First time with injections - protocol tweaks, should we ignore the numbers?

[Louis]

Gentlemen, a bit of background from my intro a few months ago. I'm 43yo and have been on 3 pumps of Androgel 1.62 and 100iu ed of HCG for just over 2 years. I have felt ok but had some lethargy, occasional night sweats, poor libido (but not ED) and sensitivity issues.

On Androgel and 100iu of hcg daily, my lab values have been consistently been as follows:

1/5/2018 labs 4 hours after application
Androgel 1.62 3 pumps / 100iu HCG ed
TT 620.4 ng/dL 264.0 - 916.0
FT 9.8 pg/mL 6.8 - 21.5
DHEA, 350 ug/dL 16 – 390
DHT 115 ng/dL 30 - 85
E2 Sensitive 15.9 pg/mL 8.0 - 35.0
SHBG 66.4 nmol/L 16.5 - 55.9

I couldn't add more Androgel because my DHT was already very high and I new I wanted to go to injections so my doctor and I decided to increase my daily hcg dose to 150iu ed to see if my FT and E2 would come up at all. Not much changed by way of the the numbers or how I felt.

3/21/2018 labs 4 hours after application
Androgel 1.62 3 pumps / 150iu HCG ed
TT 760.7 ng/dL 264.0 - 916.0
FT 12.6 pg/mL 6.8 - 21.5
E2 Sensitive 22.7 pg/mL 8.0 - 35.0
DHEA, 365 ug/dL 16 – 390
DHT 131 ng/dL 30 - 85
SHBG 62 nmol/L 16.5 - 55.9

April 2nd I began injecting 50mg of Cypionate shallow IM into the deltoid and maintained 150iu of HCG daily from my previous protocol. I have just gotten my first set of labs tested 6 weeks after starting my first cypionate protocol. I am currently injecting 50mg of Cypionate shallow IM alternating delts e3.5d and 150iu ed subq. Current labs and several previous are as follows:

5/31/2018 labs 6 hours before evening injection (4 hours after HCG injection)
50mg e3.5d / 150iu HCG ed
TT 1378 ng/dL 264.0 - 916.0
FT 27.7 pg/mL 6.8 - 21.5
E2 Sensitive 38.2 pg/mL 8.0 - 35.0
DHEA, 295 ug/dL 16 – 390
DHT 56 ng/dL 30 - 85
SHBG 50.9 nmol/L 16.5 - 55.9

I feel better than I have in quite some time. I have improved cognition and awareness, though I am more moody than I was before. The lethargy has improved, and I get morning wood 4-5x per week and general strength has improved (don't feel weak). Sensitivity is also much improved as is overall vascularity. The overheating and night sweats have persisted. Lasty, I'm feeling a little bit of bloat though I have only gained 3lbs.

Now, understanding that results will vary and this is kind of a guessing game, I want to try to make an educated decision on which direction to take my protocol tweaks. The obvious number that stands out is my total T at > 1300ng/dL. Is there any danger to it being this high? My T/E ratio appears to be 36 (if I'm calculating this correctly). Should I even concern myself with these numbers if I am actually feeling pretty good?

It seems logical that I would want to lower my TT a bit but try to keep my E2 where it is. If I were to lower my Cypionate dose to say 40mg e3.5d, my TT will certainly drop but I assume my E2 will as well since adding a little more HCG alone (prior to moving to cypionate) barely moved my E2. With a SHBG of 50 (lowest its ever been) I am thinking I should move to e3.5d HCG as well - probably using Nelson's protocol since I am already injecting shallow IM in my delts anyway.

I'm just thinking out loud, but your feedback would be much appreciated.

Thanks guys.

Louis

 

[Dave B.]

So, if I understand your testing timing, your "trough" (right before the next injection) is 1378? That seems very high. My doctor was concerned that my trough reading was about 800, but was OK with me letting it ride until my next checkup in 6 months.

Moodiness usually comes with high estrogen conversion, which is also an indicator your testosterone is too high. What does your doctor say about that level?

 

[Deleted member 16042]

The moodiness is likely to be related to E2 level. while 38 isn't high for the dose of Testosterone you are on, some guys have symptoms from that kind of level. It may not take much reduction of your testosterone dose to bring E2 down enough to decrease symptoms. I personally would try reducing dose by 10%, give it 6 weeks and re-assess, possibly lowering more after that.

