“High-Normal T”

[Deleted member 43589]

Yes he was ok with it. I decided to lower it on my own. Only inject what i want to inject and test my numbers.

I agree with you @Fernando Almaguer We as patients have to be the ultimate decision make on our own health care. Good for you!

 

[Cataceous]

... A “natural” guy with a Total T of 650 let’s say, may have equivalent (or higher) intracellular receptivity of those T molecules than a man on TRT with levels of 950. ...

If you have any scientific evidence in support of this then do share. Obviously different individuals can have such differences, but you seem to be saying that an individual responds differently to exogenous testosterone than to endogenous testosterone. Considering that the testosterone is bioidentical, your hypothesis must include factors related to the pharmacokinetics of TRT, or to its disruption of other hormones.

... But I have have a natural Total T level of 1,000-1,200ng/dL. ...

What is your SHBG?

 

[Cataceous]

... There’s no way that a hypogonadal man is only lacking in testosterone and every other hormone in his body is simultaneously fine. ...

You need to make a distinction between primary and secondary dysfunction. Testosterone interacts with a lot of hormones and systems, so hypogonadism can potentially lead to widespread secondary issues. However, I don't see that hypogonadism is necessarily tied to other primary dysfunction. When I was hypogonadal I was otherwise healthy except for the issues arising from the low testosterone.

... In turn, the system-wide dysfunction of the hypogonadal man is causing low binding affinity of the testosterone to the receptors, therefore requiring him to get his t level to a higher level to achieve the same well-being that a eugonadal man would experience at a lesser t level. ...

That's an interesting twist on an old—and unsupported—argument. Can you cite some published research that takes it beyond speculation? Again, why does the dysfunction have to be system-wide, as opposed to a focal issue at the hypothalamus or pituitary—assuming secondary hypogonadism? I trust you'll exempt primary hypogonadism.

... I’m saying that a high t level in a man on TRT is often needed to make him feel the same as he would if he were healthy to begin with with a lower t level. ...

If no evidence is required then I can say with equal certainty that the testosterone level of a man on TRT should be what it was when he was healthy, because that is the level that best integrates with his other hormones. There's the potential to upset various balances when you go above or below what's natural for you. So far I've seen no evidence that natural set points shift permanently after a bout of hypogonadism.

... Most men on TRT need a higher t level than that to feel like they did when they were 20 y/o. ...

Or not. Testosterone is not the fountain of youth.

Pituitary resistance to thyroid hormone syndrome is associated with T3 receptor mutants...​

"Thyroid hormone resistance syndrome is rare, incidence is variously quoted as 1 in 50,000 or 1 in 40,000 live births.[9]"[R]

Relevance to the average guy on TRT?

...
And my SHBG is 70. I know, it’s high. These are the results from the last time I had labs done:
TT: 1,030 ng/dL
FT: 181 pg/mL
SHBG: 71 nmol/L
Free T is still relatively high so, as long as that’s the case, the high SHBG doesn’t bother me too much.

Going by the Vermeulen method, if your SHBG were lowered to a more typical 30 nMol/L then your total testosterone would be an unremarkable 635 ng/dL. Now admittedly Vermeulen might be underestimating your FT at this SHBG, but the general principle stands.