Advice on low dose daily testosterone

[IndyColts18to88]

Hello all, new member but have been reading on here for a while.

I have been getting annual bloodwork done for quite some time, and my TT and FT have both been hovering in the low range for a few years... I'm 6'4" 270lbs (have a lifting background but definitely need to lose about 40lbs) and will be 40 on November 8.

My most recent labs are:

Free T 57pg/mL (range 47-244)
Total T 269 (range 300-1080) was mid 300s last year but upper 200s the year before
SHBG 23 (has always been low 20s)
FT % 2.1
E2/Estradiol 26 pg/ml (range 5-66)

didnt have LH or FSH tested this time, but last year they were
LH 3.54
FSH 1.46

I'm guessing that this makes me secondary? Doctor has prescribed testosterone cypionate injections, to do myself at home (he said i can do IM/Shallow IM/SubQ, up to me...and whatever frequency i would like...and whatever dose, as long as i dont go over 100mg total for the week, until follow up labs).

I have read some guys can get their #s up with lifestyle changes (i do have a desk job and diet hasnt been great... definitely need to get into better shape lifting and cardio)... but at my age, and history, i know that it is not super likely.
I have also read that some guys can do small daily shots (10-12mg daily and feel good/get good #s)... i know everyone is different, but a good friend started TRT this year (levels were low 200s) and taking 63mg per week split into two shots, got him up to 500 (he was doing it subQ)...

all of my other labs look good, minus being low in vitamin D (around 30) and low in B12 (from taking a PPI medicine...protonix...to reduce stomach acid...had to have two surgeries on my esophagus, so this one will not change).

I know this has been a long first post... but i'd like to hear some opinions and advice from you guys! Also, are any of you on LESS than 100mg total for the week and feel good? I'd like to take the lowest dose to feel good... also, IM/Shallow IM/SubQ?

Thanks, guys!!!

 

[madman]

Hello all, new member but have been reading on here for a while.

I have been getting annual bloodwork done for quite some time, and my TT and FT have both been hovering in the low range for a few years... I'm 6'4" 270lbs (have a lifting background but definitely need to lose about 40lbs) and will be 40 on November 8.

My most recent labs are:

Free T 57pg/mL (range 47-244)
Total T 269 (range 300-1080) was mid 300s last year but upper 200s the year before
SHBG 23 (has always been low 20s)
FT % 2.1
E2/Estradiol 26 pg/ml (range 5-66)

didnt have LH or FSH tested this time, but last year they were
LH 3.54
FSH 1.46

I'm guessing that this makes me secondary? Doctor has prescribed testosterone cypionate injections, to do myself at home (he said i can do IM/Shallow IM/SubQ, up to me...and whatever frequency i would like...and whatever dose, as long as i dont go over 100mg total for the week, until follow up labs).

I have read some guys can get their #s up with lifestyle changes (i do have a desk job and diet hasnt been great... definitely need to get into better shape lifting and cardio)... but at my age, and history, i know that it is not super likely.
I have also read that some guys can do small daily shots (10-12mg daily and feel good/get good #s)... i know everyone is different, but a good friend started TRT this year (levels were low 200s) and taking 63mg per week split into two shots, got him up to 500 (he was doing it subQ)...

all of my other labs look good, minus being low in vitamin D (around 30) and low in B12 (from taking a PPI medicine...protonix...to reduce stomach acid...had to have two surgeries on my esophagus, so this one will not change).

I know this has been a long first post... but i'd like to hear some opinions and advice from you guys! Also, are any of you on LESS than 100mg total for the week and feel good? I'd like to take the lowest dose to feel good... also, IM/Shallow IM/SubQ?

Thanks, guys!!!

If anything I would start off injecting twice weekly (50 mg every 3.5 days) than 6 weeks in when blood work is done you could look into injecting more frequently as in EOD or daily if need be.

The first 6 weeks of trt can be very misleading when it comes down to how one truly feels regarding relief/improvement of low-t symptoms on such protocol (dose t/injection frequency) as there is a lot going on (hpta shutdown/hormones in flux).

Patience is key and once healthy TT/FT levels are achieved and blood levels have stabilized on such protocol (4-6 weeks) it will take the body 2-3 months to adapt to those new levels and this is the critical time period when one should gauge how they truly feel overall regarding relief/improvement of low-T symptoms.

