Testosterone levels now too high?

[abaftabeam]

Hi Everyone,

37 year old here that started TRT back in February. The clinic I went to put me on 20% cream applied to the scrotum once a day. So far I've been really happy with the results, my libido has sky rocketed, more energy, and can lift more for longer at the gym.
Yesterday I got my first follow up blood work done and got the results. My follow up appointment with my clinic is for the 15th, but when looking over my bloodwork it looks like my test is way too high now? I have experienced some minor side effects, the worst of it being back acne and a bit on my forearms. I also have trouble sleeping.

I had my blood taken 5 hours after cream application as per the clinic.

My results pre-trt were:
Estradiol: <40 pmol/L
Testosterone: 13.1 nmol/L
Test Free 280 pmol/L

Results after 3 months of the cream:
Estradiol: 82 pmol/L
DHEA-S: 4.7 umol/L
Tesosterone: 41.4 nmol/L
Test Free: 1414 pmol/L


Any suggestions? Are my levels so high because I took it 5 hours after applying the cream?

 

[madman]

Hi Everyone,

37 year old here that started TRT back in February. The clinic I went to put me on 20% cream applied to the scrotum once a day. So far I've been really happy with the results, my libido has sky rocketed, more energy, and can lift more for longer at the gym.
Yesterday I got my first follow up blood work done and got the results. My follow up appointment with my clinic is for the 15th, but when looking over my bloodwork it looks like my test is way too high now? I have experienced some minor side effects, the worst of it being back acne and a bit on my forearms. I also have trouble sleeping.

I had my blood taken 5 hours after cream application as per the clinic.

My results pre-trt were:
Estradiol: <40 pmol/L
Testosterone: 13.1 nmol/L
Test Free 280 pmol/L

Results after 3 months of the cream:
Estradiol: 82 pmol/L
DHEA-S: 4.7 umol/L
Tesosterone: 41.4 nmol/L
Test Free: 1414 pmol/L


Any suggestions? Are my levels so high because I took it 5 hours after applying the cream?

*Always post labs with reference ranges and method of testing/assay used

What is your dose?

You had blood work done around peak so it would be expected that serum levels would be high.

If you feel great overall and your blood markers are healthy then I would not be too concerned.

The back acne is a result of high FT.

Also, keep in mind that testosterone has a tonic effect on the CNS and high FT levels can easily make one feel amped up which can interfere with sleep.

Your true trough FT level may still be on the high end (only labs would tell).

Running a lower FT level would improve the acne let alone reduce the amped-up feeling some can experience.

Keep in mind that you are only applying once daily and true trough levels will be lower.....by how much only labs would tell.

Even then although TT is important to know FT is what truly matters as it is the active unbound fraction of testosterone responsible for the positive effects.

The only way to know where your FT level truly sits is to have it tested using the most accurate assays such as the gold standard Equilibrium Dialysis or Ultrafiltration (next best).

Not sure what method (calculated/direct) or assay (direct, ED, or UF) was used but you can rest assured with a TT 41.4 nmol/L (1194 ng/dL) that your FT would be high even if you had highish/high SHBG let alone may very well be absurdly high if your SHBG was low/lowish.

Was your SHBG tested as it is critical and will have a significant impact on TT/FT?

Again too many get caught up in where TT sits when they should be more concerned with where their FT level sits.

Too many on trt have no clue where their FT level truly sits as they are using/relying upon inaccurate assays.

Unfortunately many are running much higher levels than they think which can cause numerous issues for some.

Next time you have blood work done request one of these assays for FT:

You can purchase through Nelsons discountedlabs which uses Quest Diagnostics.


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