I’m on 10 weeks of trt with 60mg”s twice a week IM. Levels came back around 550 at trough and free t at 18, E2 at 56 (using hcg 400ius 2x a week). I feel okay but I know those aren’t in the optimal range. My main reasoning is I have lower shbg around 16.5 pre treatment it is now at 11.8 on trt at my trough . Would my levels go up in both total and free test if I switch to EOD injections? Maybe 30mg m-w-f-s? Any suggestions? Thanks for anyone’s input ! happy new year also
madman
Super Moderator
Although your trough TT may seem subpar seeing as your SHBG is very low 11 nmol/L then your FT should be descent and keep in mind that your peak (8-12 hrs) post-injection will be much higher.
Top it off that we have no idea what testing method was used for TT/FT/e2 and you left out the reference ranges.
The most accurate assays would be TT/e2 (LC/MS-MS) and FT (ED or UF).
Although TT is important to know you should be more concerned with FT as it is the active unbound fraction of testosterone responsible for the beneficial effects.
It is critical to have it tested using the most accurate assays.
Unfortunately many tend to use/rely on the piss poor direct immunoassay or calculated linear law-of-mass action which can over/underestimate.
To truly know where your FT sits on such protocol (dose T/injection frequency) you would need to have it tested using the most accurate assays such as the gold standard Equilibrium Dialysis or Ultrafiltration (next best).
The most important thing is you stated you feel okay and although your FT levels may still be descent due to your low SHBG you may have room to bring it up but again we have no idea what testing method was used let alone reference range.
If you did not have your FT tested by Equilibrium Dialysis or Ultrafiltration then I would have it retested before jumping to any conclusions.
With an SHBG of 11 nmol/L, you will not need a very high trough TT to attain a robust FT level.
You would most likely do better-injecting EOD or daily but again you need to know where your FT level truly sits on your current protocol.
madman
Super Moderator
When it comes to testing FT you should be using one of these assays as it is critical when on trt to know where your FT level truly sits on such protocol.
Use Nelsons discounted labs.
1 Testosterone, Total and Free (NO Upper Limit) plus Hematocrit
2 Testosterone, Total, LC/MS and Free (Equilibrium Ultrafiltration)
Use Nelsons discounted labs.
1 Testosterone, Total and Free (NO Upper Limit) plus Hematocrit
2 Testosterone, Total, LC/MS and Free (Equilibrium Ultrafiltration)
Wow thank you so much . And yes I have heard of those types of testing although I don’t think the general places like LabCorp, quest diagnostics, or cpl, even has those unfortunately I tried to look them up I’m pretty sure it was just immunoassay aka the shitty one . Anyways more in depth the reference ranges were testosterone range = 300-1080ng/dL. Calc Free test = 47.0- 244.0 pg/ml. Total Estrogens = 19.0- 69.0 Pg/ml.
Shbg 16.5- 55.9 nmol/L
My levels again were testosterone of 550 ng/dL
Free testosterone of 180 pg/ml , estrogen of 54.6 pg/ml. Shbg of 11.8 nmol/L. Thank you for posting those tests , is it generally safe to send them thru the mail without getting damaged ?
Shbg 16.5- 55.9 nmol/L
My levels again were testosterone of 550 ng/dL
Free testosterone of 180 pg/ml , estrogen of 54.6 pg/ml. Shbg of 11.8 nmol/L. Thank you for posting those tests , is it generally safe to send them thru the mail without getting damaged ?
madman
Super Moderator
The tests I posted above are the most accurate assays for FT and they are from Quest and you can purchase them through Nelsons discountedlabs.
Labcorp also offers both FT assays but you are better off purchasing through discountedlabs than going to Quest for blood work.
You would be emailed a pdf to print off if you order through discountedlabs.
Your FT was calculated.
Again although your TT may not seem that high your FT level should be descent as your SHBG is very low 11 nmol/L.
Even then I would retest your FT using one of the accurate assays to see where your FT truly sits before jumping to any conclusions.
Okay gotcha . I’ll make sure to order those tests and take them to cpl which is where I go. So I’ll buy them on discounted labs then take the pdf printout and take it to cpl labs and they’ll draw the blood ? I’m assuming they still charge me for the blood draw don’t they ? Sorry this would be my first time ordering my own tests I usually get what my doctor ordered for me sent to cpl and then go get my blood drawn
madman
Super Moderator
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Thank you @madman , I’ll post an update when I get them done they already look so much cheaper then the prices at the labs . @Nelson Vergel , I’m new to this site and I gotta say this is quite possibly the best thing anyone with a any hormonal or blood issue could ever ask for thank you so much !
