I think neglected Total Testosterone focusing too much on free T...

[BillyJ03z]

I think I might have found out why I wasn't feeling so good on TRT all these past years... I wasn't optimizing my Total T.. I was focusing too much on my free T which was always in the top 90% or higher of the free range which is great but my Total T was in the bottom Labcorp range (mid 400's)... I should have my Total in the 800's or higher... I believe I have been way too conservative with my Cyp dosages. I was doing 100mg's per week which was putting me at mid 400's total T.... I just recently upped my Cyp dosage to 180mg per week... I will see how it goes....

 

[Robotics]

me too. sounds like you might be going too far in the other direction though, as by the sounds of it you are low shbg? were you taking an ai and what was your e2?

 

[BillyJ03z]

me too. sounds like you might be going too far in the other direction though, as by the sounds of it you are low shbg? were you taking an ai and what was your e2?

Yes, SHBG was very low (bottom 5% of labcorp range, mostly 15 and lower).... I used AI (arimidex) very rarely if at all as my estradiol and e2 sensitive labs have all been mostly ideal ranges (between 20-30 labcorp range)... I didn't realize that I was neglecting my total test as it was never optimal, like I said because I was so concerned with my FT levels...

 

[Gman86]

Or u could just need a higher free T and total T is still mostly irrelevant. I noticed a huge improvement when I got my free T from top of the range to almost double the top of the range. Once my free T got in the low to mid 40’s, I noticed a big improvement. Labcorp’s free T range was (8.7-25.1) for reference. Here were the free T labs I had done when I noticed the improvements. I had both labcorp and quest run my free T on the same day, within 30 mins of eachother

Free T - 398.2 (46.0-224.0) QUEST
Free T - 44.3 pg/ml (8.7-25.1) LABCORP

 

[M.J]

Or u could just need a higher free T and total T is still mostly irrelevant. I noticed a huge improvement when I got my free T from top of the range to almost double the top of the range. Once my free T got in the low to mid 40’s, I noticed a big improvement. Labcorp’s free T range was (8.7-25.1) for reference. Here were the free T labs I had done when I noticed the improvements. I had both labcorp and quest run my free T on the same day, within 30 mins of eachother

Free T - 398.2 (46.0-224.0) QUEST
Free T - 44.3 pg/ml (8.7-25.1) LABCORP

gman from reading all over the forum,
“It seems” the best way is higher fluctuation, which can only be achieved by cream or natesto. U may feel good on injections but never close to those two.
After all they mimic the natural testosterone behavior. Also no hematocrit issues.

What’s your though on this?

 

[Cataceous]

The standard direct free T test is inaccurate and should not be used for treatment decisions. Instead, go by the Tru-T free testosterone calculator. Using an SHBG of 15 nMol/L and default albumin, one finds that total testosterone in the range of 450-800 ng/dL puts calculated free testosterone within the healthy normal range of 16-31 ng/dL.

 

[BillyJ03z]

The standard direct free T test is inaccurate and should not be used for treatment decisions. Instead, go by the Tru-T free testosterone calculator. Using an SHBG of 15 nMol/L and default albumin, one finds that total testosterone in the range of 450-800 ng/dL puts calculated free testosterone within the healthy normal range of 16-31 ng/dL.

So I did the calculations and where I stand as of last lab test with Total T @ 407, I am at 14.7ng/dl...... (Total T 407, FT 24.3, Albumin 4.7, SHBG 8.8) Keeping all things the same and increasing Total T to 800 puts me at 30.7ng/dl..... So this theoretically supports my thoughts that I need vastly increase my Total T levels as I have been underdosing with my Cyp injections...

 

[Cataceous]

Another piece of the puzzle may be free estradiol. You can get a decent estimate using the spreadsheet discussed here. A possible problem with having low SHBG is that the ratio of free estradiol to free testosterone is higher than normal. Be aware that as you increase your testosterone dose you will push free estradiol into supraphysiological territory before that happens with free testosterone. I believe the reference range for free estradiol is about 0.2-1.3 pg/mL. You will probably exceed this well before reaching total testosterone of 800 ng/dL, assuming total estradiol increases in proportion to free testosterone. It's another reason to proceed slowly with the increases, and to go no higher than needed to get symptom relief.

 

[Robotics]

Another piece of the puzzle may be free estradiol. You can get a decent estimate using the spreadsheet discussed here. A possible problem with having low SHBG is that the ratio of free estradiol to free testosterone is higher than normal. Be aware that as you increase your testosterone dose you will push free estradiol into supraphysiological territory before that happens with free testosterone. I believe the reference range for free estradiol is about 0.2-1.3 pg/mL. You will probably exceed this well before reaching total testosterone of 800 ng/dL, assuming total estradiol increases in proportion to free testosterone. It's another reason to proceed slowly with the increases, and to go no higher than needed to get symptom relief.

what free estradiol do you suggest people target? Maybe at least mid range since it would be our trough free E2 value? or have you heard at what free e2 levels low shbg guys are feeling good?

