Latest Blood Work-Testosterone and HCG

[Smokin Joe]

Went to my Endo today and received my latest blood work. The results kind of shocked me when she told me my numbers this time. Total T-1052 up from 611, Free T-19 up from 12.0 and hematocrit holding at 48. PSA-2.3.
The total t has me concerned being this high in such a short period. I inject 40 mg twice in a seven day period and have been on this regimen consistently for about a 100 days. First question; When using exogenous T how long before the testicles shut down any production ? Second question; Should I cut back on my dose ?
It seems exogenous T is a supplement to the testicles until production is shut off and then dose adjustments may have to be made. Is this correct ?
If I add HCG to my regimen should I decrease my T as HCG causes T production ?
Though I have been using T since 2007 this is the first time being regulated by a Dr who I can work with to a point.
I feel good at this point and this is the best my T numbers have ever been but want to be careful going forward.
Comments please.

 

[Vettester Chris]

Joe, I'm just a little confused on your post, regarding the part about the testicles shutting down production (?). I presume you were shutdown, or suppressed going into your TRT program? If your diagnosis was "secondary", then a good chance your gonadotropin (LH, FSH) values were low? When you start TRT your LH will go even lower. E.g., it's normal to see a male with hypogonadism having LH in the 1.5 to 3.0 range, causing testosterone serum to be in the 200ng/dl to 300ng/dl range. Starting TRT will increase the serum level, but it's quite common to see LH drop < 1.0.

Yes on the HCG contributing to your serum increase "if" you're secondary. The amount of increase just depends on the status of your Leydig cells and testicular responsiveness to the LH analogue. It will be different for each guy. For me, 250iu x 3/wk of HCG combined with 120mg/wk of test cypionate will achieve approx. the same serum level as if I were on 200mg per week of cypionate by iteself. That's a 40% reduction in cypionate to achieve approx. the same serum results. Again, this will vary with each patient, and I would highly encourage several follow lab intervals to get your protocol dialed in correctly.

Whether your serum level should come down or not is a call for you and your doctor to make. 1052 isn't outrageously high. On another note, your free test is at 1.8%. You probably have a little room to get your SHBG down a bit, which in turn could increase your free & bio available test. This is really the number that matters when looking at it from a biological standpoint. 19 IMO is a good place to be on free test. Being 1.8% of serum value tells me that you can maybe refine a few areas (like SHBG), maybe look at your Vitamin D level, E2, and other variables related to the endocrine system, and if your FT% can get to 2.0-2.5 range you can adjust your protocol accordingly for total serum.

 

[Jasen Bruce]

Hi Joe
I would not be concerned with a total testosterone of 1052. I assume you were concerned because it may be flagged as too high on your lab reference ranges, but keep in mind those reference ranges are skewed. They are based upon the mean demographic of patients who complete that specific test. During the last few decades, the majority of patients who received blood testing (let alone testosterone) are older men. Only recently has a younger demographic of men ordering testosterone testing started to increase in numbers. Usually the target range for total testosterone is between 700ng-1200ng depending on the individual. We have blood tested twenty year olds (and some older) who were as high as 1500ng naturally.

I did not see mentioned what day you had your blood drawn, how many days after your injection? This will make a difference even when injecting a small amount twice per week. The first 2 days after your injection may typically yield a slightly higher peak before leveling out. All depends on the person, but when you draw your blood try to be consistent with which days you do it.

Your dosage will not be changed based upon testicular shut down, which has already happened to you long ago as you've been on TRT since 2007. Your dosage should be adjusted based upon follow up blood work and your symptoms.

If you are feeling great and lab markers are in order than I wouldn't change a thing. Are you also monitoring your estradiol? This is important as well.

 

[Smokin Joe]

Thanks for the quick reply from the both of you.
Chris when I started T replacement I was still in the low normal range of Total T (450) but low Free T so I was considered neither primary or secondary. I was fortunate enough to have found a Doc who recognized the value of free T.
I am taking 4000 IU of D-3 and 25mg of DHEA and thats about it.
Jasen my Endo does not test for Estradiol unless there is a reason such as gyno etc. I will do my own through Life Extension tomorrow. I have not had an estrogen over 20 so far with a Total T of 611 last time. It has been on my mind to check it as my sex drive and erectile quality is still down. I was sure to see a difference with numbers this high. My energy is up and I'm lifting again carefully as I have L-4/L-5/S-1 issues.
I had my blood drawn the same day as my injection. As stated I inject twice a week at 40mg each.
Hope this helps and Thanks.

 

[Jasen Bruce]

Hey Joe, if you want to save money you can order any blood test directly from Defy Medical. They will send you to a Labcorp close to your home. The cost for Estradiol Sensitive is $30. Here is a price list for other commonly ordered hormone tests: http://defymedical.com/shop/category/12-blood-testing-services

You can call 813-445-7342 and request an Estradiol test or email me at [email protected].

Very soon there will be a blood testing portal available to all ExcelMale members, until then you are welcome to contact me for testing.

That is crazy that your endo will not test E2 unless there are symptoms present. The problem with that mentality is that once symptoms like gyno arise it is very difficult to reverse without surgery. Gyno takes a long time to develop and by the time you actually see symptoms it can be too late. It is a good idea to get tested now and stay ahead of the side effects