What could cause Peak and Trough testosterone levels to be the same

I've been on TRT for years now. Started when I was about 25 and I'm 39 now. My previous doctor never really monitored so I don't know what my historical levels were. After about 2 years of not taking testosterone I started back up at a wellness clinic. I get blood tests on a regular basis and have had multiple peak and trough tests. The problem is, my peak level always comes back nearly identical to my trough, about 540 for both. Which doesn't actually help me feel better. I have been doing 190mg of cypionate per week as well as the standard HCG and 1/4 tab (.25 mg) arimidex twice a week. I haven't heard of this happening before and can't find any information on something like this. I was wondering if anybody has any ideas on what could be causing it. I recently got a new doctor and we decided to try changing from cypionate to enanthate and doing 200mg every 5 days to see if I respond better to the slightly faster acting type. Thinking it should supply a slightly higher dose of testosterone to my system.

Does anybody have experience with something like this happening or heard if this happening before. Or what likely causes could be.

Welcome to Excelmale. So as we're all clear - when are you testing for your peak and when are you testing for your trough in relation to your injection?

Peak is done 2 days after injection and trough is done 7 days after before I take my next injection.

Dnn said:

Peak is done 2 days after injection and trough is done 7 days after before I take my next injection.

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Trough is done just prior, as in an hour or two, before your next injection. If you inject on a Tuesday morning, for example, you have blood drawn on Tuesday before your shot. You aren't measuring a trough at all. What are the details of your protocol?

I don't think you'll do any better with this doctor, his comment on cypionate versus enanthate being faster acting is wrong. Enanthate has a little bit shorter half life and depending on your SHBG level this protocol could be wrong for you. Your SHBG level dictates how much and how often you inject per week, if any of this sounds new to you, you would do better to find another doctor.


Most guys inject their doses twice weekly to keep levels stable.

You need to post some labs.
Total T
Free T
E2 sensitive LS/MS/MS method
SHBG

Typically I'll inject Monday evening. I go in Monday afternoon for a trough measurement. For a peak I'll go in Wednesday afternoon. On my last test E2 was 35.4 and TT was 562 everything else came in about mid-range. SHBG wasn't measured in this test, nor was free testosterone. It had been doing in the past. I was planning on asking them for that again on the next test. Last trough I had done also came in about 560. I've had multiple done and they all keep coming back about the same. I'd have to have the place I go send me the results, I don't have a copy on hand of my previous ones. The doctor at the clinic was a bit baffled though. Said he's heard of this happening but never seen it and didn't know what could be causing it.

Dnn said:

Typically I'll inject Monday evening. I go in Monday afternoon for a trough measurement. For a peak I'll go in Wednesday afternoon. On my last test E2 was 35.4 and TT was 562 everything else came in about mid-range. SHBG wasn't measured in this test, nor was free testosterone. It had been doing in the past. I was planning on asking them for that again on the next test. Last trough I had done also came in about 560. I've had multiple done and they all keep coming back about the same. I'd have to have the place I go send me the results, I don't have a copy on hand of my previous ones. The doctor at the clinic was a bit baffled though. Said he's heard of this happening but never seen it and didn't know what could be causing it.

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Your earlier response to when you test was a bit misleading. I apologize for reading it as if you were testing at an odd time for trough measurement. How do you feel? You didn't know where things stood with your earlier doctor...what impact has this had on your subjective response??

Yes, the enanthate is slightly faster acting. The shorter half life dictates that it hits your system a little quicker and will supply a slightly higher amount of actual testosterone.

I feel ok but never really good. Good enough to not be completely lethargic all the time and can force myself to workout but never to where I feel much motivation for much of anything.

