Testosterone too high after 8 weeks on 200 mg Cypionate / Week!

[RSM]

Hi guys,

I found this forum after reading up on TRT treatment and hope you have a few suggestions for me.

I am a 44 year old male that have noticed a gradual decrease in testosterone levels over the years and my weight climbed from about 240 lbs up to a high of 310 lbs at 6'-2". It really became apparent the last year or so and about 10 weeks ago my latest blood work indicated a testosterone level lower than 200 ng/dL.

My doctor prescribed 200 mg testosterone cypionate per week. The first 4 weeks I took 200 mg Depo Testosterone per week which came in 1cc vials. I self injected every Friday evening. After 4 weeks I received a generic brand when I refilled the prescription. The new brand was 200 mg Perrigo which also came in 1cc vials. I have taken this also for 4 weeks. I had blood work done last week after 7 weeks on the TRT treatment and spoke with the Doctor's office. The results indicate that my testosterone levels are over 1200 ng/dl! The test was done on a Wednesday afternoon and the injection was made the previous Friday evening.

I do feel good on this dosage and my libido is great! My weight has also dropped down to 280 lbs and I work out every other day with weights (including deadlifts, hack squats, leg press, bench press etc.) and end with a 30 minute cardio session. My diet is also fairly clean and I try to drink at least 1 gallon water / day and eat 6 times a day.

The doctor's office wanted to change my treatment to 200 mg every 3 weeks however I read this will cause issues with my levels going up and down. So I am thinking 100 mg once a week. If the levels are still too high after 6 weeks on that protocol then perhaps 50 mg per week. I am hoping that once I get my weight down to about 220-230 lbs my natural levels will recover and I can stop TRT treatment. At that point I would focus on deadlifts, squats etc. to promote natural testosterone levels.

I will get the full report soon and can post more detailed data.

Just thought I'd start this thread in the meantime to get some opinions. Thanks for reading and looking forward to your feedback!

 

[Vince Carter]

First things, your TT is showing high(er) because you're injecting on Friday PM, and having bloods on Wed. You should be having bloods on FRIDAY just before your injection. You want to see your lowest point. I would retest and then decide if you want to change your dose. You're basing this 1200 and any decision to change dosing on a rather flawed test. I would start there.

The doctor's office wanted to change my treatment to 200 mg every 3 weeks however I read this will cause issues with my levels going up and down. So I am thinking 100 mg once a week. If the levels are still too high after 6 weeks on that protocol then perhaps 50 mg per week. I am hoping that once I get my weight down to about 220-230 lbs my natural levels will recover and I can stop TRT treatment. At that point I would focus on deadlifts, squats etc. to promote natural testosterone levels.

That's a very bad idea for the reason you stated, and I would not go to 100mg, either. I would stay the course at 200mg/week, you say you feel good and that you like it so why change? Retest as I said above and then consider a small change. Neither is thinking your natural levels will recover. Testosterone/TRT is for life. Now you could reach your weight goal and attempt a restart but that in and of itself is a complicated thing that takes several drugs over a month or two. But you can't just stop Testosterone and hope to return to some normal state.

 

[Vince]

I agree, you did to do labs on injection day before you inject. I wouldn't lower the dose.

 

[Virginian]

Yes, do your blood work just before the next injection. Had you done so you probably would have a level of roughly 1000 rather than 1200 ng/dL.

I can see why your doctor would be unhappy. Most doctors like levels within the normal range. Your levels were out of range high.

I personally keep my levels at roughly the same as yours - about 1200 ng/dL. I inject 90 mg E4D, equal to about 157 mg/week. At those levels I have gained muscle, strength, energy, and definition and lost fat. I have not yet detected any adverse effects. I watch hemocrit and lipids carefully.

To make my doctor happy, I reduce dose and delay an injection for a few days just before blood work. Doctor is happy with levels in range and not much higher than 800 ng/dL.

 

[Gee]

Each AAS and chemical enhancement compound has a theoretical active-life of its own. An active-life is the period of time that a chemical remains active. Also each has their own half-life. A half-life is the period necessary for half of the dosage to migrate from the injection site into the vascular system and clear. So a 200 mg injection of testosterone enanthate would theoretically release 100 mg of testosterone by its half-life of 4 days, but remain effectively active for its active-life for 8 days. Naturally there is a continued clearing of each half-life after this time frame.
So if testosterone enanthate was injected on day #1 and then released half of its 200 mg dose (100 mg) by day #4, then this would have exceed the normal plasma level/threshold and establish a new one. Thus caused an effect superior to normal plasma levels. This is what is meant by the term supraphysiological by the way.

