Dialing in right dosage/regiment on TRT

[rayrock1]

Began my journey on TRT 8 weeks ago.
PRE TRT
--------Total T : 215
--------SHBG: 67
---------Free T: 2.35
--------BIOAVAILABLE T:69
--------Hemocrit : 45
---------E2 :14
After 5 weeks of 100mg/ week Test Cypionate, HCG 250iu twice week:
Total T:524
SHBG: 47
Free T: 7.91
Bioavailable T: 231
Hemocrit: 50
E2 : 15
Dr visit yesterday, to review lab results from 3 weeks ago( Dr was on vacation and office is booked}, I was told bioavailable T is above 190 so Testosterone is normal and that was the defining parameter. I complained that the day before my injection of T, and the day after, tend to be regressive days, down in mood,off.
Also that my achy testicles where mostly better on the HCG with intermittent pain only.
I feel that the regiment is okay but generally not feeling great.
I also commented on the low Free T number and that from what I have been reading, I am still out of the range.
Dr Crislers book sites, he likes to see his patients in the upper quartile of the range of total T, and from other posts here, a Free t of 20-30 normally. I know its not a numerical equation per se but I have to credence to the some of lab values of others my age here have generously shared.
The Dr's suggestion was to increase HCG to 700iu weekly, injecting 350iu day before T.C. injection and increase T Cypionate to 140mg/week and keep injecting e3.5d, and that more frequent injection was not necessary.
My question is how do you know when your at the right dosage/regiment? I have had low T for 2 decades and I am not sure how good or great it can get.

 

[Systemlord]

My question is how do you know when your at the right dosage/regiment?

You won't have any complaints, libido and erections will be strong, you'll have good energy levels and mentally you'll feel capable. You'll know.

 

[madman]

Began my journey on TRT 8 weeks ago.
PRE TRT
--------Total T : 215
--------SHBG: 67
---------Free T: 2.35
--------BIOAVAILABLE T:69
--------Hemocrit : 45
---------E2 :14
After 5 weeks of 100mg/ week Test Cypionate, HCG 250iu twice week:
Total T:524
SHBG: 47
Free T: 7.91
Bioavailable T: 231
Hemocrit: 50
E2 : 15
Dr visit yesterday, to review lab results from 3 weeks ago( Dr was on vacation and office is booked}, I was told bioavailable T is above 190 so Testosterone is normal and that was the defining parameter. I complained that the day before my injection of T, and the day after, tend to be regressive days, down in mood,off.
Also that my achy testicles where mostly better on the HCG with intermittent pain only.
I feel that the regiment is okay but generally not feeling great.
I also commented on the low Free T number and that from what I have been reading, I am still out of the range.
Dr Crislers book sites, he likes to see his patients in the upper quartile of the range of total T, and from other posts here, a Free t of 20-30 normally. I know its not a numerical equation per se but I have to credence to the some of lab values of others my age here have generously shared.
The Dr's suggestion was to increase HCG to 700iu weekly, injecting 350iu day before T.C. injection and increase T Cypionate to 140mg/week and keep injecting e3.5d, and that more frequent injection was not necessary.
My question is how do you know when your at the right dosage/regiment? I have had low T for 2 decades and I am not sure how good or great it can get.

Need to post reference ranges.

Seeing as you are on once-weekly injections (100mg/week) with a trough TT 524 ng/dl and SHBG on the higher end than your FT levels would be far from optimal.

Although your peak TT/FT/e2 levels will be much higher post-injection the downfall of injecting higher doses of T once weekly is that there will be a big difference in the peak--->trough as your levels will be very high post-injection only to end up much lower come weeks end and your blood levels will not be as stable throughout the week which can have a yo-yo effect on ones mood/energy/libido/erectile function/overall well-being.

Would have been far better off splitting the dose 100 mg/week and injecting 50 mg twice weekly (every 3.5 days) as not only would blood levels be more stable but you minimize the peak--->trough levels and could very well have achieved better T levels.

That said you will most likely need a slight dose increase but even then I would not jump from 100--->140 mg/week as 20 mg/week increase will have a big impact on increasing your TT/FT level and you would be better off injecting 120mg/week (60 mg every 3.5 days).

Start low and go slow is key.

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

What is critical is to make sure when testing your FT that you get 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.

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

You also need to keep in mind that pre-trt your hematocrit was 45 and after 5 weeks on 100 mg/week protocol it jumped up to 50 which is a big increase.

Any time one uses exogenous testosterone it will result in driving up RBCs/hemoglobin/hematocrit and this will happen within the 1st month and can take anywhere from 9-12 months to reach peak levels.

Increasing your T dose will only drive up your levels further.

 

[madman]

You won't have any complaints, libido and erections will be strong, you'll have good energy levels and mentally you'll feel capable. You'll know.

If that were only true as we very well know many can have optimal TT/FT levels and still struggle with libido/erectile function!

