Do changes in body weight affect dose response?

[seppuku]

Hi everyone,

I put myself on diy trt last September, 2022. I'm (obviously) using ugl testosterone enanthate 300mg/ml, and i'm using Medichecks here in the UK to monitor bloods.

My starting dose last Sept was 120mg per week, split 60mg Sun AM / 60mg Wed PM
Bloods taken 8 weeks in, trough reading on a Wednesday late afternoon were over range as follows (units were nmol/l but i'll convert everything here for ease of the mostly US members on the site):

Blood test Wed 23rd Nov 2022 - (120mg pw, 60mg Sun AM/ 60mg Wed PM)
Total test - 857 ng/dl (192 ng/dl - 740 ng/dl)
Free test - 19 ng/dl (4.6 ng/dl - 13.5 ng/dl)
E2 - 74 pg/ml (11 pg/ml - 43 pg/ml)
SHBG - 30 nmol/l (19nmol/l - 76 nmol/l)
**Basic blood test, no HCT, lipids etc

I wrote a post here at the time, and the general advice was to lower dose, which I did to 96mg (48/48).

Follow up blood work, 6 months later at new dosage (trough reading):

Blood test Wed 10th May 2023 - (96mg pw, 48mg Sun AM / 48mg Wed PM)
Total test - 717 ng/dl (192 ng/dl - 740 ng/dl)
Free test - 15.4 ng/dl (4.6 ng/dl - 13.5 ng/dl)
E2 - 65 pg/ml (11 pg/ml - 43 pg/ml)
SHBG - 31 nmol/l (19 nmol/l - 76 nmol/l)
HCT - 50.5% (40% - 52%)
Haemoglobin - 167 g/l (130 g/l - 180 g/l)

I've just recently had another blood test, approx 6 months on from the one above (trough reading)-

Blood test Wed 22nd Nov 2023 - (96mg pw, 48mg Sun AM / 48mg Wed PM)
Total test - 922 ng/dl (192 ng/dl - 740 ng/dl)
Free test - 22 ng/dl (4.6 ng/dl - 13.5 ng/dl)
E2 - 69 pg/ml (11 pg/ml - 43 pg/ml)
SHBG - 31 nmol/l (19 nmol/l - 76 nmol/l)
HCT - 51.1% (38% - 50%) ***(UPPER LIMIT HAS DROPPED SINCE PREVIOUS TEST?)
Haemoglobin - 171 g/l (130 g/l - 170 g/l) ***(UPPER LIMIT HAS DROPPED SINCE PREVIOUS TEST?)

So now to get to my question - what could make my various results higher over time when using the same dosage? I will point out that each blood test has been during use of different vials of testosterone (each one has lasted me about 6 months, so i'm now on my 3rd). Granted, it's UGL, not pharma. But, it is from the same manufacturer, and with the same batch number for the first and third blood test (I bought six vials at once to try and keep things as accurate as possible, but I misread the batch number when taking out vial #2 from my stash. Vial #3 is the same batch as vial #1 though). The brand is Southern Ghost, very popular UGL here in the UK which is frequently tested and shown to be pretty accurately dosed. A member on a UK site I use sent off a vial for independent testing a few weeks back (as he didn't think he was getting the results he thought he should while on a cycle), and it came back at 296.7 mg/ml.

One other variable I can think of is that i've been dieting since around the time of blood test #2 (to get my BMI down for a hip replacement). I was back then around 120kg This last test a week ago, I was 109kg, so 11kg (24lb) less.

So (finally my question) - do changes in bodyweight (body fat) result in different testosterone levels from the same dosages, ie, now i weigh less would the same dosage give a higher blood reading? Or is the fact i've only been administering testosterone for just over a year have anything to do with it? Or are those variations normal for everyone anyhow, and to be expected?

And lastly - would you agree that I should now reduce my dosage further, seeing as my HCT has crept up a bit (and i'm even more over range for total and free test than I was when on 120mg pw)? I'm due to inject now actually, so i'm going to reduce slightly from 48mg to 42mg (so from 96mg pw to 84mg pw), but i'd appreciate members opinions.

Thanks in advance.

