T Too High - on 60mg of Test a Week!

[acmdds]

Hello Everyone,

Been reading as much as possible here, and I'm very happy I found this forum, all the info has been very helpful.

I would quickly like to introduce myself, I'm 37, 195lbs 5'10. Over the past two years I have been having many of the low t symptoms we all read about here so I decided to do something about. I found a local low t center and I signed up. My first labs were:

Labcorp
Total T 534 (348-1197)
Free T 6.7 ng/dl (1.26%)
Estradiol non-sensitive - 35 (7.6-42.6)
TSH .870
IGF1 114 (83-233)
Progesterone .2 (0-.5)
T4 1.25
Shbg - 67.7 -(16.5-55.9)
Hematocrit 39.3 (37.5-51.0)
PSA .5 (0-4.0)
All lipid panel and metabolic panel are normal within ranges


My Nurse practitioner noted that my t was in normal range however I did have a high shbg and low free t, so he recommend test CYP. Now here is where I feel things got weird. I'm a Denist, but as much as I have medical training, I don't have a thourough knowledge of the complexities of hormone therapy, as it's just not something we dentists deal with. So, that being said, my NP decided on front load dose of 240mg IM once a week, 500mg IU HcG 2x a week and 1mg anastrazole 2x a week. Reading most of the protocols here, this just did not seem to be the right starting dose, but at the time I did not know that.
The result from my first dose was that I experienced extreme and excruciating panic attacks and anxiety starting later that day and for another day or so, to the point that I had to take xanax to get through the week. Went back the following week for follow up, informed my NP about the anxiety, he decided to switch to 30mg subq twice a week. With time, my anxiety has improved but still mildly present.

At my six week follow up lab I was shocked to see that my t level was above the chart at >1500!
Hematocrit slightly crept up to 41 and estradiol went down to 22 and shbg down to 47. Granted , it may have been my fault as I tested on the day before my next injection and not on injection day.

Regardless, we decided to test again in four weeks. Surprisingly, same result, >1500t, also e2 shot up to 76, due to the fact I quit taking Ai, and yes I know, I will ask him to test sensitive estradiol next time.

So my question is, why is my T so high at such a low dose. I have an appt. with my NP tomorrow, but he has told me 30mg 2x a week is very conservative. Other than the anxiety, I am feeling so much better, better sex, better energy, also lifted my mild depression completely. Would hate to have to stop therapy so soon, seeing all the benefits it has given me so far.

I would appreciate any feedback on my situation. Thanks!

 

[CoastWatcher]

Welcome to Excelmale. You posted a total testosterone in excess of 1500 while injecting 60mg of testosterone in divided doses, 30mg, every 3.5 days? I don't believe it. I believe you, but I am in a state of disbelief relative to the results you obtained. That's a dose that I would have expected to return an anemic result. It makes no sense. The only other change was dropping the AI? I would retest at the proper time, just prior to an injection, and pull the appropriate estradiol test at the same time.

 

[James]

1,500 TT with two 30mg injections each week. That's unheard of. I doubled that at 60mg twice weekly and pulled half your TT at 750 TT (LabCorp).

 

[AbsoluteZ3R0]

What is your free testosterone following the injections? My only guess (and it's not very good) is that somehow your natural production hasn't shut down, so you are getting a surplus from the injections as well as from your own testes and the HCG. I know Dr Saya has mentioned that even miniscule doses of testosterone cause rapid shut down, but perhaps it isn't true across the board. All that said, even if you are not shut down, a total of >1500 is pretty ridiculous. I suppose the other possible explanation is just insanely high SHBG.

 

[Vince]

When were labs done, on injection day before you injected. After starting a new protocol, you need to wait at least 6 weeks before labs.

 

[acmdds]

Welcome to Excelmale. You posted a total testosterone in excess of 1500 while injecting 60mg of testosterone in divided doses, 30mg, every 3.5 days? I don't believe it. I believe you, but I am in a state of disbelief relative to the results you obtained. That's a dose that I would have expected to return an anemic result. It makes no sense. The only other change was dropping the AI? I would retest at the proper time, just prior to an injection, and pull the appropriate estradiol test at the same time.

