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Testosterone Replacement, Low T, HCG, & Beyond
Testosterone Basics & Questions
Dosage protocol and lab test change help
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<blockquote data-quote="madman" data-source="post: 187198" data-attributes="member: 13851"><p>This is a complete mess!</p><p></p><p>If anything after starting when you had blood work done on the once-weekly 100 mg/week protocol although your trough TT 524 ng/dl which may very well seem sub-par let alone not high enough to achieve a healthy FT as your levels are still too low the main issue is you did not use an accurate assay so we have no idea where your FT truly sits.</p><p></p><p>You need to have it tested using the most accurate assay such as the gold standard Equilibrium Dialysis or Ultrafiltration.</p><p></p><p></p><p><span style="color: rgb(184, 49, 47)">At this Dr visit, I complained of achy testicles, so my Dr put my on HCG, 500iu/week, split into 2 injections. I also complained of feeling a slump after the first 3 days had passed, on the once injection per week schedule, so he also increased my test dosage to 120 mg/week and suggested to also split the dose as well, into 2 injections per week e3.5d</span></p><p></p><p>As you can clearly see the downfall of injecting higher doses of T once-weekly is that not only will there be a significant difference between peak--->trough levels (high post-injection and elevated within the first few days only to be much lower come weeks end) but blood levels will not be as stable throughout the week which can result in a yo-yo effect on energy/mood/libido/erectile function/recovery.</p><p></p><p>Switching to twice weekly and splitting the overall weekly dose 100 mg (50 mg every 3.5 days) would have been a sensible move but your doctor not only added hCG but increased your T dose when you would have most likely achieved better trough TT/FT levels leaving the dose as is 100 mg/week (50 mg every 3.5 days).</p><p></p><p></p><p><span style="color: rgb(184, 49, 47)">On the following month, I returned to the Dr. I told him that I split the dosage on the Test as he recommended but left the dosage per week the same ,at the 100 mg, and initiated the 500 iu HCG as he suggested. I did not want to change to many variables and figured he would retest to see where things were with the dosage split at e3.5d and the HCG addition.</span></p><p><span style="color: rgb(184, 49, 47)"></span></p><p><span style="color: rgb(184, 49, 47)"><u>The Dr. did not want to retest, as he said, nothing in the Test dosage had changed</u>. I told him my Testicles were still an issue and I still felt a slump the day before and day of my injection day. <u>He suggested to increase my HCG to 700iu/week and my Test Cyp. to 140 mg/week, still injecting e3.5d</u>.</span></p><p></p><p>Bad move on your doctors part even though T dose was left the same 100 mg/week (50 mg every 3.5 days) the injection frequency was changed which will have a big impact on your peak--->trough levels and blood work should have been done to see where your trough TT/FT/e2 let alone hemoglobin/hematocrit sit on such.</p><p></p><p>No bloodwork and having ABSOLUTELY no idea where your TT/FT/e2 levels sit he turns around and increase your dose from 100mg/week (50 mg every 3.5 days) to 140mg/week (70mg every 3.5 days) which is a large jump 40 mg/week and top it off with the fact that he also ups your hCG dose.</p><p></p><p>Increasing the overall weekly T dose by 20 mg can have a big impact on bumping up TT/FT/e2 levels yet he bumped you up by 40 mg which is a big increase.</p><p></p><p></p><p><span style="color: rgb(184, 49, 47)">I decided to modify his suggestions once again, bad patient I quess, to increase the HCG to only 600iu/week and my Test Cyp to 120 mg/week injecting e3.5d, and try it for another month before increasing to the dosages he recommended. At this months end, the lab results were as follows from a different lab, Quest Lab</span></p><p><span style="color: rgb(184, 49, 47)"></span></p><p><span style="color: rgb(184, 49, 47)"><u>Quest Labs;</u></span></p><p><span style="color: rgb(184, 49, 47)"></span></p><p><span style="color: rgb(184, 49, 47)">Hemocrit 50.3 range; [38-50]</span></p><p><span style="color: rgb(184, 49, 47)"></span></p><p><span style="color: rgb(184, 49, 47)">Total T 1296 [250-827 ng/dl ]</span></p><p><span style="color: rgb(184, 49, 47)"></span></p><p><span style="color: rgb(184, 49, 47)">Free T 132 [46-224 pg/ml ]</span></p><p><span style="color: rgb(184, 49, 47)"></span></p><p><span style="color: rgb(184, 49, 47)">Bioavailable T 300 [110-575 ng/dl ]</span></p><p><span style="color: rgb(184, 49, 47)"></span></p><p><span style="color: rgb(184, 49, 47)">Estradiol [35384-7] 57 [0-29 pg/ml]</span></p><p><span style="color: rgb(184, 49, 47)"></span></p><p><span style="color: rgb(184, 49, 47)">SHGB 55 [10-50 nmol/l ]</span></p><p></p><p></p><p></p><p></p><p>You then take it in your own hands and decided to go from 100mg/week (50 mg every 3.5 days) to 120 mg/week (60 mg every 3.5 days) and slightly lower your hCG dose.</p><p></p><p>Not surprised to say the least that at the trough on the higher dose T 120 mg/week (60 mg every 3.5 days) + hCG that you are now hitting a much higher trough TT and although FT is only in the mid-range you had it tested using an inaccurate method (calculated).</p><p></p><p>Seeing as you are hitting a trough TT 1296 ng/dL even with a higher SHBG of 55 nmol/L than I bet your FT level would have been much higher if you would have had it tested using an accurate assay such as the gold standard Equilibrium Dialysis or Ultrafiltration.</p><p></p><p>Imagine how much higher your levels would have been if you took your doctor's piss poor advice and jumped up from 100 mg/week to 140 mg/week.</p></blockquote><p></p>
