My latest labs... Any Guesses on what my Peak TT is?

[DaveK22]

So I did my blood work at the utmost trough...I usually inject Friday am around 7:00 am and I did this blood work Friday 7:20 am. After the blood draw, I resumed my scheduled injection.

So I selected some key panels to share...I'm wondering if there is a way to estimate what my Peak TT & Free would be? Still waiting on E2 to come in from Quest.

I went back on TRT 10 months ago & changed protocols a few times. These labs were after 10 weeks at current protocol (listed below). Also, hoping HCT & Hemo slowly lowers over time (currently not donating).

Any best guesses? Thx in advance

 

[Vince]

I like all your levels except for your hemoglobin and hematocrit, hopefully they will stop rising.

How do you feel on your latest protocol?

 

[Systemlord]

Check folic acid and B12 due to the high MCH.

Do you drink alcohol?

 

[DaveK22]

Check folic acid and B12 due to the high MCH.

Do you drink alcohol?

I admit I drink more than I should & that's likely not helping things. I wish I could offset booze with occasional edibles but I can't due to my job & drug testing (under Federal rules, not State).

So back to my original question...is there anyway to calculate (or estimate) what my peak TT & Free might be?

 

[Systemlord]

So back to my original question...is there anyway to calculate (or estimate) what my peak TT & Free might be?

It’s nearly impossible to test true peak. Too many variables. You could peak anywhere between 12-18 hours, no way to know for sure, so difficult to choose the appropriate time to run labs.

 

[tropicaldaze1950]

IIRC, between 200 to 300 points higher than trough. If you want something more precise, as @Systemlord said, 12 to 18 hours post injection, but to what purpose? It always comes back to the question of how you're feeling and functioning, which includes sexual function. Numbers only serve a purpose, IMO, if you're not experiencing benefits or you're feeling worse.

 

[FunkOdyssey]

Readalot posted a table for this somewhere that gives you a multiplier to estimate your peak level based on trough, depending on your ester and frequency. Maybe someone can find it.

 

[DaveK22]

Thanks for all the feedback so far. I should mention that I am not the "typical" TRT guy as I have the Accutane version of PFS...all conventional "rules" are out the window. I've moved on from dwelling on all that & just trying to dial in best I can with my permanently "damaged" hormonal system.

FOR ME... TT levels (low or high) don't have a big difference energy or strength wise. What higher TT & FT does do is give some better libido and help with brain fog. There is a theory on the PFS forums about "silencing of androgen receptors"...but let's not go there here lol.

On a lighter side...any guesses on what my E2 will be? I'm curious to see...waiting on Quest as it's the last essay I'm waiting on from this draw.

 

[Systemlord]

On a lighter side...any guesses on what my E2 will be?

No, too many unknown variables, like clearance rate of estrogen, aromatase enzymes consideration etc..

Imagine throwing darts at a dartboard in the dark.

 

[Cataceous]

No, too many unknown variables, like clearance rate of estrogen, aromatase enzymes consideration etc..

Imagine throwing darts at a dartboard in the dark.

It's not that bad. There is published work yielding predictive equations for estradiol and DHT. Discussed here:

How to Predict Estradiol and DHT at Different Testosterone Doses

I was able to come up with a table using the predictive model equation derived from data in this study: The Effects of Injected Testosterone Dose and Age on the Conversion of Testosterone to Estradiol and Dihydrotestosterone in Young and Older Men Summary This video discusses a research paper...

www.excelmale.com

... I'm wondering if there is a way to estimate what my Peak TT & Free would be? ...

On E3.5D injections of T cypionate peaks may be about 50% over troughs. So Peak TT is around 1,400-1,500 ng/dL. Peak free T is over 300 on that Quest scale. If your average TT is about 1,200 ng/dL, then the Vermeulen calculated free testosterone is 36.5 ng/dL. In comparison, the top-of-range daily peak for healthy young men is about 23 ng/dL, and the average young guy's peak is around 15 ng/dl.

 

[madman]

So I did my blood work at the utmost trough...I usually inject Friday am around 7:00 am and I did this blood work Friday 7:20 am. After the blood draw, I resumed my scheduled injection.

So I selected some key panels to share...I'm wondering if there is a way to estimate what my Peak TT & Free would be? Still waiting on E2 to come in from Quest.

I went back on TRT 10 months ago & changed protocols a few times. These labs were after 10 weeks at current protocol (listed below). Also, hoping HCT & Hemo slowly lowers over time (currently not donating).