Here is a pic of my latest labs, showing >1500. I know, I don't believe it either, something is not right. My protocol is 30mg of t cyp Monday morning and Thurs afternoon, with 500iu hcg. My first follow up labs were six weeks after I started trt, but when I saw that I was >1500 we decided to retest in four weeks. This second test was done this Monday right before I injected that day. I thought a significant lower dose would have brought it down. I'm having a phone consult with my NP later today, will keep you all informed on what he says.

 

[Will Brink]

Here is a pic of my latest labs, showing >1500. I know, I don't believe it either, something is not right. My protocol is 30mg of t cyp Monday morning and Thurs afternoon, with 500iu hcg. My first follow up labs were six weeks after I started trt, but when I saw that I was >1500 we decided to retest in four weeks. This second test was done this Monday right before I injected that day. I thought a significant lower dose would have brought it down. I'm having a phone consult with my NP later today, will keep you all informed on what he says.

My guess is, at 500+ already, you were not hypo gonadal technically and your HPTA working, and it may be a short lived thing. You may also be very responsive to the HCG with a full functioning HPTA and getting an exaggerated response. Make sure to test at appropriate time also.

 

[Vince Carter]

With an SHBG @ 67 pre-TRT he's going to pull these kind of troughs, a dose change downward is warranted and you should add SHBG to your next few sets of labs til you can setlle on a dose and trough.

 

[Vince]

I think you might be Injecting more T than you think?

 

[acmdds]

When I first got my pre t labs back at TT 530, I seriously had my reservations about starting trt. However, due to my depression, my psych had my try over six different antidepressants, all of them did not work ultimately and most made me feel worse. That's why I decided to try trt, I had nothing more to lose I thought. My pre T symptoms were constant fatigue, no motivation, weight gain, not too much problem with ED except sometimes difficult to maintain erection, and infrequent morning wood. The SSRIs helped on some symptoms but the sexual side effects were unbearable. I'm definitely not in this to get juiced up or anything like, just want to feel like I did in my early thirties/twenties. In my mind I think that if I was feeling this bad at 37 with T at 530, imagine where I would be at 45 if I did not do something about it. Since trt I have been off ssri's and feel better than ever, with exception to some anxiety.

 

[Vince Carter]

When I first got my pre t labs back at TT 530, I seriously had my reservations about starting trt. However, due to my depression, my psych had my try over six different antidepressants, all of them did not work ultimately and most made me feel worse. That's why I decided to try trt, I had nothing more to lose I thought. My pre T symptoms were constant fatigue, no motivation, weight gain, not too much problem with ED except sometimes difficult to maintain erection, and infrequent morning wood. The SSRIs helped on some symptoms but the sexual side effects were unbearable. I'm definitely not in this to get juiced up or anything like, just want to feel like I did in my early thirties/twenties. In my mind I think that if I was feeling this bad at 37 with T at 530, imagine where I would be at 45 if I did not do something about it. Since trt I have been off ssri's and feel better than ever, with exception to some anxiety.

Your problem is SHBG related, all your T is bound up and unusable, look at how low your Free T is, likely where your symptoms originate from. Some Drs will treat Free T over a total.
You need to keep on testing Free T, Total T, and SHBG, and (ultra) sensitive Estradiol LC/MS/MS, in order to get a handle on what's going on for you. For your last test @ 1500 you omitted any Free T testing.

 

[a_crossfitter]

Here is a pic of my latest labs, showing >1500. I know, I don't believe it either, something is not right. My protocol is 30mg of t cyp Monday morning and Thurs afternoon, with 500iu hcg. My first follow up labs were six weeks after I started trt, but when I saw that I was >1500 we decided to retest in four weeks. This second test was done this Monday right before I injected that day. I thought a significant lower dose would have brought it down. I'm having a phone consult with my NP later today, will keep you all informed on what he says.


View attachment 3664

Hi there!

I honestly think you should've been retested. Never rule out test equipment malfunction.

***I'm an engineer***

 

[themud]

docdds,

I do daily injections at 10 mg. My first BW showed TT at 365. Started the test injections and my next test was 1349! Coastwatcher et al didn't think that was enough and neither did I. I just wanted to start out conservative. I tested again on my own and it was 998 for Labcorp, then days later with my Dr. and she uses Quest that showed 1179. My anxiety was higher than ever and this is coming from someone whos pulse and bp drops in high stress situations. My anxiety is getting better and if I stay busy I have no anxiety.

