What manufacturer was the vial of your T? Seems potent
I assume this is still the Quest equilibrium dialysis free testosterone test? This test method is considered the gold standard. Unfortunately there's currently no standardization across different labs, so you must ignore misguided assertions that this range is somehow low. Measurements using this test can be compared only to the reference range or to other measurements from the same test. In any case, you're still over the top of the reference range. Total estrogen isn't as useful as estradiol, but either is expected to be high in the presence of high free testosterone. The original recommendation of dropping to 80 mg per week still holds. It's likely your SHBG is low, so you can expect total testosterone to appear somewhat low even when free testosterone is normal. You should focus on free testosterone, as this parameter is best associated with the benefits from testosterone. But more is not better. There's virtually no case when it's healthier to have a hormone significantly outside of its reference range.
What??? That's not how it works with medication especially Testosterone.
The details are there, albeit a little vague. He'd presumably been using 160 mg per week of testosterone cypionate. This resulted in very high total and free testosterone. These were not even peak values. He reduced the dose to 120 mg per week, but still has free testosterone above the top of the reference range.
Outliers perhaps, but men, under medical care, who feel and function better, with higher numbers. You know that every man on T isn't into weight lifting. All they want is to get their penis to stand at attention more than now and then. If higher total and free accomplish that, for those subset of men, whether it's injections, cream/gel or pellets, then so be it. I understand where you're coming from but, as I've stated on another thread; since none of us knew what our TT, free T, E2, DHT, DHEA, pregnenolone/progesterone were when we were teenagers/young men, it becomes a guessing game and even if one tries to emulate those lab values, that doesn't necessarily equal success.
Yeah, Quest labs is what they use. I did try cream for a bit but my insurance provider would not pay for it. It was pretty pricey. They do pay for the test cyp at only $23 a vial and that I can get easily, so I am going that route. I have been running without any AI at the 30 units twice weekly that I have been recently using.
With what other hormone is anyone going to say "Start out at double or triple the top-of-range and if you feel ok then stick with it."? I believe that's unwise and backwards. It makes more sense to explore the full physiological range before assuming you're special and need higher doses to feel ok. It's unequivocal that risks rise with dose, and for some guys the risks will even be present in upper parts of the physiological range. If your body naturally produced 4 mg of testosterone per day at your prime then is everything going to function properly if you take 8 mg for TRT? And even if you don't have overt problems, is it safe to continue for the next 20 years? The low-and-slow approach does fit all—at least all who are in this for good health along with symptom resolution.
I've not read of many men who do well on 4 mg per day. There was a long thread on T-Nation, last year, just about that, with one man saying that he didn't feel good until he dropped to 5 mg, daily. I tried 10 mg, daily, for several months, which, after subtracting the ester, would be 35 mg per week. The numbers looked good, but I didn't feel anything. And you could logically argue that most doctors wouldn't prescribe 5 mg, IM or subq, so we'll never know how well it does or doesn't work.
The million dollar question. As you suggest, we have to look beyond the single variable of testosterone. If we also need proper levels of GnRH/kisspeptin/LH/progesterone/etc. then chances are good that adjusting our testosterone intake alone is an exercise in futility. I think we have many of the other tools we need, but lack the knowledge to use them effectively. Admittedly without a better understanding of all the interactions, tweaking the other variables is not risk-free. However, it's likely that there are also risks in leaving some hormones in a disrupted state, either too low or too high.