Any best guesses? Thx in advance

View attachment 38553

You are injecting 130 mg T split (65 mg every 3.5 days).

If you are injecting at 7 am Friday then your following injection should be Monday at 7 pm if you want to be precise as in every 3.5 days or 84 hrs.

The best time for labs on such a schedule to test true trough would be Friday morning at 7 a.m.

You had your blood work done right around this time.

As you can see you are hitting a very high-end trough TT 958 ng/dL and with a somewhat lowish SHBG 23 nmol/L your trough FT would be high.

Unfortunately, you never tested your FT using what is considered the most accurate assay the gold-standard Equilibrium Dialysis.

Quest let alone Nelson's discounted labs offers this assay.

Not sure why you would not jump on this as it is not that expensive, especially through discounted labs.

Even then if we take your high-end TT 958 ng/dL, somewhat lowish SHBG 23 nmol/L, and Albumin 4.2 g/dL then your cFT using the Vermeulen linear law-of-mass action would be very high as in 27.8 ng/dL.

Keep in mind as of now cFTV tends to overestimate somewhat when compared against the gold-standard Equilibrium Dialysis so your trough FT may very well be somewhat lower.

Even then it would still be very high.

As you should very well know your peak TT, FT, and estradiol are going to be higher.

You are hitting a high-end trough TT 958 ng/dL and a very high trough FT.

Not sure if you are injecting strictly sub-q or IM but I would bet your peak TT is around 1400 ng/dL and FT would be through the roof!

Regardless if you feel great overall on your current protocol minus any sides and blood markers are healthy then I would not change a thing.

Yes, your hematocrit and hemoglobin are just over the top end but not really high, and if you are not experiencing any negative symptoms then I would not be too concerned.

Most doctors in the know would not recommend donating or lowering your T dose unless your hematocrit hits 52-54%.

Yes, there are some who prefer not letting it get too far past the top-end but again whether one is experiencing any negative sides comes into play.

The shit kicker here is that you and many still fail to understand that where your hematocrit sits 6-10 weeks in let alone 6 months is not a given where it will stay as hematocrit will increase within the first month of starting TRT or tweaking a protocol (increasing dose of T) and will take anywhere from 6-9 months and in some cases up to one year to reach peak levels.

You are only 10 weeks into your protocol and your hematocrit is just over the top end of the reference range it will most likely continue to rise in the coming months so just be prepared for this as things may be worse off in the long run due to you running a very high trough FT level.

T.Cyp 100 mg/week - Night sweats, anxiety

Sorry to hear you are struggling there mate. Something similar I had as well or at least some of the symptoms you've listed. Most of mine were- elevated BP and RHR, some anxiety, feeling hot and overstimulation, as I believe. My protocol of choice, since starting TRT less then 12 months ago...

www.excelmale.com

This needs to be stressed!

Patience is key when tweaking a protocol (decreasing/increasing T dose).


*It has to be noted that the largest increase in hematocrit levels is seen in the first year after initiation of testosterone therapy. On the other hand it is expected that a decrease can take a similar amount of time. Especially when taking into account that the lifespan of a erythrocyte is 120 days. Hence, interventions to lower hematocrit levels should be evaluated after 6 months and a decrease can be expected until 1 year after the intervention.

 

[madman]

So I did my blood work at the utmost trough...I usually inject Friday am around 7:00 am and I did this blood work Friday 7:20 am. After the blood draw, I resumed my scheduled injection.

So I selected some key panels to share...I'm wondering if there is a way to estimate what my Peak TT & Free would be? Still waiting on E2 to come in from Quest.

I went back on TRT 10 months ago & changed protocols a few times. These labs were after 10 weeks at current protocol (listed below). Also, hoping HCT & Hemo slowly lowers over time (currently not donating).

Any best guesses? Thx in advance

View attachment 38553

I went back on TRT 10 months ago & changed protocols a few times. These labs were after 10 weeks at current protocol (listed below). Also, hoping HCT & Hemo slowly lowers over time (currently not donating).

You are only 10 weeks in.

Highly doubtful especially seeing as you are running a very high trough FT let alone your peak will be through the roof!

 

[DaveK22]

@madman Thanks for all the great information. I will re-read again after work to fully digest.

