High Testosterone Levels after IM Cypionate Therapy

[haydn]

I was hoping to get some advice from others more familiar with TRT. I was diagnosed with hypogonadism with an initial total testosterone level of 180. This may be related to being on Finasteride for over 5 years (I am now one year off it), but in any case, after poor results on Androgel 1.62, my doctor has prescribed 200 mg injections of testosterone cypionate once a week combined with 1 mg of Arimidex every other day.

After two weeks on this protocol, I was retested and my results were as follows:

Total Testosterone: 1,785
Free Testosterone: 487
Bioavailable Testosterone: 1,024
Sex Hormone Binding Globulin: 21
Albumin: 4.6

Any interpretation would be appreciated. Do levels initially spike and then reduce, or is it likely that I will need to reduce the weekly dosage to 100 - 150 mg instead?

Thanks in advance

 

[Gene Devine]

Clearly the 200 mg per week is way too much as you are way over the top of the lab reference range.

200 mg dosage a week is usually the largest dose we see in TRT for men so you would have probably done better at 100 mg a week and work up or down from there based on labs.

Also, I don't see you estrogen lab on here. Taking 1 mg of an AI every other day is outrageous.

I am going to guess that your estrogen levels are tanked and you feel like crap.

Need to see all you labs complete with reference ranges for us to make any recommendations.

 

[Vettester Chris]

Agree with Gene ... The 1mg of AI EOD is not good, and can backfire on you severely. I personally knew a guy that was down for months with taking those types of doses. His immune system was shot, sick puppy! If you're needing that much to keep your E2 in check, then that means you need to pull back and find the balance that your body is designed to work with. 1.5mg split into 0.5x3/wk dosages is usually on the high end for TRT and E2 management.

Again, when it starts going over that, it is telling you that your body is aggressively converting downstream to deal with the excess testosterone. You have an excellent amount of "Free & Bio Available Test", Free at 2.73% thanks to the low 20's on your SHBG ... That IMO is what should be a big focal point for you. With that kind of Free Test, you could cut your serum level in half and be doing better than most. Keep in mind, a good percentage of other members here will be in the 1 to 2 percentile. Free is the unbound part of the test that is reaching the receptor sites, so do the math on where 2.73% is sitting compared to a guy with a 1.9%, which isn't bad itself.

Maybe consider the smaller dose, and split it up 2x per week for more stable serum levels. Look into backfilling with Pregnenolone and DHEA, add B12 methyl, keep your iron, D3, various electrolytes, and other variables thereof in balance, and you can help ensure you are addressing a whole litany of hormonal pathways that will work effectively, as designed, which further supports the results you are aiming to achieve with your TRT campaign.

 

[Vettester Chris]

Another thought on the E2 .. Just an FYI, I don't take any AI at all!! I found the right 'zone', where my body manages the conversion of E2 adequately, and for me that's what the balance of this is all about. I'm also one of those low SHBG, high free test guys! In my case, I've achieved this with 2x subQ injections (IM on occasion), and backfilling and supplementing the items needed to support all the items that can help with the quest for homeostasis. In my case anyways, finding some form of well being wouldn't be possible with just concentrating on one key hormone and the downstream effects thereafter. For me, keeping other variables in check has also made the TRT portion of my routine a bit easier to manage. Just food for thought ...

 

[haydn]

Thanks very much to both of you for the input. The lab work was done by Quest Diagnostics and while they were able to provide the testosterone figures, the other tests (Estrone, Estriol and Estradiol) won't be available for another 10 days because Quest ran out of a critical component required to perform the lab work (how is that even possible?). As a result, I have no idea what any of my estrogen levels are and won't for another two weeks.

I contacted the doctor's office and they thought the labs may be in error, so they've asked me to maintain the same dose (200 mg) and have a full panel performed at Labcorp as well. I think it's likely that you're both right and the 200 Mg dose is too high. I've suffered from intermittently sore nipples, which seems odd give the high dose of Anastrazole, but perhaps it doesn't negate the effects of the high T levels. At this point, I suppose I have to be patient and wait for the next round of labs to complete.

I've had a great deal of trouble finding a physician that strikes me as competent at dealing with TRT. My current doctor places every TRT patient on that dose of Anastrozole regardless of E levels. If either of you have any recommendations for a good TRT physician (I'm in California, but willing to fly wherever to get a handle on things), I'd really welcome it. Thanks again.

 

[haydn]

By the way, when I get the completed and new set of labs, I'll post all the results. I welcome your recommendations.

 

[Gene Devine]

Thanks very much to both of you for the input. The lab work was done by Quest Diagnostics and while they were able to provide the testosterone figures, the other tests (Estrone, Estriol and Estradiol) won't be available for another 10 days because Quest ran out of a critical component required to perform the lab work (how is that even possible?). As a result, I have no idea what any of my estrogen levels are and won't for another two weeks.

I contacted the doctor's office and they thought the labs may be in error, so they've asked me to maintain the same dose (200 mg) and have a full panel performed at Labcorp as well. I think it's likely that you're both right and the 200 Mg dose is too high. I've suffered from intermittently sore nipples, which seems odd give the high dose of Anastrazole, but perhaps it doesn't negate the effects of the high T levels. At this point, I suppose I have to be patient and wait for the next round of labs to complete.

I've had a great deal of trouble finding a physician that strikes me as competent at dealing with TRT. My current doctor places every TRT patient on that dose of Anastrozole regardless of E levels. If either of you have any recommendations for a good TRT physician (I'm in California, but willing to fly wherever to get a handle on things), I'd really welcome it. Thanks again.

If you can get to LA, Dr Mark Gordon is the man to see.

He's one of the best in TRT for men in the country.

http://www.millenniumhealthcenters.com/id2.html

 

[haydn]

Thanks Gene. I'll contact his office on Monday and fly down there as need be. It would be worth seeing someone out of the area if it means having a physician well versed in TRT. I'll keep you posted.

 

[Nelson Vergel]

Dr Rand McClain in Santa Monica is a friend and super intelligent. He treats many celebrities but has reasonable prices

 

[Gene Devine]

Jonathanb - This is not your thread, you are hijacking it.

I am going to move your post and start a new thread.