Having SHBG in the low 20s does not mean one will need to inject more frequently mind you when injecting larger doses of T it can have a stronger impact on lowering SHBG but even then it is not a given.

Depending on the protocol (dose T/injection frequency) some men will notice a large drop in SHBG whereas others may only notice a slight decrease.

My SHBG pre-trt 34 nmol/L and injecting 150 mg (75 mg every 3.5 days) resulted in an SHBG 30-31 nmol/L.

If you have no issue poking yourself EOD or daily then go nuts but seeing as you are just starting trt I would wait until the 6-week mark before jumping into it headfirst that is just me though.

 

[madman]

Also, keep in mind when first starting trt how you feel during the first 6 weeks can be very misleading.

What kind of levels to expect from 100mg weekly

I'm a new to this entire scene, started with levels of around 320, age 40, doctor started me on 100mg once a week. Curious on what type of levels I should expect to see from this? Thanks

www.excelmale.com

 

[IndyColts18to88]

If anything I would start off injecting twice weekly (50 mg every 3.5 days) than 6 weeks in when blood work is done you could look into injecting more frequently as in EOD or daily if need be.

The first 6 weeks of trt can be very misleading when it comes down to how one truly feels regarding relief/improvement of low-t symptoms on such protocol (dose t/injection frequency) as there is a lot going on (hpta shutdown/hormones in flux).

Patience is key and once healthy TT/FT levels are achieved and blood levels have stabilized on such protocol (4-6 weeks) it will take the body 2-3 months to adapt to those new levels and this is the critical time period when one should gauge how they truly feel overall regarding relief/improvement of low-T symptoms.

Having SHBG in the low 20s does not mean one will need to inject more frequently mind you when injecting larger doses of T it can have a stronger impact on lowering SHBG but even then it is not a given.

Depending on the protocol (dose T/injection frequency) some men will notice a large drop in SHBG whereas others may only notice a slight decrease.

My SHBG pre-trt 34 nmol/L and injecting 150 mg (75 mg every 3.5 days) resulted in an SHBG 30-31 nmol/L.

If you have no issue poking yourself EOD or daily then go nuts but seeing as you are just starting trt I would wait until the 6-week mark before jumping into it headfirst that is just me though.

Thanks for the reply! I wasnt sure if my SHBG being on the lower end, maybe ED or EOD would work better overall, long term... my gf is diabetic and has to take 4 sometimes 5 shots per day (subq), so i figure one a day wouldnt hurt me.

 

[madman]

Thanks for the reply! I wasnt sure if my SHBG being on the lower end, maybe ED or EOD would work better overall, long term... my gf is diabetic and has to take 4 sometimes 5 shots per day (subq), so i figure one a day wouldnt hurt me.

If you prefer poking yourself daily then do what you feel is best but again it is not a given that this will be the best injection frequency even with SHBG in the low-mid 20s.

 

[IndyColts18to88]

Anyone in here have success with less than 100mg per week? If so, how much/how often/subq or IM/what are levels etc?

 

[Cataceous]

I'm injecting the equivalent of 43 mg testosterone cypionate a week. It's the best I've felt overall on TRT, and I've been on as much as 100 mg per week. I inject daily, and peak testosterone is probably close to 700 ng/dL, at least mid to upper 600s. The actual protocol is 3.2 mg T enanthate and 2.4 mg T propionate injected daily subcutaneously.

I'll put in a plug for starting with a higher injection frequency: The data you gather can be useful in making predictions later on. Starting with at least EOD injections means that after things settle down you will likely have a pretty constant total serum testosterone. If you measure this along with SHBG and ideally albumin too then the dose-response relationship lets you estimate in advance the results of other protocols. The more data points you collect, the better your estimates.

 

[IndyColts18to88]

I'm injecting the equivalent of 43 mg testosterone cypionate a week. It's the best I've felt overall on TRT, and I've been on as much as 100 mg per week. I inject daily, and peak testosterone is probably close to 700 ng/dL, at least mid to upper 600s. The actual protocol is 3.2 mg T enanthate and 2.4 mg T propionate injected daily subcutaneously.

I'll put in a plug for starting with a higher injection frequency: The data you gather can be useful in making predictions later on. Starting with at least EOD injections means that after things settle down you will likely have a pretty constant total serum testosterone. If you measure this along with SHBG and ideally albumin too then the dose-response relationship lets you estimate in advance the results of other protocols. The more data points you collect, the better your estimates.