 

[Systemlord]

So now to get to my question - what could make my various results higher over time when using the same dosage?

Response to treatment, individual sensitivities, variations in vial strength, which the FDA allows to vary by a percentage. The other variable you may not have considered, your body response changes over time as you get older.

Personally, I wouldn't give it any further thought, especially if you feel optimal.

 

[seppuku]

Response to treatment, individual sensitivities, variations in vial strength, which the FDA allows to vary by a percentage. The other variable you may not have considered, your body response changes over time as you get older.

Personally, I wouldn't give it any further thought, especially if you feel optimal.

I feel just fine - great libido, erectile function etc. I just worry that i'll do another blood panel in 6 months, and find myself stuck with a sky high hct. I'm not working with a doctor, and i think our NHS turn people away when trying to donate blood with a hct at 54% and over. I suppose, it might not move any further up if i keep the dosage the same, and maybe i'm just panicing and over thinking this. It didn't help that the lab range upper limit changed from 52% on the previous test to 50% on this latest one, causing the pointer on the bar chart app to be in the red zone with me now at 51%. If that had been 6 months prior, it would have still been in the green, 'safe' zone. I know hct levels on trt are a contentious topic right now, it would be nice if the experts could all agree on what's best to do.

 

[seppuku]

Putting here screenshots of my latest blood test - anyone care to comment? Am i going to die?

 

[Vince]

My levels always change. I just continue using the same dose because I feel good and I'm having zero issues.

 

[seppuku]

My levels always change. I just continue using the same dose because I feel good and I'm having zero issues.

Thanks Vince. I've been down the rabbit hole of reading about what is and what's not a safe hct level today, and i'm not sure i'm any clearer as opinions seem to vary so much. My platelets were mid range though, and apparently that's good as it's all tied in with hct risk? So you think my trough (3.5 day) test / free test levels look ok, not too high?

What about my cholesterol numbers? I've been combining coconut oil with ev olive oil in the evenings when cooking (stir fry). Not a lot of either as i'm trying to lose weight, but i'm going to drop the coconut oil completely in case that's affecting my LDL.

 

[Systemlord]

My levels always change. I just continue using the same dose because I feel good and I'm having zero issues.

My levels have remain consistent on Jatenzo. Right around 5 hours after my morning dosage, I'm always around 550 ng/dL. If I test closer to 6 hours, then 450 ng/dL.

 

[Vince]

My levels have remain consistent on Jatenzo. Right around 5 hours after my morning dosage, I'm always around 550 ng/dL. If I test closer to 6 hours, then 450 ng/dL.

That's a very good level for young or older men who never had good testosterone levels to begin with. I'm sure you know for older men who at one time had very good testosterone levels. They would suffer a greatly with low levels like that.

 

[Systemlord]

That's a very good level for young or older men who never had good testosterone levels to begin with. I'm sure you know for older men who at one time had very good testosterone levels. They would suffer a greatly with low levels like that.

Once I mistakenly double dosed (1052 @5 hours) and noticed I was much stronger in the gym that one day! I was adding a lot more weight that day.

Then the next day things return to as they are now.

I’d kill to get a dose increase.

 

[Cataceous]

... I know hct levels on trt are a contentious topic right now, it would be nice if the experts could all agree on what's best to do.

I think the answer is pretty obvious when you're taking more testosterone than 95+% of men ever make naturally. You might feel good now, but how do you know you wouldn't feel as good or better with doses more in line with average production? Too many men learn the hard way that more testosterone isn't better for overall health. I take the equivalent of 43 mg of testosterone enanthate per week and do much better than when I was taking 100 mg, or even 65 mg. The only tradeoff has been in a marginal reduction in athleticism, which is a small price to pay.

Elevated HCT is only contentious because the sky's-the-limit crowd wants to pretend the risks don't exist. They studiously avoid discussing the increased stress on the heart and vasculature that results from rising blood viscosity. This isn't to say that your value of 51% is dangerous in general, but if you're one of the unlucky ones whose compensatory mechanisms are lacking then you could end up paying a price.

