Roche ECLIA)


I'm on week 11 of my protocol, and so far the only TRT-induced changes I can measure with absolute certainty are the following:

1. Acne. Minor acne started developing at week 5, and has gotten slightly more severe over the last 6 weeks. Limited to chest/traps/front shoulders currently, back and face are clear.
2. Gym performance. My 1RM on my B/S/DL are all about 7% higher than my previous PRs, which are from about 3 years ago.
3. I gained like 10 lbs over the course of 2 weeks. I'm guessing it was water weight, since my diet had not changed during that time (though it has since).

Things that are subtle enough that they could totally be placebo:

1. Less anxiety. But I try to meditate regularly, and I have a spiritual practice central to my life, so it's hard to say if things haven't just been better in that regard.
2. Better libido/erection quality. Mostly noticing more erections in the middle of the night/in the morning, but maybe I'm just looking for them. I've also been off of porn for almost 3 years, and celibate for almost 2, so it's hard to gauge.
3. Better overall mood.
4. More motivated.

The patient care coordinator at my clinic suggested I lower my dosage to 120mg/week to combat acne. Given I'm only 11 weeks into my protocol, is there any chance the acne is go away on it's own once things have had a few more months to stabilize? Admittedly, I do enjoy the anabolic effects of my current dosage and would like to keep it here if possible. But if it's unlikely my acne will subside, and my other numbers (HCT and E2 especially) are a risk, then I would reduce my dosage.

 

[Vince]

11 weeks in. IM VG injections. No adjuncts of any kind.

TT 1141.2 ng/dl (LC/MS-MS)
FT 347 (ordered the sensitive assay, labeled as MS/Dialysis? Mentions LC/MS-MS in the details, units not listed)
E2 97.1 pg/ml (sensitive, details state LC/MS-MS)
SHBG 25.1 nmol/L
HCT 49.6%

I also ordered the standard assays to compare, and to my total shock there wasn't much difference--definitely not enough to justify the cost of the sensitive assays. Given how vocal some forum members are about getting the sensitive assays, I assumed there'd be a big discrepency.

TT 1251 (standard)
FT 35.8 pg/ml (so I assume the sensitive FT result above converts to 34.7 pg/ml?)
E2 95.1 pg/ml (Roche ECLIA)


I'm on week 11 of my protocol, and so far the only TRT-induced changes I can measure with absolute certainty are the following:

1. Acne. Minor acne started developing at week 5, and has gotten slightly more severe over the last 6 weeks. Limited to chest/traps/front shoulders currently, back and face are clear.
2. Gym performance. My 1RM on my B/S/DL are all about 7% higher than my previous PRs, which are from about 3 years ago.
3. I gained like 10 lbs over the course of 2 weeks. I'm guessing it was water weight, since my diet had not changed during that time (though it has since).

Things that are subtle enough that they could totally be placebo:

1. Less anxiety. But I try to meditate regularly, and I have a spiritual practice central to my life, so it's hard to say if things haven't just been better in that regard.
2. Better libido/erection quality. Mostly noticing more erections in the middle of the night/in the morning, but maybe I'm just looking for them. I've also been off of porn for almost 3 years, and celibate for almost 2, so it's hard to gauge.
3. Better overall mood.
4. More motivated.

The patient care coordinator at my clinic suggested I lower my dosage to 120mg/week to combat acne. Given I'm only 11 weeks into my protocol, is there any chance the acne is go away on it's own once things have had a few more months to stabilize? Admittedly, I do enjoy the anabolic effects of my current dosage and would like to keep it here if possible. But if it's unlikely my acne will subside, and my other numbers (HCT and E2 especially) are a risk, then I would reduce my dosage.

If the acne isn't too much of a pain. My only concern would be, HCT. Hopefully it will not rise too high.

There's nothing wrong with, lowering your dose. Just to see what affect it has on you.

 

[Seas and Mulberry]

If the acne isn't too much of a pain. My only concern would be, HCT. Hopefully it will not rise too high.

There's nothing wrong with, lowering your dose. Just to see what affect it has on you.

Thanks for the feedback. So, an E2 of 95 isn't abnormally high in relation to my other values?

