Off topic I know, but I haven't been able to figure out how to post yet my apologiesI am new to the forums and TRT. I have been on TRT since mid-November and its been a rollercoaster. My first round was with my GP who prescribed 100mg 1X per week and my TT went from 363 to 724, FT went from 3.6 to 14 total estradiol went from 71 to 133. He prescribed Anastrazole 1mg every other day and CDG 1000mg per day. Thanks to the forums I did not execute. Never the less I took some AI and went to 50mg 2x per week. My TT 3 weeks later was at 920 and FT went to 17 SHBG was at 36 down from 43. I only took 3mg total of AI over 3-4 weeks and my E2 ultra went from 50 to 7.4. I ditched my GP for
DEFY and the DR prescribed 140mg (70x2) per week and DHEA 10mg per night as my DHT and free T were on the low side but I started getting high E2 sypmtoms so I went to 3x per week. I am currently doing BW this Monday. Each time protocol I felt the sweetspot and it passed by like an express train through a statioin. Currently I feel my E2 may still be high as well I expect my TT to be high. I am not sleeping that well but ok. morning wood has been frustrating with a period in the last two months of several per morning to hit or miss now. This is why I think my dose may be too high as I blew through my sweetspotI also feel a little sweaty while at rest and some anxiety. I'd like your thoughts if you have time. Also I have floaters in my eyes and would like to try 12mg Astaxanthin but have read this can kill libido and DHT which is up and down. Last question can I take 3mg extended melatonin per night or is this a TRT disrupter. Thanks for any insight I'd so appreciate your thoughts Sir!
I have been on TRT since mid-November and its been a rollercoaster. My first round was with my GP who prescribed 100mg 1X per week and my TT went from 363 to 724, FT went from 3.6 to 14 total estradiol went from 71 to 133. He prescribed Anastrazole 1mg every other day and CDG 1000mg per day. Thanks to the forums I did not execute.
Messy situation you put yourself in here.
Always include the testing method used/reference range especially for the most critical fraction free testosterone.
The standard starting dose by those in the know is 100 mg T/week and you stated that your TT went from 363 ng/dL---> a robust 724 ng/dL and more importantly your FT went from 3.6---> a healthy 14 ng/dL .
The s**t kicker here is how many weeks after starting therapy did you have your blood work done and how many days post-injection?
What testing method was used for FT (calculated, direct IA, Equilibrium Dialysis or Ultrafiltration).
Keep in mind that although TT is important to know FT is what truly matters here as it is the active unbound fraction of T responsible for the positive effects.
The only way to know where your FT truly sits would be testing it using the most accurate assay the gold standard Equilibrium Dialysis especially in cases of altered SHBG.
If you do not have access to such which. is highly doubtful unless you live outside of the US then you would need to use/rely on the next best testing method the go to calculated linear law-of-mass action Vermeulen (cFTV) which will give a good approximation although it tends to overestimate slightly.
No one should be using/relying on the known to be inaccurate direct immunoassay (CLIA/RIA)!
Keep in mind most healthy young natty males would be hitting a cFTV 13-15 ng/dL or a FT 12 ng/dL tested using the gold standard ED assay and this would be a short-lived daily peak to boot.
Just to put this in perspective!
FT <5 ng/dL would be considerd low.
FT 5-9 ng/dL would be considered the grey zone where some men may experience symptoms of low-T.
FT 10-15 ng/dL would be healthy.
FT 20-25 ng/dL would be high-end/high!
The majority of men will do well with a trough FT 15-25 ng/dL depending on the injection frequency.
You need to wait 4-6 weeks after starting as it will take time to for your blood levels to stabilize as in reach steady-state due to the pharmacokinetics esterified TC/TE.
If you get your blood work done before you have reached steady-state then your results will be be skewed and you will have no idea where your trough TT and more importantly trough FT, estradiol and SHBG will end up.
Blood work should be done 6 weeks in and we always want to test at the true trough (lowest point) before your next injection which would be 7 days post-injection in your case.
All that can be said is you were hitting a robust TT 724 ng/dL and more importantly healthy FT but again did you wait 6 weeks for blood levels to stabilize and was your blood work done at the true trough.
Luckily you did not start the AI which would have been a bad move as you would have crashed a critical T metabolite estradiol which would have a negative impact on symptom relief/improvement and your overall health especially long-term.
Ts metabolites estradiol and DHT are needed in healthy amounts to experience the full spectrum of testosterone-beneficial effects on (cardiovascular health, brain health, libido, erectile function, bone health, tendon health, immune system, lipids, and body composition).
Again have no idea here how many weeks in after first starting therapy blood work was done or how many days post injection so we are shooting in the. dark here.
Even then have no clue. how long you stayed on your starting protocol before splitting your weekly dose 100 mg T split 50 mg twice-weekly.
What needs to be stressed here and this is where many fail as they lack the understanding of how exogenous T works when first starting TTh or tweaking a protocol (dose T/injection frequency) the weeks leading up until blood levels have stabilized mean nothing when looking at the bigger picture here as your hormones will be in FLUX during the weeks leading up until steady-state is achieved and it is common for one to experience ups/downs along the way as the body is trying to adjust to the increase in T and its metabolites (estradiol/DHT).
Many tend to experience what is called the honeymoon period where one feels euphoric, increased libido and erections and overall well-being due to increased dopamine, rising T and lighting up of the ARs (androgen receptors).
Unfortunately this is short-lived and temporary as the body will eventually adapt and things tend to wane back in the norm as in healthy.
Even then once steady-state is achieved it will still take the body time as in a few more months to adapt to its new set-point and this is the critical time period where one needs to gauge how they truly feel overall regarding relief/improvement of low-T symptoms and overall well-being.