But to clarify a few things...I have been back on TRT now for over 10 months. When I said I changed protocols a few times, it was going from daily injections > E3D > E3.5D but my T-Cyp was always on the higher side

The current protocol (and labs) is closer to 12 weeks (not 10 like I initially stated) and it was also me trying shallow IM for first time. I've read that some say feel better doing shallow IM but for me I did not feel any difference. I'm going back to sub-q as it's just easier for me.

I'm running the high levels as I'm trying to "offset" some the permanent damage from my use of accutane. I actually don't feel that much difference than lower levels of T-Cyp as far as energy but it does seem to give a little libido. Because of the 'tane damage, when not on TRT I was 250 TT, no libido, and mild brain fog which I why I was going higher

I'm pleased that my HCT isn't higher given my high levels but I still may not rule out going down a bit with my weekly T-cyp dose.

 

[DaveK22]

@madman @Vince @Systemlord @Cataceous
E2=75

 

[Vince]

@madman @Vince @Systemlord @Cataceous
E2=75

Personally, I wouldn't be too concerned. If you're not having any symptoms from higher E2. I would leave it where it's at.

 

[tropicaldaze1950]

Personally, I wouldn't be too concerned. If you're not having any symptoms from higher E2. I would leave it where it's at.

Agree. Men worry or their doctors automatically prescribe an ai because the prevailing advice or thought is that E2 'should' be between 20 and 30 pg, but the contrarian school, led by Dr. Rouzier and the doctors who trained with him, says ignore it or even supplement it. I don't believe there's a wrong or right perspective. To your point; if a man isn't experiencing problems from high estradiol, don't mess with it.

 

[Systemlord]

@madman @Vince @Systemlord @Cataceous
E2=75

Excellent, you have a healthy estrogen level. I’ve had my estrogen level as high as 70 and I feel great.

 

[madman]

@madman Thanks for all the great information. I will re-read again after work to fully digest.

But to clarify a few things...I have been back on TRT now for over 10 months. When I said I changed protocols a few times, it was going from daily injections > E3D > E3.5D but my T-Cyp was always on the higher side

The current protocol (and labs) is closer to 12 weeks (not 10 like I initially stated) and it was also me trying shallow IM for first time. I've read that some say feel better doing shallow IM but for me I did not feel any difference. I'm going back to sub-q as it's just easier for me.

I'm running the high levels as I'm trying to "offset" some the permanent damage from my use of accutane. I actually don't feel that much difference than lower levels of T-Cyp as far as energy but it does seem to give a little libido. Because of the 'tane damage, when not on TRT I was 250 TT, no libido, and mild brain fog which I why I was going higher

I'm pleased that my HCT isn't higher given my high levels but I still may not rule out going down a bit with my weekly T-cyp dose.

Not sure how many months out of the 10 were dedicated to the daily injection protocol but I would say at least 3 if you had given it a fighting chance to claim whether it was truly a success or failure.

Keep in mind that although you have been on TRT for 10 months and for the most part running higher T levels on the various protocols (daily->E3D->E3.5D) there is going to be a big difference in your peak--->trough FT levels between the daily vs E3D/E3.5D protocols.

Peak--->trough levels can have a big impact on driving up hematocrit let alone as I have stated numerous times on the forum running high FT levels steady-state will also have a big impact.

This is the mistake many make when jumping on daily injections in the hopes of lowering hematocrit let alone estradiol by clipping the peak--->trough yet many will continue to struggle with such due to running too high an FT level.

Would definitely still keep an eye on where your hematocrit may be heading.

 

[madman]

@madman @Vince @Systemlord @Cataceous
E2=75

You are running absurdly high peak let alone high trough FT levels and it is a given that you are going to be driving up your estradiol.

If you feel great overall minus any sides then I would not be too concerned.

Stick with what works for you.

If you were struggling with sides and looking into adding in an AI then I would say the better option would be lowering your overall weekly dose and bringing down your trough FT level as you easily have room to play!

 

[Cataceous]

...
E2=75

The glib reassurances ignore the fact that you're in uncharted territory, so many standard deviations above the average for men that virtually none would have that level naturally. At best, the long-term risks of maintaining such levels are unknown. Apart from being a high absolute number, your estradiol is 0.78% of testosterone, which is relatively high as well—normal is more like 0.3-0.6%.

The sensitive estradiol test is not entirely reliable, so you might want to confirm the figure. Nonetheless, your TRT dosing is excessive, so you have plenty of leeway to make your levels more physiological.