Low Total T and Normal Free T. Became hyper sensitive after HCG

[1911]

37 years old and have been on TRT for 7 years for secondary hypogonadism. When I first was diaognosed it was tested by using Clomid for one month which put me at the levels shown below. That was the best I have ever felt.

1 month of Clomid:
Total T: 815 (348-1197 ng/dL)
Free T: 438 (128-430 ng/dL)
SHBG: 34.4 (16.5-55.9 nmol/L)

After that my endo took me off Clomis and prescribed me depo-testosterone at 150mg per week. That made me test over the charts and made me extremely bloated so over the years I have been reducing the dosage every 3 months trying and hoping to find the right balance. It just never happened. I got down to 50mg per week split into 2 doses. At the beginning of 2022 I stopped the test and ordered some HGC from an Indian pharmacy and took 5000iu over a course of 1 week. It actually worked and my testis became full again. The problem is after that week I stopped with the HCG and went back on the test at 50ml per week but it made me become hyper sensitive to the depo-test. It put me in an extremely dark place, irritable, self critical, no motivation or libido. I now only take 5mg per week. If I take anything more than that I tend to get irritable, lose interest in everything, and feel like crap. I have been taking 5mg per week...sometimes every 2 weeks for the last year and my latest labs came back shown below:

Total T: 384 (250-1100 ng/dL)
Free T: 79.0 (35.0-155.0 pg/mL)

I feel alright at this dosage but definately have room to improve. I want to get back to the results I was at when I was taking Clomid but the problem is when I increase the test above 5mg it works against me. I am exhausted with this whole thing and lost my insurance a few years ago. My endo is a bit of a prick that is only concerned about not getting sued so I dont really discuss much with him other than refilling my prescription. He hasnt even asked for labs other than PSA and red blood cells for a few years now. What is going on with me? I just got a new job that is going to provide health insurance so I am looking for a new local endo since I am in a different state now. I am looking for any advice here on how to handle this. I just want to feel good. How do I increase free test without pushing total test too high? I started working out again and eat a low fat, high protein diet. I take mutli vitamins and vitamin D 5000iu daily.

 

[aneuman]

For what it's worth, at those levels of TT/FT I get the same symptoms, on the other hand, HCG always made me feel good, more optimistic, less self-critical. If I were to guess (probably incorrectly), I'd say that your free T is lower than what your body is used to, or what you need to feel good, but I don't know anything about this.

Those problems you relate (health-wise, doctor-wise, etc) are not simply yours, is what probably a large number of people (including me) have experienced, so there's nothing wrong with you.

I also assume that when you say that you are using test "50mL" you actually meant 50 mg, otherwise, that would explain why you feel so bad.

You want to feel good like, I dare to say, everyone, but some things are hard to get, simply because there are too many variables involved, from physiology to psychology. My suggestion is, if you can find a better doctor, do it, but don't have high hopes. I've consulted with some of the most recognized andrologist in the US (world?) nowadays and your experience closely matches mine. I'm now seeing one that does what you say, give me a prescription and that's it.

I recently started TRT at 90 mg/weeks (30mgx3) and have experience some positives and on the other side of the ledger, increased anxiety (which I've always had, but hCG tamed it a lot). I, just like you, only want to feel good, but maybe because I'm older, I understand that you can't always get what you want, but if you try, sometimes, you get what you need.

Good luck.

 

[Systemlord]

How do I increase free test without pushing total test too high?

Testosterone deficiency isn’t defined by Total T. Symptom or lack thereof follows Free T, not Total T.

 

[1911]

For what it's worth, at those levels of TT/FT I get the same symptoms, on the other hand, HCG always made me feel good, more optimistic, less self-critical. If I were to guess (probably incorrectly), I'd say that your free T is lower than what your body is used to, or what you need to feel good, but I don't know anything about this.

Those problems you relate (health-wise, doctor-wise, etc) are not simply yours, is what probably a large number of people (including me) have experienced, so there's nothing wrong with you.

