Optimal testosterone levels references

fndx

New Member
Hey everyone,

I'm trying to clear up some confusion regarding the "optimal" reference numbers you see posted online by doctors (for example, saying a level between 600ng/dL and 1000ng/dL is optimal).

My question is: Are these online reference ranges measured on the day of injection, i.e. on a through?

If you are on TRT, testing at a true trough (right before your next injection) means that is your absolute lowest point. If an online range says 1000ng/dL is optimal, your levels are going to be much higher in reality during the rest of the week. This is especially true if you inject only twice per week (and not daily) with Tesosterone Enanthat, like I do. For clarity I inject 0.15ml of 250mg twice per week, which equals 75mg of Testosteron per week and my through is at 932ng/dL.

Does anyone know if the standard numbers thrown around online by doctors are supposed to represent a baseline trough, or are people mistakenly comparing their lowest TRT valley to a natural morning peak?

Thanks.
 
Last edited:
Hey everyone,

I'm trying to clear up some confusion regarding the "optimal" reference numbers you see posted online by doctors (for example, saying a level between 600ng/dL and 1000ng/dL is optimal).

My question is: Are these online reference ranges measured on the day of injection, i.e. on a through?

If you are on TRT, testing at a true trough (right before your next injection) means that is your absolute lowest point. If an online range says 1000ng/dL is optimal, your levels are going to be much higher in reality during the rest of the week. This is especially true if you inject only twice per week (and not daily) with Tesosterone Enanthat, like I do. For clarity I inject 0.15ml of 250mg twice per week, which equals 75mg of Testosteron per week and my through is at 932ng/dL.

Does anyone know if the standard numbers thrown around online by doctors are supposed to represent a baseline trough, or are people mistakenly comparing their lowest TRT valley to a natural morning peak?

Thanks.


Would not get too caught up on the TT even though it is important to know FT is what truly matters as it is the active unbound fraction of T responsible for the positive effects.

Those in the know would be testing at true trough (lowest point) before your next injection to make sure you are still achieving a healthy FT.

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.

Need to keep in mind that there is a big difference between one running a high-end/high trough FT 20-25 ng/dL injecting daily vs twice-weekly vs once weekly.

Also going to be a big difference in peak--->trough on said protocol!

It is expected that peak TT and more importantly FT would be supraphysiologic that is why you need to be mindful of how high you push your trough.

You are injecting 75 mg TE split twice-weekly (37.5 mg every 3.5 days) and hitting a high-end trough TT 932 ng/dL.

Definitely hitting a stellar trough on 75 mg T/week but the s**t kicker here is where does your FT sit?

Your trough FT is what truly matters here and you have three scenarios low/lowish SHBG, normal SHBG or highish/high SHBG.

We can use the go to linear law-of-mass action calculated Vermeulen (cFTV) to get an idea of where your trough FT would sit.

With a high-end trough trough TT 932 ng/dL and low/lowish SHBG 10 or 20 nmol/L, Albumin 4.3 g/dL (default) then your cFTV 33.3 or 27.8 ng/dL would be very high/high!


SHBG 10 nmol/L - cFTV 33.3 ng/dL
1780954605468.webp


SHBG 20 nmol/L - cFTV 27.8 ng/dL
1780954621980.webp



With a high-end trough trough TT 932 ng/dL and normal SHBG 30 nmol/L, Albumin 4.3 g/dL (default) then your cFTV 23.4 ng/dL would be high-end as in near the top-end.

SHBG 30 nmol/L - cFTV 23.4 ng/dL
1780954834151.webp


With a high-end trough trough TT 932 ng/dL and highish/high SHBG 40 or 50 nmol/L, Albumin 4.3 g/dL (default) then your cFTV 19.9 or 17.7 ng/dL would be high-end/healthy.

SHBG 40 nmol/L - cFTV 19.9 ng/dL
1780955176918.webp


SHBG 50 nmol/L - cFTV 17.1 ng/dL
1780955218054.webp

As you can see even a man with a high trough TT 932 ng/dL and high SHBG 50 nmol/L he would still be hitting a healthy trough cFTV 17.1 ng/dL as in upper teens 3.5 days post-injection!

Where does your SHBG sit?




 
Lab values are derived from the population that the lab is testing, ever notice how Quest and LabCorp have different lab ranges? There is no optimal number, no one has proven XXXX is optimal you have to figure that out for yourself with your symptoms. Having your trough at the highest "low" point in the lab range isn't IMHO the best for most guys.
 
My FT is 461.472ng/dL, and my SHBG is 40!

You would mean your trough FT is 46.1 ng/dL as there is no way you would be hitting a FT let alone at trough 461.1 ng/dL.

