Is my Testosterone too high?

[Grrrr]

After being on testosterone and never feeling good. I finally increased my dose and finally feel symptom free, but my levels are high, which has me concerned long term even though i feel great right now

TESTOSTERONE, TOTAL
1950 (250-1100 ng/dL)

TESTOSTERONE, FREE
492.3 (35.0-155.0 pg/mL )

ESTRADIOL,ULTRASENSITIVE,
90 < OR = 29 pg/mL

 

[at15]

how long have you been on this new regimen? do you have CBC and lipid panel results?

 

[Grrrr]

12 weeks. CBC / lipid are all within range.

 

[Sean Mosher]

And this was taken at trough, correct?

 

[Grrrr]

Yes, but I am on daily injections SUB Q

 

[Sean Mosher]

If there aren't any other glaring issues, symptoms or bloodwork wise then I wouldn't worry about the numbers.
They are what they are.

Out of curiosity though, what's your overall protocol?

 

[Grrrr]

25mg daily testosterone, 350iu hcg eod

 

[cigpk]

I personally wouldn’t feel comfortable running testosterone that high for long term but I also have a lot of fears/anxiety about trt so I sort of run the minimal effective dose.

I’ve had total t levels over 1500 at trough and I have found that I actually feel better running around 785-800 at trough. But that’s just me.

 

[Grrrr]

What causes the drop in HDL, is it the AI or testosterone?

 

[Gman86]

What was your protocol and labs before the increase? Also what's you SHBG? I assume it's in the teens or twenties with such a high free T level.

 

[Gman86]

At what point in during the 12 weeks did you start to feel the improvements? Did it take the full 12 weeks to feel better?

 

[Grrrr]

After maybe 4 weeks.. I just gradually increased my T over a year and finally started feeling good at like 175mg weekly

 

[cigpk]

The way I think about it is this, and Im not a doctor or anything so I don’t know much but I would be interested to hear some other opinions.

High/healthy total testosterone and free testosterone levels shouldn’t make someone feel bad or less than average by any means.. and I don’t mean over the high end of the range and especially not at trough. I mean hovering around the top of the range more or less for both free and total T.

So if we get ourselves back into the high/healthy range of total/free T, shouldn’t we be looking elsewhere for why we don’t feel good? Maybe it’s DHT, Maybe estrogen, Maybe it’s thyroid, maybe it’s a vitamin deficiency, maybe it’s something else.

I personally don’t think having a trough level testosterone at 3x over the top end of the range should be the answer if you’re just using testosterone in the idea of “replacement therapy.”

Again, just my two cents. I initially thought I needed to get my testosterone as high as possible to feel good but I’ve realized that’s not a good long term solution for me. It causes insomnia, anger, anxiety, all kinds of shit.

I guess it may work for some people but I would err on the side of caution and maybe see what else I could optimize in my health before shooting for levels that high.

 

[Gman86]

After maybe 4 weeks.. I just gradually increased my T over a year and finally started feeling good at like 175mg weekly

What’s ur SHBG?

 

[Grrrr]

Like 20

 

[Mr S]

I personally wouldn’t feel comfortable running testosterone that high for long term but I also have a lot of fears/anxiety about trt so I sort of run the minimal effective dose.

I’ve had total t levels over 1500 at trough and I have found that I actually feel better running around 785-800 at trough. But that’s just me.

His levels weren’t taken at trough as he injects daily. If your level of T at trough is 700 you must have your T levels way beyond 1,000 at peak.

 

[Mr S]

After being on testosterone and never feeling good. I finally increased my dose and finally feel symptom free, but my levels are high, which has me concerned long term even though i feel great right now

TESTOSTERONE, TOTAL
1950 (250-1100 ng/dL)

TESTOSTERONE, FREE
492.3 (35.0-155.0 pg/mL )

ESTRADIOL,ULTRASENSITIVE,
90 < OR = 29 pg/mL

How do you like the HCG?

 

[cigpk]

His levels weren’t taken at trough as he injects daily. If your level of T at trough is 700 you must have your T levels way beyond 1,000 at peak.

