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Testosterone Replacement, Low T, HCG, & Beyond
Testosterone Side Effect Management
Heart palpitations
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<blockquote data-quote="madman" data-source="post: 193403" data-attributes="member: 13851"><p>I understand that you started off on once-weekly injections but you stated that....<strong>At 8 weeks in, I started having heart palpitations. They were annoying at first, but then they started waking me up at night. I normally inject subcutaneously every Friday, <u><strong>b</strong>ut I skipped this past Friday to see if I can get this under control</u>.</strong>.</p><p></p><p>That is why I said it was a bad move seeing as you skipped your injection which means you would not be injecting again until the next Friday (2 weeks later) which would surely have your T levels hypogonadal before the 2-week mark.</p><p></p><p>You need to know where your SHBG level sits which is critical as it will not only have a significant impact on where your FT level sits but will also dictate what injection frequency may suit you best!</p><p></p><p>Hard to believe your doctor would not test SHBG let alone e2 pre/post trt but then again not surprising as many fail when it comes to thorough testing let alone using accurate assays.</p><p></p><p>TT, FT, e2, SHBG, DHT, prolactin, LH/FSH, DHEA, Vit D, PSA, Lipids, CMP, CBC (which will include hemoglobin/hematocrit), cortisol(4 points), and a full thyroid panel should be tested pre-trt.</p><p></p><p>Follow up (6-12 weeks) and twice-yearly should include TT, FT, e2, DHT, PSA, Lipids, CMP, CBC.</p><p></p><p>Other tests can be added if need be.</p><p></p><p>Regarding your FT I have no idea what testing method was used from the labs you posted as it only shows the reference range.</p><p></p><p>What lab was used?</p><p></p><p>Again seeing as the TT/FT levels posted are your true trough levels (7 days) post-injection than regardless of whether you were injecting exogenous esterified T subcutaneously or intramuscularly your TT/FT levels are going to be much higher at peak (8-12 hrs) post-injection and during the first few days.</p><p></p><p>The best piece of advice would be to split your weekly dose T (100 mg) and inject twice weekly (50 mg every 3.5 days) which will not only clip your peak--->trough but will result in more stable levels.</p><p></p><p>Looks like you have already made the change as you just recently started the new</p><p>protocol using a lower weekly dose T (80 mg).</p><p></p><p>Mind you we have no idea what your SHBG is.</p><p></p><p>You will now need to wait 4-6 weeks for blood levels to stabilize than have blood work done at the true trough to see where your TT/FT/e2 levels sit on such dose.</p><p></p><p>As I have stated numerous times on the forum that although TT is important to know FT is what truly matters as it is the active unbound fraction of testosterone responsible for the positive effects.</p><p></p><p>When it comes to testing FT it is critical that you use the most accurate assays such as the gold standard Equilibrium Dialysis or Ultrafiltration (next best) to know where your FT level truly sits on such protocol (dose T/injection frequency).</p><p></p><p>Use Nelsons discountedlabs as either one of these will suffice!</p><p></p><p>1 <a href="https://www.discountedlabs.com/hematocrit-total-and-free-testosterone-1500-ng-dl" target="_blank">Testosterone, Total and Free (NO Upper Limit) plus Hematocrit</a></p><p>2 <a href="https://www.discountedlabs.com/testosterone-free-dialysis-and-total-ls-ms-ms" target="_blank">Testosterone, Total, LC/MS and Free (Equilibrium Ultrafiltration)</a></p></blockquote><p></p>
[QUOTE="madman, post: 193403, member: 13851"] I understand that you started off on once-weekly injections but you stated that....[B]At 8 weeks in, I started having heart palpitations. They were annoying at first, but then they started waking me up at night. I normally inject subcutaneously every Friday, [U][B]b[/B]ut I skipped this past Friday to see if I can get this under control[/U].[/B]. That is why I said it was a bad move seeing as you skipped your injection which means you would not be injecting again until the next Friday (2 weeks later) which would surely have your T levels hypogonadal before the 2-week mark. You need to know where your SHBG level sits which is critical as it will not only have a significant impact on where your FT level sits but will also dictate what injection frequency may suit you best! Hard to believe your doctor would not test SHBG let alone e2 pre/post trt but then again not surprising as many fail when it comes to thorough testing let alone using accurate assays. TT, FT, e2, SHBG, DHT, prolactin, LH/FSH, DHEA, Vit D, PSA, Lipids, CMP, CBC (which will include hemoglobin/hematocrit), cortisol(4 points), and a full thyroid panel should be tested pre-trt. Follow up (6-12 weeks) and twice-yearly should include TT, FT, e2, DHT, PSA, Lipids, CMP, CBC. Other tests can be added if need be. Regarding your FT I have no idea what testing method was used from the labs you posted as it only shows the reference range. What lab was used? Again seeing as the TT/FT levels posted are your true trough levels (7 days) post-injection than regardless of whether you were injecting exogenous esterified T subcutaneously or intramuscularly your TT/FT levels are going to be much higher at peak (8-12 hrs) post-injection and during the first few days. The best piece of advice would be to split your weekly dose T (100 mg) and inject twice weekly (50 mg every 3.5 days) which will not only clip your peak--->trough but will result in more stable levels. Looks like you have already made the change as you just recently started the new protocol using a lower weekly dose T (80 mg). Mind you we have no idea what your SHBG is. You will now need to wait 4-6 weeks for blood levels to stabilize than have blood work done at the true trough to see where your TT/FT/e2 levels sit on such dose. As I have stated numerous times on the forum that although TT is important to know FT is what truly matters as it is the active unbound fraction of testosterone responsible for the positive effects. When it comes to testing FT it is critical that you use the most accurate assays such as the gold standard Equilibrium Dialysis or Ultrafiltration (next best) to know where your FT level truly sits on such protocol (dose T/injection frequency). Use Nelsons discountedlabs as either one of these will suffice! 1 [URL="https://www.discountedlabs.com/hematocrit-total-and-free-testosterone-1500-ng-dl"]Testosterone, Total and Free (NO Upper Limit) plus Hematocrit[/URL] 2 [URL='https://www.discountedlabs.com/testosterone-free-dialysis-and-total-ls-ms-ms']Testosterone, Total, LC/MS and Free (Equilibrium Ultrafiltration)[/URL] [/QUOTE]
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Testosterone Replacement, Low T, HCG, & Beyond
Testosterone Side Effect Management
Heart palpitations
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