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Testosterone Replacement, Low T, HCG, & Beyond
Testosterone Basics & Questions
Lowered TT and FT went Higher! Now What?
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<blockquote data-quote="madman" data-source="post: 219646" data-attributes="member: 13851"><p>You made the mistake of not having your FT tested using an accurate assay on all of your labs.</p><p></p><p>You most likely had it tested using the piss poor direct immunoassay (Nov.24/2021), using the older outdated calculated linear law-of-mass action cFTV (Jan.18/2022), and on your most recent set luckily what would be considered one of the most accurate assays the gold standard equilibrium Dialysis.</p><p></p><p>When comparing labs whether TT, FT, or estradiol you need to use the same lab and the same assays (most accurate) TT/estradiol (LC/MS-MS) and FT (Equilibrium Dialysis or Ultrafiltration).</p><p></p><p>The only way to know where your FT level truly sits is to have it tested using the most accurate methods such as the gold standard Equilibrium Dialysis or Ultrafiltration (next best).</p><p></p><p>Unfortunately many are using/relying upon the piss poor known to be inaccurate direct immunoassay.</p><p></p><p>Even more critical to use the most accurate assays (ED or UF), especially in cases of altered SHBG.</p><p></p><p>FT of 5-10 ng/dL would be considered low.</p><p></p><p>FT 16-31 ng/dL is healthy.</p><p></p><p>Most men will do well with FT 20-30 ng/dL.</p><p></p><p>Some may choose/want to run higher levels.</p><p></p><p>Comes down to the individual.</p><p></p><p></p><p></p><p></p><p><strong><u>Nov 24, 2021 - Felt like crap - like Low T/E symptoms - Crashed my E</u></strong></p><p><u><strong>TT 759 </strong></u><strong>(264-916)</strong></p><p><strong>FT 12.2 (7.2-24.0)</strong></p><p><strong>Estradiol 5.4 (7.6 - 42.6) Crashed it on crumbs of AI's</strong></p><p><strong><u>SHBG 44.6</u> (19.3-76.4)</strong></p><p><strong>Ferritin - 46 (30-400)</strong></p><p><strong>Iron - 208</strong></p><p><strong>Hemoglobin 16.9</strong></p><p><strong>Hematocrit - 50.8</strong></p><p><strong>Protocol EOD 26mg Test Cyp and crumbs (yes crumbs) of AI as needed for bloating, low mood (been on this for 3 years)</strong></p><p><strong>*labcorp</strong></p><p></p><p></p><p>You were injecting 91mg T/week (26 mg EOD).</p><p></p><p>If your labs were done at the true trough (this is when we want to test) then with a robust TT 759 ng/dL, SHBG 44.6 nmol/L, Albumin 4.3 g/dL (fixed) then your trough FT would most likely be around 25 ng/dL (just above mid-range).</p><p></p><p>Keeping in mind peak TT, FT will be higher.</p><p></p><p>[URL unfurl="true"]https://tru-t.org/[/URL]</p><p>[ATTACH=full]20334[/ATTACH]</p><p></p><p>As you can see estradiol was horribly low and most likely why you felt like shit!</p><p></p><p>Ferritin is closer to the lower end most likely from frequent blood donations from trying to manage elevated RBCs/hemoglobin/hematocrit.</p><p></p><p></p><p></p><p></p><p><strong>***Changed Protocol to bring back E****</strong></p><p><strong></strong></p><p><strong><u>Jan 18th, 2022 - Felt Great - almost best I have felt except the 24/7 anxiety and insomnia</u></strong></p><p><strong><u>TT 1167</u> (250-1100)</strong></p><p><strong>FT 173.9 (46-224.0)</strong></p><p><strong>Estradiol 40 (< or = 29)</strong></p><p><strong><u>SHBG 36.6</u> (22-77)</strong></p><p><strong><u>Ferritin 26</u> (38-380)</strong></p><p><strong>Hemoglobin 16.4</strong></p><p><strong>Hematocrit - 48.7</strong></p><p><strong>Protocol ED 16mg Cyp, no AI's. Added 6mg Boron, 10,000IU Vit D3 5 days per week, and curcumin 250mg daily</strong></p><p><strong>*Quest</strong></p><p></p><p></p><p>You were injecting 112 mg T/week (16 mg daily).</p><p></p><p>If your labs were done at the true trough (this is when we want to test) then with a very high TT 1167 ng/dL, SHBG 36.6 nmol/L, Albumin 4.3 g/dL (fixed) then your trough FT would most likely be around 41-42 ng/dL (very high).