The body has Action/Reaction periods and factors. Basically the body begins to adapt significantly to most attempts at altering homeostasis after 2-3 weeks. (the best results on a cycle or other androgens is around 10-30 days just FYI). After this period is when side effects can start to outweigh the good on people who abuse dosages (higher than TRT dose just more FYI)

Any drug introduced into the body by any method will have a range or period of time that it is "most effective." This is the part of a drug's active- life that provides the greatest results. It would appear a drug would have the same effect during its complete active-life. Sadly, it is not that simple.

After an injection of a drug is given, it takes a period of time for the enzyme esterase to act upon the drugs ester and subsequent release into the vascular system. The longer the AAS (or any drug) ester chain, the longer its active-life. This also means the longer it will take before migration. Once the drug has migrated into the vascular system it may, depending on its structure, take a period or time to become effective. Believe it or not, this is not as difficult to predict as it would seem. Generally speaking a drugs most effective period is about equal to its half-life.
No, not the first half of its active-life, but usually the center portion of its active- life. As example, if a drug has an active-life of 16 days, it will have a "most effective period" of about 8 days.

I hope this helps you to understand why your levels were elevated!

 

[RSM]

Fascinating responses. I am still learning a lot and have many more questions. I really appreciate all the responses. Thank you for taking your time to weigh in since I am sure this has been asked quite a few times by others.

I mentioned to my doctor that the test was taken too soon after the injection and he agreed to continue with the treatment for now. So I am still on 200 mg per week. My blood test results have been mailed and I will post once I receive it. My next blood test will be done on a Friday and we'll see where we stand at that point.

I am noticing some minor strength gains but I am taking it easy to save my joints. I have been lifting weights for over 25 years and have to be careful now. I think my strength in lifts would also have gone up more if I ate more carbs but since my goal is weight loss I have reduced carbs quite a bit - still get in oatmeal, vegetables and low calorie whole wheat bread with an occasional cheat meal over the weekends. I tend to function better with some carbs and have a hard time with very restricted carb intake - maybe I was not getting enough fats when I tried it.

Btw, is it normal to be waking up with morning wood every day on TRT? I seem to get this for the past couple of weeks and the erections are very pronounced. I also tend to wake up quite often but go to sleep again after a bathroom trip and try to get all the sleep I need.

Regarding my blood test, I was told to get it early in the morning. I work into the evenings and get up around 11am - noon or even 1PM. So my morning starts later than others.

- Would it really make a difference if blood was drawn at 2PM instead of 9AM in my case?
- Should I always fast for the tests?
- Should the lab also take a urine sample along with the blood work?

 

[Vince Carter]

Big ragin boners are a very good sign that things are in balance hormonally. Its not the gold standard everything is perfect but it's a great sign. The importance of the blood test I would get up early and get it done. I think it's that important. I would be up early. I always 12hr fast for any blood test. We don't use urine sampling for anything around here.

 

[RSM]

Big ragin boners are a very good sign that things are in balance hormonally. Its not the gold standard everything is perfect but it's a great sign. The importance of the blood test I would get up early and get it done. I think it's that important. I would be up early. I always 12hr fast for any blood test. We don't use urine sampling for anything around here.

Ok - I can go to bed earlier on a blood test day.

I always get up the same time and figured that the hormone levels were more dependent on when you get up after sleeping than how long the sun has been up lol! After all, I am getting the raging boners at 10 -11 AM when I am nearing the end of my sleep cycles!

 

[Virginian]

- Would it really make a difference if blood was drawn at 2PM instead of 9AM in my case?
- Should I always fast for the tests?
- Should the lab also take a urine sample along with the blood work?

Natural T is highest just after you wake up. Not true for injected T. On TRT, it doesn't matter what time of day you have blood drawn.

You do not have to fast for tests of T levels.

Urine tests are not necessary for measuring T.

Morning wood is a good sign that hormones are in balance. Enjoy,

 

[RSM]

Natural T is highest just after you wake up. Not true for injected T. On TRT, it doesn't matter what time of day you have blood drawn.

You do not have to fast for tests of T levels.

Urine tests are not necessary for measuring T.

Morning wood is a good sign that hormones are in balance. Enjoy,

That's what I thought. Thanks!