Awesome, man, and thanks! I was thinking of doing 10mg daily, subQ...but wondered if a little less or little more would be better/just as good... on steroidplotter, doing 9mg daily still has levels at healthy normal range, but im not sure how well that relates to real life? also, not sure if bodyweight plays a big part in dose needed? i'm 6'4 260s-270

 

[madman]

Awesome, man, and thanks! I was thinking of doing 10mg daily, subQ...but wondered if a little less or little more would be better/just as good... on steroidplotter, doing 9mg daily still has levels at healthy normal range, but im not sure how well that relates to real life? also, not sure if bodyweight plays a big part in dose needed? i'm 6'4 260s-270

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

Effect of Weight on Serum T with Sub-Q TE in Men with TD

Effect of Weight on Serum Testosterone with Subcutaneous Testosterone Enanthate in Men with Testosterone Deficiency (2020) SAT-037 Background: In men, obesity is often associated with low testosterone (T) levels, but the information is limited as to how body weight affects the pharmacokinetic...

www.excelmale.com

 

[Cataceous]

Awesome, man, and thanks! I was thinking of doing 10mg daily, subQ...but wondered if a little less or little more would be better/just as good... on steroidplotter, doing 9mg daily still has levels at healthy normal range, but im not sure how well that relates to real life? also, not sure if bodyweight plays a big part in dose needed? i'm 6'4 260s-270

Men naturally make 3-9 mg of testosterone per day. This would be the equivalent of 30-90 mg testosterone cypionate per week. However, natural production includes a ~40% drop in serum testosterone each day. To account for this in a TRT protocol that gives constant serums levels requires an increase of ~25%. This puts the range of doses for testosterone cypionate at 40-110 mg per week, or 5-16 mg per day. Body weight is a factor, so it's certainly possible that you will need to be in the upper part of range, or even over.

 

[IndyColts18to88]

Men naturally make 3-9 mg of testosterone per day. This would be the equivalent of 30-90 mg testosterone cypionate per week. However, natural production includes a ~40% drop in serum testosterone each day. To account for this in a TRT protocol that gives constant serums levels requires an increase of ~25%. This puts the range of doses for testosterone cypionate at 40-110 mg per week, or 5-16 mg per day. Body weight is a factor, so it's certainly possible that you will need to be in the upper part of range, or even over.

with that said, and me being at 269 total t right now... even at 10mg per day, i would assume i'd jump way above that, by the time my levels settled/become stable? I'm going in for new labs in 8 weeks from Monday, and i'm starting my shots either this weekend or Monday... just trying to decide if i should do shallow IM in the shoulders or subq (i'm planning to do daily...i've become prone to panic/anxiety since about age 30, never had it before...could even be hormone related, honestly)... so with me prone to that, i'm not looking to feel all amped up, i currently have no problem with erections (even have morning wood at least half of the time)... i just want to be in normal range for health reasons.

I know everyone is different and i probably seem like i'm all over the place rambling... but this is a big decision for me and a life long one, at that... so i want to make things as smooth as i can, starting out and long term.

With me being higher on the bodyfat % but also carrying quite a bit of muscle from my past years of lifting and getting back in the gym/muscle memory etc... would you suggest i start with shallow IM in the shoulders or subq? what daily dose would you think?

 

[Cataceous]

I'd go with 15 mg daily subQ. With your SHBG a tad on the low side and likely to go lower you might aim for somewhat lower total testosterone than is typical. Maybe around 500-700 ng/dL. The goal is to achieve a reasonable level of free testosterone, which can be measured with one of the accurate methods, or guesstimated with one of the calculators.

When you first start TRT you will have an additive effect, during which time your injected testosterone is added to your natural testosterone. Over time the natural production is suppressed to low levels, leaving only what you're injecting. Sometimes the extra-high initial levels give a honeymoon period. "madman" is offering good advice: The goal is to titrate your dose to provide decent serum testosterone/free testosterone, and then wait an additional period before evaluating your progress. For example, suppose you start with 15 mg TC daily, and after 6 weeks you measure total testosterone to be 500 ng/dL. You decide you'd rather target 700 ng/dL. Then you'd increase the dose to 21 mg daily and wait another 4-6 weeks to retest things. If your level is then close enough to the target, you'd continue with the protocol for at least another 2-3 months before deciding if changes are needed. You'll likely have ups and downs along the way. It can be tempting to make changes before things have really settled down. But this should be resisted because it makes it harder to determine what's actually going to work for the long run.