[QUOTE="madman, post: 187198, member: 13851"] This is a complete mess! If anything after starting when you had blood work done on the once-weekly 100 mg/week protocol although your trough TT 524 ng/dl which may very well seem sub-par let alone not high enough to achieve a healthy FT as your levels are still too low the main issue is you did not use an accurate assay so we have no idea where your FT truly sits. You need to have it tested using the most accurate assay such as the gold standard Equilibrium Dialysis or Ultrafiltration. [COLOR=rgb(184, 49, 47)]At this Dr visit, I complained of achy testicles, so my Dr put my on HCG, 500iu/week, split into 2 injections. I also complained of feeling a slump after the first 3 days had passed, on the once injection per week schedule, so he also increased my test dosage to 120 mg/week and suggested to also split the dose as well, into 2 injections per week e3.5d[/COLOR] As you can clearly see the downfall of injecting higher doses of T once-weekly is that not only will there be a significant difference between peak--->trough levels (high post-injection and elevated within the first few days only to be much lower come weeks end) but blood levels will not be as stable throughout the week which can result in a yo-yo effect on energy/mood/libido/erectile function/recovery. Switching to twice weekly and splitting the overall weekly dose 100 mg (50 mg every 3.5 days) would have been a sensible move but your doctor not only added hCG but increased your T dose when you would have most likely achieved better trough TT/FT levels leaving the dose as is 100 mg/week (50 mg every 3.5 days). [COLOR=rgb(184, 49, 47)]On the following month, I returned to the Dr. I told him that I split the dosage on the Test as he recommended but left the dosage per week the same ,at the 100 mg, and initiated the 500 iu HCG as he suggested. I did not want to change to many variables and figured he would retest to see where things were with the dosage split at e3.5d and the HCG addition. [U]The Dr. did not want to retest, as he said, nothing in the Test dosage had changed[/U]. I told him my Testicles were still an issue and I still felt a slump the day before and day of my injection day. [U]He suggested to increase my HCG to 700iu/week and my Test Cyp. to 140 mg/week, still injecting e3.5d[/U].[/COLOR] Bad move on your doctors part even though T dose was left the same 100 mg/week (50 mg every 3.5 days) the injection frequency was changed which will have a big impact on your peak--->trough levels and blood work should have been done to see where your trough TT/FT/e2 let alone hemoglobin/hematocrit sit on such. No bloodwork and having ABSOLUTELY no idea where your TT/FT/e2 levels sit he turns around and increase your dose from 100mg/week (50 mg every 3.5 days) to 140mg/week (70mg every 3.5 days) which is a large jump 40 mg/week and top it off with the fact that he also ups your hCG dose. Increasing the overall weekly T dose by 20 mg can have a big impact on bumping up TT/FT/e2 levels yet he bumped you up by 40 mg which is a big increase. [COLOR=rgb(184, 49, 47)]I decided to modify his suggestions once again, bad patient I quess, to increase the HCG to only 600iu/week and my Test Cyp to 120 mg/week injecting e3.5d, and try it for another month before increasing to the dosages he recommended. At this months end, the lab results were as follows from a different lab, Quest Lab [U]Quest Labs;[/U] Hemocrit 50.3 range; [38-50] Total T 1296 [250-827 ng/dl ] Free T 132 [46-224 pg/ml ] Bioavailable T 300 [110-575 ng/dl ] Estradiol [35384-7] 57 [0-29 pg/ml] SHGB 55 [10-50 nmol/l ][/COLOR] You then take it in your own hands and decided to go from 100mg/week (50 mg every 3.5 days) to 120 mg/week (60 mg every 3.5 days) and slightly lower your hCG dose. Not surprised to say the least that at the trough on the higher dose T 120 mg/week (60 mg every 3.5 days) + hCG that you are now hitting a much higher trough TT and although FT is only in the mid-range you had it tested using an inaccurate method (calculated). Seeing as you are hitting a trough TT 1296 ng/dL even with a higher SHBG of 55 nmol/L than I bet your FT level would have been much higher if you would have had it tested using an accurate assay such as the gold standard Equilibrium Dialysis or Ultrafiltration. Imagine how much higher your levels would have been if you took your doctor's piss poor advice and jumped up from 100 mg/week to 140 mg/week. [/QUOTE]
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Dosage protocol and lab test change help
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