 

[seppuku]

I think the answer is pretty obvious when you're taking more testosterone than 95+% of men ever make naturally. You might feel good now, but how do you know you wouldn't feel as good or better with doses more in line with average production? Too many men learn the hard way that more testosterone isn't better for overall health. I take the equivalent of 43 mg of testosterone enanthate per week and do much better than when I was taking 100 mg, or even 65 mg. The only tradeoff has been in a marginal reduction in athleticism, which is a small price to pay.

Elevated HCT is only contentious because the sky's-the-limit crowd wants to pretend the risks don't exist. They studiously avoid discussing the increased stress on the heart and vasculature that results from rising blood viscosity. This isn't to say that your value of 51% is dangerous in general, but if you're one of the unlucky ones whose compensatory mechanisms are lacking then you could end up paying a price.

Thanks for replying Cataceous. I was just a bit puzzled why markers had gone up over 6 months at the same dose (96mg a week split 48/48). The only two things that had changed were my bodyweight, and the vial. Regardless, i reduced Wednesday's dose by 6mg (each mark on the syringe would be 6mg) down to 42mg and will do the same in the morning to total 84mg per week. Do you think that would be enough?

Your weekly dosage dose seem quite low, but don't you also use hcg? I have read your schedule before but i can't remember.

 

[Cataceous]

Thanks for replying Cataceous. I was just a bit puzzled why markers had gone up over 6 months at the same dose (96mg a week split 48/48). The only two things that had changed were my bodyweight, and the vial. Regardless, i reduced Wednesday's dose by 6mg (each mark on the syringe would be 6mg) down to 42mg and will do the same in the morning to total 84mg per week. Do you think that would be enough?

Your weekly dosage dose seem quite low, but don't you also use hcg? I have read your schedule before but i can't remember.

As the others have said, there are many possible influences on your results, including vial mis-dosing and lab errors. My current thinking is that changes in body weight should not have much of a direct effect. The metabolism of testosterone occurs primarily in the liver. I doubt the rate changes much unless there are significant insults to the organ.

Indirectly, changes in body composition could in theory affect the rate of depot absorption. Slower absorption would lead to lower peaks and higher troughs, even as average levels remain unchanged.

I can't predict if the 12 mg/week reduction in TE will be enough, but it does seem likely that you'll see a reduction in HCT if other variables are held constant. A benefit of lowering the dose slowly is that you may avoid withdrawal-type symptoms that many complain about. Such symptoms are reported to resolve within a few months. Many who aren't aware of this assume it's a return to hypogonadism and give up prematurely. It's good to recall that there is a threshold effect for hypogonadism; for the vast majority of men, symptoms will not occur if total testosterone reaches somewhere in the 400s ng/dL each day, assuming normal SHBG.

I no longer use hCG, and even when I did, the production of endogenous testosterone seemed to be minimal.

One reason why I need less testosterone is that I use a blend of testosterone enanthate and testosterone propionate, injected daily. Natural men have a diurnal rhythm, with serum testosterone highest in the early morning. The TE/TP blend attempts to mimic this to an extent. The hypothesis is that some benefits of testosterone derive from daily peak levels, whereas side effects are more driven by trough or average levels. This concept is supported by the clinical trials for Natesto. Many of these men have quite low baseline testosterone, but the three large, but relatively brief testosterone pulses each day are sufficient to resolve hypogonadism.

 

[Fernando Almaguer]

As the others have said, there are many possible influences on your results, including vial mis-dosing and lab errors. My current thinking is that changes in body weight should not have much of a direct effect. The metabolism of testosterone occurs primarily in the liver. I doubt the rate changes much unless there are significant insults to the organ.

Indirectly, changes in body composition could in theory affect the rate of depot absorption. Slower absorption would lead to lower peaks and higher troughs, even as average levels remain unchanged.

I can't predict if the 12 mg/week reduction in TE will be enough, but it does seem likely that you'll see a reduction in HCT if other variables are held constant. A benefit of lowering the dose slowly is that you may avoid withdrawal-type symptoms that many complain about. Such symptoms are reported to resolve within a few months. Many who aren't aware of this assume it's a return to hypogonadism and give up prematurely. It's good to recall that there is a threshold effect for hypogonadism; for the vast majority of men, symptoms will not occur if total testosterone reaches somewhere in the 400s ng/dL each day, assuming normal SHBG.