Yes, HCT is my main concern as well. My biggest fear right now is falling into a downward spiral of frequent blood donations -> crashing ferritin -> iron supplementation -> elevated HCT -> repeat. I didn't even know this was a thing until coming onto these forums, it seems rarely talked about elsewhere.

 

[Gman86]

Ur HCT is literally perfect. Like legit perfect. Don’t worry about it unless it goes over 55%. If urs hovers around high 40’s to low 50’s ur perfectly fine and have nothing to worry about. Here’s a quick video that explains why too many men on HRT stress about their HCT when they don’t need to. I personally don’t worry about it unless it gets around 55% or higher. Which it never has, and been on HRT for 8 years, and with levels much higher than urs

 

[Gman86]

Here’s a reply I made to a guy about acne one time. I saved it so I wouldn’t have to write it out every time I gave someone advice on acne. Imo, if u feel as good as u do, I wouldn’t change a thing


Here’s the reply I saved,

Acne should be treated from within, first and foremost. U can also treat it externally, but 90% of ur efforts should be spent treating acne from within. Here’s the reply I wrote to the other guy



Sounds like ur on the right track as far as getting ur acne under control. The main thing is definitely diet and lowering inflammation. So the main things are zero/ very little gluten, and zero/ very little crap processed dairy. U can do dairy as long as it’s grassfed, raw (unpasteurized), unhomogenized, and preferably organic. But non-grassfed, pasteurized dairy is horrible for u, and will increase inflammation like crazy. Obv there’s a ton of other ways to reduce inflammation through diet, but those are two of the biggest culprits.



As far as accutane goes, ur kind of on the right track. But u want to stay away from synthetic vitamin A, it’s basically a poison to the body in that form. Vitamin A is definitely a great remedy for acne however. So what u want to do is stick to the most bioavailable and natural form of vitamin A that the body prefers, which is retinol. It’s mainly found in animal products. The #1 source being liver. I personally eat raw liver twice per week. About 7oz total per week. I get grassfed beef liver from my local farmers market. Just cut it up in tiny pieces and swallow it down with water, don’t even chew it. Been doing this for years. If ur opposed to eating liver, the next best thing is taking a desiccated grassfed beef liver supplement. They come in capsules with the desiccated ground up beef liver in them. The brand I recommend is ancestral supplements. Whichever one u get just make sure they use liver from cows that are grassfed year round, and are grass finished. Make sure they never intake any grains or crap food. There’s obv other sources of retinol, but in amounts nowhere near liver. But I think pastured egg yolks have a bit, and I think some fish like salmon have some retinol. Just look up top sources of retinol on Google. I think grassfed cheese has a decent amount of retinol as well.



The member above mentioning progesterone is spot on as well. Progesterone is produced mainly in the testicles, so most of us have very low levels while on TRT. Progesterone opposes E2 and DHT and controls the conversion of test into E2 and DHT. So getting ur progesterone levels into a healthy range should help with any acne issues



And the last thing to look into is DIM and Calcium D-Glucarate. Not the biggest fan of DIM as it’s also an anti androgen, and inhibits MTOR and IGF-1 production, which means it inhibits growth. And if building lean muscle tissue is of importance to u, DIM doesn’t seem like the best thing to be taking. But CDG seems to control E2 and acne for a lot of men on TRT, without the growth inhibiting aspect. Here’s a quick video of a guy talking about how both help control his acne while on TRT

(Test your levels dim vs calcium d glucarate. Both took care of his acne)

 

[madman]

11 weeks in. IM VG injections. No adjuncts of any kind.

TT 1141.2 ng/dl (LC/MS-MS)
FT 347 (ordered the sensitive assay, labeled as MS/Dialysis? Mentions LC/MS-MS in the details, units not listed)
E2 97.1 pg/ml (sensitive, details state LC/MS-MS)
SHBG 25.1 nmol/L
HCT 49.6%

I also ordered the standard assays to compare, and to my total shock there wasn't much difference--definitely not enough to justify the cost of the sensitive assays. Given how vocal some forum members are about getting the sensitive assays, I assumed there'd be a big discrepency.

