Lab results don't reflect increased dose

[Chrisu0017]

My doctor recently upped my dose based on lab results, but total and free T don't seem to reflect the change.

Previous dose 120 mg/ week (split 2x 60): Total T 762 ng/dL, Free T 21.2 pg/mL, E2 20.2 pg/ mL

Upped dose to 140 mg/ week (split 2x 70). Retest 4 weeks later: Total T 780 ng/dL, Free T 19.4 pg/mL, E2 30.7 pg/ mL

Also changed Adex dose at the same time from 0.5 mg twice weekly to 0.25 mg twice weekly. I thought Total/Free T would have increased more with the additional 20mg/week. Any thoughts?

 

[CoastWatcher]

Welcome to Excelmale - we hope you'll be a regular contributor. What is your SHBG? You may well be clearing testosterone too quickly due to a low SHBG value. Was your estradiol test the "sensitive" assay (LC, MS/MS)?

 

[ERO]

How long after the dosing change did you test?

 

[CoastWatcher]

And...when did capture those two reports? Were they both drawn prior to an injection? Most importantly, how are you feeling?

 

[Chrisu0017]

Unfortunately SHBG was never tested. At 100 mg/week, Total T was 576, so I expect SHBG may be low. E2 is the sensitive assay.

 

[CoastWatcher]

Unfortunately SHBG was never tested. At 100 mg/week, Total T was 576, so I expect SHBG may be low. E2 is the sensitive assay.

I'd urge you to get a handle on your SHBG level (you can test yourself via Discountedlabs.com). Should it prove to be low, you can move to a more frequent dosing schedule. A number of members inject every other day, and I inject on a daily basis. There is typically a work-around that can be adopted to deal with SHBG-related challenges. ERO raised a good question: how much time had passed after you made your dosing change and the second lab draw?

 

[Chrisu0017]

And...when did capture those two reports? Were they both drawn prior to an injection? Most importantly, how are you feeling?

My last test was 4 weeks after the dose change. I'm injecting every 3.5 days - Monday evening/Friday morning. All blood tests thus far have been done at the same time Monday afternoon, just prior to my injection.

Remarkable improvement compared to prior to starting TRT. Still a small amount of fatigue, but the sever fatigue that I was experiencing is long gone.

 

[CoastWatcher]

My last test was 4 weeks after the dose change. I'm injecting every 3.5 days - Monday evening/Friday morning. All blood tests thus far have been done at the same time Monday afternoon, just prior to my injection.

Remarkable improvement compared to prior to starting TRT. Still a small amount of fatigue, but the sever fatigue that I was experiencing is long gone.

The missing SHBG number will prove interesting. I went from an every 3.5 day injection cycle to a daily one because of slowly rising estradiol ((I wanted to avoid an AI) and low SHBG that was clearing testosterone too quickly. Which isn't to say you have to adopt daily injections. But there are possibities that you can explore to feel even more solidly dialed-in.

 

[Chrisu0017]

The missing SHBG number will prove interesting. I went from an every 3.5 day injection cycle to a daily one because of slowly rising estradiol ((I wanted to avoid an AI) and low SHBG that was clearing testosterone too quickly. Which isn't to say you have to adopt daily injections. But there are possibities that you can explore to feel even more solidly dialed-in.

Thanks. I'll have to get it tested, but sounds like low SHBG may be a possibility. My E2 rose and I started experiencing symptoms several months after starting TRT, hence the AI. More frequent injections wouldn't bother me if I did need to go that route. In fact, I suggested my current 3.5 day protocol to my doctor, primarily based on what I'd read of other's experiences.

 

[CoastWatcher]

Thanks. I'll have to get it tested, but sounds like low SHBG may be a possibility. My E2 rose and I started experiencing symptoms several months after starting TRT, hence the AI. More frequent injections wouldn't bother me if I did need to go that route. In fact, I suggested my current 3.5 day protocol to my doctor, primarily based on what I'd read of other's experiences.

Is your doctor on top of things? Or are you bringing him/her along?

 

[Chrisu0017]

Is your doctor on top of things? Or are you bringing him/her along?

My doctor is my PCP. He's not up to speed with the latest protocols, but has a number of patients that he treats. He's open to discussion and learning and has even done research and spoken with colleagues in an effort to help me. I'm happy with the progress so far.

 

[Vince]

My doctor recently upped my dose based on lab results, but total and free T don't seem to reflect the change.

Previous dose 120 mg/ week (split 2x 60): Total T 762 ng/dL, Free T 21.2 pg/mL, E2 20.2 pg/ mL

Upped dose to 140 mg/ week (split 2x 70). Retest 4 weeks later: Total T 780 ng/dL, Free T 19.4 pg/mL, E2 30.7 pg/ mL

Also changed Adex dose at the same time from 0.5 mg twice weekly to 0.25 mg twice weekly. I thought Total/Free T would have increased more with the additional 20mg/week. Any thoughts?

I increase my dose to 90mg every 3 1/2 day from 80mg every 3 1/2 days and my numbers went down? My latest testosterone panel from 3-21-16

Read more at: https://www.excelmale.com/forum/showthread.php?6502-My-latest-testosterone-panel-from-3-21-16

 

[Vince Carter]

My doctor recently upped my dose based on lab results, but total and free T don't seem to reflect the change.

Previous dose 120 mg/ week (split 2x 60): Total T 762 ng/dL, Free T 21.2 pg/mL, E2 20.2 pg/ mL

Upped dose to 140 mg/ week (split 2x 70). Retest 4 weeks later: Total T 780 ng/dL, Free T 19.4 pg/mL, E2 30.7 pg/ mL

Also changed Adex dose at the same time from 0.5 mg twice weekly to 0.25 mg twice weekly. I thought Total/Free T would have increased more with the additional 20mg/week. Any thoughts?

My opoinion is that 70mg is just too much, for you the indivdual, to shoot at one-time. Just based on this you posted, increase T by 20mg, and your E2 shot up 10 points while you TT and FT are statistically unchanged. If 140mg is what you want to use, you'll likely need to split in to an EOD injection schedule. Your SHBG level will give you a fair clue as to that.

 

[Chrisu0017]

My opoinion is that 70mg is just too much, for you the indivdual, to shoot at one-time. Just based on this you posted, increase T by 20mg, and your E2 shot up 10 points while you TT and FT are statistically unchanged. If 140mg is what you want to use, you'll likely need to split in to an EOD injection schedule. Your SHBG level will give you a fair clue as to that.

Thanks. Keep in mind that my Adex dose changed from 0.5mg 2x weekly to 0.25mg 2x weekly at the same time my T dose changed from 120-140. I expected my E2 to increase with the change.

I'm planning to pull SHBG next time I get blood work.