700-1000 Total Test (labcorp) fluctuations (same protocol). Puzzled

[hombre]

Over 40 months of my TRT (dr. Saya) I took probably a dozen+ Total T measurements (used to be obsessed with wasting money on tests). Most of you are probably only doing blood work once in six months or four earlier on.

What puzzles me is how often under the exact same protocol my total test would show up on a labcorp report as 700, 900, or 1100. I'm not sure how protocol tweaking possible with those fluctuations. And I ask myself are those tests so unreliable? I base life and death decisions based on those numbers.

All my protocols were three times a week [testosterone cypionate] (Tue evening, Thu evening, Sat evening). Usually my blood would be collected on Thu morning, 10-13 hours before the next injection. Sometimes on Saturday or Tuesday.

- Would you have expected Tuesday morning to show the lowest TT number (after two day break)? (wrong, often it's 1000)
- Would you have expected that with same test cyp dosage but with reintroduction of HCG it would show higher number? (wrong, 700 with HCG vs 1000 without HCG)

Looking at my spreadsheet going back from mid 2018, some numbers:
I had 900 TT on 40 mg test cyp TIW and 300 IU HCG
I had 1000 TT on 40 mg test cyp TIW withOUT HCG
I had 726 TT on 40 mg test cyp TIW with reintroduction of HCG
I had 1000 TT on 40 mg test cyp TIW on Tuesday (the lowest valley / trough), and 750 TT on Saturday days earlier (highest valley / trough)
I had 700 TT, 900 TT, 935TT taken on the same day of the week on the same protocol (36mg !!! test cyp TIW) just a couple weeks in between
I had 700 TT on only 30mg test cyp TIW without HCG

Thoughts?


PS. I noticed extreme fluctuations even before TRT when trying to keep the day of the week / time the same: 250, 350, 500 (three weeks in a row). Three years before that I'd do only one test a year, usually around 260-280

 

[madman]

Over 40 months of my TRT (dr. Saya) I took probably a dozen+ Total T measurements (used to be obsessed with wasting money on tests). Most of you are probably only doing blood work once in six months or four earlier on.

What puzzles me is how often under the exact same protocol my total test would show up on a labcorp report as 700, 900, or 1100. I'm not sure how protocol tweaking possible with those fluctuations. And I ask myself are those tests so unreliable? I base life and death decisions based on those numbers.

All my protocols were three times a week [testosterone cypionate] (Tue evening, Thu evening, Sat evening). Usually my blood would be collected on Thu morning, 10-13 hours before the next injection. Sometimes on Saturday or Tuesday.

- Would you have expected Tuesday morning to show the lowest TT number (after two day break)? (wrong, often it's 1000)
- Would you have expected that with same test cyp dosage but with reintroduction of HCG it would show higher number? (wrong, 700 with HCG vs 1000 without HCG)

Looking at my spreadsheet going back from mid 2018, some numbers:
I had 900 TT on 40 mg test cyp TIW and 300 IU HCG
I had 1000 TT on 40 mg test cyp TIW withOUT HCG
I had 726 TT on 40 mg test cyp TIW with reintroduction of HCG
I had 1000 TT on 40 mg test cyp TIW on Tuesday (the lowest valley / trough), and 750 TT on Saturday days earlier (highest valley / trough)
I had 700 TT, 900 TT, 935TT taken on the same day of the week on the same protocol (36mg !!! test cyp TIW) just a couple weeks in between
I had 700 TT on only 30mg test cyp TIW without HCG

Thoughts?


PS. I noticed extreme fluctuations even before TRT when trying to keep the day of the week / time the same: 250, 350, 500 (three weeks in a row). Three years before that I'd do only one test a year, usually around 260-280

As you should very well know when getting blood work we always want to test at the true trough (lowest point) let alone using the same lab, assay (most accurate) LC/MS-MS for TT/e2 and Equilibrium Dialysis or Ultrafiltration for FT.

Top it off with the fact that the protocol needs to remain consistent (dose T/injection frequency/time of injections) which can all have a big impact on blood work.


All my protocols were three times a week [testosterone cypionate] (Tue evening, Thu evening, Sat evening). Usually my blood would be collected on Thu morning, 10-13 hours before the next injection. Sometimes on Saturday or Tuesday.

This is all wrong.