 

[RSM]

I finally got the results from the Dr. Office. As I mentioned the blood was drawn about 112 hours (4.66 days) after my last 200mg injection:

Testosterone Total: 1211.22 ng/dL Normal Range: 241.00-827.00

IGF/1: 217 ng/mL Normal Range: 75-216

Estrogen Total: 211 pg/mL Normal Range: 40-115

Estrone: 70 pg/mL Normal Range: 12-72

Testos Bioavail: 903 ng/dL Normal Range: 95-350

Testos Total: 1481 ng/dL Normal Range: 348-1197

Testosterone Bioav %: 61.0

 

[Jackie Treehorn]

I finally got the results from the Dr. Office. As I mentioned the blood was drawn about 112 hours (4.66 days) after my last 200mg injection:

Testosterone Total: 1211.22 ng/dL Normal Range: 241.00-827.00

IGF/1: 217 ng/mL Normal Range: 75-216

Estrogen Total: 211 pg/mL Normal Range: 40-115

Estrone: 70 pg/mL Normal Range: 12-72

Testos Bioavail: 903 ng/dL Normal Range: 95-350

Testos Total: 1481 ng/dL Normal Range: 348-1197

Testosterone Bioav %: 61.0

Your E2 is through the roof. Is this the sensitive assay? If not, it's the wrong test.

At any rate, I wouldn't change your dosage...I would just inject every 3.5 days if I were you (100mg every 3.5 days). This will help lower your E2 naturally without any AI, and then you could retest your blood in another 6 weeks or so to recheck.

How is your H&H, your RBC count? How is your PSA? Post up full labs.

 

[RSM]

Your E2 is through the roof. Is this the sensitive assay? If not, it's the wrong test.

At any rate, I wouldn't change your dosage...I would just inject every 3.5 days if I were you (100mg every 3.5 days). This will help lower your E2 naturally without any AI, and then you could retest your blood in another 6 weeks or so to recheck.

How is your H&H, your RBC count? How is your PSA? Post up full labs.

I am not sure if it the test was based on the sensitive assay method. I literally received only 5 printout sheets with the overall levels provided as I posted earlier and nothing else on the sheets. I asked the receptionist for the full labs and she told me that is what the doctor gave her.

I will be better off getting a prescription from my doctor so I can go test at any facility I prefer and get the results quicker.

My last draw involved checking testosterone, growth hormone, estrogen etc. and they needed 5 vials for the testing. I had hoped they could do all the testing with less blood drawn. This last round left bruising on my arm which has now healed fortunately.

I am injecting IM into my outer quads, alternating each leg. I don't think I can handle two IM injections a week. Would 150 mg SQ twice a week be an option?

I would not mind staying at 200 mg IM once per week and adding Arimidex and HCG. Or is it better to change to injecting 2x per week and staying away from anastrazole / arimidex and HCG?

My sleep is very broken and I suspected the higher estrogen conversion was responsible for it.

 

[CoastWatcher]

I finally got the results from the Dr. Office. As I mentioned the blood was drawn about 112 hours (4.66 days) after my last 200mg injection:

Testosterone Total: 1211.22 ng/dL Normal Range: 241.00-827.00

IGF/1: 217 ng/mL Normal Range: 75-216

Estrogen Total: 211 pg/mL Normal Range: 40-115

Estrone: 70 pg/mL Normal Range: 12-72

Testos Bioavail: 903 ng/dL Normal Range: 95-350

Testos Total: 1481 ng/dL Normal Range: 348-1197

Testosterone Bioav %: 61.0

You DIDN'T test estradiol. Total estrogen and estrone are entirely different test and of no value to you or your doctor. You need the LC, MS/MS, sensitive estradiol test.

 

[Jackie Treehorn]

I am injecting IM into my outer quads, alternating each leg. I don't think I can handle two IM injections a week. Would 150 mg SQ twice a week be an option?

OK, now you have peaked my curiosity. Why can't you handle two injections/week? What length and gauge needle are you using for this injection? There is no reason why you couldn't use an insulin pin (1/2"/29 or 27 ga) for these injections. If you don't have a lot of body fat, a 1/2" needle is probably going shallow IM anyways...if it's going SubQ, no big deal, you're still getting the bioavailability from a SubQ injection.

Oh yeah, why would you increase your dosage to 150mg BIW? Not necessary, plus 300mg/week is wandering outside TRT dosages.

I would not mind staying at 200 mg IM once per week and adding Arimidex and HCG. Or is it better to change to injecting 2x per week and staying away from anastrazole / arimidex and HCG?

First off, you don't want to avoid HCG...your Doctor should have been including it in your protocol from the start. Secondly, it's definitely better to inject every 3.5 days, especially if it will eliminate your need to take anastrozole. More frequent injections with smaller doses = less aromatization (conversion to E2).