TT 1251 (standard)
FT 35.8 pg/ml (so I assume the sensitive FT result above converts to 34.7 pg/ml?)
E2 95.1 pg/ml (Roche ECLIA)


I'm on week 11 of my protocol, and so far the only TRT-induced changes I can measure with absolute certainty are the following:

1. Acne. Minor acne started developing at week 5, and has gotten slightly more severe over the last 6 weeks. Limited to chest/traps/front shoulders currently, back and face are clear.
2. Gym performance. My 1RM on my B/S/DL are all about 7% higher than my previous PRs, which are from about 3 years ago.
3. I gained like 10 lbs over the course of 2 weeks. I'm guessing it was water weight, since my diet had not changed during that time (though it has since).

Things that are subtle enough that they could totally be placebo:

1. Less anxiety. But I try to meditate regularly, and I have a spiritual practice central to my life, so it's hard to say if things haven't just been better in that regard.
2. Better libido/erection quality. Mostly noticing more erections in the middle of the night/in the morning, but maybe I'm just looking for them. I've also been off of porn for almost 3 years, and celibate for almost 2, so it's hard to gauge.
3. Better overall mood.
4. More motivated.

The patient care coordinator at my clinic suggested I lower my dosage to 120mg/week to combat acne. Given I'm only 11 weeks into my protocol, is there any chance the acne is go away on it's own once things have had a few more months to stabilize? Admittedly, I do enjoy the anabolic effects of my current dosage and would like to keep it here if possible. But if it's unlikely my acne will subside, and my other numbers (HCT and E2 especially) are a risk, then I would reduce my dosage.

Acne (genetically prone individuals) let alone higher RBCs/hematocrit/hemoglobin are due to excess FT.

If you feel great overall and are not struggling with any sides then I would say leave it be but unfortunately, your acne went from being mild--->severe.

Your hematocrit is not too high and although your estradiol is high if you were not struggling with any sides then I would not be too concerned.

You are already 11 weeks in and blood levels will have stabilized (4-6 weeks).

Chances are that you will continue to struggle with the acne due to running higher-end trough FT levels.

Although DHT can stimulate the sebaceous (oil glands) to increase in size and produce excess sebum which can lead to acne (mild/moderate/severe) in the genetically prone there is more to the story.

Androgens and activation of the AR.

Comes down to genetics, the sensitivity of the AR to androgens, and the sensitivity of the skin/hair follicles to DHT.

Excess e2 can contribute to inflammation in some.

You could most likely clear up the acne by bringing down your trough FT level which will also lower estradiol and you may very well feel just as good overall minus the sides otherwise you will need to look into treating your acne.

Highly doubtful manipulating your diet will clear up your acne as it is due to excess androgens/FT.....hormonally induced acne!




DHT and Androgenic Side Effects

"In some regards, this local potentiation of testosterone's activity may be unwelcome, as higher androgenic activity in certain tissues may produce a number of undesirable side effects. Acne, for example, is often triggered by dihydrotestosterone activity in the sebaceous glands, and the local formation of dihydrotestosterone in the scalp is typically blamed for triggering male pattern hair loss. You should know that it is a terrible misconception among bodybuilders that dihydrotestosterone is an isolated culprit when it comes to these side effects. All anabolic/androgenic steroids exert their activities, both anabolic and androgenic, through the same cellular androgen receptor"

"Dihydrotestosterone is no different than any other steroid except that it is a more potent activator of this receptor than most, and can be formed locally in certain androgen-sensitive tissues. All steroids can cause androgenic side effects in direct relation to their affinity for this receptor, and DHT has no known unique ability in this regard"

The main point to keep in mind regarding acne or hair loss (genetically prone individuals).....is that DHT is not the sole contributor and it is the general activation of the AR that is responsible.

You are injecting 150 mg T/week split M/W/F

As you can see on the first set of labs the most accurate assays were used for TT (LC/MS-MS) and FT (Equilibrium Dialysis).

