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Testosterone Replacement, Low T, HCG, & Beyond
Testosterone Side Effect Management
Perplexing result.. thoughts?
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<blockquote data-quote="Cataceous" data-source="post: 214547" data-attributes="member: 38109"><p>Reiterating: Although I'm not certain, I think there's a decent chance that peak serum testosterone with propionate occurs 2-6 hours post-injection. If this is the case then your peak could be higher than the 33.7 nMol/L figure. A drop of 20-25% off of peak is pretty conservative. Young men can naturally have a 40% drop from peak to trough, which may also be viewed as a +/-25% swing about the average level.</p><p></p><p>At 0.38% of testosterone, estradiol is actually towards the lower end of the normal range of 0.3-0.6%. The way to bring it down is to reduce testosterone to more natural levels.</p><p></p><p>First, although testosterone and estradiol are important, they are clearly not the whole story. We touched on that in a <a href="https://www.excelmale.com/forum/threads/not-tolerating-test-prop.19887/post-192946" target="_blank">previous thread</a>, and I'll say more about that below. Second, you may not have tried levels that are normal and appropriate for your physiology. Your lowest peak testosterone seems to be at least 30 nMol/L. For healthy young guys the average peak level is more like 22.5 nMol/L. Unless you know what your levels were at your prime you have to assume a 50% chance that they were lower than 22.5 nMol, and a very high chance that they were under 30 nMol/L. Thus I think it's worthwhile to explore lower levels. This is what I've done over the years, taking from as much as 10 mg testosterone (without ester) daily to as little as 3.7 mg, and eventually deciding that 4.4 mg feels best, at least in conjunction with other elements of my protocol.</p><p></p><p>One hypothesis is that estradiol can lag testosterone, and thus is reflecting testosterone that was supraphysiological earlier in the injection cycle. It's not the most satisfying of explanations, given that the variations in estradiol aren't always that consistent. So we have to assume there are other variables in play. I have found that using propionate, either alone or in a blend, contributes to apparent "noise" in measurements. The subdued variation seen with frequent injections of longer esters gave me more consistent and predictable results. Nonetheless, I think the variation in serum testosterone obtained with a blend gives subtly better subjective results and is more natural than steady levels.</p><p></p><p>I don't think you've completely exhausted the options in conventional TRT. There's lower dosing to explore, and I don't recall if you've tried hCG. If you haven't used hCG before then it's something to consider. I found adding it to TRT to be a definite improvement. In addition, you should monitor progesterone and supplement if it's low. As suggested by [USER=13651]@tropicaldaze1950[/USER] you should ensure proper thyroid function, because symptoms can overlap those of low testosterone. If you do all this and are still having problems then there are other things to try, but with less direct supporting evidence that they are effective. You can try raising dopamine and/or acetylcholine with drugs or supplements. Your latest prolactin measurement doesn't point to reduced dopaminergic activity, so you'd want to be careful with dosing. Finally, there's restoration of the hormones upstream of testosterone. However, you have to be pretty motivated to implement such a demanding protocol. It took all of the above things to get me to the point where I can say that in most areas I am nearly as good as I was before becoming hypogonadal, and in some ways better. Unfortunately, even the best clinics are not to the point of helping guys try all of these treatments. In the best case you may find one to partner with that will at least tolerate your experimentation.</p></blockquote><p></p>
[QUOTE="Cataceous, post: 214547, member: 38109"] Reiterating: Although I'm not certain, I think there's a decent chance that peak serum testosterone with propionate occurs 2-6 hours post-injection. If this is the case then your peak could be higher than the 33.7 nMol/L figure. A drop of 20-25% off of peak is pretty conservative. Young men can naturally have a 40% drop from peak to trough, which may also be viewed as a +/-25% swing about the average level. At 0.38% of testosterone, estradiol is actually towards the lower end of the normal range of 0.3-0.6%. The way to bring it down is to reduce testosterone to more natural levels. First, although testosterone and estradiol are important, they are clearly not the whole story. We touched on that in a [URL='https://www.excelmale.com/forum/threads/not-tolerating-test-prop.19887/post-192946']previous thread[/URL], and I'll say more about that below. Second, you may not have tried levels that are normal and appropriate for your physiology. Your lowest peak testosterone seems to be at least 30 nMol/L. For healthy young guys the average peak level is more like 22.5 nMol/L. Unless you know what your levels were at your prime you have to assume a 50% chance that they were lower than 22.5 nMol, and a very high chance that they were under 30 nMol/L. Thus I think it's worthwhile to explore lower levels. This is what I've done over the years, taking from as much as 10 mg testosterone (without ester) daily to as little as 3.7 mg, and eventually deciding that 4.4 mg feels best, at least in conjunction with other elements of my protocol. One hypothesis is that estradiol can lag testosterone, and thus is reflecting testosterone that was supraphysiological earlier in the injection cycle. It's not the most satisfying of explanations, given that the variations in estradiol aren't always that consistent. So we have to assume there are other variables in play. I have found that using propionate, either alone or in a blend, contributes to apparent "noise" in measurements. The subdued variation seen with frequent injections of longer esters gave me more consistent and predictable results. Nonetheless, I think the variation in serum testosterone obtained with a blend gives subtly better subjective results and is more natural than steady levels. I don't think you've completely exhausted the options in conventional TRT. There's lower dosing to explore, and I don't recall if you've tried hCG. If you haven't used hCG before then it's something to consider. I found adding it to TRT to be a definite improvement. In addition, you should monitor progesterone and supplement if it's low. As suggested by [USER=13651]@tropicaldaze1950[/USER] you should ensure proper thyroid function, because symptoms can overlap those of low testosterone. If you do all this and are still having problems then there are other things to try, but with less direct supporting evidence that they are effective. You can try raising dopamine and/or acetylcholine with drugs or supplements. Your latest prolactin measurement doesn't point to reduced dopaminergic activity, so you'd want to be careful with dosing. Finally, there's restoration of the hormones upstream of testosterone. However, you have to be pretty motivated to implement such a demanding protocol. It took all of the above things to get me to the point where I can say that in most areas I am nearly as good as I was before becoming hypogonadal, and in some ways better. Unfortunately, even the best clinics are not to the point of helping guys try all of these treatments. In the best case you may find one to partner with that will at least tolerate your experimentation. [/QUOTE]
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Testosterone Replacement, Low T, HCG, & Beyond
Testosterone Side Effect Management
Perplexing result.. thoughts?
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