</p><p></p><p>[ATTACH=full]20335[/ATTACH]</p><p></p><p>As you can see estradiol is back up due to stopping the AI and although you felt great overall you were experiencing anxiety/insomnia which was most likely due to your very high FT level.</p><p></p><p>Keep in mind that testosterone has a tonic effect on the CNS and high FT levels can easily cause insomnia/anxiety in some individuals.</p><p></p><p>Ferritin is crashed most likely from frequent blood donations trying to manage elevated RBCs/hemoglobin/hematocrit.</p><p></p><p></p><p></p><p></p><p><strong>****Doc told me to back down the T (wasn't quite the full 30 days on this dose)***</strong></p><p><strong></strong></p><p><strong><u>Present Day - Tired/lethargic, no motivation, don't feel strong, mood so so... Figured T was high but didn't expect this!</u></strong></p><p><strong><u>TT 897</u> (250-1100)</strong></p><p><strong>FT 196.7 (35 -155)</strong></p><p><strong>Estradiol 31 (< or = 29)</strong></p><p><strong><u>SHBG 33</u> (22-77)</strong></p><p><strong><u>Ferritin 22</u> (38-380)</strong></p><p><strong>Iron 197 (50-180)</strong></p><p><strong>Hemoglobin 17.3</strong></p><p><strong>Hematocrit - 33</strong></p><p><strong>Protocol ED 13mg Cyp, no AI's. Same as above except dropped curcumin. (on this for 30 days)</strong></p><p><strong>*Quest</strong></p><p></p><p></p><p>You are injecting 91 mg T/week (13 mg daily).</p><p></p><p>If your labs were done at the true trough (this is when we want to test) then with a high TT 897 ng/dL, SHBG 33 nmol/L, Albumin 4.3 g/dL (fixed) then your trough FT would most likely be around 31-32 ng/dL (high).</p><p></p><p>[ATTACH=full]20336[/ATTACH]</p><p></p><p>You are definitely hitting a high-end FT level injecting 91 mg T/week split 13 mg daily.</p><p></p><p>On your first protocol when you were running a robust TT 759 ng/dL which would have had your FT just above mid-range (around 25 ng/dL) you felt like crap which was most likely due to crashing your estradiol.</p><p></p><p>You said you felt great overall when you were running a very high TT 1167 ng/dL which would have had your FT very high (most likely low 40 ng/dL) but you were experiencing insomnia/anxiety.</p><p></p><p>On your current protocol, you stated.....<strong>Present Day - Tired/lethargic, no motivation, don't feel strong, mood so so... Figured T was high but didn't expect this!</strong></p><p></p><p>I would say there is a good chance that your crashed ferritin has finally caught up to you.</p><p></p><p>Keep in mind that crashed ferritin/iron can cause numerous issues especially when it comes to the thyroid.</p><p></p><p>Would look into getting your ferritin back up to a healthy level before tweaking your protocol further!</p></blockquote><p></p>
[QUOTE="madman, post: 219646, member: 13851"] You made the mistake of not having your FT tested using an accurate assay on all of your labs. You most likely had it tested using the piss poor direct immunoassay (Nov.24/2021), using the older outdated calculated linear law-of-mass action cFTV (Jan.18/2022), and on your most recent set luckily what would be considered one of the most accurate assays the gold standard equilibrium Dialysis. When comparing labs whether TT, FT, or estradiol you need to use the same lab and the same assays (most accurate) TT/estradiol (LC/MS-MS) and FT (Equilibrium Dialysis or Ultrafiltration). The only way to know where your FT level truly sits is to have it tested using the most accurate methods such as the gold standard Equilibrium Dialysis or Ultrafiltration (next best). Unfortunately many are using/relying upon the piss poor known to be inaccurate direct immunoassay. Even more critical to use the most accurate assays (ED or UF), especially in cases of altered SHBG. FT of 5-10 ng/dL would be considered low. FT 16-31 ng/dL is healthy. Most men will do well with FT 20-30 ng/dL. Some may choose/want to run higher levels. Comes down to the individual. [B][U]Nov 24, 2021 - Felt like crap - like Low T/E symptoms - Crashed my E[/U][/B] [U][B]TT 759 [/B][/U][B](264-916) FT 12.2 (7.2-24.0) Estradiol 5.4 (7.6 - 42.6) Crashed it on