Do i need more testosterone? Testosterone non responder?

[tj]

I am seeing a lot of labs in the 1000 ng/dl with very low dosages. i am on HG Sustanon 65mg eod. Total t barely gets to 778 ng/dl. free t around 25ng/dl. I am a low shbg guy so i tried the daily shots but that makes me feel even worse.
Shbg always around 14-18. Even pre trt. No thyroid issues or diabetic.

Am i a non responder? Do i need more test to get higher total and free levels and feel better?
Still feeling hypogonadal: infrequent erections, no body changes, not getting stronger, getting fat around the waist etc.

Are there more people that use 250-300 or even more a week to get high normal levels?
All this hassle with injecting eod and using 230 mg a week to get medium levels and still feel like i am on nothing and looking like i don't train is starting to annoy me....
Are low SHBG guys just doomed or do we just need more test to see results.
ps. i tried al the other lower dosages and intervals, just nothing…..

 

[Vince]

I am seeing a lot of labs in the 1000 ng/dl with very low dosages. i am on HG Sustanon 65mg eod. Total t barely gets to 778 ng/dl. free t around 25ng/dl. I am a low shbg guy so i tried the daily shots but that makes me feel even worse.
Shbg always around 14-18. Even pre trt. No thyroid issues or diabetic.

Am i a non responder? Do i need more test to get higher total and free levels and feel better?
Still feeling hypogonadal: infrequent erections, no body changes, not getting stronger, getting fat around the waist etc.

Are there more people that use 250-300 or even more a week to get high normal levels?
All this hassle with injecting eod and using 230 mg a week to get medium levels and still feel like i am on nothing and looking like i don't train is starting to annoy me....
Are low SHBG guys just doomed or do we just need more test to see results.
ps. i tried al the other lower dosages and intervals, just nothing…..

Can you post your complete set of labs, along with the range.

 

[Vince Carter]

Why are you using Sustanon?

 

[tj]

Sustanon because thats the only HG test available in the Netherlands.

total t 779 ng/dl range: 336-923
free t 25ng/dl range: 4-13ng/dl


DHEA 7.6 umol/l (281 ug/dl)(ref: 1,2 10,3 umol/l)
SHBG 14.4 nmol/l range: 7 70nmol/l
TSH 1.2 mu/l ref: 0.5 -3.5
free t3 5.4 pmol/l ref: 3.1- 6.8
Free t4 14.1 pmol/l ref: 10-25
hba1c: 5,20%
Fasting glucose 5.1 mmol/l

 

[Tman]

I think it's more about your expectations. Those two numbers look really good for therapy. You font necessary feel it but you do begin to feel better.

 

[Vince]

Sustanon because thats the only HG test available in the Netherlands.

total t 779 ng/dl range: 336-923
free t 25ng/dl range: 4-13ng/dl


DHEA 7.6 umol/l (281 ug/dl)(ref: 1,2 10,3 umol/l)
SHBG 14.4 nmol/l range: 7 70nmol/l
TSH 1.2 mu/l ref: 0.5 -3.5
free t3 5.4 pmol/l ref: 3.1- 6.8
Free t4 14.1 pmol/l ref: 10-25
hba1c: 5,20%
Fasting glucose 5.1 mmol/l

Does your doctor test estrogen levels.

 

[madman]

Sustanon because thats the only HG test available in the Netherlands.

total t 779 ng/dl range: 336-923
free t 25ng/dl range: 4-13ng/dl


DHEA 7.6 umol/l (281 ug/dl)(ref: 1,2 10,3 umol/l)
SHBG 14.4 nmol/l range: 7 70nmol/l
TSH 1.2 mu/l ref: 0.5 -3.5
free t3 5.4 pmol/l ref: 3.1- 6.8
Free t4 14.1 pmol/l ref: 10-25
hba1c: 5,20%
Fasting glucose 5.1 mmol/l

When were your labs done (trough)?

I have stated this many times and I will say it again.....although relief/improvement of low-t symptoms is what truly matters as oppose to just where numbers fall in a reference range.....lab work is still critical not only for making sure blood markers are in a healthy range but to also see how said dose of testosterone effects ones TT/FT/DHT/e2 levels as an effective trt protocol will come down to most importantly ones SHBG levels and what dose of T/injection frequency is needed to achieve a TT that will result in a healthy FT level.

Unfortunately regarding testing ones FT (free testosterone) most are using the direct analog-based free testosterone immunoassays which are inaccurate.

If anything you should be getting the equilibrium dialysis or better yet save yourself the money and use the Calculate free testosterone with TruT by FPT - Try the public free testosterone calculator at tru-t.org

Do you truly know your FT levels?



