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Testosterone Replacement, Low T, HCG, & Beyond
Testosterone Basics & Questions
Dose increase?
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<blockquote data-quote="Cataceous" data-source="post: 273292" data-attributes="member: 38109"><p>In general there are some pretty good reasons to believe that <em>average</em> free testosterone should remain proportionate to the dose of testosterone. It is theoretically possible to have the underlying metabolic clearance rate constant shift, but it's questionable that this is common, given the implication of a change in liver function. My own data suggest stability of this rate constant over a period of several years.</p><p></p><p>What is common is that over time TRT can push SHBG lower. This drives down total testosterone, without affecting free testosterone. Thus when SHBG is changing, total testosterone is a poor proxy for dose efficacy. Instead one should measure free testosterone with equilibrium dialysis or else estimate it with the Vermeulen calculation. There are other possible confounding factors that can create the illusion of less responsiveness to testosterone. With only a single testosterone measurement in an injection cycle, it is easy to be misled. Even a change of injection site can affect the absorption rate, which manifests as changes in peaks and troughs, while the average is unchanged. The absorption rate can also be affected by the testosterone formulation — the carrier oil and excipients. Even one's activity level can affect the absorption rate.</p></blockquote><p></p>
[QUOTE="Cataceous, post: 273292, member: 38109"] In general there are some pretty good reasons to believe that [I]average[/I] free testosterone should remain proportionate to the dose of testosterone. It is theoretically possible to have the underlying metabolic clearance rate constant shift, but it's questionable that this is common, given the implication of a change in liver function. My own data suggest stability of this rate constant over a period of several years. What is common is that over time TRT can push SHBG lower. This drives down total testosterone, without affecting free testosterone. Thus when SHBG is changing, total testosterone is a poor proxy for dose efficacy. Instead one should measure free testosterone with equilibrium dialysis or else estimate it with the Vermeulen calculation. There are other possible confounding factors that can create the illusion of less responsiveness to testosterone. With only a single testosterone measurement in an injection cycle, it is easy to be misled. Even a change of injection site can affect the absorption rate, which manifests as changes in peaks and troughs, while the average is unchanged. The absorption rate can also be affected by the testosterone formulation — the carrier oil and excipients. Even one's activity level can affect the absorption rate. [/QUOTE]
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Testosterone Replacement, Low T, HCG, & Beyond
Testosterone Basics & Questions
Dose increase?
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