I also assume that when you say that you are using test "50mL" you actually meant 50 mg, otherwise, that would explain why you feel so bad.

You want to feel good like, I dare to say, everyone, but some things are hard to get, simply because there are too many variables involved, from physiology to psychology. My suggestion is, if you can find a better doctor, do it, but don't have high hopes. I've consulted with some of the most recognized andrologist in the US (world?) nowadays and your experience closely matches mine. I'm now seeing one that does what you say, give me a prescription and that's it.

I recently started TRT at 90 mg/weeks (30mgx3) and have experience some positives and on the other side of the ledger, increased anxiety (which I've always had, but hCG tamed it a lot). I, just like you, only want to feel good, but maybe because I'm older, I understand that you can't always get what you want, but if you try, sometimes, you get what you need.

Good luck.

Thank you. That was my error I meant to type mg and not ml. I am currently looking for a doctor. I've even debated having a company like Defy just review my labs and make adjustments. I appreciate your time.

 

[1911]

Testosterone deficiency isn’t defined by Total T. Symptom or lack thereof follows Free T, not Total T.

I understand this but if I bump up the test my total shoots up with it. I am wondering how I end up with mid range total and high free like I did when I was on Clomid. Hope that makes sense.

 

[sammmy]

You need a knowledgeable doctor because you are not understanding well what you are doing. With only 5mg Testosterone per week, you are not doing TRT and your last test result probably shows your baseline before TRT, possibly slightly suppressed, depending on when the test was done with respect to 5ml injection:

Total T: 384 (250-1100 ng/dL)
Free T: 79.0 (35.0-155.0 pg/mL)

Your baseline above does not indicate hypogonadism - your total T is low but free T is normal, probably because you have a low SHBG.

The clomid made you feel good because it overboosted your free testosterone, which is acting like a stimulant. Some people get sleep problems because of that. It could also be only temporary "honeymoon effect" because you were on clomid only 1 month. If that is what you want, the most logical thing is to retry clomid.

If I was you, I would drop everything and test to see my real baseline. You may not need TRT at all if your free T is normal, but just some stimulating supplement/herb.

 

[1911]

It's been 7 years with dozens of labs. I have a pretty good understanding of what is going on. I appreciate the comments but my baseline before TRT was

Total T: 108L (250-1100)
Free T: 16.3L (35-155)

 

[sammmy]

When was the test done with respect to the 5mg Testosterone injection and what is the strength of the injection solution mg/ml?

 

[1911]

When was the test done with respect to the 5mg Testosterone injection and what is the strength of the injection solution mg/ml?

200mg per ml

 

[sammmy]

How many ml is your full syringe and in how many smallest tick marks is it separated into, not the large tick marks but the smallest?

 

[1911]

How many ml is your full syringe and in how many smallest tick marks is it separated into, not the large tick marks but the smallest?

I use a 1ml insulin syringe and i fill it up to the 3rd tick mark

 

[sammmy]

How many minor tick marks are on the syringe? Typically they are either 50 or 100 minor tick marks.

 

[1911]

100. It's a 1cc insulin syringe.

 

[sammmy]

3 minor tick marks will be 0.03ml x 200mg/mL = 6mg testosterone ester.
3 major tick marks will be 60mg testosterone ester.

I am assuming you are injecting this one time per week, not spread out in several injections.

What testosterone ester is that and when did you do the blood test with respect to the injection?

 

[1911]

3 minor tick marks will be 0.03ml x 200mg/mL = 6mg testosterone ester.
3 major tick marks will be 60mg testosterone ester.

I am assuming you are injecting this one time per week, not spread out in several injections.

What testosterone ester is that and when did you do the blood test with respect to the injection?

Yep, minor tick marks not major once per week. Comes out to 6mg not including the waste that gets trapped. Testosterone cypionate by Pfizer. I get a 2000mg/10ml vail prescription. Obviously using much less over the 3 month prescription period. The labs listed in the first post was 36 hours after the injection.

