Could use a second set of eyes

[Setz88]

Results in pics below (my initial numbers are from March screenshots) All other pictures are post initiation of therapy. All testing is done at trough (morning of next injection, pre injection)


Therapy:
Current dose 80mg Test Cyp per week (split into two sub-q injections), have been on therapy for 7 months. Started at 50mg Test Cyp per week (about 4 months), then bumped to where I am now.


How I feel:
Been feeling irritated lately, blood pressure is up, anxiety is rearing its head again. This started a couple weeks ago. Other than that, energy/libido is much improved (slight down turn in the last couple weeks). I get bad brain fog and anxiety 12-24 hours post injection, that does not resolve until 48 hours after injection.


Provider:
seeing a urologist locally


How my day/week looks:
I work out 2-3 days per week (cardio/resistence)
I take AG1, Vitamin D (10,000IU) daily
Drink half to 1 gallon of water per day with electrolytes


Questions/Analysis:
My SHBG has dropped drastically, whichs leads me to beleive this may be causing my symptoms.
My proportion of Free Test to Total Test seems to be very high, likely due to SHBG drop
Estrogen seems to be in line
I have seen the term "hyper-responder", this may apply to me?
I want to make some adjustments to get me more in line with my goals (optimization).
I was thinking of either dropping my dose to 60mg per week or splitting my current 80mg into three times per week injections (eould prefer less injections).
Thoughts/Opinions?
Any other metrics I am missing?

 

[Cataceous]

You are right: There are signs that your current dose is too high — highish free T, low SHBG, high HCT — so it makes sense to try lowering it to 60 mg/week in two or three injections. There's nothing unusual about your dose response. Your current average intake of 8 mg/day of testosterone is above the young-men average production of 6-7 mg, and your free serum levels are similarly above the young-men averages. Excessive testosterone is helpful for muscle building, but it can be detrimental in a lot of other ways.

 

[Phil Goodman]

How did you feel at 50/week?? I’m assuming there were valid reasons for increasing your dose, which leads me to think you weren’t doing great at that dose. My first recommendation would be to go to 3 injections per week. And perhaps a very slight decrease just so it’s an even 25 mg per pin which would result in 75/week. However, if you’re getting brain fog for 12-24 hours shortly after injections then you may have to do even more frequent injections, as it could indicate that your body doesn’t tolerate the peaks very well at all. By lowering the amount per dose you could hopefully minimize or eliminate that negative aspect.

Another thing to consider may be to switch to IM. I’ve never done subq and have heard mixed things about it, but iirc one of the downsides is that it isn’t absorbed as consistently as with IM due to no blood flow. Some seem to like it, but from what I’ve read most prefer IM injections. That could be another thing to consider.

 

[Systemlord]

My SHBG has dropped drastically, whichs leads me to beleive this may be causing my symptoms.

This is perfectly normal and to be expected for men on TRT, because androgens lower SHBG.

I get bad brain fog and anxiety 12-24 hours post injection, that does not resolve until 48 hours after injection.

I had the same problem, right after my injections. TRT can suppress ferritin in some individuals.

Check your ferritin!

Also, I had a lot of brain fog on SQ injections. The effect was similar to smoking weed.

 

[Setz88]

How did you feel at 50/week?? I’m assuming there were valid reasons for increasing your dose, which leads me to think you weren’t doing great at that dose. My first recommendation would be to go to 3 injections per week. And perhaps a very slight decrease just so it’s an even 25 mg per pin which would result in 75/week. However, if you’re getting brain fog for 12-24 hours shortly after injections then you may have to do even more frequent injections, as it could indicate that your body doesn’t tolerate the peaks very well at all. By lowering the amount per dose you could hopefully minimize or eliminate that negative aspect.

Another thing to consider may be to switch to IM. I’ve never done subq and have heard mixed things about it, but iirc one of the downsides is that it isn’t absorbed as consistently as with IM due to no blood flow. Some seem to like it, but from what I’ve read most prefer IM injections. That could be another thing to consider.

I actually did great at 50mg per week (one injection per week sub-q), but that was during the first 3-4 months. I started to feel a slight lag at the latter half of the week, talked to the doc and decided to up the dose. Ive always heard that sub-q was a slower, more consistent release, but Im not against trying IM.

 

[Setz88]

This is perfectly normal and to be expected for men on TRT, because androgens lower SHBG.

I had the same problem, right after my injections. TRT can suppress ferritin in some individuals.

Check your ferritin!

Also, I had a lot of brain fog on SQ injections. The effect was similar to smoking weed.

Yes, very similar to smoking weed or taking a xanax, just not all there. Never thought to check my ferritin levels, ill look into that on my next bloods. Glad to hear the drop in SHBG is expected. But when it happens, should dose be adjusted down to compensate for side effects, if experienced?

 

[Setz88]

Could this be caused by an temporary increase in my estrogen 12-24 hours post injection? Im running at 45 pcg/ml at my trough, likely much higher at peak. Not sure what an appropriate ratio is for Free Test/Total Test/Estrogen. However, my estrogen does seem to be on the higher end. Never been on an AI, I have heard mixed reviews (good and bad).

 

[Systemlord]

Glad to hear the drop in SHBG is expected. But when it happens, should dose be adjusted down to compensate for side effects, if experienced?

If the side effects are caused by excessive dosing. The TRT may not be the reason for the side effects, it may be something else, like ferritin or some vitamin or mineral deficiency/insufficiency.

Could this be caused by an temporary increase in my estrogen 12-24 hours post injection?

Unlikely, estrogen peaks long after testosterone peaks, estrogen always follows testosterone. There's even a lag time delay between estrogen peaking and you feeling it.

Most of the side effects on TRT is from sodium reabsorption, fluid retention and NOT estrogen. That’s because TRT increases aldosterone produced in adrenal glands, which enters the kidneys, and tells the kidneys to absorb more sodium and sodium, carries water. This leads to fluid retention.

This occurs, especially after dosing changes!

If you’re exercising and eating healthy, that excessive fluid retention, extracellular will become intracellular.

 

[Setz88]

But the sides I'm experiencing are about 12 hours after injection, mostly brain fog (like I'm not even completely there) anxiety, and increase in blood pressure. I feel fine about 24-36 hours after injection.

 

[Cataceous]

If the side effects are caused by excessive dosing. The TRT may not be the reason for the side effects, it may be something else, like ferritin or some vitamin or mineral deficiency/insufficiency.
...

When you hear hoofbeats think horses before chasing after zebras. SHBG was normal before TRT, now it's crashed. HCT is on an upward trajectory. These are two of the most common symptoms of excess androgens.