Daily Injections and blood work irregularities

[Thomas1212]

Hi everyone, first post but have greatly appreciated everyone’s comments on the forum that I have been reading through. I am having some frustration getting my protocol dialed in. Started TRT 1.5 years ago and have been using Testosterone Cypionate and all injections SubQ. Blood work and dosage listed below with follow up questions.

10/2019
40mg x 3 week, total 120 mg per week
Testosterone, total - 1149 ng/d

• 250 - 1100 ng/dL

Testosterone free - 271.4 pg/mL

• 35-155 pg/mL

Estradiol - 73 pg/mL

• < OR = 39 pg/mL

Lowered dose and switched to daily injections mid October 2019 in an attempt to lower E2. New protocol 16mg daily.

12/16/2019 8 weeks on daily protocol
16mg daily, total 112 mg per week
Testosterone, total - 865 ng/dL
Testosterone free - 158 pg/mL
Estradiol - 45 pg/mL

Happy that E2 dropped and thought I was on track to a stable protocol.

4/2020 same daily protocol but higher levels
16mg daily, total 112 mg per week
Testosterone, total - 1114 ng/dL
Testosterone free - 268 pg/mL
Estradiol - 58 pg/mL

Seems like a large increase in Test even though it is the same protocol when blood work was tested in December 2019.

Lowered my dose in an attempt to lower T and E2

6/2020 8 weeks on new daily protocol
14mg daily, total 98 mg per week
Testosterone, total - 545 ng/dL
Testosterone free - 116 pg/mL
Estradiol - <15 pg/mL

All blood work was done with Quest Diagnostics. When on daily protocol blood work was drawn first thing in the morning, fasted and before daily injection.

My current dose of 14mg daily is leaving me not feeling as good as prior and definitely want my testosterone and E2 to be higher. I am having trouble deciding how to proceed.

My blood work seems to increase after a few months of the same dose. I am wondering if keeping my dose of 14mg daily for a few more months will give my body time to stabilize and potentially increase to desired levels. Has anyone else need months for blood work to stabilize? Seems like waiting 6-8 weeks is not giving me to same results that I get after 4 months of the same dose. For past year and a half my doctor keeps changing my dose but my body keeps fluctuating making it hard to get it dialed in. I am still on 14mg daily and will get blood work done again beginning of August. If it is low still I am going to try 15mg daily and hope that is the perfect dose for me.
Any and all suggestions are greatly appreciated. Thank you in advance.

 

[rayrock1]

between december and april did you change the type on needle you were injecting with? for example in december you used a tuberculin syringe with a detachable needle, in april an insulin syringe with fixed needle. I read here that you can lose .1ml with the detachable tb syringe each injection. so you think your injecting the same amount but it multiplies the effect over time.

 

[Thomas1212]

No I have used a .5cc syringe the entire time. No changes at all.
I am also surprised at such a large decrease in testosterone when I reduced my dose from 16mg to 14mg daily.

thank you for your reply

 

[Vince]

No I have used a .5cc syringe the entire time. No changes at all.
I am also surprised at such a large decrease in testosterone when I reduced my dose from 16mg to 14mg daily.

thank you for your reply

There may have been a slight strength different in your testosterone. I would definitely stay with the 16 mg daily injections. I wouldn’t be concerned with the small variations of levels.

 

[Thomas1212]

There may have been a slight strength different in your testosterone. I would definitely stay with the 16 mg daily injections. I wouldn’t be concerned with the small variations of levels.

Thank you for the suggestion. I will be getting blood work tomorrow and returning to my 16mg dose as I was doing before. Is having Testosterone free - 268 pg/mL, range 35-155, an issue at all? I know my E2 is out of range as well but from everything I have been reading online high E2 is not a problem as long as I feel good and have no symptoms.
Appreciate the help as this has been stressing me and has been a struggle to find a doctor that seems to have a fully educated approach.

 

[Vince]

Thank you for the suggestion. I will be getting blood work tomorrow and returning to my 16mg dose as I was doing before. Is having Testosterone free - 268 pg/mL, range 35-155, an issue at all? I know my E2 is out of range as well but from everything I have been reading online high E2 is not a problem as long as I feel good and have no symptoms.
Appreciate the help as this has been stressing me and has been a struggle to find a doctor that seems to have a fully educated approach.

