Did my testes come out of retirement!

[DGuthrie]

I am a 48 year old male weighing 240 pounds at 5’9” with a muscular build. I have been on TRT for several years at comfortable dose of 1.5cc weekly. I have found that when tested, my levels have fluctuated even though always taken 7 days from last injection. However, my greatest concern is after taking a 6 month hiatus from TRT and beginning again, my levels skyrocketed showing 2016 last week, which we thought was an error so retested to find it at 2394 a week later! (I did take an injection of 1.5cc after the 2016 blood draw) What could possibly cause the spike? I have eliminated my alcohol intake over the last 6 weeks I’ve been back on TRT and am also on a better sleep and nutrition schedule as well. Would that contribute to such a drastic increase? Did my testes come back from retirement? Here are my levels historically:

7/23/19 score 188

8/27/19 score 479

10/15/19 score 865

1/6/20 score 460

4/15/20 score 650

9/16/20 score 516

12/2/20 score 878

6/23/21 score 667

8/18/21 score 973

11/17/21 score 995

6/17/22 score 598

9/2/22 score 558

5/12/23 score 894

9/5/23 score 1230

Six months off

6/10/24 1716

6/10/24 2016

6/7/24 2394

(The draws on 6/10/24 were taken from two separate clinics within 20 minutes of each other)

Please, any insight will be greatly appreciated!!!

 

[Systemlord]

However, my greatest concern is after taking a 6 month hiatus from TRT and beginning again, my levels skyrocketed showing 2016 last week, which we thought was an error so retested to find it at 2394 a week later! (I did take an injection of 1.5cc after the 2016 blood draw) What could possibly cause the spike?

Biotin supplements can cause erroneously high hormone values in some testing methods. LC/MS and equilibrium dialysis are immune to this testing limitation.

You recently started biotin supplements?

 

[DGuthrie]

Biotin supplements can cause erroneously high hormone values in some testing methods. LC/MS and equilibrium dialysis are immune to this testing limitation.

You recently started biotin supplements?

No biotin supplements. Only thing I’ve added is a pre and post biotic

 

[Steve78]

No biotin supplements. Only thing I’ve added is a pre and post biotic

Did you check LH etc?

 

[Cataceous]

A possible contributing factor is variations in SHBG. Testosterone therapy tends to reduce SHBG, so during treatment you likely had fairly low levels. During the hiatus SHBG probably rebounded to normal or even high levels. This is relevant, because SHBG acts as a storage reservoir for testosterone. High levels lead to higher total testosterone, which is what you've been measuring. When SHBG varies, total testosterone is a less useful indicator of androgen status. Instead you should be relying on free testosterone, either measured with equilibrium dialysis or else calculated with the Vermeulen method. In general you would find that free testosterone is proportional to the dose of testosterone. If free testosterone changes significantly at the same dose then it may be a reflection of changes in the underlying metabolism of testosterone, which can be due to factors such as aging or liver problems.

What is the concentration of your testosterone? The volume you inject does not tell us how much you are getting unless the concentration is given. Is it testosterone cypionate? A typical concentration is 200 mg/mL. If this applies to you then you are taking 300 mg per week, which is a massive dose, and not remotely related to TRT. It would help to explain the suppression of SHBG and subsequent rebound to exceptionally high levels. True replacement doses of testosterone would be more like 40-100 mg of testosterone cypionate per week in divided doses.