 

[IndyColts18to88]

I'd go with 15 mg daily subQ. With your SHBG a tad on the low side and likely to go lower you might aim for somewhat lower total testosterone than is typical. Maybe around 500-700 ng/dL. The goal is to achieve a reasonable level of free testosterone, which can be measured with one of the accurate methods, or guesstimated with one of the calculators.

When you first start TRT you will have an additive effect, during which time your injected testosterone is added to your natural testosterone. Over time the natural production is suppressed to low levels, leaving only what you're injecting. Sometimes the extra-high initial levels give a honeymoon period. "madman" is offering good advice: The goal is to titrate your dose to provide decent serum testosterone/free testosterone, and then wait an additional period before evaluating your progress. For example, suppose you start with 15 mg TC daily, and after 6 weeks you measure total testosterone to be 500 ng/dL. You decide you'd rather target 700 ng/dL. Then you'd increase the dose to 21 mg daily and wait another 4-6 weeks to retest things. If your level is then close enough to the target, you'd continue with the protocol for at least another 2-3 months before deciding if changes are needed. You'll likely have ups and downs along the way. It can be tempting to make changes before things have really settled down. But this should be resisted because it makes it harder to determine what's actually going to work for the long run.

The ONLY thing that gives me pause about starting, is my history with having panic attacks...i worry that starting TRT will bring them back/make them worse

 

[Gunga]

The ONLY thing that gives me pause about starting, is my history with having panic attacks...i worry that starting TRT will bring them back/make them worse

My panic attacks WENT AWAY when I got my testosterone levels up. I currently dose 10 mgs daily of Test Cyp and my levels are around 650 Ng/dL at trough. I felt night and day better doing daily injections vs twice weekly. That said my SHBG is 15. I inject in my shoulders and it works the best for me. I would get small lumps and bruises occasionally if I injected sub q in the belly fat. Like Cataceous I also feel MUCH better on smaller doses. Matter of fact I think he just sold me on reducing mine a bit more to 8mgs daily. My hematocrit and blood pressure have been creeping up. Good luck!

 

[mooseman109]

I have been at this for 7 years. Started with typical 200 every 2 weeks. Have tweaked and experimented over the years. I have landed on 10mg/ day over last 2 plus years. I have felt about the same on each level. All seem to keep me at mid 600 total and 20 give or take free t. Shbg 30-40 and E2 low 20. I rotate sub q to shallow im. I am 57 5’10” and 195#. In the gym 3-4 days a week.
For me. The switching to a lower dose was more HCT driven, as I am an over achiever in red blood cell production. I have to do blood draws 3-4 months to keep in somewhat in line. The daily injections helped that, not cured, but helped.
Just remember this is a journey, and there will be ups and downs and it is a forever choice. Also as you age your body will change so your protocol will have to modify as well.
There is a ton of good advice and experience on here,But as you say we are all different.
Welcome aboard and good luck.

 

[equel]

My panic attacks WENT AWAY when I got my testosterone levels up. I currently dose 10 mgs daily of Test Cyp and my levels are around 650 Ng/dL at trough. I felt night and day better doing daily injections vs twice weekly. That said my SHBG is 15. I inject in my shoulders and it works the best for me. I would get small lumps and bruises occasionally if I injected sub q in the belly fat. Like Cataceous I also feel MUCH better on smaller doses. Matter of fact I think he just sold me on reducing mine a bit more to 8mgs daily. My hematocrit and blood pressure have been creeping up. Good luck!

Libido?

 

[IndyColts18to88]

Libido?

I know you were asking him... But that's another reason I haven't started... I have morning wood most days and no issues with ED etc...and don't want to mess that up

 

[IndyColts18to88]

My panic attacks WENT AWAY when I got my testosterone levels up. I currently dose 10 mgs daily of Test Cyp and my levels are around 650 Ng/dL at trough. I felt night and day better doing daily injections vs twice weekly. That said my SHBG is 15. I inject in my shoulders and it works the best for me. I would get small lumps and bruises occasionally if I injected sub q in the belly fat. Like Cataceous I also feel MUCH better on smaller doses. Matter of fact I think he just sold me on reducing mine a bit more to 8mgs daily. My hematocrit and blood pressure have been creeping up. Good luck!