TT 1141.2 ng/dl (LC/MS-MS)
FT 347 (ordered the sensitive assay, labeled as MS/Dialysis? Mentions LC/MS-MS in the details, units not listed)
E2 97.1 pg/ml (sensitive, details state LC/MS-MS)
SHBG 25.1 nmol/L
HCT 49.6%


You are hitting a high-end TT 1141 ng/dL and with an SHBG 25 nmol/L, your FT level is and would be very high 347 pg/mL (reference range 35-155 pg/mL).

Keep in mind that if your labs were done at true trough then peak TT/FT/estradiol levels will be higher.

Regarding your second set of labs, you tested FT using the piss poor direct immunoassay which was pointless as it is not an accurate testing method.

TT 1251 (standard)
FT 35.8 pg/ml (so I assume the sensitive FT result above converts to 34.7 pg/ml?)
E2 95.1 pg/ml (Roche ECLIA)


* (so I assume the sensitive FT result above converts to 34.7 pg/ml?).....No, as the units are in pg/mL Quest Equilibrium Dialysis (reference range 35-155 pg/mL).

Two completely different assays (scales/reference ranges) comparing the piss poor direct immunoassay to the most accurate assays (Equilibrium Dialysis or Ultrafiltration) is a waste of time!

Again the only way to know where your FT level truly sits is to have it tested using the most accurate assays such as the gold standard Equilibrium Dialysis or Ultrafiltration (next best) along with TT (LC/MS-MS).

Which you clearly did on your 1st set of labs!

 

[Seas and Mulberry]

Here’s a reply I made to a guy about acne one time. I saved it so I wouldn’t have to write it out every time I gave someone advice on acne. Imo, if u feel as good as u do, I wouldn’t change a thing


Here’s the reply I saved,

Acne should be treated from within, first and foremost. U can also treat it externally, but 90% of ur efforts should be spent treating acne from within. Here’s the reply I wrote to the other guy



Sounds like ur on the right track as far as getting ur acne under control. The main thing is definitely diet and lowering inflammation. So the main things are zero/ very little gluten, and zero/ very little crap processed dairy. U can do dairy as long as it’s grassfed, raw (unpasteurized), unhomogenized, and preferably organic. But non-grassfed, pasteurized dairy is horrible for u, and will increase inflammation like crazy. Obv there’s a ton of other ways to reduce inflammation through diet, but those are two of the biggest culprits.



As far as accutane goes, ur kind of on the right track. But u want to stay away from synthetic vitamin A, it’s basically a poison to the body in that form. Vitamin A is definitely a great remedy for acne however. So what u want to do is stick to the most bioavailable and natural form of vitamin A that the body prefers, which is retinol. It’s mainly found in animal products. The #1 source being liver. I personally eat raw liver twice per week. About 7oz total per week. I get grassfed beef liver from my local farmers market. Just cut it up in tiny pieces and swallow it down with water, don’t even chew it. Been doing this for years. If ur opposed to eating liver, the next best thing is taking a desiccated grassfed beef liver supplement. They come in capsules with the desiccated ground up beef liver in them. The brand I recommend is ancestral supplements. Whichever one u get just make sure they use liver from cows that are grassfed year round, and are grass finished. Make sure they never intake any grains or crap food. There’s obv other sources of retinol, but in amounts nowhere near liver. But I think pastured egg yolks have a bit, and I think some fish like salmon have some retinol. Just look up top sources of retinol on Google. I think grassfed cheese has a decent amount of retinol as well.



The member above mentioning progesterone is spot on as well. Progesterone is produced mainly in the testicles, so most of us have very low levels while on TRT. Progesterone opposes E2 and DHT and controls the conversion of test into E2 and DHT. So getting ur progesterone levels into a healthy range should help with any acne issues



And the last thing to look into is DIM and Calcium D-Glucarate. Not the biggest fan of DIM as it’s also an anti androgen, and inhibits MTOR and IGF-1 production, which means it inhibits growth. And if building lean muscle tissue is of importance to u, DIM doesn’t seem like the best thing to be taking. But CDG seems to control E2 and acne for a lot of men on TRT, without the growth inhibiting aspect. Here’s a quick video of a guy talking about how both help control his acne while on TRT

(Test your levels dim vs calcium d glucarate. Both took care of his acne)

Thanks, I actually read your post a while back. I've cut out dairy for a long time and I'm sure it's helping to keep the acne from being more severe. I know that it completely cleared all of my acne before getting on TRT, for almost a year. The acne only returned after starting TRT.