crumbs of AI's [U]SHBG 44.6[/U] (19.3-76.4) Ferritin - 46 (30-400) Iron - 208 Hemoglobin 16.9 Hematocrit - 50.8 Protocol EOD 26mg Test Cyp and crumbs (yes crumbs) of AI as needed for bloating, low mood (been on this for 3 years) *labcorp[/B] You were injecting 91mg T/week (26 mg EOD). If your labs were done at the true trough (this is when we want to test) then with a robust TT 759 ng/dL, SHBG 44.6 nmol/L, Albumin 4.3 g/dL (fixed) then your trough FT would most likely be around 25 ng/dL (just above mid-range). Keeping in mind peak TT, FT will be higher. [URL unfurl="true"]https://tru-t.org/[/URL] [ATTACH type="full" alt="Screenshot (11529).png"]20334[/ATTACH] As you can see estradiol was horribly low and most likely why you felt like shit! Ferritin is closer to the lower end most likely from frequent blood donations from trying to manage elevated RBCs/hemoglobin/hematocrit. [B]***Changed Protocol to bring back E**** [U]Jan 18th, 2022 - Felt Great - almost best I have felt except the 24/7 anxiety and insomnia TT 1167[/U] (250-1100) FT 173.9 (46-224.0) Estradiol 40 (< or = 29) [U]SHBG 36.6[/U] (22-77) [U]Ferritin 26[/U] (38-380) Hemoglobin 16.4 Hematocrit - 48.7 Protocol ED 16mg Cyp, no AI's. Added 6mg Boron, 10,000IU Vit D3 5 days per week, and curcumin 250mg daily *Quest[/B] You were injecting 112 mg T/week (16 mg daily). If your labs were done at the true trough (this is when we want to test) then with a very high TT 1167 ng/dL, SHBG 36.6 nmol/L, Albumin 4.3 g/dL (fixed) then your trough FT would most likely be around 41-42 ng/dL (very high). [ATTACH type="full" alt="Screenshot (11530).png"]20335[/ATTACH] As you can see estradiol is back up due to stopping the AI and although you felt great overall you were experiencing anxiety/insomnia which was most likely due to your very high FT level. Keep in mind that testosterone has a tonic effect on the CNS and high FT levels can easily cause insomnia/anxiety in some individuals. Ferritin is crashed most likely from frequent blood donations trying to manage elevated RBCs/hemoglobin/hematocrit. [B]****Doc told me to back down the T (wasn't quite the full 30 days on this dose)*** [U]Present Day - Tired/lethargic, no motivation, don't feel strong, mood so so... Figured T was high but didn't expect this! TT 897[/U] (250-1100) FT 196.7 (35 -155) Estradiol 31 (< or = 29) [U]SHBG 33[/U] (22-77) [U]Ferritin 22[/U] (38-380) Iron 197 (50-180) Hemoglobin 17.3 Hematocrit - 33 Protocol ED 13mg Cyp, no AI's. Same as above except dropped curcumin. (on this for 30 days) *Quest[/B] You are injecting 91 mg T/week (13 mg daily). If your labs were done at the true trough (this is when we want to test) then with a high TT 897 ng/dL, SHBG 33 nmol/L, Albumin 4.3 g/dL (fixed) then your trough FT would most likely be around 31-32 ng/dL (high). [ATTACH type="full" alt="Screenshot (11531).png"]20336[/ATTACH] You are definitely hitting a high-end FT level injecting 91 mg T/week split 13 mg daily. On your first protocol when you were running a robust TT 759 ng/dL which would have had your FT just above mid-range (around 25 ng/dL) you felt like crap which was most likely due to crashing your estradiol. You said you felt great overall when you were running a very high TT 1167 ng/dL which would have had your FT very high (most likely low 40 ng/dL) but you were experiencing insomnia/anxiety. On your current protocol, you stated.....[B]Present Day - Tired/lethargic, no motivation, don't feel strong, mood so so... Figured T was high but didn't expect this![/B] I would say there is a good chance that your crashed ferritin has finally caught up to you. Keep in mind that crashed ferritin/iron can cause numerous issues especially when it comes to the thyroid. Would look into getting your ferritin back up to a healthy level before tweaking your protocol further! [/QUOTE]
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Testosterone Replacement, Low T, HCG, & Beyond
Testosterone Basics & Questions
Lowered TT and FT went Higher! Now What?
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