Even then have no clue here what testing method was used and you never mentioned the reference range.

Just to be clear here the only way to know where your FT truly sits is using the most accurate testing method the gold standard Equilibrium Dialysis especially in cases of altered SHBG,

Otherwise you would need to use/rely on the go to calculated linear law-of-mass action Vermeulen (cFTV) which will give a good approximation.

This is the method (cFTV) I used in my previous reply.

No one should be using/relying on the known to be inaccurate direct immunoassay (RIA/CLIA)!

Highly doubtful you had your FT tested using the most accurate assay and if we use the next best testing method cFTV with a high-end trough TT 932 ng/dL, highish SHBG 40 nmol/L and Albumin 4.3 g/dL (default) then your cFTV 19.9 ng/dL would be closer to the top-end of the refernce range and healthy.

1781038680332.webp


1781038332527.webp

1781038574237.webp


No way with you are hitting a trough FT 46.1 ng/dL with a trough TT 932 ng/dL and highish SHBG 40 nmol/L.

Yes when it comes to reference ranges for TT depending on the lab/assay used the reference ranges can vary widely especially the bottom-end.

Even then most of the labs especially the big ones in the US Labcorp and Quest both offer the most accurate assay for TT (LC-MS/MS) and use the standardized reference range 264-916 ng/dL!

* Standardized testosterone reference interval for nonobese adult males (19-39 years of age, BMI <30) was calculated as 264-916 ng/dL.




Just to be clear before everyone keeps on blaming this that and the other people need to be aware that the main reason for the lower reference range adopted from the more recent 2017 study comes down to harmonized reference ranges and standardized assays as testosterone concentrations were measured using a higher-order liquid chromatography-tandem mass spectrometry method.


*A large study of more than 9,000 men has established harmonized reference ranges for total testosterone in men that when applied to assays that have been appropriately calibrated will effectively enable clinicians to make a correct diagnosis of hypogonadism, according to a new study published in the Endocrine Society's Journal of Clinical Endocrinology & Metabolism.


* Harmonized normal range in a healthy nonobese population of European and American men, 19 to 39 years, is 264 to 916 ng/dL. A substantial proportion of intercohort variation in testosterone levels is due to assay differences. These data demonstrate the feasibility of generating harmonized reference ranges for testosterone that can be applied to assays, which have been calibrated to a reference method and calibrator.



* We conclude that standardized hormone measurements calibrated to a higher-order benchmark, such as that offered by the CDC Clinical Reference Laboratory, provide a rational and feasible approach to generating harmonized reference ranges for testosterone and possibly other analytes.






 

Attachments

  • 1781037588936.webp
    1781037588936.webp
    167.4 KB · Views: 21
Hey everyone,

I'm trying to clear up some confusion regarding the "optimal" reference numbers you see posted online by doctors (for example, saying a level between 600ng/dL and 1000ng/dL is optimal).

My question is: Are these online reference ranges measured on the day of injection, i.e. on a through?

If you are on TRT, testing at a true trough (right before your next injection) means that is your absolute lowest point. If an online range says 1000ng/dL is optimal, your levels are going to be much higher in reality during the rest of the week. This is especially true if you inject only twice per week (and not daily) with Tesosterone Enanthat, like I do. For clarity I inject 0.15ml of 250mg twice per week, which equals 75mg of Testosteron per week and my through is at 932ng/dL.

Does anyone know if the standard numbers thrown around online by doctors are supposed to represent a baseline trough, or are people mistakenly comparing their lowest TRT valley to a natural morning peak?

Thanks.
That's a good question. I've always used my 7 day half life #'s. Simply testing on injection day, right before next dose is not necessarily going to produce "Trough #'s" unless you factor in the products half life. Which for Cyp is about 7 days. Enanthate may be 4.5 days or it could be 7 day range as well.
So, if injecting ED or EOD or bi-weekly or weekly, your "trough" #'s can get skewed or not even exist depending on your injection schedule.
I was on bi-weekly dose (every 3.5 days) So, 3.5 days after my last shot created my Peak #'s from the last shot. I did get a nice Peak value on my Lab's @ 3.5 days. But, I was intentionally checking the Peak #'s
 
That's a good question. I've always used my 7 day half life #'s. Simply testing on injection day, right before next dose is not necessarily going to produce "Trough #'s" unless you factor in the products half life. Which for Cyp is about 7 days. Enanthate may be 4.5 days or it could be 7 day range as well.
So, if injecting ED or EOD or bi-weekly or weekly, your "trough" #'s can get skewed or not even exist depending on your injection schedule.
I was on bi-weekly dose (every 3.5 days) So, 3.5 days after my last shot created my Peak #'s from the last shot. I did get a nice Peak value on my Lab's @ 3.5 days. But, I was intentionally checking the Peak #'s
That is actually an excellent point, I did not think about that although it is quite simple and obvious! Thanks for sharing. So it is most likely rather the mean in my case, instead of a through.
 