Aside from that I'm supplementing zinc, though I'm not sure it's doing much. Also using benzoyl peroxide wash twice a day, and Differin gel at night.

Part of me wonders if, for those who used some product/regiment or another and saw their acne go away, what actually happened is just that enough time passed for their hormones to stabilize.

 

[Gman86]

Thanks, I actually read your post a while back. I've cut out dairy for a long time and I'm sure it's helping to keep the acne from being more severe. I know that it completely cleared all of my acne before getting on TRT, for almost a year. The acne only returned after starting TRT.

Aside from that I'm supplementing zinc, though I'm not sure it's doing much. Also using benzoyl peroxide wash twice a day, and Differin gel at night.

Part of me wonders if, for those who used some product/regiment or another and saw their acne go away, what actually happened is just that enough time passed for their hormones to stabilize.

Ya there’s definitely a chance that once things stabilize and ur body gets used to the new homeostasis that ur acne may improve on its on. The most important part of my post on acne is in regards to retinol (bioavailable vitamin A). If ur not already in taking a good amount of it. make sure u focus on getting as much retinol in ur diet as possible. Make sure to either intake grassfed beef liver on a regular basis, or order some desiccated grassfed beef liver capsules. And then also try to get in retinol through other sources, if possible. Vitamin A is the most effective treatment for acne. U just want to stay far away from accutane, and make sure u get it through natural bioavailable sources

 

[Seas and Mulberry]

Acne (genetically prone individuals) let alone higher RBCs/hematocrit/hemoglobin are due to excess FT.

If you feel great overall and are not struggling with any sides then I would say leave it be but unfortunately, your acne went from being mild--->severe.

Your hematocrit is not too high and although your estradiol is high if you were not struggling with any sides then I would not be too concerned.

You are already 11 weeks in and blood levels will have stabilized (4-6 weeks).

Chances are that you will continue to struggle with the acne due to running higher-end trough FT levels.

Although DHT can stimulate the sebaceous (oil glands) to increase in size and produce excess sebum which can lead to acne (mild/moderate/severe) in the genetically prone there is more to the story.

Androgens and activation of the AR.

Comes down to genetics, the sensitivity of the AR to androgens, and the sensitivity of the skin/hair follicles to DHT.

Excess e2 can contribute to inflammation in some.

You could most likely clear up the acne by bringing down your trough FT level which will also lower estradiol and you may very well feel just as good overall minus the sides otherwise you will need to look into treating your acne.

Highly doubtful manipulating your diet will clear up your acne as it is due to excess androgens/FT.....hormonally induced acne!




DHT and Androgenic Side Effects

"In some regards, this local potentiation of testosterone's activity may be unwelcome, as higher androgenic activity in certain tissues may produce a number of undesirable side effects. Acne, for example, is often triggered by dihydrotestosterone activity in the sebaceous glands, and the local formation of dihydrotestosterone in the scalp is typically blamed for triggering male pattern hair loss. You should know that it is a terrible misconception among bodybuilders that dihydrotestosterone is an isolated culprit when it comes to these side effects. All anabolic/androgenic steroids exert their activities, both anabolic and androgenic, through the same cellular androgen receptor"

"Dihydrotestosterone is no different than any other steroid except that it is a more potent activator of this receptor than most, and can be formed locally in certain androgen-sensitive tissues. All steroids can cause androgenic side effects in direct relation to their affinity for this receptor, and DHT has no known unique ability in this regard"

The main point to keep in mind regarding acne or hair loss (genetically prone individuals).....is that DHT is not the sole contributor and it is the general activation of the AR that is responsible.

You are injecting 150 mg T/week split M/W/F

As you can see on the first set of labs the most accurate assays were used for TT (LC/MS-MS) and FT (Equilibrium Dialysis).