Possibly. I’m taking 2x per week injections and 3x per week hcg so my levels should be pretty stable. I also have shbg of 50-55 so I should actually be aiming for higher total T levels than most. With that said, I still stick by my belief that running total T around 2000 and free T at 3x the upper range is risky.

 

[madman]

After being on testosterone and never feeling good. I finally increased my dose and finally feel symptom free, but my levels are high, which has me concerned long term even though i feel great right now

TESTOSTERONE, TOTAL
1950 (250-1100 ng/dL)

TESTOSTERONE, FREE
492.3 (35.0-155.0 pg/mL )

ESTRADIOL,ULTRASENSITIVE,
90 < OR = 29 pg/mL

Looking at your past posts you were running a TT of around 1200.

Noticed in past posts your SHBG was around 32-35 nmol/L.

Gman asked....."What’s ur SHBG?"

You stated....."Like 20"

So although treating ones symptoms is what truly matters over just ones numbers.....do understand that where ones levels are is still an important part of the overall picture as lab work is not only critical to how said dose of T will effect ones TT/FT/e2 levels but most importantly overall health markers such as hemoglobin/hematocrit, lipids.

As you should know that use of exogenous testosterone will not only increase ones hemoglobin/hematocrit/RBC's but high levels can also have a negative impact on lipids (lowering HDL).

The goal of trt is not only to improve/relieve low-t symptoms and increase overall well-being but to minimize/prevent potential side-effects.

The most sensible approach would be to use the least amount in order to derive the full benefits while at the same time negating any potential side effects.

Although TT is important FT is what truly matters as it is the unbound active fraction of testosterone responsible for the positive effects.

Ones SHBG level is critical as not only will it dictate ones dose/injection frequency but most importantly it will have a huge impact on what dose of T is needed to achieve a TT level that will result in a healthy FT level.

Most men do well having FT in the 25-30 ng/dL range where as others may need levels in the 30-50 ng/dL range depending on the individual and there response to the use of exogenous testosterone.

Everyone is different and you have to find what TT/FT level works best for you while at the same time maintaining overall health.

Many seem to think more T is always better and higher and higher levels are needed to see benefits when in fact many can truly feel better on less.

Now for your reality check.

First and foremost although your FT is very high well above the reference range the testing you had done was the piss poor direct immunoassay which is inaccurate and unless you are getting testing done using the gold standard Equilibrium Dialysis or Ultrafiltration or better yet using the newer calculated method TruT Free Testosterone Calculator by FPT .....than you truly have no idea where your FT levels sit and if anything most would be shocked to find out that their FT levels are much higher than what the direct immunoassay is telling them.

I am going to put this plain and simple.....for having an SHBG of 20 nmol/L not only are your TT levels insanely HIGH but more importantly your FT levels are f***ing way too f****ing HIGH!

No one and I mean no one on trt needs to be running a FT level over 50 ng/dL to experience relief/improvement of low-t symptoms let alone feel great!

You are kidding yourself and if you feel you truly need FT levels that high to feel good than you most likely have other underlying issues.....thyroid/adrenal/lifestyle factors.

If we use the newer calculated method than with a TT 1950 ng/dl, SHBG 20 nmol/L and Albumin 4.3 g/dl (mean) than your FT is an absurdly high 74.72 ng/dL (way the f*** over the top end of the reference range 16-31 ng/dL)

With an SHBG of 20 nmol/L you could easily run a TT of 1325 ng/dL and your FT would still be at the top end of the 30-50 ng/dL range as FT would be 50.09 ng/dL

Again sure you may feel great overall now but hard to say in the long term!

We also have to keep in mind that a downfall of forums is as we all know there are many that post on here stating they feel amazing at such high test levels and all their health markers are A OK yet they never post full lab work to back up such claims!

Again treating symptoms is what truly matters but at the same time we need to be sensible here and regardless of some stating numbers are just numbers is irresponsible as ones long term health is KEY!

 

[at15]

12 weeks is nothing, check back in a couple years