Testosterone, Free, Mass Spectrometry/Equilibrium Dialysis (Endocrine Sciences)

TEST: 500726
Test number copied

CPT: 84402; 84403






Testosterone Therapy in Men With Hypogonadism: An Endocrine Society Clinical Practice Guideline (2018)


Testosterone Therapy in Men With Hypogonadism: An Endocrine Society * Clinical Practice Guideline



In men who have conditions that alter sex hormone–binding globulin (SHBG) (Table 2), or whose initial total testosterone concentrations are at or near the lower limit of the normal range (Fig. 1), clinicians should determine free testosterone concentrations either directly from equilibrium dialysis assays or by calculations that use total testosterone, SHBG, and albumin concentrations. Clinicians should not use direct analog-based free testosterone immunoassays, as they are inaccurate.



Seeing as you tested your FT using the wrong assay (free t 25ng/dl range: 4-13ng/dl)


If we use the TruT Free Testosterone Calculator by FPT

Taking your TT 779 ng/dL, SHBG 14.4 nmol/L and Albumin 4.3 g/dL (mean)
than your FT 29.31 ng/dL would be in top of the reference range 16-31 ng/dL

If anything it could very well be that seeing as you have low SHBG and your FT is on the high end I would be that your e2 but more importantly free estradiol is high and could definitely have a negative effect on how you feel on such protocol sustanon 250 (65mg EOD)!

Oh but your did not have your e2 tested?

You stated that you tried daily injections "I am a low shbg guy so i tried the daily shots but that makes me feel even worse".....yet you post no lab work let alone we have no idea how much time you truly invested in trying such protocol as you go on and state "All this hassle with injecting eod and using 230 mg a week to get medium levels"....6 weeks minimum should be done to say the least!

 

[madman]

I am seeing a lot of labs in the 1000 ng/dl with very low dosages. i am on HG Sustanon 65mg eod. Total t barely gets to 778 ng/dl. free t around 25ng/dl. I am a low shbg guy so i tried the daily shots but that makes me feel even worse.
Shbg always around 14-18. Even pre trt. No thyroid issues or diabetic.

Am i a non responder? Do i need more test to get higher total and free levels and feel better?
Still feeling hypogonadal: infrequent erections, no body changes, not getting stronger, getting fat around the waist etc.

Are there more people that use 250-300 or even more a week to get high normal levels?
All this hassle with injecting eod and using 230 mg a week to get medium levels and still feel like i am on nothing and looking like i don't train is starting to annoy me....
Are low SHBG guys just doomed or do we just need more test to see results.
ps. i tried al the other lower dosages and intervals, just nothing…..

Do i need more test to get higher total and free levels and feel better?

- doubtful!



All this hassle with injecting eod and using 230 mg a week to get medium levels and still feel like i am on nothing and looking like i don't train is starting to annoy me....

-looking like you don't train should be the least of your concerns

-regarding medium levels your TT is higher and regardless you should be concentrating on your FT levels as it is the unbound active fraction of testosterone responsible for the positive effects (plain and simple)!


Are low SHBG guys just doomed or do we just need more test to see results

- doomed.....far from it

- you need to look deeper into your protocol [dose/injection frequency, ester used (sustanon)]

- top it off with having your e2 tested as it is critical to know when using exogenous testosterone let alone in general....as we have no idea where your e2/free estradiol levels sit and seeing as you have low SHBG (14.4 nmol/L) for all we know your e2/free e2 is too high and could very well have a negative effect on how you feel


ps. i tried al the other lower dosages and intervals, just nothing…..

- again did you truly invest the proper time frame when trying various protocols as you say.....let alone do you have full blood work to post and again was your e2 even tested?

 

[tj]

Latest e2 is 276 pmol/l range 0- 230 pmol/l(75,18 pg/ml) non sensitive.
We have no sensitive test here.
labs done before next inject (trough)
Never used an ai and with the recent new info i doubt that it wil help.
Been on several protocols every time 6-20 weeks with lab after every period.
A lot of labwork the past 4 years...

 

[madman]

Latest e2 is 276 pmol/l range 0- 230 pmol/l(75,18 pg/ml) non sensitive.
We have no sensitive test here.
labs done before next inject (trough)
Never used an ai and with the recent new info i doubt that it wil help.
Been on several protocols every time 6-20 weeks with lab after every period.
A lot of labwork the past 4 years...

So your FT is near the top end of the range at trough and your e2 is high although it was tested using the standard assay an not the sensitive (LC/MS-MS) so we have no idea where your e2 truly sits let alone free estradiol which is important in your situation seeing as you have low SHBG.