TT 1141.2 ng/dl (LC/MS-MS)
FT 347 (ordered the sensitive assay, labeled as MS/Dialysis? Mentions LC/MS-MS in the details, units not listed)
E2 97.1 pg/ml (sensitive, details state LC/MS-MS)
SHBG 25.1 nmol/L
HCT 49.6%


You are hitting a high-end TT 1141 ng/dL and with an SHBG 25 nmol/L, your FT level is and would be very high 347 pg/mL (reference range 35-155 pg/mL).

Keep in mind that if your labs were done at true trough then peak TT/FT/estradiol levels will be higher.

Regarding your second set of labs, you tested FT using the piss poor direct immunoassay which was pointless as it is not an accurate testing method.

TT 1251 (standard)
FT 35.8 pg/ml (so I assume the sensitive FT result above converts to 34.7 pg/ml?)
E2 95.1 pg/ml (Roche ECLIA)


* (so I assume the sensitive FT result above converts to 34.7 pg/ml?).....No, as the units are in pg/mL Quest Equilibrium Dialysis (reference range 35-155 pg/mL).

Two completely different assays (scales/reference ranges) comparing the piss poor direct immunoassay to the most accurate assays (Equilibrium Dialysis or Ultrafiltration) is a waste of time!

Again the only way to know where your FT level truly sits is to have it tested using the most accurate assays such as the gold standard Equilibrium Dialysis or Ultrafiltration (next best) along with TT (LC/MS-MS).

Which you clearly did on your 1st set of labs!

Thanks for the interesting information, I did not know that about DHT and androgen receptors.

One thing that I didn't make clear in my original post, is that all of these labs were done at Labcorp on the same day from the same blood draw session. I ordered the standard and sensitive assays together on the same requisition form so that I could get a side-by-side comparison of the accuracy, letting me know if I should spend the extra for sensitive tests in the future. So when you mention Quest in your post, do you mean that Labcorp uses Quest ranges for its FT direct immunoassay?

Regarding the acne, yes I've pretty much given up on diet changes being able to eliminate it at this point. I'm not sure if topical retinoids can make a significant difference, I started Differin gel on it about 5 weeks ago. Supposedly results can take up to 3 months to show, with a possible purging period in between. And again there may have been some confusion in my post, because while I mention it getting slightly more severe, it's really just gone from very mild to mild/moderate (granted it could continue to worsen).

But thanks for the information, I do think the next logical step if side effects worsen is to drop my dosage to bring down FT levels. I admit my reason for running a high testosterone level is fairly frivolous (muscle building). The acne is a con, but ultimately pretty superficial as well. My biggest concern right now is that SHBG will continue to drop (thus raising FT further), and that HCT will continue to rise. I read somewhere that HCT can take up to a year to stabilize, something about RBC production having a 6 month cycle? Maybe I'm completely off base about this.

@madman, do you know if there's any literature out there about how long SHBG and HCT take to stabilize while on TRT?

 

[Vince]

Thanks for the feedback. So, an E2 of 95 isn't abnormally high in relation to my other values?

Yes, HCT is my main concern as well. My biggest fear right now is falling into a downward spiral of frequent blood donations -> crashing ferritin -> iron supplementation -> elevated HCT -> repeat. I didn't even know this was a thing until coming onto these forums, it seems rarely talked about elsewhere.

Right now your HCT is okay, as you know. I did have to donate every 8 weeks, for 2 years, after starting trt. After 2 years my HCT stabilized and I never donated again. I've been on trt over 6 and 1/2 years now. Is your E2 too high? If you're not having symptoms of high levels, I wouldn't be concerned.

 

[madman]

Thanks for the interesting information, I did not know that about DHT and androgen receptors.

One thing that I didn't make clear in my original post, is that all of these labs were done at Labcorp on the same day from the same blood draw session. I ordered the standard and sensitive assays together on the same requisition form so that I could get a side-by-side comparison of the accuracy, letting me know if I should spend the extra for sensitive tests in the future. So when you mention Quest in your post, do you mean that Labcorp uses Quest ranges for its FT direct immunoassay?