That's awesome man! Panic attacks are no joke. How bad were yours? Were you medicated at all for them? How long have you been on trt? How long for it to help? Did it get any worse before it got better?
Sorry for so many questions! Just trying to learn as much as I can.

 

[madman]

with that said, and me being at 269 total t right now... even at 10mg per day, i would assume i'd jump way above that, by the time my levels settled/become stable? I'm going in for new labs in 8 weeks from Monday, and i'm starting my shots either this weekend or Monday... just trying to decide if i should do shallow IM in the shoulders or subq (i'm planning to do daily...i've become prone to panic/anxiety since about age 30, never had it before...could even be hormone related, honestly)... so with me prone to that, i'm not looking to feel all amped up, i currently have no problem with erections (even have morning wood at least half of the time)... i just want to be in normal range for health reasons.

I know everyone is different and i probably seem like i'm all over the place rambling... but this is a big decision for me and a life long one, at that... so i want to make things as smooth as i can, starting out and long term.

With me being higher on the bodyfat % but also carrying quite a bit of muscle from my past years of lifting and getting back in the gym/muscle memory etc... would you suggest i start with shallow IM in the shoulders or subq? what daily dose would you think?

with that said, and me being at 269 total t right now... even at 10mg per day, i would assume i'd jump way above that, by the time my levels settled/become stable?

You have 100 mg/week to decide on what dose/injection frequency and if you are dead set on injecting daily then 10-14 mg would suffice and I would go with 14 mg daily to start.

i just want to be in normal range for health reasons.

This comes down to what TT is needed to achieve a healthy FT and as I stated earlier many factors come into play (dose T, SHBG level, injection frequency, the sensitivity of the AR, polymorphism of the AR and CAG repeat length (long/short), bodyweight).

Many tend to aim for getting FT levels in the high-end (physiological) and others do well running lower levels.


I'm going in for new labs in 8 weeks from Monday, and i'm starting my shots either this weekend or Monday... just trying to decide if i should do shallow IM in the shoulders or subq (i'm planning to do daily...i've become prone to panic/anxiety since about age 30, never had it before...could even be hormone related, honestly)... so with me prone to that, i'm not looking to feel all amped up, i currently have no problem with erections (even have morning wood at least half of the time

If you plan on poking daily then sub-q would have a slight advantage as far as minimizing scar tissue/trauma but most are using fixed insulin syringes 27-31G.

Using a fixed (low dead space) insulin syringe will have a minimal impact on scar tissue/trauma let alone minimize waste of medication as you will be drawing/injecting using the same needle.

Achieving a healthy FT level will have a positive impact on mood/overall well-being and can reduce anxiety.

The exact opposite can happen when you drive FT levels too high as testosterone has a tonic effect on the CNS and can easily make one feel amped up.

The goal is to find what level of FT you feel best at.


With me being higher on the bodyfat %

This is critical and needs to be addressed as you may struggle with e2 depending on how high you drive up your FT level.

Much more to overall health than simply having healthy testosterone levels as thyroid/adrenal health is critical let alone overall lifestyle.

Excess body fat, lack of quality sleep, excess stress, poor diet, lack of exercise can have a negative impact on the effectiveness of trt.

 

[madman]

Keep in mind that although many decide to jump on daily injections due to the main advantage of minimizing any peak--->trough and achieving stable blood levels.

Most are also hoping to minimize any issues with elevated e2 and hematocrit which can be a struggle for many when injecting larger doses of T less frequently.

The downfall to this is that when injecting lower doses of T daily it is not a given that e2 and hematocrit will drop as unfortunately many are still injecting higher daily/overall weekly doses let alone running very high TT/FT levels.

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

Too many get caught up in driving up their TT levels when FT is what truly matters and is what you want to pay attention to as yes there is such a thing as too high of an FT level which can cause one to struggle on such protocol.

Top it off with the fact that many are testing FT using inaccurate assays or flawed cFT methods and have absolutely no idea where their FT level truly sits.

These are the same men running around in circles chasing their tales struggling on a protocol only to start manipulating this that and the other.

You need to have your FT tested using the most accurate assays such as the gold standard Equilibrium Dialysis or Ultrafiltration if you want to know where your FT level truly sits.

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