That is actually an excellent point, I did not think about that although it is quite simple and obvious! Thanks for sharing. So it is most likely rather the mean in my case, instead of a through.

Your confused here.

Its not your mean you tested at true trough as in lowest point before your next injection.

Trough is always trough as in lowest point before your next injection.

Whether injecting TC or TE true peak will be achieved within 24 hrs.

There is a burst release of T and levels will start rising within the first 2 hrs post-injection.

Sift through the literature and look up the Nieschlag/Behre PK studies TE (Tmax) was shown to be anywhere from 8-24 hrs.

Keep in mind many of the PK studies never had blood sampling drawn hourly!

Look over the Antares Xyosted (TE Auto-injector)) study and that is using strictly subcutaneous injections which had TE (Tmax) 10 hrs post-injection.

Injecting once weekly true trough 7 days post-injection.

Twice-weekly every 3.5 days true trough 84 hrs post-injection.

Three times weekly (M/W/F) true trough 72 hrs post-injection (Monday AM).

EOD true rough 48 hrs post-injection

Daily trough 24 hrs post-injection.

Injecting once weekly there will be a big swing between the peak--->trough and blood levels will not be as stable throughout the week.

Increasing the injection frequency will clip the peak--->trough and levels will be more stable throughout the week.

Injecting daily has a huge impact on clipping the peak---->trough as it would be minimal and blood levels will be the most stable throughout the week
 
Hey everyone,

I'm trying to clear up some confusion regarding the "optimal" reference numbers you see posted online by doctors (for example, saying a level between 600ng/dL and 1000ng/dL is optimal).

My question is: Are these online reference ranges measured on the day of injection, i.e. on a through?

If you are on TRT, testing at a true trough (right before your next injection) means that is your absolute lowest point. If an online range says 1000ng/dL is optimal, your levels are going to be much higher in reality during the rest of the week. This is especially true if you inject only twice per week (and not daily) with Tesosterone Enanthat, like I do. For clarity I inject 0.15ml of 250mg twice per week, which equals 75mg of Testosteron per week and my through is at 932ng/dL.

Does anyone know if the standard numbers thrown around online by doctors are supposed to represent a baseline trough, or are people mistakenly comparing their lowest TRT valley to a natural morning peak?

Thanks.
Note that to answer this with real-world relevance would require breaking outcomes down into at least the categories of mood/mental health, athleticism/physical resilience, sexual desire/performance, mate attraction factors, and others like sleep quality. Optimal levels might be different for some or all of these categories. Numbers can provide clues but are almost never a destination in themselves. The blind man climbing a mountain is probably a good analogy.
 
Your confused here.

Its not your mean you tested at true trough as in lowest point before your next injection.

Trough is always trough as in lowest point before your next injection.

Whether injecting TC or TE true peak will be achieved well within 24 hrs.

There is a burst release of T and levels will start rising within the first 2 hrs post-injection.

Injecting once weekly true trough 7 days post-injection.

Twice-weekly every 3.5 days true trough 84 hrs post-injection.

Three times weekly (M/W/F) true trough 72 hrs post-injection (Monday AM).

EOD true rough 48 hrs post-injection

Daily trough 24 hrs post-injection.

Injecting once weekly there will be a big swing between the peak--->trough and blood levels will not be as stable throughout the week.

Increasing the injection frequency will clip the peak--->trough and levels will be more stable throughout the week.

Injecting daily has a huge impact on clipping the peak---->trough as it would be minimal and blood levels will be the most throughout the week
Not trying to make this even more complicated by any means. But;

Would product half life not be the "same" half life regardless of injection frequency?

SubQ injection Vs. IM certainly would change the timing of Peak level in blood. No??
 
That is actually an excellent point, I did not think about that although it is quite simple and obvious! Thanks for sharing. So it is most likely rather the mean in my case, instead of a through.

Again if we use the go to calculated linear law-of-mass action Vermeulen with a high-end trough TT 932 ng/dL, highish SHBG 40 nmol/L and Albumin 4.3 g/dL (default) then your cFTV 19.9 ng/dL would be closer to the top-end of the reference range and healthy.



1781212377378.webp



Your trough FT 19.9 ng/dL is healthy and not too high or too low.

Yes there would be room to push it up further if need be as 25-30 ng/dL would be high.