I wouldn’t be concerned with your high free testosterone levels. I like mine over the range like yours. Having high Free testosterone is pretty common when someone’s on TRT.

 

[Thomas1212]

Thank you very much for the replies. I am looking forward to getting back to 16mg a day since I have really been fatigued lately.

 

[Thomas1212]

Update from recent lab tests.

7/24/2020 12 weeks on new daily protocol
14mg daily, total 98 mg per week
Testosterone, total - 869 ng/dL (250 - 1100 ng/dL)
Testosterone free - 139 pg/mL (35-155 pg/mL)
Estradiol - 39 pg/mL (< OR = 39 pg/mL)

Here are first labs taken on new dose if needed again
6/2020 8 weeks on new daily protocol
14mg daily, total 98 mg per week
Testosterone, total - 545 ng/dL
Testosterone free - 116 pg/mL
Estradiol - <15 pg/mL


Has anyone else need 3 or more months before labs stabilize? This has happened a few times to me where I get tested 6 weeks after a new protocol change and again a few months later. Every time the test taking a few months later are significantly higher.

I have already switched back to 16mg daily since I was not feeling good even up to the day of these labs taken but I am wondering if maybe my body just needs 3-4 months before I can get an accurate gauge of how I feel on a new dose. Thank you for the help.

 

[broker]

Your initial 3x per week at 40 mgs was too high.
why not try 40 mgs every monday and thursday or every tuesday and friday? That seems to work very well.

 

[slicktop]

I'm surprised no one has mentioned SHBG yet! Have you been having that tested as well? I'm just curious how that would correlate to your dosage and test/E2 levels, if at all.

 

[Thomas1212]

I'm surprised no one has mentioned SHBG yet! Have you been having that tested as well? I'm just curious how that would correlate to your dosage and test/E2 levels, if at all.

Last time my SHBG was checked was december of last year and it was 27 with range 10-50.

 

[TorontoTRT]

You messed with something that wasn’t broken. Your E2 wasn’t high. It was in proper ratio to your testosterone. Now your free T is too low. Why would you mess with it? Did you even have any crazy side effects originally?

 

[sv1000]

Honestly it takes about 21 days for changes to Take full effect sometimes it might take 28 days with a cypionate so maybe you just didn’t get fully stabilized you have to make slow incremental changes also the difference from 14 mg and 16 mg might just be the way your body is handling it it might not seem like much but that’s 14 mg a week. I think I read it usually takes 5 half lives for something to become stable in your body.

Also the biggest thing is just go by how you feel I was using 20 to 25 mg of prop a day And dropped it down to 12 to 13 mg and I feel incredible.

 

[rayrock1]

whats a proper free T to estradiol ratio?

 

[Vince]

whats a proper free T to estradiol ratio?

Is Testosterone to Estradiol Ratio Important in Men?

Couple months ago Nelson had a take on E management and understanding E follows T makes perfect sense and treating symptoms vs numbers on bloodwork. There was alot of conversation about a ratio of keeping E2 (14-20) using the math of T÷E2. I recently moved to Nashville from So Cal and starting...

www.excelmale.com

 

[Thomas1212]

You messed with something that wasn’t broken. Your E2 wasn’t high. It was in proper ratio to your testosterone. Now your free T is too low. Why would you mess with it? Did you even have any crazy side effects originally?

I only lowered it because my doctor, who I am going to replace, was worried about my free testosterone and e2 being high out of the range. She was also worried about high Dihydrotestosterone which I am currently trying to learn more about. I am now trying 15mg a day and will be increasing to 16mg again if that doesn’t work.

 

[TorontoTRT]

I’m on 30 mg a day and I’ve never taken an AI.

 

[madman]

I’m on 30 mg a day and I’ve never taken an AI.

Seriously!

Coming from a guy who had been struggling with elevated RBCs/hemoglobin/hematocrit and crashed ferritin.

Your TT/FT levels were already high on much lower doses of T.

How do you go from 100- <100mg/week to an absurd 210mg/week (30mg daily)?

Your FT levels must be through the roof.

The majority of men on trt would lower the overall weekly T does injecting lower doses (12-20 mg/day) when switching to daily and can maintain healthy T levels.

You are injecting a whopping 30 mg/day (210 mg/week).

Very rare anyone would ever need such a dose to hit a TT/FT in the upper end.

Most men do well with FT level in the 20-30 ng/dL range.