When using TE or TC it will take 4-6 weeks to reach steady-state so the first 4-6 weeks means nothing when looking at the bigger picture here as the body is trying to ADJUST to the rising T.
Once steady-state is achieved it will take a few more months for the body to ADAPT to its new set-point.
Every protocol needs to be given a fighting chance at least 12 weeks before claiming whether it was a success or failure.
Never the less I took some AI and went to 50mg 2x per week. My TT 3 weeks later was at 920 and FT went to 17 SHBG was at 36 down from 43. I only took 3mg total of AI over 3-4 weeks and my E2 ultra went from 50 to 7.4.
If you had given your previous protocol 100 mg T once weekly a fighting chance as in 12 weeks and your trough FT needed to be brought up further then the smart move depending on where your trough FT truly sat would be spitting up the dose and injecting twice-weekly which would clip the peak and bring up the trough while at the same time keeping blood levels more stable throughout the week or increasing your weekly dose 20-25 mg which would have a big impact on driving up your TT, FT and estradiol.
You split your dose but made a big mistake by throwing in the AI let alone had your blood work done 3 weeks in so you had not even reached steady-state (4-6 weeks TC/TE) yet which means your TT, FT and estradiol will be higher.
As you can see 3 weeks in on your new protocol 100 mg T split 50 mg twice-weekly you are hitting a high-end TT 920 ng/dL and more importantly higher/healthy FT 17 ng/dL but again how many days post-injection and what is truly concerning here is you crashed your estradiol 50--->7.4 due to using an AI!
You are going to be in a world of hurt here if you do not ditch the AI as you need a healthy level of estradiol to reap the benefits of T let alone avoid the horrible sides it can cause and more importantly negative impact on your overall health especially cardiovascular, brain and bone.
I can already tell you that 3 weeks in you were already easily hitting a high end FT with a high-end TT 920 ng/dl and normalish SHBG 36 nmol/L.
If we calculate your FT using the go to linear law-of-mass action Vermeulen (cFTV) using the online calculator which is. available to the general public for free with a high-end TT 920 ng/dL, normalish SHBG 36 nmol/L and Albumin 4.3 g/dL (fixed) your FT 20.9 ng/dL would be high-end.
Top it off that you are only 3 weeks in and have not even reached steady-state yet so your TT and more importantly FT would have been higher than 20.9 ng/dL.
Again blood work needs to be done 6 weeks in whether first starting therapy or tweaking your protocol (dose T/injection frequency) otherwise your results will be skewed.
If you waited and tested 6 weeks in your TT would be >1000 ng/dL and more importantly your FT would be. high!
I ditched my GP for DEFY and the DR prescribed 140mg (70x2) per week and DHEA 10mg per night as my DHT and free T were on the low side but I started getting high E2 sypmtoms so I went to 3x per week. I am currently doing BW this Monday.
Your FT 17 ng/dL let alone cFTV 20.9 ng/dL was in no way on the low side not a chance and this is only 3 weeks in when you were injecting 100 mg T split 50 mg twice-weekly.
Now this is where things take a wild turn here as not only did you have your blood work done way too early as in 3 weeks in which already had you hitting a high-end TT and more importantly high-end FT 17 ng/dL but you jumped in with
Defy and they went and increased your weekly dose to 140 mg T/week split 70 mg T twice-weekly.
They increased your dose by a whopping 40 mg T/week yet 3 weeks in on your previous protocol 100 mg T split 50 mg twice-weekly had you hitting a high-end trough TT 920 ng/dL and more importantly healthy high-end FT 17 ng/dL.
Now they just went and jacked your TT and FT as you are going to. see a big increase in your TT and more importantly FT.
Even when one is in a situation where the dose may need to be titrated higher the most sensible move would be 20-25 mg T/week not 40 or 50 mg.
Way too big of a jump and even then you should have just stayed on 100 mg T/week split 50 mg twice-weekly and waited 6 weeks for blood levels to stabilize so you could have truly seen how high your TT and more importantly FT would have ended up on said dose.
It is a given that your FT would have been high.
Each time protocol I felt the sweetspot and it passed by like an express train through a statioin. Currently I feel my E2 may still be high as well I expect my TT to be high. I am not sleeping that well but ok. morning wood has been frustrating with a period in the last two months of several per morning to hit or miss now. This is why I think my dose may be too high as I blew through my sweetspotI also feel a little sweaty while at rest and some anxiety.
Numerous reasons here especially seeing as any time one increases the dose of T there will be a short-lived honeymoon period.
From one of my previous replies many tend to experience what is called the honeymoon period where one feels euphoric, increased libido and erections and overall well-being due to increased dopamine, rising T and lighting up of the ARs (androgen receptors).
Unfortunately this is short-lived and temporary as the body will eventually adapt and things tend to wane back in the norm as in healthy.
It is a given that your weekly dose is too high!
Again if anything you should have just stuck with 100 mg T/week split 50 mg twice-weekly without an AI and had your blood work done 6 weeks in once steady-state was. achieved so you could have seen where your trough TT and more importantly FT and estradiol would sat.
Again if you were hitting a healthy FT 17 ng/dL and this was at trough 3 weeks in then your true trough FT 6 weeks in would have been higher.
Then you would have needed to given the protocol a few more months to allow your body time to. adapt to its new set-point as this is the CRITICAL time period where one needs to gauge how they truly feel overall regarding relief/improvements of low-T symptoms.
If you do nit understand how this works and you keep tweaking your protocol too soon you will be left chasing your tail indefinitely!
As we always stress on here start low and go slow on a T only protocol.
There will always be time to titrate the dose or thrown in hCG if need be!
Patience is key when it comes to the game!