My sleep is very broken and I suspected the higher estrogen conversion was responsible for it.

Is there any reason why you can't use Discounted Labs to draw a simple sensitive E2 test? It would be nice to know your E2 level from the correct test.

 

[CoastWatcher]

OK, now you have peaked my curiosity. Why can't you handle two injections/week? What length and gauge needle are you using for this injection? There is no reason why you couldn't use an insulin pin (1/2"/29 or 27 ga) for these injections. If you don't have a lot of body fat, a 1/2" needle is probably going shallow IM anyways...if it's going SubQ, no big deal, you're still getting the bioavailability from a SubQ injection.

Oh yeah, why would you increase your dosage to 150mg BIW? Not necessary, plus 300mg/week is wandering outside TRT dosages.



First off, you don't want to avoid HCG...your Doctor should have been including it in your protocol from the start. Secondly, it's definitely better to inject every 3.5 days, especially if it will eliminate your need to take anastrozole. More frequent injections with smaller doses = less aromatization (conversion to E2).



Is there any reason why you can't use Discounted Labs to draw a simple sensitive E2 test? It would be nice to know your E2 level from the correct test.

Everything pointed out here should be given serious consideration. We have to be our own advocates in all aspects of our health, but particularly in TRT-related matters.

 

[RSM]

OK, now you have peaked my curiosity. Why can't you handle two injections/week? What length and gauge needle are you using for this injection? There is no reason why you couldn't use an insulin pin (1/2"/29 or 27 ga) for these injections. If you don't have a lot of body fat, a 1/2" needle is probably going shallow IM anyways...if it's going SubQ, no big deal, you're still getting the bioavailability from a SubQ injection.

I draw with a 22g needle and inject with a 25g. This was given to me by the Pharmacy. It is not really painful during the injection but my quad (left or right) does hurt the next day or so after the injection - it feels like muscle pain after training legs hard. The pain goes away soon after fortunately. Part of my reservation is psychological because I never seem to quite get used to the idea of jabbing myself in the leg with a needle - lol! My wife tried to inject me the first time in the glutes and did her best but was so traumatized by the process some of the test probably leaked out and she had to inject me twice haha! After that I decided to do it myself.

Oh yeah, why would you increase your dosage to 150mg BIW? Not necessary, plus 300mg/week is wandering outside TRT dosages.

It is my understanding that less absorption occurs when SQ injecting into the fat layers and to compensate the dosage is increased. That is what I read from other sources. Which is why I asked since I don't really know.

First off, you don't want to avoid HCG...your Doctor should have been including it in your protocol from the start. Secondly, it's definitely better to inject every 3.5 days, especially if it will eliminate your need to take anastrozole. More frequent injections with smaller doses = less aromatization (conversion to E2).

I did bring up aromatization with my doctor initially and he told me at these lower dosages it should not be an issue. I have not noticed sensitive nipples and my Libido is really good with very frequent morning wood as mentioned before. I am steadily losing body fat and take a ZMA supplement in the evening and DHEA in the morning along with all the other vitamins etc. My sleep has also improved a little the past week.

Is there any reason why you can't use Discounted Labs to draw a simple sensitive E2 test? It would be nice to know your E2 level from the correct test.

I would not mind that. I did call a lab and they wanted a Dr. Script. I am working on that so I can go anywhere and get it covered by Insurance.

 

[RSM]

Everything pointed out here should be given serious consideration. We have to be our own advocates in all aspects of our health, but particularly in TRT-related matters.

I agree. Fortunately my doctor is easy to work with. He was the first to admit that he is not a specialist regarding TRT treatment. But at least he suggested once per week injections from the start instead of the standard biweekly suggested by many other doctors.

 

[RSM]

You DIDN'T test estradiol. Total estrogen and estrone are entirely different test and of no value to you or your doctor. You need the LC, MS/MS, sensitive estradiol test.

I will ask that my doctor provide a script specifying the sensitive test. Is there anything else you would recommend on the script? I would like to give him a full word for word list of items that should be tested.

Edit: After posting this yesterday I found some info on Defy Medical's site. They recommend the following blood work:

Testosterone Free & Total
Estradiol Sensitive
Prostate Specific Antigen (PSA)
Metabolic Panel (CMP)
Hematocrit
Thyroid Stimulating Hormone (TSH)
DHEA-S
Luteinizing Hormone (LH)
Lipid Panel
Progesterone

Should anything else be added while we're at it?

 

[RSM]

Quick update: I had my levels tested again just before my next injection and will be consulting with Defy.

Below are the results...