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@madman the day finally came and I got around to testing my levels more accurately with discounted labs . They’re better than the ones I stated above earlier yet the quest free testosterone ranges are way fucking lower than the cpl ranges. Quests is 35-155 pg/ml yet cpl is 47-244pg/ml....which makes me really confused which is correct. Quest says I’m way high and the cpl range says I’m in the upper range . Also shbg is even lower at 8 nmol/L Which is technically a bad thing right since my body can’t really get time to use all that free testosterone into my tissues . what is your personal opinion now? If i switch to eod it should technically regulate my shbg form being so crazy low and ultimately feel my testosterone working better right? thank you again!
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In addition to switching to frequent injections I would lower the overall testosterone dose considerably. As madman noted above, peak testosterone is much higher than trough. If your absorption rate for testosterone is typical then your peak testosterone could be around 1,700 ng/dL or higher. Consider changing the protocol to 20 mg T cypionate EOD for starters. If you switch to EOD dosing and still use 120 mg TC per week then you'll smooth out your serum testosterone levels, but the result would still be quite high, likely over 1,000 ng/dL. Free testosterone could be at least 50% higher than where it is now at troughs.
Bear in mind that 20 mg TC EOD is still supplying more testosterone per day than what the average healthy young man makes naturally.
Bear in mind that 20 mg TC EOD is still supplying more testosterone per day than what the average healthy young man makes naturally.
Thank you ! I was wondering about that also if I should reduce the dose. What’s your take on the weird free testosterone ranges ?
madman
Super Moderator
I’m on 10 weeks of trt with 60mg”s twice a week IM. Levels came back around 550 at trough and free t at 18, E2 at 56 (using hcg 400ius 2x a week). I feel okay but I know those aren’t in the optimal range. My main reasoning is I have lower shbg around 16.5 pre treatment it is now at 11.8 on trt at my trough . Would my levels go up in both total and free test if I switch to EOD injections? Maybe 30mg m-w-f-s? Any suggestions? Thanks for anyone’s input ! happy new year also
Were labs done at the true trough and are you still injecting 120 mg T/week (60 mg every 3.5 days)?
Your trough TT was 550 ng/dL and now 700.
Forget comparing FT labs let alone reference ranges and you should only be concerned with the most recent FT test as it is one of the most accurate assays (Equilibrium Ultrafiltration).
Blood work should always be done using the same lab, the same assay (most accurate) and always testing at the true trough.
As you can see even with a decent TT (far from really high) that your FT is high due to your low SHBG which now sits at 11 nmol/L and if these are trough levels then the peak will be much higher.
You left out critical blood markers (RBCs/hemoglobin/hematocrit)!
With an absurdly low SHBG, you would most likely do much better injecting a lower dose of T more frequently as in daily or EOD.
madman
Super Moderator
* When comparing results it is critical that the same lab, same assay (most accurate) TT/e2 (LC/MS-MS), and FT (Equilibrium Dialysis or Ultrafiltration) is used let alone always testing at the true trough on the exact same protocol (dose T/injection frequency).
Nothing but pure confusion when one is using different labs let alone different assays when trying to compare lab results.
To top it all off when it comes to the reference ranges for measured or calculated FT they vary between different labs, and as of now, there is no standardization let alone a harmonized reference range.
Efforts are underway to standardize the procedures for FT and to generate harmonized reference ranges.
* This filthy s**t show will be coming to an end soon enough!
madman
Super Moderator
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madman
Super Moderator
CDC's Clinical Standardization Programs: Free Testosterone soon to be!
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*Measuring FT is technically challenging and shows high variability. The CDC clinical standardization program is developing a high throughput method using the gold-standard equilibrium dialysis (ED) procedure with isotope dilution ultra-high-performance liquid chromatography-tandem mass spectrometry (ID-UHPLC-MS/MS).
@madman yes this most recent was at a true trough about 30min before I would take my next shot . Still 120mg split into two 60mg shots . So that really shows how shitty the normal cheap tests are cause it underestimated me by over 100ng/dl. Free t is about the same I’m just so confused why these idiots would make their ranges so different where you’re in upper range on one and way the hell out in the other using the SAME units of measurement .I can’t wait for those universal measurements. Anyways I agree my shbg is crazy low . Could that be the reason I have high numbers yet don’t really feel that great cause it’s just leaving my body quicker than I can use it ? I will be changing to eod and probably lowering the dosage to 20-25mg . Think that would be acceptable ?
@madman here are my recent CBC numbers . I know I wasn’t hydrated like I should have been so I think that’s a fair reason. The previous test I was very punctual with hydrating 3 days before and in the am of my blood test and my rbc was 6.18, hemeglobin 17.9 and hematocrit 52.8
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