I no longer use hCG, and even when I did, the production of endogenous testosterone seemed to be minimal.

One reason why I need less testosterone is that I use a blend of testosterone enanthate and testosterone propionate, injected daily. Natural men have a diurnal rhythm, with serum testosterone highest in the early morning. The TE/TP blend attempts to mimic this to an extent. The hypothesis is that some benefits of testosterone derive from daily peak levels, whereas side effects are more driven by trough or average levels. This concept is supported by the clinical trials for Natesto. Many of these men have quite low baseline testosterone, but the three large, but relatively brief testosterone pulses each day are sufficient to resolve hypogonadism.

If one has a fatty liver and testosterone is metabolized there, could we expect higher aromatization or any other consequences.. you think?

 

[Cataceous]

If one has a fatty liver and testosterone is metabolized there, could we expect higher aromatization or any other consequences.. you think?

I was wondering about that myself. A first thought is that if fatty liver impairs liver function then metabolism of hormones should slow, increasing their levels. However, the bigger picture is probably more complicated.

 

[Fernando Almaguer]

I was wondering about that myself. A first thought is that if fatty liver impairs liver function then metabolism of hormones should slow, increasing their levels. However, the bigger picture is probably more complicated.

Always good to have your thoughts, thank you

 

[BigTex]

If one has a fatty liver and testosterone is metabolized there, could we expect higher aromatization or any other consequences.. you think?

A new study shows testosterone therapy may reduce non-alcoholic fatty liver.

According to a new study, testosterone therapy may reduce non-alcoholic fatty liver disease in obese

According to a new study, testosterone therapy may reduce non-alcoholic fatty liver disease in obese men with functional hypogonadism and type-2 diabetes.

medicalxpress.com

https://www.tandfonline.com/doi/full/10.1080/13685538.2020.1867094

 

[seppuku]

As the others have said, there are many possible influences on your results, including vial mis-dosing and lab errors. My current thinking is that changes in body weight should not have much of a direct effect. The metabolism of testosterone occurs primarily in the liver. I doubt the rate changes much unless there are significant insults to the organ.

Indirectly, changes in body composition could in theory affect the rate of depot absorption. Slower absorption would lead to lower peaks and higher troughs, even as average levels remain unchanged.

I can't predict if the 12 mg/week reduction in TE will be enough, but it does seem likely that you'll see a reduction in HCT if other variables are held constant. A benefit of lowering the dose slowly is that you may avoid withdrawal-type symptoms that many complain about. Such symptoms are reported to resolve within a few months. Many who aren't aware of this assume it's a return to hypogonadism and give up prematurely. It's good to recall that there is a threshold effect for hypogonadism; for the vast majority of men, symptoms will not occur if total testosterone reaches somewhere in the 400s ng/dL each day, assuming normal SHBG.

I no longer use hCG, and even when I did, the production of endogenous testosterone seemed to be minimal.

One reason why I need less testosterone is that I use a blend of testosterone enanthate and testosterone propionate, injected daily. Natural men have a diurnal rhythm, with serum testosterone highest in the early morning. The TE/TP blend attempts to mimic this to an extent. The hypothesis is that some benefits of testosterone derive from daily peak levels, whereas side effects are more driven by trough or average levels. This concept is supported by the clinical trials for Natesto. Many of these men have quite low baseline testosterone, but the three large, but relatively brief testosterone pulses each day are sufficient to resolve hypogonadism.

Thanks Cat. Well as you mentioned, i'm not expecting any real withdrawals if i drop dosage slowly. And i'm not sure it'll affect much (subjectively) if i settle on a fairly low dose either - to be honest, even at low natural levels i didn't have low libido etc. I went on, simply because i'd spent a decade getting blood tests showing low t, and reading how low testostetone is associated with increased all cause mortality etc (i'd used clomid for a few years, but eventually my t went low again, even though the clomid was still working to give me top end LH). So i've taken the leap for health purposes, and needing to get phlebotomies to prevent possible death doesn't sound very healthy to me. Also, if i get called in as i'm expecting to around next May and told I can have my hip op, i don't want to go into that with a raised hct level.

