High Testosterone on only 80mg/week

[jdthoosier]

I'm somewhat confused. I had not been feeling great - as though my levels have been off. My cypionate schedule is 40mg (0.2 ml) on Sundays and Thursdays. So, I went in for a blood test on Thursday before my next injection:

Testosterone - 907 ng/dL
Estradiol (Sensitive) - 18.7 pg/mL
Hematocrit - 50.2

If the trough is that high, I think that would explain why I do not feel well. I do not feel good when my T gets too high and that is the highest hematocrit test I've ever had. I feel much better when my trough hits 600/700. I'm also a high SHBG guy. I'm thinking to go down to 30mg (0.15 ml) 2x a week which seems ridiculous as I don't think I've seen anyone with a dosage this low.

 

[equel]

What is ur shbg level?

 

[Systemlord]

High SHBG men usually have high Total T and low Free T, you need to start paying attention to your Free T levels. One also needs to consider free hormone levels as opposed to hormones that are bound to SHBG, high SHBG men tend to need higher E2 to have enough Free E2.

It wouldn't surprise me at all if you need a dosage increase.

Did you wait at least 6 weeks before doing labs?

 

[Gman86]

I was thinking something similar to systemlord. If your SHBG is high, it would surprise me if you felt good with such a low E2. I would think you would need to at least double your E2 to feel optimal. And I agree, you should definitely be pulling a free testosterone with your labs. To get my free T to the top of the range, my total needs to be around 1600. And my SHBG is only 44.

 

[Vince Carter]

High SHBG men usually have high Total T and low Free T, you need to start paying attention to your Free T levels. One also needs to consider free hormone levels as opposed to hormones that are bound to SHBG, high SHBG men ted to need higher E2 to have enough Free E2.

It wouldn't surprise me at all if you need a dosage increase.

Did you wait at least 6 weeks before doing labs?

Great post, I concur.

 

[jdthoosier]

My Free T is 18.32 (ng/dL). The reference listed on the lab is 5.00 - 21.00.
My Free T % is 2.02, reference is 1.5 - 4.20.

I have not change my total dosage yet - I only took the lab to figure out where I was. My last full panel was last Oct, and my SHBG was 60.1.

 

[Gman86]

My Free T is 18.32 (ng/dL). The reference listed on the lab is 5.00 - 21.00.
My Free T % is 2.02, reference is 1.5 - 4.20.

I have not change my total dosage yet - I only took the lab to figure out where I was. My last full panel was last Oct, and my SHBG was 60.1.

So your SHBG is pretty damn high, but it’s not binding to your sex hormones very strongly. I would still imagine that you would need to get your E2 up to feel better, not lower. And by lowering your dosage, your E2 is going to get even lower. Your free T looks about perfect though. So that’s a good thing.

And E2 of 18.7 is already pretty low. When mine gets down to around 10, I consider that basically crashing my E2. I can’t imagine you feeling improvement by getting your E2 into the single digits.

 

[jdthoosier]

Thanks for the replies. I'll follow up with Defy.

 

[Systemlord]

My Free T is 18.32 (ng/dL). The reference listed on the lab is 5.00 - 21.00.
My Free T % is 2.02, reference is 1.5 - 4.20.

I have not change my total dosage yet - I only took the lab to figure out where I was. My last full panel was last Oct, and my SHBG was 60.1.

Your barely over 2% for Free T, only one direction to go. I believe Free E2 would mirror your Free T percentage, barely adequate.

 

[Cataceous]

... I'm thinking to go down to 30mg (0.15 ml) 2x a week which seems ridiculous as I don't think I've seen anyone with a dosage this low.

This isn't as unusual as you think. I've been on 63 mg T enanthate per week taken EOD and it gets serum levels to around 800 ng/dL when combined with 250 IU hCG EOD. Typical natural testosterone production is said to be 5-7 mg per day, which would correspond to 50-70 mg T cypionate a week. The better question might be why do some guys need so much, e.g. 200 mg per week to achieve decent serum levels?

 

[Sean Mosher]

This isn't as unusual as you think. I've been on 63 mg T enanthate per week taken EOD and it gets serum levels to around 800 ng/dL when combined with 250 IU hCG EOD. Typical natural testosterone production is said to be 5-7 mg per day, which would correspond to 50-70 mg T cypionate a week. The better question might be why do some guys need so much, e.g. 200 mg per week to achieve decent serum levels?

I've wondered that as well.
I actually know several guys that have been dosed as high as 250mg-300mg per week and their labs don't really indicate any reason to think they're lying when each said they feel great.
Would there by something at the cellular level or some other reason why, with these particular guys, that they just simply need more?

