Test results after 6 weeks

[WadeAllen]

Hello all

I recently decided to change providers based on cost and my new provider had labs run. I received the values today and wondered if anyone else has seen this type of turn around.

A bit of background, my last two blood tests were 7 weeks ago and my Testosterone levels were 159 on the first and 91 on the second. These were taken 3 days apart.

I have been prescribed 1ML TEST CYPIONATE (sp) once a week and 500UI of HCG 2 times a week.

May lab tests today show my Testosterone level to be >1500 and my estradiol at 121.

May last does of testosterone was Sat and the blood test was taken on Tuesday.

Should I be as alarmed as I feel?

 

[Cataceous]

You were most likely prescribed double the usual starting dose, 100 mg testosterone cypionate per week. This assumes that your cypionate is 200 mg/mL, the most common concentration. Therefore it's no surprise that your testosterone is supraphysiological. There's a simple solution: cut back to 100 mg per week, or better yet to 50 mg twice a week.

Don't be too alarmed about doing harm to yourself in the short run. All should be well when you drop to more sensible doses.

 

[WadeAllen]

Thanks for the quick response.
I believe you are correct 200mg/ml. I will double check it when I get home.

I figured since this is still fairly early in the treatment that it was still being dialed in, but a jump from 91 to over 1500 was unexpected.

 

[slicktop]

Thanks for the quick response.
I believe you are correct 200mg/ml. I will double check it when I get home.

I figured since this is still fairly early in the treatment that it was still being dialed in, but a jump from 91 to over 1500 was unexpected.

I too over responded in the beginning of my TRT journey- not to worry, you'll likely get it sorted out soon. Smaller, bi-weekly test injections tend to work better for most men *unless* you're high SHBG in which case you may tolerate a weekly shot just fine, but it's a rare case where a weekly shot has an advantage of bi-weekly. Not everyone here agrees with me on this, and that's ok, but I'd be more concerned with your estradiol level than your T level at this point simply because I know how lousy I feel with high E. Personally, I'd be taking DIM like skittles at this point and asking for anastrozole from your doc if it isn't already available to you. Do you have full labs available to post?

 

[WadeAllen]

 

[WadeAllen]

I have been taking DIM but I think I’ll start taking a bit more.

 

[slicktop]

Unless they've changed things at LabCorp, that isn't the sensitive estradiol test, so it might not be very accurate- could be high or low, but looking at your total testosterone it's a safe bet to say your estradiol is significantly elevated. Page three isn't attached- is it available? I'm wondering if a free T and SHBG is available, but if SHBG is missing they might not have done free T. I would be begging for anastrozole if I were in your shoes.

 

[WadeAllen]

Here is page 3, not much there

 

[slicktop]

No worries. It's not the end of the world, but it does leave a gap. Did your doc prescribe an AI, or will he? More importantly, how are you feeling overall? Any symptoms to report?

 

[WadeAllen]

Over all I feel ok, a bit tired and some weight gain.
I am switching providers and i believe The plan is to include AI. One of reasons I am switching providers is my current refuses to think that 20 + lbs of weight gain in the 1st two months is significant. The other reason being he is really expensive, especially for what feels like sub-standard care.

 

[Cataceous]

I would lower the dose and retest in six weeks. No other action needed, nor an AI, until testosterone has been at a normal level for some time.

 

[slicktop]

Over all I feel ok, a bit tired and some weight gain.
I am switching providers and i believe The plan is to include AI. One of reasons I am switching providers is my current refuses to think that 20 + lbs of weight gain in the 1st two months is significant. The other reason being he is really expensive, especially for what feels like sub-standard care.

I have a friend that just started TRT that added 20lbs in even less time than you- I can definitely understand your concern. What's your weight gain in percentage to your starting weight? Five to eight percent isn't uncommon when starting out.

 

[WadeAllen]

254lbs to 282lbs, so 11% if I did the math right.

 

[JohnsonC]

1500 is completely fine if you feel great at that dose. Actually it was the top of the normal range years ago. If it was normal then for people not taking testosterone, you will do just fine now. The reason the normal range has lowered is because testosterone is in decline globally and the "normal range" is just a reflection of the current population. And for Gods sake don't start AI unless you're about to grow tits, estrogen is really healthy for you and one of the big benefits of TRT. It drives male libido too and is really healthy for the cardiovascular system. It's one of the reasons woman lives longer than men

 

[Cataceous]

1500 is completely fine if you feel great at that dose. ...

You missed the fact that 1,500 ng/dL is the lower limit. He could be at 2,500 ng/dL. My level would be that high at 200 mg TC/week; with 100 mg TC it was close to 1,300. Long-term effects of ultra-high estradiol levels in men are not known. Maybe he doesn't want to be the guinea pig.

 

[JohnsonC]

You missed the fact that 1,500 ng/dL is the lower limit. He could be at 2,500 ng/dL. My level would be that high at 200 mg TC/week; with 100 mg TC it was close to 1,300. Long-term effects of ultra-high estradiol levels in men are not known. Maybe he doesn't want to be the guinea pig.

Those naturals might have been at low levels too, as testosterone is fluctating all the time. Besides that - when the "normal range" is calculated the top 5 percent are removed, so quite a lot of people had even higher levels than 1500.

Regarding T/E ratio a lot of interesting studies a coming out, most of them pointing to the fact that if you run at a high t level it's a good idea to have high estrogen too. The ratio is more important than the number.

Elevated T/E2 Ratio Is Associated with an Increased Risk of Cerebrovascular Disease in Elderly Men

"The balance between T and E2 may be more important than their absolute quantities. Extremely low or high T/E2 values will harm the brain blood vessels. Careful consideration should be given before beginning testosterone replacement treatment, and supplementation with estrogen seems a good way to protect the blood vessels of the brain in elderly men."

 

[Cataceous]

Those naturals might have been at low levels too, as testosterone is fluctating all the time. Besides that - when the "normal range" is calculated the top 5 percent are removed, so quite a lot of people had even higher levels than 1500.
...

If you look at the statistics, including standard deviations, you'd find that natural testosterone over 1,500 ng/dL is very rare, and these individuals are almost always compensating for high SHBG.

 

[JohnsonC]

That is true. The bottom line as I see it is go with symptom resolution. If you feel great at 100 mg / week and don't have anymore symptoms that's perfect. If not go higher until symptoms resolve

 

[Cataceous]

... The bottom line as I see it is go with symptom resolution. If you feel great at 100 mg / week and don't have anymore symptoms that's perfect. If not go higher until symptoms resolve

I agree, and would have everyone follow the late Dr. Crisler's advice of "low and slow". Unfortunately the OP's doctor did not.

 

[fifty]

Seems like few doctors around start low and go slow. Many it’s like starting out at 3x your levels or bust.