How lowering Test dosage increase my TT, Low SHBG guys this is for you, the less is the better!

[Gianluca]

I have been trying everyday (ED) injection for the past 4/5 months, wow how the time goes by, Doc put me on 0,13ml daily, about 200mg weekly which brought my FT to 34 and my TT to 900, on the last consult with Doc we agreed to try lower it to 0,1ml daily, now my TT is at 940 and still laughing, my FT is at 31.8 Hemoglobin went from 17.7 to 16.7, nice!

During the first 2/3 weeks when I lowered the dose I experienced detoxification, I was loosing water and bloating, way less acne on my face and body, my Systolic BP drop from 135/45 to 124 I was sleeping better and more important much less shortness of breath fatigue when doing resistance training, I was winning, despite the fact that for about 3 weeks I was literally feeling down, I could have trouble finding the motivation to get up from bed in the am, really. After 3 weeks I think everything stabilized and motivation sex drive slowly were showing up again, I think it took a good 8 weeks for these to come back, although already after 3 weeks I would gain again water, bloating, HBP, red bloated face and fatigue, shortness of breath when exercising.

My take on it and advise for low SHBG guy and non:

the more Test dose you will use the more you will push down your SHBG further elevating FT, and Free Estradiol above normal!! of course your TT FT ratio will just go messed up

I have studied nutrition for the past year and something taught in nutrition regarding Vitamins and Minerals is that the more dose you use the less the body will absorb and the more it will excrete, I have started thinking the same way for TRT, look how my FT went to 34 on 0.13ml daily and to 31.8 on 0.1ml daily, that is 140mg weekly, and still too much!

This is my believe, not sure if there is any scientific evidence or it make sense:

Using too much testosterone for long time, TRT, will eventually cause a down regulation of T receptor, as you pushing it in the body it will say: this is too much, I do not need it so down regulation, conversion to other metabolize like E2, DHT occur along with extra work for Liver and Kidneys, elevated H&H, over retention of water HBP, low HDL, you can get away with it for short period not for a life

when we do small little dosages, everyday just what the body, your body, really needs to function properly I think T receptor may do the opposite and up regulate saying hey we need Testosterone and the body will absorb most of it, Easy on Kidneys and any other side effect no longer needed

So my suggestion for low SHBG guys and non is : Daily small injections, start really low and wait fully 8 weeks before to come to a conclusion about your protocol, I'm really planing to lower my actual 20mg daily to 15mg untill my FT is about 25 see how things go

 

[HealthMan]

I agree that more is less when it comes to TRT and that many if not all side effects can be managed by lowering testosterone dosage and keeping FT within physiological range. However your FT is still high and way above physiological levels. So if you truly believe in receptors downregulation aim at low 20s for FT.

 

[HealthMan]

Just another thing to add. A lot of people think that if their FT is within range at trough day that means they are withing physiological. That might not be true specially if your trough numbers are close to the top of the range and/or low SHBG and/or less frequent injections. You are probably well above physiological levels during most of the time

 

[AbsoluteZ3R0]

This is my believe, not sure if there is any scientific evidence or it make sense:

Using too much testosterone for long time, TRT, will eventually cause a down regulation of T receptor, as you pushing it in the body it will say: this is too much, I do not need it so down regulation, conversion to other metabolize like E2, DHT occur along with extra work for Liver and Kidneys, elevated H&H, over retention of water HBP, low HDL, you can get away with it for short period not for a life

There are no such things as "beliefs" when reality is concerned. Your beliefs are objectively false. Androgen administration results in UP-regulation of androgen receptor density, not decrease. In other words, the body does not build resistance to testosterone.

You also made absolutely no mention of your SHBG levels before and after the dose change, so for all you know, your SHBG hasn't budged. There's no question that many men feel better on a more moderate dose, but as it stands you have no evidence that SHBG played any role in your subjective improvements, other than a slight (possibly insignificant) decrease in your Free/total testosterone ratio. Are you taking HCG or anastrozole? You need more data to make a case.

 

[Gianluca]

I think this is the best approach to TRT, yes my FT is still way above, I think I will lower from 0,1ml/day to 0,08ml/day, my goal is aim for about 25/7 of FT, and see then how I feel and side effects

I agree that more is less when it comes to TRT and that many if not all side effects can be managed by lowering testosterone dosage and keeping FT within physiological range. However your FT is still high and way above physiological levels. So if you truly believe in receptors downregulation aim at low 20s for FT.

