Dr. Says T Is Too High

[MG123]

Labs drawn 2.5 days after T injection and 1 day before next:

Testosterone, Serum 649 ng/dL 348 - 1197 02
Free Testosterone(Direct) 24.6 pg/mL 8.7 - 25.1 03
Estradiol, Sensitive 36.5 High pg/mL 8.0 - 35.0

Current Protocol:
46 mg Testosterone Cypionate 2x/week subcutaneously
250 iu hCG every other day

Received a note from the Dr. stating that my testosterone is higher than he would like to see it for me. I'm assuming he is meaning my free testosterone which is an RIA test and not very accurate. What do you guys think? He is wanting me to go down to 40 mg every 4 days on the Test Cyp.

 

[CoastWatcher]

He is, you believe, trying to manage your protocol on the basis of your free test value? That will be an exercise in frustration. How are you feeling?

 

[MG123]

I'm tired most of the time. I shake when I lift weights anymore. I always feel hungry and weak no matter how much I eat. I have been checking blood glucose regularly and it is fine as I was thinking it might be hypoglycemia. No history of diabetes. I am 30 years old. One good thing, my libido is through the roof. I was trying prescribed raloxifene for persistent pubertal gyno for a few weeks and all of this stuff seemed to intensify so I stopped taking it for a while to see if it was causing issues. I have been off for several days now and I am still starving and weak. Any ideas?

 

[ERO]

A lot of guys can feel low T symptoms below total T of 500 and you are barely above that at 649, but perhaps your doc is keeping you low because of the gyno.

Have you been on TRT long? If so, have you ever felt good on it?

 

[Nelson Vergel]

MG123

Your numbers are not too high.

Have your checked your TSH, free T3 and free T4?

Do you sleep well? Any extra stress?

 

[MG123]

Hi Nelson,

TSH was checked but not T3 and T4.

1.180

[TD="class: gridSpace"]TSH (HIGH SENSITIVITY)[/TD] [TD="class: gridSpace"]Range 0.340-5.600[/TD] [TD="class: gridSpace"]

[/TD]

I do notice that I wake up usually once during the night but go back to sleep. I usually stay up late to have "me time." So it is possible that I am just not sleeping enough. I just feel crappy most of the time and would rather just sleep in the morning than get up.

 

[Nelson Vergel]

Like you, I love my "me time" late at night.

I notice that if I go to bed after 10:30 pm, there is no way I can feel OK the day after even if I sleep 8 hours.

Some of us may be screwing up with our circadian rhythm no matter how good our blood work looks.

 

[MG123]

Do you think I should supplement with some melatonin tonight and try to get back on rhythm and see how I feel after that?

 

[Nelson Vergel]

If I feel too wired by 7 pm (because I went to the gym late, or I took a nap on weekends), I chew on a 3 mg melatonin tablet. In less than 20 minutes, I get tired and can easily slow down to want to go to bed. If I take melatonin after 9 pm, I feel groggy the morning after no matter how low the melatonin dose I use.

http://www.amazon.com/NOW-Foods-Melatonin-Chewable-180-Lozenges/dp/B0019LRWJG

 

[Gene Devine]

His E2 levels using the sensitive assay point to being elevated as he over the reference range.

Many of his symptoms could point to just that; some men can experience side effects of elevated E2 at even this level.

It would be consistent.

 

[Nelson Vergel]

I disagree. That estradiol level is actually pretty decent.

Most men that do not feel OK with good lab test values have sleep issues, depression, stress (adrenal fatigue), medication side effects (blood pressure meds, etc).

 

[MG123]

I just would think that my libido would be tanked if the problem was high estradiol. On the contrary, I feel like I am 15 years old again in that arena. Although from what I have read subq injection of T cause T levels to max after 24 hours. This test was 2.5 days after. So I suppose my estradiol could be in the 40s during those first few days.

 

[Vince Carter]

repeating Nelsons belief in T:E ratio being more valuable than an Estradiol test on it's own, something I'm starting to study on my own, the ratio he suggests is 14-20, and you're at 17. 5

I would suggest if you can get one the 4 tube salivary cortisol test.

 

[Hammer]

I don't see how your test is too high since you're in the 35 percentile. The doc must be concerned about your free test which is still within range or the fact that it is converting too much into estrogen. It kind of sounds like a thyroid issue. As I advise most people that ask me about my own experience with thyroid and testosterone issues, you would be well served to have a sleep study performed. Sleep apnea can zap your test levels, cause fatigue and cause a host of other symptoms.

 

[MG123]

Is the Free T really all that matters? If I take my Total T up to the end of the scale won't my Total T be off the charts?

 

[ERO]

You are at 649 and the upper-end of the normal range is typically 1100 (Depending upon the scale.) Most TRT docs like to get their guys into the upper quartile so you have a lot of room to go higher. Also, some guys don't really "feel" TRT until they get up above 800 or so.

 

[chaps]

I'm tired most of the time. I shake when I lift weights anymore. I always feel hungry and weak no matter how much I eat. I have been checking blood glucose regularly and it is fine as I was thinking it might be hypoglycemia. No history of diabetes. I am 30 years old. One good thing, my libido is through the roof. I was trying prescribed raloxifene for persistent pubertal gyno for a few weeks and all of this stuff seemed to intensify so I stopped taking it for a while to see if it was causing issues. I have been off for several days now and I am still starving and weak. Any ideas?

Get your sleep and adrenals tested, I had both sleep apnea and adrenal fatigue and you will feel awful, difficulty maintaining blood sugar, sleep disturbances, a laundry list of symptoms. Feeling generally unwell all the time is a real red flag, when adrenals go out thyroid can also go out as well.