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Testosterone Replacement, Low T, HCG, & Beyond
Testosterone Basics & Questions
Complete apathy/depression from too high E2?
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<blockquote data-quote="madman" data-source="post: 185169" data-attributes="member: 13851"><p>First off when starting trt there is a lot going on as not only will your hpta eventually shutdown (2-6 weeks) depending on the dose of T used as higher doses 200+mg/week will result in quicker shutdown (2 weeks) and lower doses 100mg/week complete shutdown will take longer.</p><p></p><p>Top it off with the fact that your hormones will be in FLUX during the weeks leading up until levels stabilize (4-6 weeks) and depending on the individual let alone starting dose of trt it is common for some men to experience ups/downs during the transition whereas many others will experience what we call the HONEYMOON phase where you feel almost euphoric due to the dopamine rush and hormone levels rising but it is short-lived and temporary as the body will eventually adapt.</p><p></p><p>Even then once blood levels stabilize (4-6 weeks) it will take 2-3 months for the body to adapt to the new level and this is the time when one should TRULY gauge how they feel regarding relief/improvement of low-t symptoms/overall well-being.</p><p></p><p>Too many make the mistake of gauging how they feel during the first 6 weeks of trt when the hpta is in the process of shutting down and serum levels of testosterone are in FLUX during the weeks leading up until blood levels stabilize.</p><p></p><p>Why your doctor would start you off on daily injections is beyond me seeing as you have high SHBG and higher doses of T injected less frequently as in once weekly would have a stronger impact on driving down SHBG and even than in many cases we are talking 200+mg/week.</p><p></p><p>c-17 alpha-alkylated orals will have the biggest impact on hammering down SHBG</p><p></p><p>Depending on the protocol (dose of T/injection frequency) some men may notice a larger drop in SHBG but there are many who will not see any significant reduction.</p><p></p><p>I inject 150mg/week (75mg every 3.5 days) pre-trt my SHBG was 34 nmol/L and as of now (3.5 yrs on trt) it has always hovered around 30-32 nmol/L.</p><p></p><p>If anything you should have started off with once-weekly injections or twice weekly (every 3.5 days) injections.</p><p></p><p>Before making any rash decisions you need to stick to your current protocol and have blood work done within the next week to truly see where said protocol (dose of T/injection frequency) has your TT/FT/e2 let alone RBCs/hemoglobin/hematocrit and then decide whether a slight dose increase is needed.</p><p></p><p>Sure how you feel may be terrible but again it is horrible advice to increase your dose when you have absolutely no F***ing idea where such protocol has your T levels.</p><p></p><p>Your doctor is a complete idiot for recommending a dose increase when you have no idea where your levels sit on your current protocol (24mg daily) as you have not had blood work done yet let alone going from 160mg/week (24mg daily) to 210mg/week (30mg/daily) and getting blood work 3 weeks later when your hormones will still be in FLUX!</p><p></p><p>Labs are critical and should always be done 6 weeks after starting trt or anytime a protocol is tweaked (dose/injection frequency).</p><p></p><p>Not only are we looking at labs to see where said protocol (dose/injection frequency) has your TT/FT/e2 levels but to make sure other blood markers are in a healthy range and to avoid/minimize any potential side-effects.</p><p></p><p>Sure treating symptoms is what truly matters but where your TT/FT serum levels sit is still important as yes there is such a thing as running too high of a level on trt and although the ultimate goal is to provide relief/improvement of low-t symptoms and overall well-being keeping blood markers healthy long-term and avoiding/minimizing any potential side-effects is key.</p><p></p><p>Most men do well with FT in the 20-30 ng/dL range and some feel better running slightly higher levels.</p><p></p><p>Regardless of high SHBG even with a TT 1200-1000 ng/dL you should easily be able to achieve an FT in the top end.