I've done two jabs now at the reduced dose, i'll give that a couple of weeks and maybe knock another 12mg / week off to put me at 72mg total test E per week.

 

[seppuku]

If one has a fatty liver and testosterone is metabolized there, could we expect higher aromatization or any other consequences.. you think?

Not sure if i have that or not. I do know that my ALP & ALT are well within range. My gamma-gt is raised, but it has been for a few years now. I showed my gp that result, he said i shouldn't worry as it wasn't that bad (the test a few weeks ago was at 79 U/L with a range of 8 - 61 It was a bit higher than that on the result i showed him at the time).

 

[Marchickney]

Thanks Cat. Well as you mentioned, i'm not expecting any real withdrawals if i drop dosage slowly. And i'm not sure it'll affect much (subjectively) if i settle on a fairly low dose either - to be honest, even at low natural levels i didn't have low libido etc. I went on, simply because i'd spent a decade getting blood tests showing low t, and reading how low testostetone is associated with increased all cause mortality etc (i'd used clomid for a few years, but eventually my t went low again, even though the clomid was still working to give me top end LH). So i've taken the leap for health purposes, and needing to get phlebotomies to prevent possible death doesn't sound very healthy to me. Also, if i get called in as i'm expecting to around next May and told I can have my hip op, i don't want to go into that with a raised hct level.

I've done two jabs now at the reduced dose, i'll give that a couple of weeks and maybe knock another 12mg / week off to put me at 72mg total test E per week.

Hi - interesting post
Also treading very similar path, started 100mg Test cyp & HCG with clinic , bloods come back way over etc...
left as tbey wanted to just leave me on same doseage and felt that what was point in paying £150 a month to not even be getting Drs consultation/advice so started going alone with a reputable UGL.
Tried various esthers /doseages/HCG/proviron/pregnalone/DHEA etc
Found I responded positively to Sustanon better than Cyp & Prop
Reduced down to 90mg/wk Sustanon (bloods just over top end)

Currently @ 75mg 3 x week Sun pm/ Wed am/Fri noon
and HCG 300iu Tue am /Thurs noon/Sat pm
doing a 12 week stint before bloods in new year

Going to continue Dialing in around 50/60/75mg and similarly with HCG to keep balls functioning as i tried without for a month, and my libido/balls ground to a halt.

After a TBi and major accident my libido is shot compared to old me but i have improved EF symptons and Ejaculation frequency to a consistent 2 or 3 a week (as opposed to daily) pre crash but it was 1 every 2 weeks Pre TRT.

If you want any recomendation UGL wise PM me got a great UK lab with consistent results tests wise.

Keep us informed how you go please & good luck sir

 

[Marchickney]

Hi - interesting post
Also treading very similar path, started 100mg Test cyp & HCG with clinic , bloods come back way over etc...
left as tbey wanted to just leave me on same doseage and felt that what was point in paying £150 a month to not even be getting Drs consultation/advice so started going alone with a reputable UGL.
Tried various esthers /doseages/HCG/proviron/pregnalone/DHEA etc
Found I responded positively to Sustanon better than Cyp & Prop
Reduced down to 90mg/wk Sustanon (bloods just over top end)

Currently @ 75mg /wk 3 x week 25mg x3 Sun pm/ Wed am/Fri noon
and HCG 900iu/wk (300iu x3 Tue am /Thurs noon/Sat pm)
doing a 12 week stint before bloods in new year

Going to continue Dialing down and try 12 weeks at 50 & subsequently 60 mg/wk and similarly on a dial in refining HCG between 750iu-1000iu/wk keep balls functioning, as i tried without for a month, and my libido/balls ground to a halt. I am looking for best libido results in addition to the weight gain and bone health & density benefits i have already improved.

After a TBi and major accident my libido is shot compared to old me but i have improved EF symptons and Ejaculation frequency to a consistent 2 or 3 a week (as opposed to daily) pre crash but it was 1 every 2 weeks Pre TRT.

i log all my results, bloods and orgasms
resisted the temptation of logging and creating a Stiffy graph though

If you want any recomendation UGL wise PM me got a great UK lab with consistent results tests wise.

Keep us informed how you go please & good luck sir