Regarding the acne, yes I've pretty much given up on diet changes being able to eliminate it at this point. I'm not sure if topical retinoids can make a significant difference, I started Differin gel on it about 5 weeks ago. Supposedly results can take up to 3 months to show, with a possible purging period in between. And again there may have been some confusion in my post, because while I mention it getting slightly more severe, it's really just gone from very mild to mild/moderate (granted it could continue to worsen).

But thanks for the information, I do think the next logical step if side effects worsen is to drop my dosage to bring down FT levels. I admit my reason for running a high testosterone level is fairly frivolous (muscle building). The acne is a con, but ultimately pretty superficial as well. My biggest concern right now is that SHBG will continue to drop (thus raising FT further), and that HCT will continue to rise. I read somewhere that HCT can take up to a year to stabilize, something about RBC production having a 6 month cycle? Maybe I'm completely off base about this.

@madman, do you know if there's any literature out there about how long SHBG and HCT take to stabilize while on trt?

* (so I assume the sensitive FT result above converts to 34.7 pg/ml?).....No, as the units are in pg/mL Quest Equilibrium Dialysis (reference range 35-155 pg/mL).

My mistake as I thought they were done through Quest.

Regardless the units are still in pg/mL Labcorp Equilibrium Dialysis (reference range 52-280 pg/mL).

The piss poor direct immunoassay through Labcorp reference range varies depending on age.....30-39 (reference range 8.7-25.1 pg/mL).

The direct immunoassay is known to be inaccurate and should not be used/relied upon when testing FT.

You should have ordered the Equilibrium Ultrafiltration through Labcorp which would have been much cheaper or if anything purchase the Equilibrium Dialysis or Ultrafiltration assay through Nelsons discounted labs which would be cheaper in the long run.

FT Equilibrium Dialysis assay through Labcorp is very expensive.

Keep in mind that will there not be a significant impact on body composition (muscle gains/fat loss) whether running a TT 1200 or 800.

Even then when using therapeutic doses of T the impact on muscle/strength gains will be minor when compared to using steroid doses of T (300-600 mg/week).

Although having healthy TT/FT levels will have a positive impact on muscle, fat loss, one's diet/training protocol is key let alone GENETICS will have the final say!




post # 6

Testosterone use causing erythrocytosis

A 60-year-old man with a medical history of depression, seasonal allergies, remote appendectomy, and cholecystectomy presented to the emergency department with a sudden headache. Upon examination, his blood pressure was elevated (190/112 mm Hg) and he had erythrocytosis (hemoglobin 196 [normal...

www.excelmale.com

When using exogenous T RBCs/hemoglobin/hematocrit will increase within the 1st month and can take up to 9-12 months to reach peak levels.

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.

Injectable T has been shown to have a greater impact on increasing HCT compared to transdermal T.

3–18% with transdermal administration and up to 44% with injection.

In most cases when using injectable T high supra-physiological peaks post-injection and overall T levels (running too high TT/FT level) will have a big impact on increasing HCT.

Manipulating injection frequency by injecting more frequently using lower doses of T resulting in minimizing the peak--->trough and maintaining more stable levels may lessen the impact on HCT but it is not a given.

As again running very high TT/FT levels will have a stronger impact on driving up HCT.

Although injectables have been shown to have a greater impact on HCT you can see even when using a transdermal formulation that maintains stable serum concentrations that the impact it has on HCT is DEPENDANT ON THE DOSE AND SERUM LEVEL OF T.

Using higher doses of transdermal T and achieving higher TT/FT levels will have a great impact on HCT levels.

How high an FT level you are running is critical.

It is a given that most men on trt struggling with elevated RBCs/hemoglobin/hematocrit are running too high an FT level.

Sure some men are more sensitive than others as they may still struggle with elevated blood markers when running lower T levels but it is far from common and many may already have an underlying health issue contributing to such.

If you are struggling with such blood markers then in most cases finding the lowest FT level you can run while still maintaining the beneficial effects may very well be the solution.

Easier said than done as many men on trt tend to do better running higher-end FT levels within reason.

Mind you some are lucky and never have an issue or levels tend to stabilize over time.

Others will continue to struggle until the cows come home.

Unfortunately too many are caught up in running absurdly high trough FT levels due to the herd mentality spewed on the bro forums and gootube!