 

[Gianluca]

I thought about that as well and wanted to get blood drawn in the early am before my daily injection and late in the day like at 5pm when LabCorp would close, then I thought I would keep the $ in my pocket and I just got my blood drawn in the am before injection

although doing daily injections I'm thinking there is no much change in FT levels lets say 8/9 Hours after injection, but just a blood work would tell

Just another thing to add. A lot of people think that if their FT is within range at trough day that means they are withing physiological. That might not be true specially if your trough numbers are close to the top of the range and/or low SHBG and/or less frequent injections. You are probably well above physiological levels during most of the time

 

[Gianluca]

you definitely are right, not knowing the SHBG after we cannot say for sure that increased by lowering the dose of Test, then what else did increase my TT with less medication? the more testosterone is used the more the suppression of SHBG, elevating FT and FE especially for people who have low SHBG to start

my SHBG before was at 10 and unfortunately I do not have an after, although, actually I was using AI at 1mg weekly, that is another factor lowering SHBG further increasing FT FE, with my Total Estradiol at 11, HCG 100IU before and after, in the after I didn't use AI and my TE (sensitive) went up to 45, I really still "believe" my SHBG increased to be able to obtain a higher TT with less medication, considering the b4 use of AI I don't even consider my FT lowered that much

thank you for the lesson on Androgen administration, I know now that may be not the case then, although I have never understood why when first started TRT at 200mg weekly divided in two doses my FT shoot up to 47 for gradually stabilize at 27 after about 6 months, probably my body just learned how to metabolize the medication faster? same when, with Doc, we try to increase to 220 weekly, felt great for 2/3 weeks then again felt like before the increase, like my body would adopt to it

There are no such things as "beliefs" when reality is concerned. Your beliefs are objectively false. Androgen administration results in UP-regulation of androgen receptor density, not decrease. In other words, the body does not build resistance to testosterone.

You also made absolutely no mention of your SHBG levels before and after the dose change, so for all you know, your SHBG hasn't budged. There's no question that many men feel better on a more moderate dose, but as it stands you have no evidence that SHBG played any role in your subjective improvements, other than a slight (possibly insignificant) decrease in your Free/total testosterone ratio. Are you taking HCG or anastrozole? You need more data to make a case.

 

[Vince Carter]

Im on to this as well, been cutting my Cyp dose from 28mg/D to 24mg/D and now to 20mg/D. I started by looking at Free Estradiol which was coming in twice the lab range for me inspite of using .25mg/AI EOD and still pulling a ~42 LC/MS/MS so I've got this long history of high E conversion but it was when I started pulling Estradiol Free that I got a better look at things. Faced with more AI (undesirable) we cut the Cyp dose as that was the only thing left as I had removed DHEA, Preg and for a period of time HCG even, but was still converting at a high rate. In the end I decided that letting my Free T being astronomically high was (possibly) the problem with a number of things...E, H/H to name two.
I have labs out now on the 20mg/D dose and not sure where I'm going from here, 18mg possibly. I don't have the intent of getting off the AI but finding a balance there with .25mg EOD and my daily Cyp dose.

my SHBG consistently comes in at 12-15

 

[IronKnight]

However your FT is still high and way above physiological levels. So if you truly believe in receptors downregulation aim at low 20s for FT.

The physiological range of FT ends at 54.7 pg/ml.
Therefore 25pg/ml is not even half of the limit of the physiological range, don't let modern lab ranges fool you

That said, everybody is free to experiment and determine the level at which they feel better and side effect management is easier. In this line, what I am doing personally is:
- Document how I feel subjectively before I see the labs
- Record the labs together with body composition, weight, etc.

The wealth of information that comes from that is simply terrific.

 

[HealthMan]

The physiological range of FT ends at 54.7 pg/ml.
Therefore 25pg/ml is not even half of the limit of the physiological range, don't let modern lab ranges fool you

That said, everybody is free to experiment and determine the level at which they feel better and side effect management is easier. In this line, what I am doing personally is:
- Document how I feel subjectively before I see the labs
- Record the labs together with body composition, weight, etc.

The wealth of information that comes from that is simply terrific.

