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Testosterone Replacement, Low T, HCG, & Beyond
Testosterone Basics & Questions
Switch to IM from SQ? Lower E2? Sleep, digestion, maybe lower Free T...
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<blockquote data-quote="eyeheartny" data-source="post: 203726" data-attributes="member: 18882"><p>Long-term TRT patient, current protocol is 154mg/week in EOD SubQ shots (into thigh, belly, hip, etc). I've struggled on and off with digestion issues (constipation) and lack of deep sleep. A few months ago I started intermittent fasting and it's been good for dropping some weight. That combined with lots of cardio has also raised my SHBG a bit, which is good based on where it was before (up to 29 nmol/L from 20 nmol/L a year ago).</p><p></p><p>I got bloodwork done recently because my sleep quality has declined dramatically and my constipation has been worse despite plenty of water and fiber once I break my fast in the afternoon. I'm also retaining water in my hands after I wake up in the morning (Oura sleep ring hard to remove). I take 2.5mg of tadalafil every morning, which I know has long-term effects of shifting the T:E2 ratio toward more T and lower E2. I've been on that about a year. Constipation was better a year ago prior to that addition. Sleep was best a few months ago. No changes to protocol during that time. I am now fasting. I slept great the first few months I was fasting so I don't think it's that.</p><table class='post-table ' style='width: 100%'><tr><td ><p>Test</p></td><td ><p>Result</p></td><td ><p>Range</p></td></tr><tr><td ><p>Testosterone, Total</p></td><td ><p>709.40 ng/dL</p></td><td ><p>240.24 - 870.68 ng/dL</p></td></tr><tr><td ><p>Estradiol, Sensitive (Quest Diagnostics)</p></td><td ><p>34 * H * pg/mL</p></td><td ><p>< or = 29 pg/mL</p></td></tr><tr><td ><p>Sex Hormone Binding Globulin</p></td><td ><p>29 nmol/L</p></td><td ><p>13 - 71 nmol/L</p></td></tr><tr><td ><p>Testosterone, Free Calculation</p></td><td ><p>132 pg/mL</p></td><td ><p>47 - 244 pg/mL</p></td></tr></table>Couple of questions. First, according to the TruT calculator, my free T (based on SHBG and albumin of 3.9) is closer to 271.5 pg/mL. Even the older Vermeulen calculator has me around 215 pg/mL. I'm not too bothered by the number but it's notable how wide the spread is.</p><p></p><p></p><p>In terms of things to try tweaking, I have a few options in mind:</p><ul> <li data-xf-list-type="ul">Switch from SQ to shallow IM shots</li> <li data-xf-list-type="ul">Keep T the same and try a low dose of exemestane to see if lowering that E2 level helps with constipation and sleep</li> <li data-xf-list-type="ul">Raise or lower my T dose a bit to try to target a higher Free T or E2 or lower E2 level</li> </ul><p>What would you guys recommend?</p></blockquote><p></p>
[QUOTE="eyeheartny, post: 203726, member: 18882"] Long-term TRT patient, current protocol is 154mg/week in EOD SubQ shots (into thigh, belly, hip, etc). I've struggled on and off with digestion issues (constipation) and lack of deep sleep. A few months ago I started intermittent fasting and it's been good for dropping some weight. That combined with lots of cardio has also raised my SHBG a bit, which is good based on where it was before (up to 29 nmol/L from 20 nmol/L a year ago). I got bloodwork done recently because my sleep quality has declined dramatically and my constipation has been worse despite plenty of water and fiber once I break my fast in the afternoon. I'm also retaining water in my hands after I wake up in the morning (Oura sleep ring hard to remove). I take 2.5mg of tadalafil every morning, which I know has long-term effects of shifting the T:E2 ratio toward more T and lower E2. I've been on that about a year. Constipation was better a year ago prior to that addition. Sleep was best a few months ago. No changes to protocol during that time. I am now fasting. I slept great the first few months I was fasting so I don't think it's that. [TABLE][TR][TD] Test [/TD] [TD] Result [/TD] [TD] Range [/TD][/TR] [TR][TD] Testosterone, Total [/TD] [TD] 709.40 ng/dL [/TD] [TD] 240.24 - 870.68 ng/dL [/TD][/TR] [TR][TD] Estradiol, Sensitive (Quest Diagnostics) [/TD] [TD] 34 * H * pg/mL [/TD] [TD] < or = 29 pg/mL [/TD][/TR] [TR][TD] Sex Hormone Binding Globulin [/TD] [TD] 29 nmol/L [/TD] [TD] 13 - 71 nmol/L [/TD][/TR] [TR][TD] Testosterone, Free Calculation [/TD] [TD] 132 pg/mL [/TD] [TD] 47 - 244 pg/mL [/TD][/TR][/TABLE] Couple of questions. First, according to the TruT calculator, my free T (based on SHBG and albumin of 3.9) is closer to 271.5 pg/mL. Even the older Vermeulen calculator has me around 215 pg/mL. I'm not too bothered by the number but it's notable how wide the spread is. In terms of things to try tweaking, I have a few options in mind: [LIST] [*]Switch from SQ to shallow IM shots [*]Keep T the same and try a low dose of exemestane to see if lowering that E2 level helps with constipation and sleep [*]Raise or lower my T dose a bit to try to target a higher Free T or E2 or lower E2 level [/LIST] What would you guys recommend? [/QUOTE]
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Testosterone Replacement, Low T, HCG, & Beyond
Testosterone Basics & Questions
Switch to IM from SQ? Lower E2? Sleep, digestion, maybe lower Free T...
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