If you are injecting 3x/week (Tue/Thu/Sat evening) then you should be having blood work done Tuesday evening before your injection which would be the true trough.

No point in comparing what TT level you achieve if labs were not done at the true trough every time.


PS. I noticed extreme fluctuations even before TRT when trying to keep the day of the week / time the same: 250, 350, 500 (three weeks in a row). Three years before that I'd do only one test a year, usually around 260-280

Lack of quality sleep, excess stress (mental/physical), whether one has fasted can all have a big impact on natty endogenous T levels.






*In men using intramuscular testosterone (IM T), clinical experience shows us that, despite stable dosing and frequency, total testosterone peak (Tp) and trough (Tt) levels are highly variable

Variance in Peak and Trough T Levels in Men Using Intramuscular T Injections

MP85-14 VARIANCE IN PEAK AND TROUGH TESTOSTERONE LEVELS IN MEN USING INTRAMUSCULAR TESTOSTERONE Bruno Nascimento*, Helen L Bernie, Elizabeth Schofield, John P. Mulhall, New York, NY INTRODUCTION AND OBJECTIVES In men using intramuscular testosterone (IM T), clinical experience shows us that...

www.excelmale.com

Sure lab errors can happen now and then but doubtful it played any big part in your results.

Although TT is important to know keep in mind that FT is what truly matters as it is the active unbound fraction of testosterone responsible for the positive effects.

 

[CaptianCurious]

Hey hombre. I've had a similar experience, plus the studies all suggest it'll vary.

Personally, I don't even test anymore. Just my opinion, but I think much of the testing on these sites is a waste of time. Testing because the dose is too high or there are symptoms from undiscovered issues.

I found a few studies on secretion rates of younger men, and they're all in the 4-12 mg/day range, w/ a median of 6-7mg. Picking something near the 10th percentile is probably ~10 mg/day, more or less. For cypionate, which is 70% test, that'd be 100mg/week.

So that's about what my dose averages, but travel makes it vary between 90-130/week. I've never had any unwanted side effects and E/H&H have always been perfect. I currently use undecanoate every 2 weeks. But whatever ester I use, I dose 1/2 the 1/2 life.

Your protocol seems reasonable to me. From one study I read, I worked out I should lower my T dose 10/mg/week for each 500 iu of hcg to keep E in the range I wanted, or something pretty close to that.

 

[madman]

Hey hombre. I've had a similar experience, plus the studies all suggest it'll vary.

Personally, I don't even test anymore. Just my opinion, but I think much of the testing on these sites is a waste of time. Testing because the dose is too high or there are symptoms from undiscovered issues.

I found a few studies on secretion rates of younger men, and they're all in the 4-12 mg/day range, w/ a median of 6-7mg. Picking something near the 10th percentile is probably ~10 mg/day, more or less. For cypionate, which is 70% test, that'd be 100mg/week.

So that's about what my dose averages, but travel makes it vary between 90-130/week. I've never had any unwanted side effects and E/H&H have always been perfect. I currently use undecanoate every 2 weeks. But whatever ester I use, I dose 1/2 the 1/2 life.

Your protocol seems reasonable to me. From one study I read, I worked out I should lower my T dose 10/mg/week for each 500 iu of hcg to keep E in the range I wanted, or something pretty close to that.

Lab work is critical and if you are not getting blood work done twice yearly (every 6 months) then you should not be injecting exogenous testosterone.

I agree that many on trt have blood work done much more than what would be needed or become obsessed with staying within a certain range or trying to find some magical number when it comes to e2.

Let alone one of the biggest mistakes is when tweaking a protocol (increasing or decreasing dose T/ changing injection frequency) is gauging how they feel within the first 4-6 weeks when unfortunately hormone levels are in FLUX during the weeks leading up until blood levels stabilize.

Top it off with the fact that once blood levels stabilize it will take 2-3 months for the body to adapt and this is the CRITICAL time period when one should gauge how they truly feel overall regarding relief/improvement of low-t symptoms.

Keep in mind that although the daily production rates in a healthy young male can vary between 4-12 mg/day and on average 5-7mg there is much more involved when it comes to how one will respond to a specific dose when using exogenous esterified testosterone.

Aside from the ester used/injection frequency.

Many factors come into play SHBG level, polymorphism of the AR/CAG repeat length (short/long), the sensitivity of the AR, body weight.