Seeing as these labs were done at trough your TT/FT/e2 levels will be even higher at peak!

 

[Systemlord]

You say you tried daily injections and felt worse, perhaps the dosage was either too high or too low. It will be hard to determine much of anything without lab testing to track your progress.

High estrogen can ruin the good effects of TRT, getting the dosage right is important. There are some that will need an estrogen blocker on TRT.

I felt like a million bucks on only 10mg cypionate daily.

Usually a very high Free T means very high E2 in low SHBG men, bring down Free T and E2 should also decrease. I strongly believe this is why you feel so unwell.

It's a mistake to believe that every man will do well in the high normal ranges, some men feel much better mid-normal levels.

 

[equel]

Ur free T is very high so ur free e2 is probably sky high given ur low shbg. U need a SMALLER dose, not higher.

Try 30 eod or 15 ed.

 

[tj]

Very confusing. Looks like there are two camps. The one that says go as high as possible with testosterone to relieve symptoms. Even if this means total t of 1200-1600 or above and free t 30-50 ng/dl with just letting the estrogen go even if its 100 pg/ml. And never use an AI. (dr nichols, neil rouzier etc)

And the other that says lower dosages for lower total t, free t and lower estrogen. Use an AI if needed to lower estrogen.

 

[tj]

Doesn't high free t also means high free estrogen even if you have a higher SHGB?
Logically you would think that high free e2 isn't something exclusively for low SHBG guys but something that always would occur if free t was high?

 

[madman]

Very confusing. Looks like there are two camps. The one that says go as high as possible with testosterone to relieve symptoms. Even if this means total t of 1200-1600 or above and free t 30-50 ng/dl with just letting the estrogen go even if its 100 pg/ml. And never use an AI. (dr nichols, neil rouzier etc)

And the other that says lower dosages for lower total t, free t and lower estrogen. Use an AI if needed to lower estrogen.

No one is saying you have to stay in the reference range for TT/FT as there is nothing wrong with one running a higher TT 1200+ or FT level in the 30-50 ng/dL as long as one is not experiencing any side effects and blood markers are in a healthy range.....but again depending on ones SHBG whether high/normal/low it comes down to what TT does one need to achieve a healthy FT in order to experience relief/improvement of low-t symptoms while minimizing side effects and keeping blood markers in a healthy range.

Most men would do well with a FT in the 20-30 ng/dL range where as others may need levels higher.

Not everyone can handle running higher TT/FT levels and in cases of low SHBG running too high a FT level would result in high e2/free estradiol which can end up putting a damper on running an effective protocol unless an aromatase inhibitor is used sensibly.....although it would be preferable if one could get away without having to use an a.i.

Do understand that one with a higher SHBG would need to run a higher TT in order to achieve the same FT levels compared to one with low SHBG.

As I stated previously:

If we use the TruT Free Testosterone Calculator by FPT

Taking your TT 779 ng/dL, SHBG 14.4 nmol/L and Albumin 4.3 g/dL (mean)
than your FT 29.31 ng/dL would be in top of the reference range 16-31 ng/dL

Now your FT levels are near the top of the reference range at trough.....again most likely your e2/free estradiol is high but again we have no idea where your e2/free estradiol truly sits due to not having access to the proper testing method.

Can you try running higher FT levels.....sure but do understand that not only will your e2/free estradiol increase but it will result in an increased hemoglobin/hematocrit level and possibly have a negative effect on lipids (decrease HDL).

I would tread lightly trying to push your TT/FT levels really high seeing as you have low SHBG.

As an example if you wanted to push your FT levels close to the upper end 50 ng/dl (well over the reference range of 16-31 ng/dL -TruT Free Testosterone Calculator by FPT

Than with your SHBG of 14.4 nmol/L you would need to run a TT of 1300 ng/dL to achieve a FT of 49.86 ng/dL

Looking at one with high SHBG 70 nmol/L they would need to run a TT of roughly 1500 ng/dL to achieve a FT of 50.28 ng/dL

The one that says go as high as possible with testosterone to relieve symptoms. Even if this means total t of 1200-1600 or above and free t 30-50 ng/dl with just letting the estrogen go even if its 100 pg/ml. And never use an AI. (dr nichols, neil rouzier etc)

Both solely prefer the transdermal method and one is notorious for transdermal cream scrotal application (twice daily am/pm) and one of the main benefits is a large increase in DHT which may negate the effects of high e2.

Doubtful many using injectable could tolerate running TT 1500+.....let alone 1200+ without experiencing negative effects due to very high FT levels.

Even than using transdermal whether standard body application or scrotally some would not be able to handle running such high TT/FT levels.

