Seems the standard protocol for TRT is to start at 100mg Test C per week. Should one consider a higher starting dose if they are:
1.) Larger (in my case 6'3", 200lbs, <10%bf)
2.) Have low total T of which a very high amount is SHBG
My last test results are:
Total test: 499 ng/dL
SHBG: 55.1 nmol/L
Albumin: 4.6 g/dL
Free T: 7.26 ng/dL = 1.45 %
(Free T calculated using:
Free & Bioavailable Testosterone calculator )
I understand the SHBG range to be 16.5-55.9 nmol/L, which would put me at the top of the range.
As always thanks for all the great advice y'all give.
Although your TT is average 499 ng/dL.....seeing as your SHBG is higher (top end of the range) at 55.1 nmol/L your FT level is low.
I would not say it is very high as in well over the top end of the range.
The linear law-of-mass action calculated (Vermeulen method) used above is outdated and tends to under estimate FT by as much as 40% when compared to the gold standard Equilibrium Dialysis.
If you truly want to know where your FT level sits than you would need to use the most accurate testing the gold standard Equilibrium Dialysis or Ultrafiltration (next best).....or if anything use the newer calculated TruT model/algorithm which is based on the newer research/understanding of SHBG:T binding and has been shown to be on par with results obtained by the gold standard Equilibrium Dialysis testing method.
It is available online toi the general public.....
TruT Free Testosterone Calculator by FPT
As you can see if we take your TT 499 ng/dL, SHBG 55.1 nmol/L, Albumin 4.3 g/dL (mean) than your FT is 14.33 ng/dL (LOW).....(reference range 16-31 ng/dL).
Regardless of pre-trt level/SHBG.....most sensible piece of advice is to start low and go slow.
Sure with a high/highish SHBG one will need to attain a higher TT than one with low/lowish
SHBG to attain a healthy FT level but even than the TT level needed will not need to be extremely high as most would seem to think.....due to the newer research/understanding of SHBG:T binding.
No one can say if.....let alone to what degree your SHBG may drop when on trt as some notice minimal if any changes whereas others may experience a larger drop.
Sure larger doses of T injected less frequently as in once weekly may have a more significant impact on lowering ones SHBG when on trt but even than it is usually high doses of androgens as in 250+ which have been shown in studies to have such an effect.
You can start of on once weekly injections if you wish but it would be more sensible to split your dose and inject twice weekly (every 3.5 days) as not only will your T levels be more stable throughout the week but you will also soften the extremes between your peak--->trough level.
100 mg is a descent starting dose.....you could go higher but I would definitely not jump into the 200-210 mg once weekly injections your clinic is prescribing.....even with an SHBG of 55 nmol/L......210 mg/week is way too high a starting dose and in many cases most would never need such.
Most men on trt on average are injecting 100-150 mg/week.....and yes some using 200 mg/week (not common) as most would never need such a dose to hit a healthy FT level.
Most men on trt do well having a FT trough in the 30--->30+ ng/dL range.