Testosterone dosage question

[Proraven]

Got a question on testosterone dosage. I’ve used a traditional urologist who typically prescribed .5 ML injection a week for cypionate, I self injected weekly for 4 years now. Recently I visited a health rejuvenation clinic with a good reputation in my area, and their doctor prescribed 1.4 ML a week.

The Rx is your standard 200mg/ML.

1.4 ML weekly seems like a lot to me. He’s basically tripling my original dose. Sorry to ask such a basic question. Any thoughts?

 

[madman]

Got a question on testosterone dosage. I’ve used a traditional urologist who typically prescribed .5 ML injection a week for cypionate, I self injected weekly for 4 years now. Recently I visited a health rejuvenation clinic with a good reputation in my area, and their doctor prescribed 1.4 ML a week.

The Rx is your standard 200mg/ML.

1.4 ML weekly seems like a lot to me. He’s basically tripling my original dose. Sorry to ask such a basic question. Any thoughts?

How do you feel overall regarding relief/improvement of low-t symptoms (energy/mood/libido/erectile function/recovery) 4 years in using 100 mg/week?

Sounds like a standard T-mill clinic.....280 mg/week is way too high a dose for trt and would have most men's TT/FT levels way too high!

On average most men are using 100-150 mg/week.....mind you some are using 200 mg/week (not common) as even at that dose it would have many mens TT/FT levels too high.

Seeing as you were using 100 mg/week for 4 years where did your TT, FT and estradiol levels sit at such dose?

Was your SHBG tested and if so where does it sit?

SHBG is critical as it will dictate what dose of T is needed to achieve a TT which will result in a healthy FT level.

Regarding injection frequency most are injecting twice weekly (every 3.5 days) which will result in more stable T levels throughout the week while minimizing the extreme between ones peak--->trough levels.....in cases of men with low/lowish SHBG many need to inject EOD or daily to reap the benefits of trt.

Although TT is important to know FT is what truly matters as it is the unbound active fraction of testosterone responsible for the benefits.

What made this doctor come to the conclusion that you needed to increase your T dose from 100 mg/week--->a whopping 280 mg/week?

Did he even do full lab work to see where your TT, FT and estradiol levels sit on the 100 mg/week protocol and was SHBG tested let alone did he have your RBCs, hemoglobin and hematocrit tested?

A common side effect of using exogenous testosterone is it will result in an increased RBCs, hemoglobin and hematocrit within the first month of starting TRT and the biggest increase will be seen at the 3-6 month mark as levels tend to stabilize for most 6 months in whereas others will take 9-12 months before levels fully stabilize.

Anytime T dose is increased it will result in increased RBCs, hemoglobin and hematocrit.

Would be more helpful if you posted lab work from your 100 mg/week protocol as you should have the most recent labs.....you have been on trt for 4 years.

I would think twice before jumping in head first as 100 mg/week may be all you need and if anything if you truly are not feeling your best overall than a slight dose increase may be needed.

When starting or changing protocol on trt.....starting low and going slow is the most sensible approach.....and again if a dose increase is needed going from 100--->120 mg/week than having full blood work 6 weeks later would be wise.

 

[madman]

Prescribing one 280 mg T/week of testosterone for trt is plain retarded!

300 mg T/week would be considered a mild steroid cycle.....most using steroid doses of testosterone are using 300-600 mg/week.

 

[Proraven]

Thank you. Yes, he did a full blood lab analysis with me before prescribing. What surprises me is he was so reasonable and meticulous in his explanation of my lab results (we spoke for an hour), that the Rx was so much. I didn’t notice the size of the dosage until I picked it up afterwards. Something is not adding up.

I think I’ll call him on Monday. My testosterone Rx is covered by insurance, and surprisingly the clinic didn’t try to upsell me on anything. Just a $150 fee to sit with the doctor, which I thought was reasonable and worth it.

I’ll scan and post my labs later. Almost all my numbers, except tryglicerides, were in order and in normal range.

 

[madman]

Recently I visited a health rejuvenation clinic with a good reputation in my area, and their doctor prescribed 1.4 ML a week.

The Rx is your standard 200mg/ML.


Health rejuvenation clinic.....really?

Thank you. Yes, he did a full blood lab analysis with me before prescribing. What surprises me is he was so reasonable and meticulous in his explanation of my lab results (we spoke for an hour), that the Rx was so much. I didn’t notice the size of the dosage until I picked it up afterwards. Something is not adding up.

I think I’ll call him on Monday. My testosterone Rx is covered by insurance, and surprisingly the clinic didn’t try to upsell me on anything. Just a $150 fee to sit with the doctor, which I thought was reasonable and worth it.

I’ll scan and post my labs later. Almost all my numbers, except tryglicerides, were in order and in normal range.

I could see if the strength of the testosterone was ℞ 100 mg/ml.....than 1.4 ml (140 mg/week) would make more sense.

There is no way anyone needs 280 mg/week for trt.....as trough TT/FT levels would be through the roof.....well above what any man would need to benefit from testosterone replacement.

Again post your labs as we have no idea what your TT, FT, estradiol and SHBG levels sit on such dose 100 mg T/week!

 

[madman]

Stating your dose and injection protocol (100mg T/week) without posting labs or at least telling us where your trough TT, FT, estradiol and SHBG levels sit.....let alone critical blood markers RBCs, hemoglobin and hematocrit leaves us in the dark as far overall feedback you will receive on here!

 

[abe]

Got a question on testosterone dosage. I’ve used a traditional urologist who typically prescribed .5 ML injection a week for cypionate, I self injected weekly for 4 years now. Recently I visited a health rejuvenation clinic with a good reputation in my area, and their doctor prescribed 1.4 ML a week.

The Rx is your standard 200mg/ML.