</p><p></p><p>Forget the mumbo jumbo spewed on some of the other forums that men need a TT 1600-2000 ng/dL and FT 50-60 ng/dL range to experience the beneficial effects of trt.</p><p></p><p>Trough levels are critical.</p><p></p><p>Do understand that most healthy young males have an average TT 600 ng/dL, SHBG 30-35nmol/L, and an FT around 20 ng/dL.</p><p></p><p>You should easily be able to achieve a healthy FT level in the top end 30 ng/dL with a TT 1200-1000 ng/dL even with higher SHBG.</p><p></p><p>When it comes down to testing FT forget about relying on the direct immunoassay and you should be getting the most accurate assay such as the gold standard Equilibrium Dialysis or Ultrafiltration (next best) if you truly want to know where your FT level sits.</p><p></p><p></p><p></p><p></p><p>[URL unfurl="true"]https://www.labcorp.com/tests/500726/testosterone-free-mass-spectrometry-equilibrium-dialysis-endocrine-sciences[/URL]</p><p></p><p><span style="color: rgb(0, 0, 0)">reference range</span><span style="color: rgb(184, 49, 47)"> 52−280 pg/mL ( 5.2-28.0 ng/dL)</span></p><p></p><p></p><p><span style="color: rgb(0, 0, 0)">[URL unfurl="true"]https://www.labcorp.com/tests/070038/testosterone-free-equilibrium-ultrafiltration-with-total-testosterone-lc-ms-ms[/URL]</span></p><p></p><p>reference range <span style="color: rgb(184, 49, 47)">5.00-21.00 ng/dL</span></p><p></p><p></p><p></p><p>Notice the top end of the reference ranges roughly 20-30 ng/dL.</p><p></p><p>Sound familiar.</p><p></p><p>Most doctors in the know would tell you that most patients do well having FT in the 20-30 ng/dL range and many aim for the higher end.</p><p></p><p>Is there anything wrong with running higher levels.....absolutely not if blood markers are in a healthy range and you feel well overall but even than doubtful one would need levels in the 50-60ng/dL range.</p><p></p><p>Many of these same men claiming to need to run very high levels to benefit can have underlying issues dysfunctional thyroid/adrenals.</p><p></p><p>Let me put it this way most hypogonadal men have TT <300 ng/dL or 600-700 ng/dL (high SHBG) with low/sub-par FT.</p><p></p><p>FT of 5-9 ng/dL would be considered low and even then many can still experience low-t symptoms with slightly higher levels.</p><p></p><p>Taking a hypogonadal man from low/sub-par FT to levels of 20-30 ng/dL would have a huge impact on relieving/improving low-t symptoms.</p><p></p><p>You need LABS!</p></blockquote><p></p>
[QUOTE="madman, post: 185169, member: 13851"] First off when starting trt there is a lot going on as not only will your hpta eventually shutdown (2-6 weeks) depending on the dose of T used as higher doses 200+mg/week will result in quicker shutdown (2 weeks) and lower doses 100mg/week complete shutdown will take longer. Top it off with the fact that your hormones will be in FLUX during the weeks leading up until levels stabilize (4-6 weeks) and depending on the individual let alone starting dose of trt it is common for some men to experience ups/downs during the transition whereas many others will experience what we call the HONEYMOON phase where you feel almost euphoric due to the dopamine rush and hormone levels rising but it is short-lived and temporary as the body will eventually adapt. Even then once blood levels stabilize (4-6 weeks) it will take 2-3 months for the body to adapt to the new level and this is the time when one should TRULY gauge how they feel regarding relief/improvement of low-t symptoms/overall well-being. Too many make the mistake of gauging how they feel during the first 6 weeks of trt when the hpta is in the process of shutting down and serum levels of testosterone are in FLUX during the weeks leading up until blood levels stabilize. Why your doctor would start you off on daily injections is beyond me seeing as you have high SHBG and higher doses of T injected less frequently as in once weekly would have a stronger impact on driving down SHBG and even than in many cases we are talking 200+mg/week. c-17 alpha-alkylated orals will have the biggest impact on hammering down SHBG Depending on the protocol (dose of T/injection frequency) some men may notice a larger drop in SHBG but there are many who will not see any significant reduction. I inject 150mg/week (75mg every 3.5 days) pre-trt my SHBG was 