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These are not good. You are right on the line of metabolic syndrome with these values (HDL <= 40 and Triglycerides >= 150 is the cutoff), and the Trig/HDL ratio of 3.4 is associated with significantly elevated CVD risk, regardless of your LDL. We had a great discussion on this in a recent...

This, because free T3 is what matters. It would be analogous to supplementing testosterone when your total testosterone is on the low side, even though your free testosterone was at a good level. You don't want high or "optimal" levels of thyroid hormone either - this is associated with a...

I love that you did this experiment and wrote up all of the details for us. Very puzzling results though!

Cortex released a video on this concept of using hCG and DHEA as the foundation of a protocol and then tailoring testosterone dose around that: I have kept going back and forth with hCG myself. I've noticed, now that I have some Janoshik-verified potent hCG (eutrig), if I take 250 iu EOD...

Fasting insulin and lipid panel (HDL and triglycerides specifically). Many of us had sleep issues in the beginning, and water retention is pretty much a given. Most or all of the water retention disappears eventually as you adapt to the new levels. You will certainly be able to find a dose...

That's your fasting glucose, not fasting insulin. You want to see your fasting insulin to determine whether you have insulin resistance. Your lipid panel has some big clues also, between HDL, triglycerides, and their ratio. Insulin resistant men often have a rough time on TRT. They aromatize...

Do you recall what it was?

These free T numbers you are reporting are bogus - likely labcorp direct free T if I had to guess. Your real free T (vermeulen calculation) with 100 mg was 21.8 ng/dL assuming 4.3 albumin, which is a very reasonable level for men on TRT. You have a high SHBG, so this reasonable free T is...

True, but importantly, there's not even a hint in these 20+ studies that looked at effects of TRT on cognition that the lack of GnRH is causing cognitive deficits either. Some trends in that direction would be very persuasive in terms of convincing me to take this GnRH issue seriously. There...

This is quite plausible. Your absolute level of E2 is low, the ratio of T & DHT / E2 is very high, and you have enclomiphene antagonizing estrogen receptors on top of that. I would rather take less of something in this situation than add another compound to increase estradiol. Reducing the...

I've actually been on test cyp for the last couple months and it's working fine for me. 35 mg EOD.

Ran into this article today on CGM benefits in early type 2 diabetes (see attached).

Great suggestions from Guided above. The Clot Thickens is a must read. Chromium can be effective, but can also cause major insomnia in some; watch for that. Time restricted eating, definitely. Avoid seed oils, definitely. Absolutely agree. He actually provided a fasting insulin level in his...

In my opinion, it's more helpful to think about specific target levels, independent of reference ranges, which vary widely from lab to lab. You'll test total testosterone, and you'll need it (together with SHBG) to calculate free testosterone, but free testosterone is where the rubber meets the...

The following review discusses the findings of over 20 studies that investigated the effects of TRT on cognition, in both healthy men, and men with Alzheimer's or other forms of cognitive decline. We might expect worsened cognition if the lack of GnRH is impactful, or an acceleration of...

It sounds reasonable, and might be helpful in some cases.

One more thought I had about GnRH: humans pre-puberty have little/no GnRH secretion, and with varying age of puberty, some will have spent more or less years of their life in this low GnRH state. If the absence of GnRH is harmful then, we might expect later puberty to correlate with increased...

Testosterone with no ester attached.

GnRH has neuroprotective and anti-aging effects in mice. However, studies of men on TRT with suppressed GnRH do not show higher rates of dementia, nor do they show higher rates of all cause mortality. If the lack of GnRH is having negative effects then, it's either too subtle to affect health...

Compounded bioidentical / native testosterone in a lipid-based delivery vehicle, similar in that respect to Kyzatrex and the other oral TU products. The bioidentical testosterone is better tolerated than TU with fewer gastrointestinal side effects, and appears to be less suppressive of the HPT...

In the kyzatrex trial I mentioned, they started at 7 ng/dL free T and increased by 7 ng/dL to 14 ng/dL with the 200 mg bid dose. I would be looking to create a dramatic difference from your 10 ng/dL baseline with this experiment to ensure the results are noticeable, and targeting something more...

hCG will only complicate things - I would leave that out (at least initially). I work for Maximus so my bias is towards our oral testosterone, but with Kyzatrex, you will need much higher doses than 100 mg to move the needle. 200 mg bid only produced 14 ng/dL free T in their phase 3 trial. You'd...

Just curious: how did you manage to have four kids by age 30, having been in med school and residency the entire time? I feel like there's a story there.

I'll give you my less conservative perspective. Yes, I would experiment with increasing T levels, given your symptoms, which would produce a positive result on the ADAM questionnaire. Your levels, while not low, are not high enough to rule out the possibility that more T could improve the...

We have data showing no statistically significant suppression with once daily oral testosterone at Maximus which will be published soon on the website. The shorter half-life of bioidentical oral testosterone vs. testosterone undecanoate is likely responsible. Please see attached excerpts.

I don't have a trough level for my current protocol, but I took a midpoint level of 1230 ng/dL total, 28 ng/dL free, 30 pg/mL e2. This was on 35 mg test cyp EOD, and I took labs afternoon of the day after injection.

I'd be going alot higher with these labs. There's being careful, there's being very careful, and then there's just straight up wasting time. Straight to 100 mg if it were me, at least.

They suggest 25-50 mg a week, because above 50 mg it supposedly causes paradoxical estrogenic effects via conversion to 3b-androstanediol.

No, that looks amazing. So expensive though, wtf.

Most people who are still using test prop have been forced to switch to UGL suppliers.