1.4 ML weekly seems like a lot to me. He’s basically tripling my original dose. Sorry to ask such a basic question. Any thoughts?

I do like your dose of 100 milligrams of testosterone weekly. I'm sure there's no reason why you need to increase it. It's pretty much a good medium range. I know some members have any issues, thankfully you don't sound like one of them.

 

[Proraven]

Labs posted. I scanned for what I thought were the two most important pages. Let me know if you need more.

 

[Proraven]

I knew my estrogen was going to be low...I had been taking Armidex for about a year, and my urologist had not seen me or any recent blood labs. The doctor at the clinic immediately said to get off the Armidex. I still plan on calling him Monday to double check his dosage.

 

[fifty]

Shbg of 15 and 280mg test 1x/wk?

I would move to 50mg 2x/wk then go from there.

 

[abe]

I knew my estrogen was going to be low...I had been taking Armidex for about a year, and my urologist had not seen me or any recent blood labs. The doctor at the clinic immediately said to get off the Armidex. I still plan on calling him Monday to double check his dosage.

How much Armidex are you taking? When you said you were injecting 100 mg of testosterone, I thought that was your total protocol.

 

[fifty]

$20 says over 1mg

 

[Proraven]

1mg Of anastroze, 2x per week. I’m stopping that as of this week.

Previous Rx with original urologist was .5 ML per week of test cypionate.

I appreciate everyone’s advice. I’m going to call the new Doc on Monday. I think there’s literally a handwriting mistake somewhere on the clinic Rx.

 

[abe]

1mg Of anastroze, 2x per week. I’m stopping that as of this week.

Previous Rx with original urologist was .5 ML per week of test cypionate.

I appreciate everyone’s advice. I’m going to call the new Doc on Monday. I think there’s literally a handwriting mistake somewhere on the clinic Rx.

I've been on T for over four and a half years and never consider using an AI. I do know everyone is different, and there is probably some men that do need it. I am thankful that my doctor never pushed one on me.

 

[Mr S]

1mg Of anastroze, 2x per week. I’m stopping that as of this week.

Previous Rx with original urologist was .5 ML per week of test cypionate.

I appreciate everyone’s advice. I’m going to call the new Doc on Monday. I think there’s literally a handwriting mistake somewhere on the clinic Rx.

Did the pharmacy fill the prescription? That’s 6 1ml/200mg vials. I don’t know how things work in your area, but for me it would be impossible to get 6 vials. I can imagine any pharmacist around here calling up my Dr’s office to verify the dosage.

 

[madman]

Labs posted. I scanned for what I thought were the two most important pages. Let me know if you need more.

You were on 100 mg/week of T and taking 1mg (2x/week) of an aromatase inhibitor (anastrozole).....my god you must feel like a sack of s**t overall!

Not only is your e2 crashed and believe it or not healthy estradiol levels are critical in men as not only can it have a positive effect on ones mood/libido/erectile function/lipids but most importantly healthy levels are needed for beneficial effects on ones brain/cardiovascular/bone/immune health.

You definitely need to get off the a.i. and when you retest use the proper e2 sensitive assay (LC-MS/MS).

Seeing as your SHBG is low 15 nmol/L you should be injecting smaller doses of testosterone more frequently as in EOD or daily as oppose to a large dose once weekly.....you can start off twice weekly (every 3.5 days) and decide if you eventually need to move to more frequently.

Your TT level of 590 ng/dL is by no means high and your FT is just over mid-range mind you it was done using the law-of-mass action equation the Vermeulen calculated method which tends to overestimate and if anything free testosterone should be tested using the gold standard Equilibrium Dialysis or Ultrafiltration or better yet using the newer TruT Free Testosterone Calculator by FPT.....which is on par with the accuracy of the gold standard Equilibrium Dialysis.

How many days after your once weekly 100 mg injection were labs done?.....was it at true trough (7 days later just before your next injection) as one always wants to test at their lowest point in the week to see whether levels are too low/high and if a dose adjustment is needed.

If we use the newer calculated TruT to truly see where your FT level sits than taking your TT 590 ng/dL, SHBG 15 nmol/L and Albumin 4.3 g/dL(mean) than your FT is 21.82 ng/dL (just under the mean (mid-range of the reference range 16-31 ng/dL)

You could definitely bring your TT levels up in order to increase your FT levels but if anything you need to look into injecting smaller doses of T more frequently and you would most likely only need a small increase in overall weekly dose depending on how often you inject.....mind you most can still achieve the same/slightly better TT levels using a slightly lower overall weekly T dose when moving to daily injections.

Men with low/lowish SHBG can get away with running a lower TT level in order to achieve a healthy FT level.

To give you an example as you can see when using the newer TruT calculator one with an SHBG of 15 nmol/L would only need to hit a TT of 824 ng/dL to have a FT of 31.01 ng/dL (top of the reference range 16-31 ng/dL)

So taking your TT is 590 ng/dL--->824 ng/dL would have your FT levels at the top of the reference range.

Most men do well having FT levels in the 20-30 ng/dL range mind you the majority do not need to have levels well over the top end of the reference range.

Not saying one needs to be at the top of the reference range or higher as some men do better with a mid-range FT level at trough.....but it comes down to the individual and how they feel at said level.....let alone what level of FT one can run in order to reap the benefits of T as in improvement/relief of low-t symptoms (mood/energy/libido/erectile function/recovery) while at the same time minimizing/avoiding any potential side-effects.

 

[at15]

numbers look healthy besides e2. if you really dont want to mess with things just drop the anastrozole and continue injecting 100mg once per week regardless of what the dosage on your prescription says.

just because someones shbg is on the lower end does not mean automatically once weekly will not work. its not that simple.

most "health rejuvenation" clinics are complete jokes maximizing profits by loading guys up with high dosages of everything.