 

[sammmy]

With that microdosing, you are in TRT state on the day of the injection and the day after. For the remaining part of the week, you are probably in a hypogonadal state.

You could try another mode of administration with daily microdosing: daily injections, oral testosterone, transdermal Androgel, nasal gel Natesto.

 

[aneuman]

It's known that a healthy adult male (25-35 years old) makes from 6-9mg of testosterone per day, that's 42-63 mg per week, so one could argue that proper TRT is to replace endogenous T with exogenous T between those numbers. My understanding is that T. Cypionate, for example is 70% T and 30% ester, so a typical TRT dose would theoretically be from approx 45 mg to 67 mg per week, and that should maintain physiological levels, again, theoretical, but at least that should be consideration for a dosage. @Cataceous have stressed that out in this forum multiple times.

Dosing below that is unlikely to resolve any issues. I recently read somewhere that the cutoff for shutting down LH production is about 9mg per day, that means, at least theoretically, below 9mg/day of exogenous T, some LH and testicular function is maintained, although I'm not sure if its contribution would have any clinical value.

It seems that 5mg/day insignificantly low, and if what I said above is correct, those 5mg + some endogenous production put you at your current values, which are not enough to resolve the symptoms.

What you could do, if you haven't yet, is slightly up the dosage trying to get a trough of 700-800 ng/dL (assuming you felt well on Clomid at those levels), keeping in mind that it takes very looong 6-8 weeks until levels are stabilized. You could also discuss with your new doctor other forms of supplementation (topical, pills, etc). This is very convoluted journey I have found, compounded by some inept doctors, money-making clinics, and know-it-all people like me on this forum.

I (and I'm speaking for myself here) would never order anything from UGL or Indian or Chinese pharmacies (not trying to start WW3 here, just stating what I'd do), also don't try to mix endogenous production (hCG) and exogenous replacement (T.Cyp) simultaneously for the purpose of achieving desirables T values until you understand how your body reacts to that and what effect is each medication contributing.

 

[1911]

I appreciate the advice. I will try to increase the volume once again at minimum 45mg split throughout the week and will retest in a month. I have just been hesitant to increase the volume after injecting 20mg last year and was extremely irritable. I never want to be in that state again. I will be trying to find a new doctor but that process will take a few months and I start a new job soon. I cant afford to be thrown off mentally and physically again.

 

[aneuman]

I appreciate the advice. I will try to increase the volume once again at minimum 45mg split throughout the week and will retest in a month. I have just been hesitant to increase the volume after injecting 20mg last year and was extremely irritable. I never want to be in that state again. I will be trying to find a new doctor but that process will take a few months and I start a new job soon. I cant afford to be thrown off mentally and physically again.

The most important thing you need is patience. I'm speaking from experience here. since I have a genetic disease that makes me produce no patience at all :-D.

Try injecting 5 mg of t.Cyp M-W-F the first week (15 mg total), then the second week up the dosage to 10 mg for a total of 30 mg a week, if you tolerate that, try upping it to 15mg, for a total of 45 mg/week. then after that, maintain that dosage and wait 4-6 weeks until the levels start building up and stabilizing. The reason I propose this is to allow your body to slowly getting used to higher level of T without causing unpleasant side effects, but it may be a coupe of months until you'll be ready to make new adjustments to your protocol. It'll be tempting to add hCG, peptides, creams, and prayers to your protocols, don't do it. Prayers are okay though.

This is what I'd try to do myself. I'm sure there are other school of thoughts out there, particularly in blogs and YouTube videos that will recommend you buy testosterone by the truck load, and permanently attach a firehose to your veins to inject 20 Kg of T Cypionate per minute until your levels are above 55,000 Kg/ml because reference ranges mean nothing and are just statistical numbers, I just happen to disagree with them.

Keep in mind though, that I'm just another unknown person on the internet that speaks with great authority but may not know nothing about this topic.

Take my advice: don't take advice from me.

Good luck.

 

[camygod]

Im really beginning to feel Paul Borresen was right about cypitonante being a shit Ester