Blood panel, how's mine look?

[kelj358]

Hello all. Been snooping around for a bit doing research on TRT. Just started back in march of this year. Dr prescribed 200mg/every 2 weeks of depo test...so pretty sure he has no idea what he's doing when it comes to TRT. I started doing 100mg/week 6 weeks ago. Feeling pretty good, but nothing super noticeable. Feeling a little stronger, no real change in body composition yet. Actually, have put on about 8lbs...but bodyfat % has stayed the same. right about 15.5 %. After doing some more reading..im thinking of moving to 50mg twice a week. Below is my blood panel from last week. Thoughts? E2 was 39.

 

[Cataceous]

Your instincts are good with respect to dose frequency. With once-weekly doses of testosterone cypionate it's common to have peak levels that are two to three times trough levels. This is decidedly unnatural. Assuming your lab work is at trough then you are likely going from very high to mid-low levels with each injection cycle. To remedy this I would go a step further by reducing to 30-40 mg twice weekly. In spite of its popularity, even that 100 mg/week is excessive as a starting dose, providing much more testosterone than most healthy men ever make naturally. Some can tolerate it, while others do not.

 

[kelj358]

Your instincts are good with respect to dose frequency. With once-weekly doses of testosterone cypionate it's common to have peak levels that are two to three times trough levels. This is decidedly unnatural. Assuming your lab work is at trough then you are likely going from very high to mid-low levels with each injection cycle. To remedy this I would go a step further by reducing to 30-40 mg twice weekly. In spite of its popularity, even that 100 mg/week is excessive as starting dose, providing much more testosterone than most healthy men ever make naturally. Some can tolerate it, while

yes, panel drawn at trough

 

[Vince]

Hello all. Been snooping around for a bit doing research on TRT. Just started back in march of this year. Dr prescribed 200mg/every 2 weeks of depo test...so pretty sure he has no idea what he's doing when it comes to TRT. I started doing 100mg/week 6 weeks ago. Feeling pretty good, but nothing super noticeable. Feeling a little stronger, no real change in body composition yet. Actually, have put on about 8lbs...but bodyfat % has stayed the same. right about 15.5 %. After doing some more reading..im thinking of moving to 50mg twice a week. Below is my blood panel from last week. Thoughts? E2 was 39.

View attachment 52265

I would say your panel looks pretty good. I do agree with you injecting twice a week. You may want to add in HCG. I think eventually you'll need to add HCG just to keep your testicles full, along with a good libido.

 

[kelj358]

So, the HCG would increase libido and keep the balls from shriveling up to nothing? lol Is that generally the case with long term trt?

 

[Guided_by_Voices]

So, the HCG would increase libido and keep the balls from shriveling up to nothing? lol Is that generally the case with long term trt?

Yes. It's just like when you put a muscle in a cast. It/They atrophy from lack of use

 

[Systemlord]

I didn’t respond very well to even twice weekly injections. The higher the dose frequency the greater the response for me.

I now dose twice daily, Jatenzo.

 

[Vince]

So, the HCG would increase libido and keep the balls from shriveling up to nothing? lol Is that generally the case with long term trt?

Yes, I inject 500 IU of HCG every third day. I combine both HCG and testosterone in the same syringe, like Nelson

 

[kelj358]

So, it's very likey that my peak is somewhere around 1,000? Am I safe to assume that with some of the data I've seen on this site? Is it common to get a blood panel near peak? Again...I'm a rookie at this stuff, but most seem to have blood work done at trough.

 

[Cataceous]

So, it's very likey that my peak is somewhere around 1,000? Am I safe to assume that with some of the data I've seen on this site? Is it common to get a blood panel near peak? Again...I'm a rookie at this stuff, but most seem to have blood work done at trough.

I would guess at least 1,200-1,300 ng/dL for your peak. It is considered standard practice to test at trough, but then you do need to keep in mind that the peak is a lot higher with weekly injections. With twice-weekly injections peaks may be more like 50% over troughs. To some extent testing at trough is used as an excuse to dose higher. That's fine for those who value athleticism and body composition above all else. But for overall health you'll likely be better off with the lowest dose that resolves symptoms of hypogonadism. Many fail to appreciate the negative effects of exogenous testosterone, especially when in excess. Here's a good post on the subject. Over the years I've gradually retreated from conventional TRT, now favoring the fast-acting modalities—e.g. testosterone nasal gel—that resolve hypogonadism with less chance of causing hormonal chaos.

 

[Vince]

I would guess at least 1,200-1,300 ng/dL for your peak. It is considered standard practice to test at trough, but then you do need to keep in mind that the peak is a lot higher with weekly injections. With twice-weekly injections peaks may be more like 50% over troughs. To some extent testing at trough is used as an excuse to dose higher. That's fine for those who value athleticism and body composition above all else. But for overall health you'll likely be better off with the lowest dose that resolves symptoms of hypogonadism. Many fail to appreciate the negative effects of exogenous testosterone, especially when in excess. Here's a good post on the subject. Over the years I've gradually retreated from conventional TRT, now favoring the fast-acting modalities—e.g. testosterone nasal gel—that resolve hypogonadism with less chance of causing hormonal chaos.

High doses failed you, correct? Many men had lowered levels when they were young so of course when they use TRT they must still aim for lower levels. Your levels are not much higher than when you originally started TRT. Is that correct?