Again keep in mind that your peak TT and more importantly FT and estradiol would be higher.

You are injecting twice-weekly (every 3.5 days) so your true peak within 24 hrs will be higher than your true trough 84 hrs post-injection.

As I already stated injecting more frequently will clip the peak--->trough as in soften the peak and raise the trough!
 
Not trying to make this even more complicated by any means. But;

Would product half life not be the "same" half life regardless of injection frequency?

SubQ injection Vs. IM certainly would change the timing of Peak level in blood. No??

Regardless of whether one is injecting TC or TE true peak would be achieved anywhere from 8-24 hrs post-injection.

When it comes to the half-life they are basically interchangeable.

Both esters have been shown to have similar peaks even though TC is slightly longer acting.

Sift through the literature and look up the Nieschlag/Behre PK studies TE (Tmax) was shown to be anywhere from 8-24 hrs.

Even then look over the M Schulte-Beerbuhl, E Nieschlag study TC/TE.

COMPARISON OF TESTOSTERONE, DIHYDROTESTOSTERONE, LUTEINIZING HORMONE, AND FOLLICLE-STIMULATING HORMONE IN SERUM AFTER INJECTION OF TESTOSTERONE ENANTHATE OR TESTOSTERONE CYPIONATE (1980)


DISCUSSION


Injection of either testosterone enanthate or testosterone cypionate in equivalent doses yielded identical serum testosterone concentrations both in terms of maximal concentrations and in terms of duration of elevation above basal levels. Maximal and supraphysiologic levels were achieved as early as the 1st day after injection, and these values had returned to basal concentrations on day 10. There were also no differences in the conversion of testosterone to DHT and in the suppression of LH and FSH observed. Thus, both esters show the same pharmacokinetic properties and appear to be equally useful for clinical purposes.


The studies are posted on here.

Keep in mind many of the PK studies never had blood sampling drawn hourly!

Look over the Antares Xyosted (TE Auto-injector)) study and that is using strictly subcutaneous injections which shows TE (Tmax) 10 hrs post-injection.

My reply from an older thread (posted on here).

Regarding half-lives keep in mind that a majority of studies on the PK/PD of the various T-esters were done using IM (once weekly/fortnightly) injections in a small number of subjects and most of the literature is from decades ago.

Top it off that blood samples were generally collected once per day at a consistent time not every few hrs over a 24 hr period.

The 2019 Kaminetsky 52-week phase III study injecting TE strictly sub-q (Xyosted auto-injector) more frequent sampling was done during pharmacokinetic assessment.

Over a 24 hr period blood draws were done at predefined intervals (0, 2, 4, 8, 12, 24) then 48, 72, 96,120, 144, and 168 hours post-dose.

There is not going to be a big difference in the PKs (TC vs TE) although TC is slightly longer acting they are basically interchangeable.

There is. lots of misinformation out there littered on the forums/net regarding the half-life TC which is shorter than many think.

TE/TC are basically interchangeable and the half-life of TC is not 8 days.

TE: 7-carbon aliphatic ester side-chain

TC: 8-carbon aliphatic ester side-chain



T levels will start rising fairly quick even when using the medium-chain esters.

There will be a burst release of T within 2 hrs post-injection and true peak can be achieved within 24 hrs even as soon as 8-12 in some cases!

Depending on the dose injected T levels will be high/very high post-injection (peak/during the first few days) as once Tmax (within 24 hrs) is achieved levels start to decline gradually over the following days.

Increasing your injection frequency clips the peak--->trough let alone keeps blood levels more stable throughout the week.

There is going to be a big difference in peak--->trough injecting once weekly vs twice-weekly vs daily.

Even then when looking at the PKs injecting once weekly there can be high variability in T levels (peak/trough) between men.

Even then much more to the story here!




My reply from an older thread:

I would not fret over whether one uses enanthate vs cypionate as they are basically interchangeable.

Regardless of the minor differences in the esters between the two, there are many other factors that affect the rate at which testosterone is released from the oily depot at the injection site.

Sub-q vs IM, the volume of injection, injection depth, site of injection, lymphatic flow, and the concentration of BOH (benzyl alcohol) is other possible factors that can affect absorption rates of the esterified hormone.

As far as testosterone esters 100 mg of enanthate= 72 mg active testosterone and 100 mg cypionate= 70 mg active testosterone.

Would not even waste my time getting too caught up on the PKs.

If anything I would be far more concerned with your protocol (dose T/injection frequency)/SHBG level and where such has your trough FT levels!








 
Regardless of whether one is injecting TC or TE true peak would be achieved anywhere from 8-24 hrs post-injection.