 

[Chrander]

If that were only true as we very well know many can have optimal TT/FT levels and still struggle with libido/erectile function!

That is so so true. I struggle with that my self. Libido is just not there. Trying to figure things out... Not a easy task.

 

[rayrock1]

Thank you everyone for your replies,
does increasing the number of injections lead to higher free t levels, assuming the weekly amount is the same. for example 100mg\week divided into eod instead of e3.5d?

 

[Systemlord]

does increasing the number of injections lead to higher free t levels

It can and with less testosterone in some cases, you'll also have higher trough levels.

 

[Blackhawk]

I have similar SHBG and it has been even higher, and do better on more frequent injections anyway. I've tried E3D EOD and ED. EOD is my sweet spot. I had a bit of a roller coaster with E2 on E3D interval and on ED just kept me retaining water all the time. I wouldn;t have thought the adjustment between every, every other and every third day would have made so much difference, but it did.

Your symptoms can be from inadequate free T or E2, and from high HCT. I also had this and had to reduce dose because of it until BP came back down, and symptoms abated. I've remained on lower dose since bu have tweaked up and down a little as other things have changed my metabolism.

HCG can provide relief to your cajones, but can also increase E2. I also changed to HCG EOD along with my T cyp injections. 180iu-200iu EOD is my sweet spot.

These kinds of adjusments may or may not help you, I am N=1. Everyone is an individual.


BTW, Nothing personal, common mistake. Just bugs me when i see it.

reg•i•men rĕj′ə-mən, -mĕn″
► Noun: A regulated system, as of medication, diet, or exercise, used to promote health or treat illness or injury.

reg•i•ment rĕj′ə-mənt
► Noun: A military unit of ground troops consisting of at least two battalions, usually commanded by a colonel.


Cheers

 

[Blackhawk]

Thank you everyone for your replies,
does increasing the number of injections lead to higher free t levels, assuming the weekly amount is the same. for example 100mg\week divided into eod instead of e3.5d?

My experience is yes, my Total and free T went up when dosing more frequently. This is because blood levels don't decrease as much over more days so through levels are higher. Some guys who dose every day find they feel better on smaller weekly dose. e.g. if they were doing say 120/week E3.5D and go to daily, reducing to 12-14mg/day (84-98mg/week is plenty). Again, this is just verbally playing with numbers based on many many posts from guys who have been through this. What works for you will be found through your own adjusting.

 

[mooseman109]

Welcome to the journey. It is just that. You can go for periods of time and all will be clicking and then out of nowhere boom, things are not as good, time for a change. It is the never attainable goal of perfection that we are all striving for. We occasionally find that spot, but it does not remain as our bodies are constantly changing as well.
Enjoy the journey and keep positive

 

[rayrock1]

thanks for the replies, it seems most guys switch to daily after their hemocrit gets too high. does this mean the body is saying the dose is super physiologic at that point and needs to be lowered?

 

[rayrock1]

nighthawk, do you inject your HCG together in one syringe with the Testosterone? Also on your EOD protocol, does this mean you inject on different days every week as you rotate through? To figure this all out,did you go for repetitive blood tests?

 

[DS3]

Welcome to the journey. It is just that. You can go for periods of time and all will be clicking and then out of nowhere boom, things are not as good, time for a change. It is the never attainable goal of perfection that we are all striving for. We occasionally find that spot, but it does not remain as our bodies are constantly changing as well.
Enjoy the journey and keep positive

This is one of the most, if not the most, important and truest statements I have ever read on Excel. 'That spot' tends to be inconsistent for many TRT patients, which is part of the reason we are all modifying what we do fairly regularly.

 

[Blackhawk]

nighthawk, do you inject your HCG together in one syringe with the Testosterone? Also on your EOD protocol, does this mean you inject on different days every week as you rotate through? To figure this all out,did you go for repetitive blood tests?

Do you mean me?

Yes I draw both into the same syringe.

Yes EOD means alternating Sunday Tuesday, Thursday, Saturday with Monday, Wedensday, Friday week to week.

My dosage adjustments and dosing frequency changes were done over ~1 1/2 years, and yes i had labs after each change. To "figure it out" I also had the guidance of Dr Saya.

 

[Blackhawk]

thanks for the replies, it seems most guys switch to daily after their hemocrit gets too high. does this mean the body is saying the dose is super physiologic at that point and needs to be lowered?

Often, yes. Prior to going daily, those who have been taking large doses less frequently also can be supraphysiological with very high peaks. e.g. 200mg/wk dosed @ 1/week will create very high supraphysiological peaks that you won't see from labs taken at trough.

And, often more importantly regarding daily dosing, is SHBG. If your SHBG is normal to high, daily is not necessarily better. My SHBG has fluctuated over the years, but remains high normal to high. I do best on EOD. Daily dosing provokes consistently high E2 symptoms.

 

[rayrock1]

thank you for your reply.