 

[Vince Carter]

Self-Reporting though is fraught with errors in being truthful though for the most part the whole thing is predicated on how you feel. Some guys and I'm one find certain side's to be intolerable while other guys may be very benign or transparent. Hard to know except to just believe him.

 

[madman]

10. Conclusions
In 2015, a large body of evidence indicated an important role for AR CAG polymorphism in conditioning the peripheral effect of testosterone, even if its contribution warrants further assessment because of the many controversial findings in each androgen-related action. Of note, other associations are emerging (e.g., between anogenital distance and the androgen receptor CAG repeat length [106]), but they still need further confirmation. We believe that the differing results could be justified in light of the difference in the clinical characteristics of the studied subjects, the methodology (transversal/longitudinal studies), and the number of assessed patients. Also, it must be highlighted that so far not all andrological outcomes have been analyzed in depth (e.g., sexual function). Uniformity of methodological evaluation and the study of scarcely considered outcomes are the routes that scientific research will have to take in order to clarify this important issue.
At present, AR CAG polymorphism is not recommended in the routine setting. However, in the near future, it could become of clinical relevance because of the theoretical possibility of identifying subjects more or less at risk for various disorders and more or less responsive to testosterone treatment. In this last case, study of CAG repeat length could allow us to individually tailor testosterone replacement therapy, as subjects with shorter CAG repeat could need lower doses of testosterone while men with longer repeats could require higher ones.



Polymorphism of the AR and CAG repeat length (short/long), sensitivity of the AR, ones AR density/distribution could very well play a big part.

As we know ones SHBG levels have a big impact on what dose of T is needed in order to achieve a healthy FT level.

 

[Cataceous]

...
Would there by something at the cellular level or some other reason why, with these particular guys, that they just simply need more?

It may also involve the portion of testosterone's metabolic clearance rate that's not tied to SHBG.

 

[Sean Mosher]

Good stuff Madman and Cataceous.

 

[jdthoosier]

Follow-up: Feeling so much better the past week.

1. Donated blood (had not done so in 2 years).
2. Started 5mg of amlopidine daily- I'm not going to play around with guessing at my blood pressure rise and trying to lower it 'naturally', just going to deal with it. I would prefer to try Losartan but due to the recall mess, my PCP wants to wait.
3. Set a baseline of 220 IU HCG/32mg cyptionate 2x a week. I was on 250 IU HCG 2x a week prior but my blood pressure starting going up and I cut it out for a few weeks to see if it was a culprit.

So far, blood pressure is down from 140-150/90 to 125-30/80, better morning erections, more libido, feeling more calm, not feeling the hot flushes, etc. Will retest in probably a month or so to assess.

 

[Logan24]

Thanks for the replies. I'll follow up with Defy.

Follow-up: Feeling so much better the past week.

1. Donated blood (had not done so in 2 years).
2. Started 5mg of amlopidine daily- I'm not going to play around with guessing at my blood pressure rise and trying to lower it 'naturally', just going to deal with it. I would prefer to try Losartan but due to the recall mess, my PCP wants to wait.
3. Set a baseline of 220 IU HCG/32mg cyptionate 2x a week. I was on 250 IU HCG 2x a week prior but my blood pressure starting going up and I cut it out for a few weeks to see if it was a culprit.

So far, blood pressure is down from 140-150/90 to 125-30/80, better morning erections, more libido, feeling more calm, not feeling the hot flushes, etc. Will retest in probably a month or so to assess.

I am in a very similar situation as you with similar labs. Curious to see how you’re doing after lowering your dose?

 

[jdthoosier]

So far, happy with the results as far as how I feel. I'll do labs in about a month and see what the numbers are.

Note that this is my 5th year on TRT and 4th year of injections. I've found it hard to find that "good" range that I can sustain. I know that I feel best with my trough in the 700's and estradiol in the mid to upper 20's. It's been hard to consistently keep it there. Seems like the troughs keep rising higher over time and I have to reduce dosage.

I started with 100 mg/week. Felt great for a while but the troughs kept going up, at one point it was up to 1220, and estradiol hit 49 and I did not feel good. Since then, it's been a gradual reduction of cypionate + adding in HCG to try to maintain a reasonable range.

 

[Systemlord]

If you want consistency in how you feel over time and want to keep your trough levels as steady as possible, increase your injection frequencies and inject smaller doses.

 

[jdthoosier]

I started at once per week, but moved to two injections per week during the first year of injections. I'm more of a high SHBG guy - so my understanding from this forum is that more frequent injections would be counterproductive.