If anything one would have to run TT levels of 1300-1500+ to achieve FT levels in the 50 ng/dL range and only in cases of absurdly high SHBG levels 100 nmol/L (or higher) or possible AR resistance (older men or previous steroid users) would one need to run TT levels of 1600+ ng/dL.

Regarding these doctors stating running FT levels in the 30-50 ng/dL range are you sure their patients FT levels are all tested using the gold standard equilibrium dialysis or taking their TT,SHBG,Albumin and using the:


TruT™ by FPT
The novel, FDA-registered TruT™ algorithm uses modern understanding of molecular interactions to improve the accuracy of free-T calculations.



* For all we know these patients FT levels whether 30-60 ng/dL are done using flawed FT testing methods!

 

[madman]

Ur free T is very high so ur free e2 is probably sky high given ur low shbg. U need a SMALLER dose, not higher.

Try 30 eod or 15 ed.

His FT is by no means very high and if anything unless it was done using the gold standard equilibrium dialysis or calculated using the TruT Free Testosterone calculator by FPT than we would have no idea where his FT levels truly sit.

If we use the new calculated method which was done in the previous post and take his TT 779 ng/dL, SHBG 14.4 nmol/L and Albumin 4.3 g/dL (mean) than his FT 29.31 ng/dL (trough) would be in top of the reference range 16-31 ng/dL.....sure even though it is near the top of the reference range using the new calculated method he may very well need to run a lower TT/FT due to his low SHBG as for all we know his e2/free estradiol may be too high!

He had his FT tested using the wrong assay (free t 25ng/dl range: 4-13ng/dl)

 

[madman]

You say you tried daily injections and felt worse, perhaps the dosage was either too high or too low. It will be hard to determine much of anything without lab testing to track your progress.

High estrogen can ruin the good effects of TRT, getting the dosage right is important. There are some that will need an estrogen blocker on TRT.

I felt like a million bucks on only 10mg cypionate daily.

Usually a very high Free T means very high E2 in low SHBG men, bring down Free T and E2 should also decrease. I strongly believe this is why you feel so unwell.

It's a mistake to believe that every man will do well in the high normal ranges, some men feel much better mid-normal levels.

True....but again his FT level is not very high as the wrong FT testing method was used.

You have been on the forum long enough.....you should know this by now!

 

[Cataceous]

Latest e2 is 276 pmol/l range 0- 230 pmol/l(75,18 pg/ml) non sensitive.
We have no sensitive test here.
labs done before next inject (trough)
...

Just to get a sense of the numbers, putting your total estradiol and other measurements into a free estradiol calculator yields calculated free estradiol of 2.3 pg/mL. The normal range for this is about 0.3-1.5 pg/mL. It is possible that your immunoassay-based estradiol test is falsely elevated. However, it's still a good bet that your free estradiol is on the high side.

 

[fifty]

I’m starting to wonder which tests aren’t wrong.
E2: wrong but consistent
E2 sensitive: Accurate with occasional large errors.
Pregnenolone: inaccurate
Direct free T: wrong
Total T: ???
Prolactin: accurate if you’ve been celebate and bed rested for 72hrs

What else?

 

[madman]

I am seeing a lot of labs in the 1000 ng/dl with very low dosages. i am on HG Sustanon 65mg eod. Total t barely gets to 778 ng/dl. free t around 25ng/dl. I am a low shbg guy so i tried the daily shots but that makes me feel even worse.
Shbg always around 14-18. Even pre trt. No thyroid issues or diabetic.

Am i a non responder? Do i need more test to get higher total and free levels and feel better?
Still feeling hypogonadal: infrequent erections, no body changes, not getting stronger, getting fat around the waist etc.

Are there more people that use 250-300 or even more a week to get high normal levels?
All this hassle with injecting eod and using 230 mg a week to get medium levels and still feel like i am on nothing and looking like i don't train is starting to annoy me....
Are low SHBG guys just doomed or do we just need more test to see results.
ps. i tried al the other lower dosages and intervals, just nothing…..

You mention nothing regarding mood/energy/libido.....just seem to be dwelling on "no body changes, not getting stronger, getting fat around the waist etc".....and although healthy testosterone levels can aid in improved body composition (muscle gain/fat loss)....ones diet/training protocol let alone genetics will have the final say!

We are on trt here not steroids.....not sure what type of magical body transformation you are expecting from trt.

If one is strength training and following the proper diet the muscle/strength gains on trt doses will be mild compared to what one would achieve using steroid doses of testosterone (300-600 mg/week)!

Your FT (trough) is near the top of the reference range.....is your diet/training protocol on point and getting fat around the waist could have more to do with your diet or simply be water bloat.