It is my guess that my natural production had a slow death and I would even wager that my next BW will show it lower. On that note I was reading some body builder forums that had guys who were cycling with T at 3000-4000 and some started to try to get their ranges down to a high TRT level, like 1000-1500. The ones that did this felt better, were able to drop AI and claim they made better gains.

 

[meanbreen]

I think you might be Injecting more T than you think?

That is what I was thinking. Maybe OP is loading .3ML thinking that equates to 30MG. Even still 120MG a week shouldn't yield that high of total testosterone.

 

[CoastWatcher]

That is what I was thinking. Maybe OP is loading .3ML thinking that equates to 30MG. Even still 120MG a week shouldn't yield that high of total testosterone.

But...the member is a dentist who prescribes regularly and injects patients during the course of his day.

 

[themud]

CW,

I quickly thought maybe doing double too, but I agree with you. He most likely knows his IU, and CC doses in and out.

 

[acmdds]

Yeah guys, I do know my dosages. I'm not sure but I do relate to themud here as his experience sounds similar.
Just spoke to my NP, we are retesting in six weeks, he was skeptical at this result too as he was well expecting to raise, not lower my dose, we are keep same dose for now. I will be getting the proper tests as well, free t, shbg sensitive estradiol.
Going to lower hcg to 250iu weekly and switch to 3x weekly doses to hopefully better manage my anxiety.
I'm thinking of getting tested on my own prior to six weeks with a Total/Free T test that measures >1500 to see exactly where I am. Could it be that I'm just highly sensitive to exogenous T, is that possible?

 

[a_crossfitter]

Yeah guys, I do know my dosages. I'm not sure but I do relate to themud here as his experience sounds similar.
Just spoke to my NP, we are retesting in six weeks, he was skeptical at this result too as he was well expecting to raise, not lower my dose, we are keep same dose for now. I will be getting the proper tests as well, free t, shbg sensitive estradiol.
Going to lower hcg to 250iu weekly and switch to 3x weekly doses to hopefully better manage my anxiety.
I'm thinking of getting tested on my own prior to six weeks with a Total/Free T test that measures >1500 to see exactly where I am. Could it be that I'm just highly sensitive to exogenous T, is that possible?

If you are feeling good then I would not change anything.

 

[AbsoluteZ3R0]

Yeah guys, I do know my dosages. I'm not sure but I do relate to themud here as his experience sounds similar.
Just spoke to my NP, we are retesting in six weeks, he was skeptical at this result too as he was well expecting to raise, not lower my dose, we are keep same dose for now. I will be getting the proper tests as well, free t, shbg sensitive estradiol.
Going to lower hcg to 250iu weekly and switch to 3x weekly doses to hopefully better manage my anxiety.
I'm thinking of getting tested on my own prior to six weeks with a Total/Free T test that measures >1500 to see exactly where I am. Could it be that I'm just highly sensitive to exogenous T, is that possible?

As I mentioned earlier, I think it's just a combination of high SHBG and you not fully shutting down like most would after 6 weeks, or it could be lab/machine error as someone else noted. If your free test had been in the normal range, we could probably have concluded that SHBG was to blame.

 

[get2dichoppa]

As I mentioned earlier, I think it's just a combination of high SHBG and you not fully shutting down like most would after 6 weeks, or it could be lab/machine error as someone else noted. If your free test had been in the normal range, we could probably have concluded that SHBG was to blame.

Sounds like he had multiple testing at 60mg per week, first at six weeks then at 10 weeks, hard to see lab error twice.

Im going to lend my anecdotal advice to you docdds, more is not always better. At 30mg EOD (~112mg per week) my trough levels were:

TT = 835 (348-1197)
FT = 34 (5-21)
E2 Sensitive = 60 (8-35)

On a dose the most would consider low/beginner my Free T was way out of range, along with my E2. People respond differently, its why there are so many threads asking for advice - if everyone was the same the golden protocol would exist. I had to learn this the hard way, ive been bouncing around so many protocols because I was too egotistical to lower my dose under 100mg per week. I have now lowered my dose to 22.5mg EOD (~85mg per week, because I refuse to use an AI again) and im already feeling much better. Sometimes a very low dose works for people, if you feel good I would keep your dose, no need to raise it because you feel its low.