Labcorp range for FT is 8.7-25.1 pg/mL. If you think 54.7 pg/ml is physiological go ahead find me one men whose natural FT is even close to that level

 

[HealthMan]

https://pdfs.semanticscholar.org/95b3/3e3dc8168f4e4b1c41e3c37f4eb84e98bdf1.pdf

Look at FT distribution (not the best article to show this because they use an older population but you can find many more in the internet - although most men on TRT are over 40 years old so in this sense this graph is very representative. I like the FT distribution graph to make my point. In younger men you will have a similar distribution but a bit higher levels). Physiological levels are not even close to the level you mentioned. Maybe a few abnormal men might have really high FT levels. But abdormalities have nothing to do with physiological levels

 

[HealthMan]

Just to add. Therapeutic benefits of TRT in most men are seem when FT is brought to the mid-upper range of true physiological levels of the population. Crazy high FT levels in my opinion have one really great benefit: body composition. More and more men are on TRT not only for the therapeutic benefits but to achieve great body composition. I dont see nothing wrong with that. Anyone can do whatever they want with their body. So pushing FT very high will of course bring a lot of benefits when it comes to body composition. But try to find scientific excuse to push physiological limits higher to be able to use a higher testosterone dosage to achieve better body composition is a bit of a stretch IMO. Just accept the free testosterone levels are above physiological range.

 

[Gianluca]

nice Vince, thanks for sharing, I just lowered today to 16mg daily from 20mg daily, let's see, I did have some issue with Free Estradiol, I was able to check it once last year when I was on 3 x week of about 200mg and mt FE was 3 times more! I think probably the best approach for us is very tiny dosages everyday

Im on to this as well, been cutting my Cyp dose from 28mg/D to 24mg/D and now to 20mg/D. I started by looking at Free Estradiol which was coming in twice the lab range for me inspite of using .25mg/AI EOD and still pulling a ~42 LC/MS/MS so I've got this long history of high E conversion but it was when I started pulling Estradiol Free that I got a better look at things. Faced with more AI (undesirable) we cut the Cyp dose as that was the only thing left as I had removed DHEA, Preg and for a period of time HCG even, but was still converting at a high rate. In the end I decided that letting my Free T being astronomically high was (possibly) the problem with a number of things...E, H/H to name two.
I have labs out now on the 20mg/D dose and not sure where I'm going from here, 18mg possibly. I don't have the intent of getting off the AI but finding a balance there with .25mg EOD and my daily Cyp dose.

my SHBG consistently comes in at 12-15

 

[Gianluca]

yes I agree, everyone physiological level may be different, maybe some people can't never achieve total benefits without occurring side effects,

The physiological range of FT ends at 54.7 pg/ml.
Therefore 25pg/ml is not even half of the limit of the physiological range, don't let modern lab ranges fool you

That said, everybody is free to experiment and determine the level at which they feel better and side effect management is easier. In this line, what I am doing personally is:
- Document how I feel subjectively before I see the labs
- Record the labs together with body composition, weight, etc.

The wealth of information that comes from that is simply terrific.

 

[Gianluca]

thanks for sharing this, to add to your comment below I agree that if someone would seek for improvement in body composition, like I did from TRT, probably would make more sense running a "safe" cycle on top of TRT, if that it is really the goal, even LifeExtention foundation believe most benefits from TRT are seeing starting from 15 of FT, of course heart brain protection and so on, they actually recommend anyone to have their FT btw 20-25

https://pdfs.semanticscholar.org/95b3/3e3dc8168f4e4b1c41e3c37f4eb84e98bdf1.pdf

Look at FT distribution (not the best article to show this because they use an older population but you can find many more in the internet - although most men on TRT are over 40 years old so in this sense this graph is very representative. I like the FT distribution graph to make my point. In younger men you will have a similar distribution but a bit higher levels). Physiological levels are not even close to the level you mentioned. Maybe a few abnormal men might have really high FT levels. But abdormalities have nothing to do with physiological levels

 

[HealthMan]

thanks for sharing this, to add to your comment below I agree that if someone would seek for improvement in body composition, like I did from TRT, probably would make more sense running a "safe" cycle on top of TRT, if that it is really the goal, even LifeExtention foundation believe most benefits from TRT are seeing starting from 15 of FT, of course heart brain protection and so on, they actually recommend anyone to have their FT btw 20-25

Agree
Low 20s seems a good target

 

[IronKnight]

Labcorp range for FT is 8.7-25.1 pg/mL. If you think 54.7 pg/ml is physiological go ahead find me one men whose natural FT is even close to that level

Again, I did not share believes, I shared proof and rationale, read the post:
https://www.excelmale.com/forum/sho...levels-achieved-naturally&p=102943#post102943

As explained in the post, the top of the free T range in some countries like Spain is 42.5pg/ml, and ranges in other places ended at 54.7 pg/ml, therefore 54.7 pg/ml is a physiologically possible value, naturally (it was part of a range for a reason).
There is evidence of a general decline in T levels due to plastics, stress, lack of sleep, worse nutritional value of the food we eat, pollution, etc. If labs use sick people to determine ranges that does not reflect optimal levels that were possible 100 years ago.