Along with higher E2, running total and free T levels that high often cause significantly elevated hematocrit and hemoglobin. Do you monitor these?

https://www.excelmale.com/forum/sho...t)-Caused-by-Testosterone-Replacement-Therapy

 

[Louis]

Thanks gentlemen. Yes my TT is high. I don't know the impact that elevated value would have other than RBC and HCT. Blackhawk, thank you for asking. Yes, I do and my HCT has steaily been 48 (37.5-51%) on Androgel. This last set of labs on Cypionate it was 46.1%. Additionally, my RBC has regularly been slightly high at 5.8-5.9 (4.14-5.8 x10E6/uL). This last set of labs on Cypionate it was 5.57.

To clarify, I do not think my E2 is elevated at all given my TT. I have historically had low E2 and low FT so I am glad the number is higher. What I need to figure out is which way am I going to try to lower my TT and not lower my E2 too much. I also have historically had a SHBG value of > 60 which is why we felt I needed injections to give a higher dose that would increase my FT and hopefully E2 (which it has).

Since I only like to change one medication at a time, I can either lower my Cypionate or my HCG. Keeping in mind that my SHBG has come down to 50 (from 60+) and I finally have a good FT% the options I am considering are either:

A. Lower my dose of Cypionate to 40mg e3.5d (80mg/week) and continue 150iu HCG ed (1050iu/week)
B. Continue 50mg Cypionate e3.5d (100mg/week) and lower dose of HCG to 400iu e3.5d (800iu/week)

I think the goal should be to lower my TT but also not to drop my E2 in hopes of improving my T/E ratio.

 

[Louis]

I've decided to go with option A. I'll lower my dose of Cypionate from 50mg e3.5d to 40mg e3.5d and keep my HCG at 150iu ed. I know this isn't an exactly accurate (comparing gels and injections) but if increasing from 100iu of HCG ed (700iu/week) to 150iu ed (1050/week) only increased my TT from 620 to 760, I'm guessing it would only lower it by a similar value. I don't know but at least it's something so let's see how this goes in 6 more weeks.

Onward gentlemen...

 

[Deleted member 16042]

One consideration: HCG half life is relatively short compared to T cyp. If you start with changing HCG, you will potentially feel any changes quite a lot sooner,

But with what has happened to me personally and many others on this forum when changing from gel to injection, going above normal physiological TT and FT range, then having HCT soar, and E2 too high, I'd personally opt for lower T cyp dosage first to avoid what seems maybe not inevitable, but very likely... elevation of HGB/HCT.

 

[Vince Carter]

I would reduce the Cyp dosage and ignore the TT (it's 97% bound up so ignore it) and adjust your dose downward based on your Free T, get it down closer to the lab range. I would maintain everything else. I see that youre headed that way anyway. Also ~38 sounds about right by the numbers it's pretty fair but may be too high, for YOU. T/E ratio is a garbage notion to follow, as much as the 21-30 Sensitive E2. No one knows that the ratio "should" be so how can any one follow it, plus, the numbers that are given such as 14-20 would have your E2 very high any way and no guy want's that.

At a total 1378 you'd have to run E2 @ ~80 to get in the 14-20 "ratio".

 

[Louis]

One consideration: HCG half life is relatively short compared to T cyp. If you start with changing HCG, you will potentially feel any changes quite a lot sooner,

But with what has happened to me personally and many others on this forum when changing from gel to injection, going above normal physiological TT and FT range, then having HCT soar, and E2 too high, I'd personally opt for lower T cyp dosage first to avoid what seems maybe not inevitable, but very likely... elevation of HGB/HCT.

Thanks Blackhawk, I appreciate the heads up on what to look out for.

I would reduce the Cyp dosage and ignore the TT (it's 97% bound up so ignore it) and adjust your dose downward based on your Free T, get it down closer to the lab range. I would maintain everything else. I see that youre headed that way anyway. Also ~38 sounds about right by the numbers it's pretty fair but may be too high, for YOU. T/E ratio is a garbage notion to follow, as much as the 21-30 Sensitive E2. No one knows that the ratio "should" be so how can any one follow it, plus, the numbers that are given such as 14-20 would have your E2 very high any way and no guy want's that.

At a total 1378 you'd have to run E2 @ ~80 to get in the 14-20 "ratio".

Vince, I know we shouldn't be a slave to the numbers but I thought that the T/E ratio was was the standard. That's also a very interesting point about total T being bound up. I've never considered that point of view.

I appreciate the insight guys, I really do. I There's rarely a wasted click navigating the forum.

 

[CoastWatcher]

I thought that the T/E ratio was was the standard.

The testosterone:estradiol ratio is one metric among many that you and your doctor can consider when evaluating your protocol. It's by no means a value that can be supported by studies...because there are none. Consider it a starting point in conversation that you and your doctor can pursue as you weigh other factors.