 

[Cataceous]

High doses failed you, correct? Many men had lowered levels when they were young so of course when they use TRT they must still aim for lower levels. Your levels are not much higher than when you originally started TRT. Is that correct?

By conventional standards I was never on high doses. But when I started out with 100 mg testosterone cypionate per week delivered EOD it put TT at about 1,250 ng/dL. Thanks to the influence of the late Curt Moyer I knew this was higher than I wanted, and titrated down to more like 65 mg/week. Of course now that I know that 100 mg TC/week—10 mg T/day—is basically not even physiological, I do discourage starting so high. For me even the 65 mg/week was excessive, though I was in denial for a long time. It hadn't occurred to me that having free testosterone in the top quartile of the reference range could be so problematic even as I was enjoying the enhanced athleticism.

There is this common assumption that the optimum TRT dose is the one that yields your particular healthy youthful levels. But without evidence it remains speculative. There's also a contrary hypothesis saying that the higher levels of youth are actually not ideal for aging bodies.

With respect to my levels not being much over my original hypogonadal ones, you are alluding to my recent accidental discovery that such levels can produce surprisingly good results. I certainly had not intended to be dosing at < 1 mg T per day, yet measurements suggested that that's what happened as I experimented with testosterone suspension.

 

[Guided_by_Voices]

. It hadn't occurred to me that having free testosterone in the top quartile of the reference range could be so problematic even as I was enjoying the enhanced athleticism.

What are you referring to here?

Also, have you checked E2 at your current lower dose? I too seem to feel better at lower doses but my E2 has been too low, at least on paper. I'm becoming more intrested in the E2 injections.

 

[Vince]

By conventional standards I was never on high doses. But when I started out with 100 mg testosterone cypionate per week delivered EOD it put TT at about 1,250 ng/dL. Thanks to the influence of the late Curt Moyer I knew this was higher than I wanted, and titrated down to more like 65 mg/week. Of course now that I know that 100 mg TC/week—10 mg T/day—is basically not even physiological I do discourage starting so high. For me even the 65 mg/week was excessive, though I was in denial for a long time. It hadn't occurred to me that having free testosterone in the top quartile of the reference range could be so problematic even as I was enjoying the enhanced athleticism.

There is this common assumption that the optimum TRT dose is the one that yields your particular healthy youthful levels. But without evidence it remains speculative. There's also a contrary hypothesis saying that the higher levels of youth are actually not ideal for aging bodies.

With respect to my levels not being much over my original hypogonadal ones, you are alluding to my recent accidental discovery that such levels can produce surprisingly good results. I certainly had not intended to be dosing at < 1 mg T per day, yet measurements suggested that that's what happened as I experimented with testosterone suspension.

I thought I would post this for members.

I'm sure you know that not all members agree with your assumptions. Sorry wish I could write more but I have a busy day ahead of me. Have to work out. Peace brother.

Curtis Moyer Obituary (2018) - Albuquerque, NM - Albuquerque Journal

View Curtis Moyer's obituary, send flowers and sign the guestbook.

www.legacy.com

 

[kelj358]

appreciate the info gents.

 

[Cataceous]

. It hadn't occurred to me that having free testosterone in the top quartile of the reference range could be so problematic even as I was enjoying the enhanced athleticism.

What are you referring to here?
...

For quite some time I was using 18 mg TE EOD, which resulted in TT of ~800 ng/dL, SHBG ~30 nMol/L. Vermeulen calculated free T was around 20 ng/dL, which puts it in the mid to lower part of the top quartile for healthy younger men. The worst symptom I'd link to this was a persistent headache. It came on so gradually that I didn't make the connection. It was only after I switched to lower doses via a TE/TP blend that this resolved. There was also a steady decline in libido and reliability of sexual function. I don't blame these solely on the higher dose, as I'm sure the accumulation of time with HPTA suppression was a contributor. This occurred in spite of using hCG throughout. I also have a sense that the higher dosing had a negative impact on motivation.

Also, have you checked E2 at your current lower dose? I too seem to feel better at lower doses but my E2 has been too low, at least on paper. I'm becoming more intrested in the E2 injections.

My aromatization runs at the higher end. In the last test estradiol was about 29 pg/mL, which would be unremarkable except that testosterone was only about 310 ng/dL. I expect a somewhat more reasonable ratio when I straighten out the dosing situation with testosterone suspension. By the time I'm finished experimenting it may actually be a water-based testosterone solution. At that point I will again have some precision in dosing, rather than the current guesswork.

I wouldn't hesitate to inject estradiol if I were at your end of the spectrum—as long as there's already HPTA suppression. I did have a period with crashed estradiol, and supplementation was immediately helpful.

 

[Cataceous]

...
I'm sure you know that not all members agree with your assumptions. Sorry wish I could write more but I have a busy day ahead of me. Have to work out. Peace brother.
...

That's a bit of a hit-and-run. I'm prepared to defend my hypotheses, particularly the one saying that a starting dose of 100 mg TC/week is excessive. The main caveat is that these high doses came about due to the assumption of infrequent injections—once or twice a month to once a week. Under these conditions the higher doses are needed to achieve reasonable minimum levels towards the end of each injection cycle. But we now acknowledge that these are poor protocols, which cause large swings in levels. With more frequent injections and steadier levels there is no good reason to make 100 mg TC/week a default starting dose.