 

[Gman86]

gman from reading all over the forum,
“It seems” the best way is higher fluctuation, which can only be achieved by cream or natesto. U may feel good on injections but never close to those two.
After all they mimic the natural testosterone behavior. Also no hematocrit issues.

What’s your though on this?

Ya the whole fluctuating levels theory is super interesting, and something I wish we had more conclusive information about. I actually tried the cream by itself for 2 months. My last set of labs was actually when I first figured out I feel better with free T in the 40’s. These were the last labs I had done on the cream

11-30-19
3 clicks to scrotum am, 1 click to scrotum, 2 clicks to forearms pm
Labs done 3.5 hours after am application
Total T - >1500 ng/dl (264-916)
Free T - 45.0 pg/ml (8.7-25.1)

I then ended up switching to injections, and tried to get my free T around the same level, which I was able to do with 180mg of test enanthate per week. I definitely felt better on the cream, not significantly better, but better. But I was on it for 2 months, I wonder if I would of continued feeling more improvements the longer I was on it

 

[M.J]

Ya the whole fluctuating levels theory is super interesting, and something I wish we had more conclusive information about. I actually tried the cream by itself for 2 months. My last set of labs was actually when I first figured out I feel better with free T in the 40’s. These were the last labs I had done on the cream

11-30-19
3 clicks to scrotum am, 1 click to scrotum, 2 clicks to forearms pm
Labs done 3.5 hours after am application
Total T - >1500 ng/dl (264-916)
Free T - 45.0 pg/ml (8.7-25.1)

I then ended up switching to injections, and tried to get my free T around the same level, which I was able to do with 180mg of test enanthate per week. I definitely felt better on the cream, not significantly better, but better. But I was on it for 2 months, I wonder if I would of continued feeling more improvements the longer I was on it

i can’t help thinking, this whole libido thing could work like tickling, meaning the fast movement daily in T may generate this tickling affect to something in the body ( the higher the movement between numbers the better).

I myself tried cream long time back. Maybe you felt good cuz higher T mean fast movement between different levels, yes you have high free T. But maybe that not it for libido.

that could mean something. Specially from seeing a lot of positive feed back From the cream. also we don’t need to be concerned about hematocrit with it.
Unfortunately cream is not available here, natesto also is not. I will have to figure away to order it.

 

[Gman86]

i can’t help thinking, this whole libido thing could work like tickling, meaning the fast movement daily in T may generate this tickling affect to something in the body ( the higher the movement between numbers the better).

I myself tried cream long time back. Maybe you felt good cuz higher T mean fast movement between different levels, yes you have high free T. But maybe that not it for libido.

that could mean something. Specially from seeing a lot of positive feed back From the cream. also we don’t need to be concerned about hematocrit with it.
Unfortunately cream is not available here, natesto also is not. I will have to figure away to order it.

Oh ya, forgot to answer ur question about HCT. Was 52 on those last cream labs, and 48 when I was on 180mg of test enanthate

Surprisingly on the cream libido wasn’t the best. It wasn’t bad. Maybe a 6/10. Thought with the higher DHT and free T that libido would of been better. Felt better mentally and energy wise tho on the cream than any other protocol I’ve tried.

 

[Cataceous]

what free estradiol do you suggest people target? Maybe at least mid range since it would be our trough free E2 value? or have you heard at what free e2 levels low shbg guys are feeling good?

In the absence of better knowledge I figure it's safest to target mid-range. Most of us don't know what our optimal youthful levels for hormones were, so I look at what the average healthy young guy might have. This would be roughly: TT: 600-700 ng/dL, E2: 30 pg/mL, SHBG: 30 nMol/L. This is putting calculated free estradiol at about 0.7-0.8 pg/mL, which is indeed mid-range on the reference scale.

As you note, this may or may not apply to guys with low SHBG. I haven't seen enough data to say if there's some systematic difference, such as needing a lower estradiol target, or needing to force the free hormone ratios to more normal values.

 

[M.J]

Oh ya, forgot to answer ur question about HCT. Was 52 on those last cream labs, and 48 when I was on 180mg of test enanthate

Surprisingly on the cream libido wasn’t the best. It wasn’t bad. Maybe a 6/10. Thought with the higher DHT and free T that libido would of been better. Felt better mentally and energy wise tho on the cream than any other protocol I’ve tried.

I thought Using cream will have less if any affect on HCT ?

 

[Gman86]

I thought Using cream will have less if any affect on HCT ?

I’m pretty sure most of the time it is lower when using the cream, at least from what I’ve seen with other guys’ labs.