Hello from NC

You know I asked why the change from getting blood work at trough and blood work two days post injection. Urologists just said he saw my previous bloodwork from June and he wanted to see how it was closer to peak levels. He didn’t really expand on the why to me.
His nurse already sent in a Rx for the arimidex, when she called me earlier today. I’m a bit hesitant to try but i’m also sort of out of options.

I hear you saying free t and total t labs.

If i know those lab levels what can I do besides take the dose i’m prescribed?
I guess I don't understand how I can increase my free testosterone if that’s such a thing.

thanks for the feedback.

Driving up TT will drive up FT.

Even then if you are injecting said dose once weekly one can split the weekly dose and inject twice-weekly to clip the peak--->trough (lowering peak/bringing up trough).

You need to know where said protocol (dose of T/injection frequency) has your trough TT, FT and estradiol.

We have no idea where the most critical fraction FT sits at trough on your current protocol 80 mg T injected once weekly.

The goal here is too achieve e healthy trough FT.

You do not want to be hitting too low or too high a trough otherwise you will run into issues.

Trough needs to be high enough so you can maintain the beneficial effects throughout the week.
 
Driving up TT will drive up FT.

Even then if you are injecting said dose once weekly one can split the weekly dose and inject twice-weekly to clip the peak--->trough (lowering peak/bringing up trough).

You need to know where said protocol (dose of T/injection frequency) has your trough TT, FT and estradiol.

We have no idea where the most critical fraction FT sits at trough on your current protocol 80 mg T injected once weekly.

The goal here is too achieve e healthy trough FT.

You do not want to be hitting too low or too high a trough otherwise you will run into issues.

Trough needs to be high enough so you can maintain the beneficial effects throughout the week.
Doc did mention splitting my doses in the future as he had patients have good success. He wants me to try the AI for 8 weeks ( see if that improves libido) and re do labs but for now he said calling the single dose weekly a baseline and adjust from there. He said if we add AI and adjust dose frequency at the same time it would be to many changes at once.

I do agree with the above managing the OSA is key as I told the nurse and doc as well that i've always had slightly elevated hematocrit most likely do to that.
I've lost close to 50 lbs. in the last year so that has helped some but i'm sure it is still there. I sit at 225-230 lbs right now, ideally if I could get to 200-210 I would be happy and would probably aromatize less.

This is all a bit out of my lane, I'll ask the doc about the free test as well when I see them again in 8 weeks.

Appreciate you sharing your thoughts
 
Doc did mention splitting my doses in the future as he had patients have good success. He wants me to try the AI for 8 weeks ( see if that improves libido) and re do labs but for now he said calling the single dose weekly a baseline and adjust from there. He said if we add AI and adjust dose frequency at the same time it would be to many changes at once.

I do agree with the above managing the OSA is key as I told the nurse and doc as well that i've always had slightly elevated hematocrit most likely do to that.
I've lost close to 50 lbs. in the last year so that has helped some but i'm sure it is still there. I sit at 225-230 lbs right now, ideally if I could get to 200-210 I would be happy and would probably aromatize less.

This is all a bit out of my lane, I'll ask the doc about the free test as well when I see them again in 8 weeks.

Appreciate you sharing your thoughts

If that is the route he wants to take then do what you feel is best.

Even then you still need to know where your trough FT sits as again we have no clue here.

If he is not going to test your free testosterone let alone find out where your trough level sits than I would find another urologist/andrologist who understands how this works.

If you are dealing with a doctor who gives you any grief then you can always pay out of pocket and get labs done.

Yes splitting the weekly dose may be needed but you need to stick with your current protocol and find out where your trough FT sits before even considering this is needed and yes you definitely do not want to change more than one thing at a time.

If anything pay out of pocket and up the $49 so you can do labs yourself to see where your trough TT/FT sit and you can throw estradiol sensitive in there too.






 

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⚠️ Medical Disclaimer

This tool provides predictions based on statistical models and should NOT replace professional medical advice. Always consult with your healthcare provider before making any changes to your TRT protocol.

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Understanding Your Hormones

Estradiol (E2)

A form of estrogen produced from testosterone. Important for bone health, mood, and libido. Too high can cause side effects; too low can affect well-being.

DHT

Dihydrotestosterone is a potent androgen derived from testosterone. Affects hair growth, prostate health, and masculinization effects.

Free Testosterone

The biologically active form of testosterone not bound to proteins. Directly available for cellular uptake and biological effects.

Scientific Reference

Lakshman KM, Kaplan B, Travison TG, Basaria S, Knapp PE, Singh AB, LaValley MP, Mazer NA, Bhasin S. The effects of injected testosterone dose and age on the conversion of testosterone to estradiol and dihydrotestosterone in young and older men. J Clin Endocrinol Metab. 2010 Aug;95(8):3955-64.

DOI: 10.1210/jc.2010-0102 | PMID: 20534765 | PMCID: PMC2913038

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