When it comes to the half-life they are basically interchangeable.

Both esters have been shown to have similar peaks even though TC is slightly longer acting.

Sift through the literature and look up the Nieschlag/Behre PK studies TE (Tmax) was shown to be anywhere from 8-24 hrs.

Even then look over the M Schulte-Beerbuhl, E Nieschlag study TC/TE.

COMPARISON OF TESTOSTERONE, DIHYDROTESTOSTERONE, LUTEINIZING HORMONE, AND FOLLICLE-STIMULATING HORMONE IN SERUM AFTER INJECTION OF TESTOSTERONE ENANTHATE OR TESTOSTERONE CYPIONATE (1980)


DISCUSSION


Injection of either testosterone enanthate or testosterone cypionate in equivalent doses yielded identical serum testosterone concentrations both in terms of maximal concentrations and in terms of duration of elevation above basal levels. Maximal and supraphysiologic levels were achieved as early as the 1st day after injection, and these values had returned to basal concentrations on day 10. There were also no differences in the conversion of testosterone to DHT and in the suppression of LH and FSH observed. Thus, both esters show the same pharmacokinetic properties and appear to be equally useful for clinical purposes.


The studies are posted on here.

Keep in mind many of the PK studies never had blood sampling drawn hourly!

Look over the Antares Xyosted (TE Auto-injector)) study and that is using strictly subcutaneous injections which shows TE (Tmax) 10 hrs post-injection.

My reply from an older thread (posted on here).

Regarding half-lives keep in mind that a majority of studies on the PK/PD of the various T-esters were done using IM (once weekly/fortnightly) injections in a small number of subjects and most of the literature is from decades ago.

Top it off that blood samples were generally collected once per day at a consistent time not every few hrs over a 24 hr period.

The 2019 Kaminetsky 52-week phase III study injecting TE strictly sub-q (Xyosted auto-injector) more frequent sampling was done during pharmacokinetic assessment.

Over a 24 hr period blood draws were done at predefined intervals (0, 2, 4, 8, 12, 24) then 48, 72, 96,120, 144, and 168 hours post-dose.

There is not going to be a big difference in the PKs (TC vs TE) although TC is slightly longer acting they are basically interchangeable.

There is. lots of misinformation out there littered on the forums/net regarding the half-life TC which is shorter than many think.

TE/TC are basically interchangeable and the half-life of TC is not 8 days.

TE: 7-carbon aliphatic ester side-chain

TC: 8-carbon aliphatic ester side-chain



T levels will start rising fairly quick even when using the medium-chain esters.

There will be a burst release of T within 2 hrs post-injection and true peak can be achieved within 24 hrs even as soon as 8-12 in some cases!

Depending on the dose injected T levels will be high/very high post-injection (peak/during the first few days) as once Tmax (within 24 hrs) is achieved levels start to decline gradually over the following days.

Increasing your injection frequency clips the peak--->trough let alone keeps blood levels more stable throughout the week.

There is going to be a big difference in peak--->trough injecting once weekly vs twice-weekly vs daily.

Even then when looking at the PKs injecting once weekly there can be high variability in T levels (peak/trough) between men.

Even then much more to the story here!




My reply from an older thread:

I would not fret over whether one uses enanthate vs cypionate as they are basically interchangeable.

Regardless of the minor differences in the esters between the two, there are many other factors that affect the rate at which testosterone is released from the oily depot at the injection site.

Sub-q vs IM, the volume of injection, injection depth, site of injection, lymphatic flow, and the concentration of BOH (benzyl alcohol) is other possible factors that can affect absorption rates of the esterified hormone.

As far as testosterone esters 100 mg of enanthate= 72 mg active testosterone and 100 mg cypionate= 70 mg active testosterone.

Would not even waste my time getting too caught up on the PKs.

If anything I would be far more concerned with your protocol (dose T/injection frequency)/SHBG level and where such has your trough FT levels!








Holy crap!! Thx! I've got some reading to do!

Every chart I have seen over the yrs indicated 2-3 days to Peak on basic TC or TE.

I will admit through personal exp, the very noticeable "effect" (on libido, night/morn wood) of 1 larger (bolus) IM injection was def felt sometime on day 2 and continued through day 3 and waning from there.
But, I never had that same effect with subQ injections, regardless of dosage.

TRT is not an easy journey by any means. If the Gov's would get the hell out of the way, we could actually move into the 21st century on safe and effective therapeutic measures
 

ExcelMale Newsletter Signup

Online statistics

Members online
9
Guests online
1,293
Total visitors
1,302

Latest posts

Beyond Testosterone Podcast

Back
Top