Lab values and testing

[Greg Kevorkian]

First question, if you make a change in your T dose can you get labs after 4 weeks?

I went from 140 mgs of cypionate to 100 mgs.
On 140 my level day before my next shot was 1380
On 120 my level pre shot was 1375
On 100 mgs it was 1361
Presently went down to 80 mgs third week but hevents tested.
I couldn't believe that it only dropped basically 20
Doctors wants my pre shot level to be "around" 800. I am 74 years old if that makes any difference.
And yes at those levels my E2 was up.

Any toughs as to why my levels haven't dropped a lot?

Thank you !!

 

[Vince]

Your Labs should stabilize after 6 weeks. I usually like to wait 12 weeks, before getting labs.

When I first started trt, I got Labs after 12 weeks. Then even after adjusting my protocol, I waited six months. That's what I do now, I wait 6 months before my next labs.

 

[sh1973]

You probably have high shbg because my levels pretty much mirror yours. I do 60mg once weekly which puts my trough in the 700ng range.

 

[Greg Kevorkian]

You probably have high shbg because my levels pretty much mirror yours. I do 60mg once weekly which puts my trough in the 700ng range.

How do you feel at that level. My next labs we are checking SHBG How many mgs did you start with?

 

[sh1973]

Much better in all aspects. Anything above a 1000ng and I feel like hell especially insomnia.

 

[Greg Kevorkian]

Much better in all aspects. Anything above a 1000ng and I feel like hell especially insomnia.

Wow i am dealing with insomnia right now funny you said that. Glad you are doing well

 

[sh1973]

With levels high as yours I fall asleep at 10 or so and wide awake at 2-3 am. Not fun!

 

[Greg Kevorkian]

it is not fun. Probably high estradiol. Cant wait to get these labs done.

 

[sh1973]

If your shbg is high it’s very doubtful you have a problem with estrogen. I’ve had levels of test well over 1500ng before and E2 still within range. I’d advise being a long term trt user not to mess with E2. Typically doesn’t turn out well.

 

[sh1973]

I don’t use anything but test and have found less is better in all respects.

 

[Greg Kevorkian]

I have had my shbg tested many times in the past and always good. I know being in the physiological range usually you usually wont have to deal with high E2 or high DHT.
Time will tell this is my third week on 80 mgs shot this morning.
Whats amazing to me is you watch videos on youtube on T or read articles and everyone has a different opinion on what to do. Drives me crazy.

 

[sh1973]

I think Nelson’s information and several others doctors stance on leaving estrogen be is the best advice. If your test dose is correct, providing a persons not obese, things should fall in line. There are always outliers of course. My philosophy is, the less medications the better.

 

[Greg Kevorkian]

I agree 1000 % I have seen most of Nelsons videos as well as so many more
I know nelson is not a proponent of AIs and I don't like playing with that stuff, not good for you. I appreciate all your input, can't wait to get my levels down to a "normal" level.

 

[sh1973]

I think you’ll be much happier, good luck

 

[Greg Kevorkian]

Ill let you know Thanks again

 

[xqfq]

I have had my shbg tested many times in the past and always good. I know being in the physiological range usually you usually wont have to deal with high E2 or high DHT.
Time will tell this is my third week on 80 mgs shot this morning.
Whats amazing to me is you watch videos on youtube on T or read articles and everyone has a different opinion on what to do. Drives me crazy.

I am not sure what’s going on with your total T labs, but one possibility is that your Free T could be decreasing but your total T is staying the same.

The standard free T “direct” lab isn’t super reliable, so people usually also test SHBG at the same time as total T to get an idea. But if you have the free T figures you might be able to see a pattern.

It sounds like you’re in tune with symptoms which is good. I would monitor blood pressure as well between the different protocols.

 

[Greg Kevorkian]

I am not sure what’s going on with your total T labs, but one possibility is that your Free T could be decreasing but your total T is staying the same.

The standard free T “direct” lab isn’t super reliable, so people usually also test SHBG at the same time as total T to get an idea. But if you have the free T figures you might be able to see a pattern.

It sounds like you’re in tune with symptoms which is good. I would monitor blood pressure as well between the different protocols.

I'ii get my free T on the next lab. Thanks for that info.

 

[madman]

First question, if you make a change in your T dose can you get labs after 4 weeks?

I went from 140 mgs of cypionate to 100 mgs.
On 140 my level day before my next shot was 1380
On 120 my level pre shot was 1375
On 100 mgs it was 1361
Presently went down to 80 mgs third week but hevents tested.
I couldn't believe that it only dropped basically 20
Doctors wants my pre shot level to be "around" 800. I am 74 years old if that makes any difference.
And yes at those levels my E2 was up.

Any toughs as to why my levels haven't dropped a lot?

Thank you !!

In general you should give it 6 weeks.....you want to make sure your blood levels have stabilized before getting labs as anytime one increases/decreases T dose levels will be in FLUX during the following weeks leading up untils levels stabilize so testing too early is pointless as you will not be getting an accurate result.

You stated you started off on 140 mg than had labs done and your TT trough levels were high so you dropped the dose to 120 mg than had labs done and your levels barely dropped so you dropped the dose to 100 mg than had labs done and again your TT trough levels were only slightly lower than your TT trough levels when you were injecting 140 mg.....seems odd.

Did you wait the full 6 weeks between the dose reductions?

If you are only injecting once weekly whether 140--->100 mg of T than if the levels stated above are your true trough (labs 7 days after your previous injection) than not only are your trough levels really high.....your peak levels would be absurdly high as T levels will peak 24-36 hrs post injection.

What testing method was used for TT?

Exactly how long were you on each dose of cypionate as again if it was only 4 weeks than your levels would still be in flux.....let alone hard to believe you could truly gauge how you felt overall on each dose.

Even though it will take 6 weeks for blood levels to stabilize many tend to experience the honeymoon period during the weeks leading up until levels stabilize as not only are levels in flux but they are increasing which can affect people in different ways as some tend to feel amazing regarding mood/energy/libido/erectile function as oppose to others who may tend to experience ups/downs along the way.

Even than once levels stabilize one needs to give it a good 2-3 months for the body to adapt to those new levels.....let alone truly gauge how said protocol (T dose/injection frequency) makes them feel overall regarding relief/improvement of low-T symptoms.

You state your doctor wants your TT trough around 800 ng/dL which is misleading because what truly matters is your free testosterone as it is the unbound active fraction of testosterone responsible for the beneficial effects.

Knowing your SHBG level is also critical as it will impact your FT level.....let alone what TT level you would be need to aim for to attain a healthy FT level.

 

[madman]

Your doctors main concern should be how you feel overall and relief/improvement of low-T symptoms.

The main goal is to have you feeling well while at the same time keeping your blood markers in a healthy range and avoiding/minimizing any potential negative effects.

Although treating the patient should always come first over numbers.....lab work is critical as not only do we need to see how said dose of T affects ones TT/FT/e2 levels but most importantly overall blood markers.

 

[Greg Kevorkian]

Thanks for that through explanation. I tested at four weeks but now on 80 mgs and will wait six weeks. I am getting free T and shbg
So we will see how it goes I want to be in the physiological range and of course hoping to feel good. My opinion in that range won’t have to deal with E2and high DHT with I have.
Thanks again.