34 nmol/L and as of now (3.5 yrs on trt) it has always hovered around 30-32 nmol/L. If anything you should have started off with once-weekly injections or twice weekly (every 3.5 days) injections. Before making any rash decisions you need to stick to your current protocol and have blood work done within the next week to truly see where said protocol (dose of T/injection frequency) has your TT/FT/e2 let alone RBCs/hemoglobin/hematocrit and then decide whether a slight dose increase is needed. Sure how you feel may be terrible but again it is horrible advice to increase your dose when you have absolutely no F***ing idea where such protocol has your T levels. Your doctor is a complete idiot for recommending a dose increase when you have no idea where your levels sit on your current protocol (24mg daily) as you have not had blood work done yet let alone going from 160mg/week (24mg daily) to 210mg/week (30mg/daily) and getting blood work 3 weeks later when your hormones will still be in FLUX! Labs are critical and should always be done 6 weeks after starting trt or anytime a protocol is tweaked (dose/injection frequency). Not only are we looking at labs to see where said protocol (dose/injection frequency) has your TT/FT/e2 levels but to make sure other blood markers are in a healthy range and to avoid/minimize any potential side-effects. Sure treating symptoms is what truly matters but where your TT/FT serum levels sit is still important as yes there is such a thing as running too high of a level on trt and although the ultimate goal is to provide relief/improvement of low-t symptoms and overall well-being keeping blood markers healthy long-term and avoiding/minimizing any potential side-effects is key. Most men do well with FT in the 20-30 ng/dL range and some feel better running slightly higher levels. Regardless of high SHBG even with a TT 1200-1000 ng/dL you should easily be able to achieve an FT in the top end. Forget the mumbo jumbo spewed on some of the other forums that men need a TT 1600-2000 ng/dL and FT 50-60 ng/dL range to experience the beneficial effects of trt. Trough levels are critical. Do understand that most healthy young males have an average TT 600 ng/dL, SHBG 30-35nmol/L, and an FT around 20 ng/dL. You should easily be able to achieve a healthy FT level in the top end 30 ng/dL with a TT 1200-1000 ng/dL even with higher SHBG. When it comes down to testing FT forget about relying on the direct immunoassay and you should be getting the most accurate assay such as the gold standard Equilibrium Dialysis or Ultrafiltration (next best) if you truly want to know where your FT level sits. [URL unfurl="true"]https://www.labcorp.com/tests/500726/testosterone-free-mass-spectrometry-equilibrium-dialysis-endocrine-sciences[/URL] [COLOR=rgb(0, 0, 0)]reference range[/COLOR][COLOR=rgb(184, 49, 47)] 52−280 pg/mL ( 5.2-28.0 ng/dL)[/COLOR] [COLOR=rgb(0, 0, 0)][URL unfurl="true"]https://www.labcorp.com/tests/070038/testosterone-free-equilibrium-ultrafiltration-with-total-testosterone-lc-ms-ms[/URL][/COLOR] reference range [COLOR=rgb(184, 49, 47)]5.00-21.00 ng/dL[/COLOR] Notice the top end of the reference ranges roughly 20-30 ng/dL. Sound familiar. Most doctors in the know would tell you that most patients do well having FT in the 20-30 ng/dL range and many aim for the higher end. Is there anything wrong with running higher levels.....absolutely not if blood markers are in a healthy range and you feel well overall but even than doubtful one would need levels in the 50-60ng/dL range. Many of these same men claiming to need to run very high levels to benefit can have underlying issues dysfunctional thyroid/adrenals. Let me put it this way most hypogonadal men have TT <300 ng/dL or 600-700 ng/dL (high SHBG) with low/sub-par FT. FT of 5-9 ng/dL would be considered low and even then many can still experience low-t symptoms with slightly higher levels. Taking a hypogonadal man from low/sub-par FT to levels of 20-30 ng/dL would have a huge impact on relieving/improving low-t symptoms. You need LABS! [/QUOTE]
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Testosterone Replacement, Low T, HCG, & Beyond
Testosterone Basics & Questions
Complete apathy/depression from too high E2?
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