You need to understand that a FT 5-9 ng/dL would be considered low and 16-31 ng/dL would be the healthy range with 31 ng/dL being on the high end.

Most healthy young men have FT level of around 20 ng/dL.

Please Read - Protocol Change...

So, after my hematocrit rose to 54% on 100 mg testosterone (1233 ng/dl peak, 704 ng/dl trough) enanthate once weekly injections , I decided six weeks ago to change my protocol to twice weekly injections, @ 40 mg each. Morning Wood has completely disappeared, libido is pretty low, and actually I...

www.excelmale.com

So, after my hematocrit rose to 54% on 100 mg testosterone (1233 ng/dl peak, 704 ng/dl trough) enanthate once weekly injections , I decided six weeks ago to change my protocol to twice weekly injections, @ 40 mg each. Morning Wood has completely disappeared, libido is pretty low, and actually I have more acne now than before. I will be doing blood tests next week to see where the haematocrit is, and upping my dosage again. Here is my question. What would be more optimal:

50 mg twice a week (100 mg)
60 mg every four days (105 mg)
80 mg every five days (112 mg)

High hematocrit regardless of dose or frequency. Time to stop?

Guys really need your input and advice. Regardless of dosage, which isn’t even high, 100 mg once weekly or 40 mg twice weekly, my hematocrit, RBC, and hemoglobin, are not budging. On my latest labs after an 80 mg a week protocol divided into two shots, my haematocrit is still 55, haemoglobin is...

www.excelmale.com

72 mg TE blood test results! Ideal?

Here are the total and free testosterone blood test results after 6 1/2 weeks on current new protocol, which is 72 mg TE every 5 days. Test was done 40 hours post injection, so at peak. TT - 33.3 nmol/L (960 ng/dl) range 8.4 - 28.8 FT - 810 pmol/L (23.3 ng/dl) range 196 - 636 FT/TT ratio 2.43%...

www.excelmale.com

Here are the total and free testosterone blood test results after 6 1/2 weeks on current new protocol, which is 72 mg TE every 5 days. Test was done 40 hours post injection, so at peak.

TT - 33.3 nmol/L (960 ng/dl) range 8.4 - 28.8
FT - 810 pmol/L (23.3 ng/dl) range 196 - 636
FT/TT ratio 2.43%
Estimated SHGB 32.4

Seem ideal?
I feel great on this. Better then 100 mg once a week, and also way better then 40 mg every 3.5 day.

Please review and critique the latest labs

72 mg TE every 5 days. Due to the high hct, hg, rbc I made a blood donation yesterday. So my peak TT/FT is 961 / 23.3, and my trough on day 5 right before injection is 600 / 13.5. Is the trough too low? SHBG 30.9 Estradiol 35 (129 pmol range

www.excelmale.com

72 mg TE every 5 days. Due to the high hct, hg, rbc I made a blood donation yesterday. So my peak TT/FT is 961 / 23.3, and my trough on day 5 right before injection is 600 / 13.5. Is the trough too low?

SHBG 30.9
Estradiol 35 (129 pmol range <162)
DHEA-S 173.2 (4.7 umol range <15)
ALT 40 (range <50))
AST 21 (range <35)
GGT 20 (range 14-62)

 

[TorontoTRT]

Dosage change has no effect on my hematocrit or hemoglobin. Previous tests on just over 200 mg a week split every 3 days had my TT at 976 and FT at 27.

 

[madman]

Dosage change has no effect on my hematocrit or hemoglobin. Previous tests on just over 200 mg a week split every 3 days had my TT at 976 and FT at 27.

That would most likely be your trough level and the peak will be much higher.

The peak will be 8-12hrs post-injection!

Hard to believe you would only hit a peak of 976 ng/dL when injecting just over 200mg/week split every 3 days.

I was hitting a 1200 ng/dL trough injecting 150mg/week (75mg every 3.5 days).

We have no access to the most accurate testing methods such as the gold standard Equilibrium Dialysis or Ultrafiltration (next best) for FT in Canada.

So you have no idea where your FT level truly sits.

You are relying on the outdated and flawed calculated linear law-of mass action Vermuelen.

Bet your FT was much higher than 27 ng/dL.

Now your most recent protocol is 210mg/week (30mg esterified T daily) which would be a whopping dose f 21mg (no ester) of active unbound T if you are using Tcyp.

30mg daily is a huge dose for trt and your TT/FT levels are most likely very high.