Dnn said:

Typically I'll inject Monday evening. I go in Monday afternoon for a trough measurement. For a peak I'll go in Wednesday afternoon. On my last test E2 was 35.4 and TT was 562 everything else came in about mid-range. SHBG wasn't measured in this test, nor was free testosterone. It had been doing in the past. I was planning on asking them for that again on the next test. Last trough I had done also came in about 560. I've had multiple done and they all keep coming back about the same. I'd have to have the place I go send me the results, I don't have a copy on hand of my previous ones. The doctor at the clinic was a bit baffled though. Said he's heard of this happening but never seen it and didn't know what could be causing it.

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How did you settle on 190mg dosage if it is only peaking your testosterone in the 500s? Your peak/trough numbers just don't make sense. If you're injecting a substance into your body it will show up on a blood test. The other option might be to switch labs, maybe they are not doing good testing?

Dave B. said:

How did you settle on 190mg dosage if it is only peaking your testosterone in the 500s? Your peak/trough numbers just don't make sense. If you're injecting a substance into your body it will show up on a blood test. The other option might be to switch labs, maybe they are not doing good testing?

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190mg was just what I was up to after they had been slowly bumping it up while trying to get my numbers up. The thing that was odd was that my trough was the same and had even come in slightly higher than my peak a couple times. They had it tested at 2 different labs as well and ran a quality check on the testosterone to ensure it was properly dosed. The doctor said he's heard if this happening but had never actually seen it. The theory was the testosterone could be cascading elsewhere.

I just switched to enanthate with my new doc, thinking with slightly shorter carbon chain it's a little faster acting with a shorter half life so we should get more testosterone delivered to my system in a shorter time. We also upped to 200mg every 5 days (because of the shorter half life). I'll go back in a few weeks and get tested for peak and trough again. I was just hoping to find someone who's heard of this happening before and a probable cause. If something is causing it that can be fixed i'd like to take care of it so I don't have to run really high doses. Plus after 14 years doing this, being a pin cushion gets a little old. I'd like to inject as infrequently as I can to feel good.

Dnn said:

190mg was just what I was up to after they had been slowly bumping it up while trying to get my numbers up. The thing that was odd was that my trough was the same and had even come in slightly higher than my peak a couple times. They had it tested at 2 different labs as well and ran a quality check on the testosterone to ensure it was properly dosed. The doctor said he's heard if this happening but had never actually seen it. The theory was the testosterone could be cascading elsewhere.

I just switched to enanthate with my new doc, thinking with slightly shorter carbon chain it's a little faster acting with a shorter half life so we should get more testosterone delivered to my system in a shorter time. We also upped to 200mg every 5 days (because of the shorter half life). I'll go back in a few weeks and get tested for peak and trough again. I was just hoping to find someone who's heard of this happening before and a probable cause. If something is causing it that can be fixed i'd like to take care of it so I don't have to run really high doses. Plus after 14 years doing this, being a pin cushion gets a little old. I'd like to inject as infrequently as I can to feel good.

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The difference in half-life between enanthate and cypionate is negligible, sure enanthate may be slightly faster acting but regardless of the minor differences in the esters between the two there are many other factors which effect the rate at which the testosterone is released from the oily depot at the injection site.

Volume of injection/ injection depth/site of injection/lymphatic flow/concentration of BOH (benzyl alcohol) are other possible factors which can effect absorption rates of the esterified hormone.

As far as testosterone esters 100 mg of enanthate= 72 mg active testosterone and 100 mg cypionate= 70 mg active testosterone.

Now when looking at propionate there is definitely a big difference in the active amount of hormone as 100 mg propionate= 83 mg active testosterone compared to either enanthate/cypionate.

You state you are injecting 190 mg/week..........................Systemlord makes an important point you need to know your SHBG first and foremost as it will dicate your injection frequency/protocol and of course you need to post lab work showing total t, free t, estradiol (sensitive assay), dht, prolactin, dhea, thyroid panel, cbc (complete blood count) among other health markers to develop a better understanding of how your hormones/body chemistry are being effected by your protocol ( testosterone dose/injection frequency).

Hard to believe you would just inject once weekly without knowing your shbg as if your level was low than injecting once weekly would result in poor results/effectiveness.