Saying that > 25pg/ml is outside of the physiological range is therefore innacurate, as well as the Labcorp test being representative about what is physiologically possible. Those assumptions are wrong, and in the post referenced above you have anecdotal evidence of men walking around in the 1400s without TRT as well (also outside of Labcorp's range, interestingly).

 

[Vince Carter]

Note too that a lab range is a sample of the population that that lab tests, no Dr, scientist or any one else decided that those numbers are healthy.

 

[Virginian]

Something I don't understand here. I just pulled out my last lab results from Quest Labs. Quest states that the Reference Range for Free Testosterone is 30.0 - 135.0 pg/mL. What am I missing?

 

[HealthMan]

Again, I did not share believes, I shared proof and rationale, read the post:
https://www.excelmale.com/forum/sho...levels-achieved-naturally&p=102943#post102943

As explained in the post, the top of the free T range in some countries like Spain is 42.5pg/ml, and ranges in other places ended at 54.7 pg/ml, therefore 54.7 pg/ml is a physiologically possible value, naturally (it was part of a range for a reason).
There is evidence of a general decline in T levels due to plastics, stress, lack of sleep, worse nutritional value of the food we eat, pollution, etc. If labs use sick people to determine ranges that does not reflect optimal levels that were possible 100 years ago.

Saying that > 25pg/ml is outside of the physiological range is therefore innacurate, as well as the Labcorp test being representative about what is physiologically possible. Those assumptions are wrong, and in the post referenced above you have anecdotal evidence of men walking around in the 1400s without TRT as well (also outside of Labcorp's range, interestingly).

You are wrong. Here we go:

> medical Definition of physiological. 1 : of or relating to physiology. 2 : characteristic of or appropriate to an organism's healthy or normal functioning.

> In health-related fields, a reference range or reference interval is the range of values for a physiologic measurement in healthy persons (for example, the amount of creatinine in the blood, or the partial pressure of oxygen).

https://en.m.wikipedia.org/wiki/Reference_range

Free Testosterone ranges are calculated using statistical normal range distributions. So they use a sample of the population and usually use 95% percentile to determine the range.

“Values outside a reference range are not necessarily pathologic, and they are not necessarily abnormal in any sense other than statistically. Nonetheless, they are indicators of probable pathosis.”

The study you showed that referenced normal upper range as 54.7 probably used a different methodology to calculate FT therefore not being comparable with Labcorp ranges. For example Quest reference range for FT is 35-155 pg/ml that does not mean FT upper range from Quest is more than 5x of Labcorp range. So the high value is probably due to a different methodology.

So the reference range is usually 95% percentile of the population which means that 2.5% of the population has levels above the upper range and 2.5% of the population has levels below the lower range. If you want to extrapolate that to 99% of the population you just need adjust the range by multiplying the z-value for the desired confidence levels by sample standard deviation divided by square root of sample size.

So physiological value is characteristic of a normal organism. A 99% percentile is very representative of a normal population. So you might be correct saying that stating that FT level above 25 is above physiological range might be incorrect. But if we adjust that upper range to 99 or even 99.9% of the population we will not get even close to 54.7.
I am using labcorp as an example because most here use labcorp. So again the higher reference ranges you saw are probably using a different methodology so not comparable.

You can find the plenty of studies in the internet calculating FT levels for healthy individuals, general population, and even broken down by age.

My educated guess based on some data i saw in some studies looking at FT levels for healthy individuals aged 25-34 (where testosterone levels are the highest) the most you can push FT to talk about normal physiological levels is 30 pg/ml using Labcorp methodology.

This is why most members here ask labwork to be posted with reference range.

I should have asked Bonneti which Laboratory he used before making any assessment.

And last. Yes 1400 i agree might be still considered physiological range (and I never said otherwise) But not 54.7 FT!!