Tapering down T dosage

[Scott Myslinski]

Hi all. I'm a patient of Defy medical and have a question about how safe it is to lower testosterone dosages after starting treatment. Here are my stats:

-25 year old male, 160lb
- don't drink/smoke, weight train 2x/week hard and eat very healthy whole foods
-On T cypionate IM (80ml 2x per week or 160 per week)
- On HCG (500 units 2x per week)
- anastrozole - 0.125mg 2x per week

initial blood values:
-Total T: 125ng/dL (Standard: 375-1000)
-Free T: 0.43ng/dL (Standard: 0.87-5.47)
-Estradiol: 46.3pg/ml (Standard: 20.0-75.0)
-LH: 1.5mIU/ml (Standard: 1.7-11.2)
-FSH: 5.9mIU/ml (Standard: 1.7-11.2)
-SHBG: 41.4nmol/L (Stabdard: 20.0-60.0)
-DHEA-S: 205.7ug/dL (Standard: 164.3-530.5)
-TSH: 2.44uIU/mL (Stabdard: 0.45-4.5)
-PSA: 0.2ng/mL (Standard: 0.0-4.0)

After 4.5 weeks of treatment (as specified above):
-Total T: >1500ng/dL
-Free T: >50.0ng/dL
-Estradiol: 83.3 pg/nL

Ive experience significant water retention (10+ lbs), lower sex drive, and some irritability since starting treatment. My question is should I lower the T, decrease the HcG, up the AI, or multiple?

my concerns are:
1. If I decrease the T now that I've been on 160mg / week will anything less be ineffective because my tolerance is higher?? Or does this not really matter after 4.5 weeks
2. I'm concerned about raising the AI too much and getting some of the negative side effects that have been discussed here and in the medical literature.

thank you and I appreciate your help in advance!

 

[Vince Carter]

Exactly day/time did you inject and day/time you had the blood drawn for labs...i bet you did this all wrong as you can't pull >1500 on 80mg

 

[Scott Myslinski]

I inject on Monday mornings and Thursday evenings (both 500 units HCG and 80 T each time).

i drew blood at 1:30pm on Thursday, before my injection.

 

[Vince Carter]

what time do you inject...not to beat a drum but some people think 11:59am is in the morning. And 1330 isnt Thursday evening, either. If you're not doing this in a strict and regimented manner, your labs will appear elevated. For instance, I would recommend that you do labs on a Monday at about 0800/0830, then inject. You almost have to work it in that precise of a manner or things look high when they're not. Notwithstanding my comments or these labs that look artificially high, why did you do 4.5weeks, (way too early), when Defy run's labs @ 90 days for new guys.

 

[Scott Myslinski]

Thank you. I appreciate your advice.

i would still love guidance on the questions in my original post if you don't mind.

i inject at 7:45am on Monday's and 7:30pm On Thursday's.

i did 4 weeks labs as Nelson suggests in his book to see how I was getting along and because of the water retention issue.

 

[Vince Carter]

I am helping you...doing your labs right is crucial. You're not doing it right.

That's the help you need whether youre seeing it, or not. Making treatment choices at 4 weeks is typically ill advised for a new guy...the body takes much longer to reach Homeostasis than 4 weeks especially for a new guy such as yourself. Most of the issues you raise like water retention are just transient changes that come with the territory.

 

[Scott Myslinski]

Okay thank you very much Vince! I appreciate you taking the time

 

[CoastWatcher]

One doesn't develop a "tolerance" to testosterone as one does an opiate. Patients regularly adjust their dose of exogenous testosterone in order to bring their serum levels into a therapeutic range.

What sort of discussion resulted in your starting dose being as hefty as it is? Is your follow-up estradiol value the result of a sensitive assay?

 

[Scott Myslinski]

The doctor decided to start with a higher dosage because my free and total values were so low for my age.

No assay unfortunately, just the sensitive I believe.

 

[Re-Ride]

0.80ml of 200mg/ml is 160mg per shot or 320mg/week. Perhaps that was a typo.

 

[CoastWatcher]

0.80ml of 200mg/ml is 160mg per shot or 320mg/week. Perhaps that was a typo.

I hope so too! I didn't catch that.

 

[Scott Myslinski]

Yes apologies I meant half that dosage. So 160mg per week or 80mg per shot

 

[Scott Myslinski]

Hi all - for what it's worth and in case others revisit this thread later on, everyone's individual experience will vary and they should all consult with a physician and monitor their bloods over time, but Defy medical recommended in my specific situation:

• DECREASE to Testosterone Cypionate 0.30mL twice per week (prev 0.40mL twice per week)
• INCREASE to Anastrozole 0.125mg three times per week (prev 0.125mg twice per week)
• DECREASE to HCG 400iu twice per week (prev 500iu twice per week)

 

[CoastWatcher]

Hi all - for what it's worth and in case others revisit this thread later on, everyone's individual experience will vary and they should all consult with a physician and monitor their bloods over time, but Defy medical recommended in my specific situation:

• DECREASE to Testosterone Cypionate 0.30mL twice per week (prev 0.40mL twice per week)
• INCREASE to Anastrozole 0.125mg three times per week (prev 0.125mg twice per week)
• DECREASE to HCG 400iu twice per week (prev 500iu twice per week)

That's a very prudent set of adjustments. All the best.