Very high FT on 70mg/wk?

[Cataceous]

...
I know dialysis is the method always championed on this website, but science seems to believe the different test methods correlate very highly (r > 96).
...

I believe @madman has linked to studies that are far less charitable. My own results are pretty striking in comparing LabCorp's direct immunoassay test to the Tru-T calculation. Free testosterone is expected to be pretty linear with dose. It's true that N is small in these data and the exceptionally good correlation of Tru-T is surely overstated. Nonetheless, it's food for thought.

 

[tareload]

I believe @madman has linked to studies that are far less charitable. My own results are pretty striking in comparing LabCorp's direct immunoassay test to the Tru-T calculation. Free testosterone is expected to be pretty linear with dose. It's true that N is small in these data and the exceptionally good correlation of Tru-T is surely overstated. Nonetheless, it's food for thought.

View attachment 20415
View attachment 20416

For the interested reader, note the units on the ordinate (y-axis) of both graphs above. This is where folks get really confused between (1) correlation vs (2) parity (as compared to ED or UF measurement). direct RIA fT measurement does not yield a physically realistic estimate of fT. Multiply the direct RIA fT measurement [convert typical pg/mL to ng/dL] by 7 to get ballpark actual fT number [ng/dL].

Hence, taking the direct RIA fT at face value would cause one to drastically underestimate their %fT (and also really mess up any estimate of SHBG from fT+TT using online calculator).

Response from LabCorp About Their Incorrect Unit Usages For Their Free Testosterone - Direct - Test

I've been irked for a year by the apparent incorrect unit usage for the particular Free Testosterone test mentioned above. I periodically reach out to whatever relevant executive I can find. No luck for months until the below correspondence. In brief his explanation doesn't hold up in my view...

www.excelmale.com

 

[tareload]

How much testosterone is converted to estradiol?

A man with 1500 ng/dL of testosterone (many men on ExcelMale.com ) may have 1500 x 0.004 = 6.0 ng/dl = 60 pg/ml of estradiol Some doctors may choose to treat 45 pg/ml but I disagree and always have. This would create a T/E ratio of 1500/60 = 25 We have some fertility data on T/E ratios: Is...

www.excelmale.com

 

[bixt]

Tru-T calculation

I thought the consensus here was to use Vermulean.


I ran the following numbers just now on TruT. Constant TT=1200. Albumin 4.4. SHBG was varied as follows along with the truT FT result:

SHBG 15 -> 45ng/dl
SHBG 30 -> 43ng/dl
SHBG 60 -> 39ng/dl
SHBG 90 -> 36ng/dl


Above tru T = Hardly any variation in FT to massive changes in SHBG! Completely contrary to what we see in real life. I think this calculator is bogus. Everyone gets to have a high FT with TruT. Now lets run the same numbers vermulean:

SHBG 15 -> 40ng/dl
SHBG 30 -> 31ng/dl
SHBG 60 -> 20ng/dl
SHBG 90 -> 14ng/dl

Looks to me much more grounded in real world, as far as SHBG affects things. We span the range from high FT, to upper range, average and lowish.

TruT is going to fool high SHBG people into thinking that they have a high FT, when in reality it could be lower range.

 

[tareload]

I thought the consensus here was to use Vermulean.


I ran the following numbers just now on TruT. Constant TT=1200. Albumin 4.4. SHBG was varied as follows along with the truT FT result:

SHBG 15 -> 45ng/dl
SHBG 30 -> 43ng/dl
SHBG 60 -> 39ng/dl
SHBG 90 -> 36ng/dl


Above tru T = Hardly any variation in FT to massive changes in SHBG! Completely contrary to what we see in real life. I think this calculator is bogus. Everyone gets to have a high FT with TruT. Now lets run the same numbers vermulean:

SHBG 15 -> 40ng/dl
SHBG 30 -> 31ng/dl
SHBG 60 -> 20ng/dl
SHBG 90 -> 14ng/dl

Looks to me much more grounded in real world, as far as SHBG affects things. We span the range from high FT, to upper range, average and lowish.

TruT is going to fool high SHBG people into thinking that they have a high FT, when in reality it could be lower range.

Excellent analysis. I keep trying to get @madman to take a beer bet . All doesn't appear to be right in Tru-T land unless a significant portion of prior ED fT results appearing in the open literature are flawed.


You can break up all the literature papers into two camps: one camp where the ED fT data matches Tru-T (cfTz) and the other camp matches Vermeulen decently (cfTV).

Harmonized reference ranges for Total and Free T levels

Accurate Measurement and Harmonized Reference Ranges for Total and Free Testosterone Levels (2022) Ravi Jasuja, Ph.D., Karol M. Pencina, Ph.D., Liming Peng, MSc, Shalender Bhasin, MB, BS* INTRODUCTION A central tenet of endocrinology is that the hormones secreted by the endocrine glands...

www.excelmale.com

However, from a risk reduction standpoint Tru-T is the winner since it keeps the dosing down for the higher SHBG guys!!

 

[bixt]

You can break up all the literature papers into two camps: one camp where the ED fT data matches Tru-T (cfTz) and the other camp matches Vermeulen decently (cfTV)

When I discovered the two calculators, I used to have a habit of punching in random bloods people posted on various forums. The FT was almost always close to (or closer to) Vermulean and never with TruT. So I am firmly with camp V.

 

[tareload]

When I discovered the two calculators, I used to have a habit of punching in random bloods people posted on various forums. The FT was almost always close to (or closer to) Vermulean and never with TruT. So I am firmly with camp V.

To your point, the interested reader can scan this thread linked below and then posts below the linked post for a non-exhaustive review of literature and anecdotal data comparisons (there was a nice thread a T-Nation with people's fT numbers based on ED/UF fT):

Calculate Free Testosterone with TruT by FPT

[0026] Fig. 7 depicts the thermodynamic Parameters associated with testosterone's binding to SHBG derived from the fit of binding isotherms and ITC data to new model. While this parameter set is not unique, together they consistently describe the binding isotherms, depletion curves and ITC data...

www.excelmale.com

 

[Cataceous]

I thought the consensus here was to use Vermulean.
...

I look at both calculations now. I tend to find Vermeulen making more sense when SHBG isn't midrange. BTW, here are the numbers with Vermeulen:

 

[GreenMachineX]

I definitely felt much less anxiety and CNS stimulation when dosing EOD many months ago. The anxiety right now is unreal. What symptoms did you experience on daily injections?

I only chose daily injections because I was previously running a blend to mimic diurnal variation, just as cataceous and some other guys here have done.

I wanted to switch back to EOD, but I feared the large spikes in T would cause additional issues, and as such, I tried to smooth the transition by staying on daily shots.

Anyway, I am not sure what’s going on — what’s causing this unbearable anxiety, considering I’m running the lowest amount of test I’ve ever run. I am guessing symptoms are due to low E2 / high test:E2 ratio.

I'm in a very similar situation right now. I started with 10mg daily, had top of range free T, extreme anxiety and couldnt sleep at all. I didn't understand what was happening because at 25mg EOD I slept and felt fine, so I increased to 12mg then 13/14mg daily just for a couple days and ended up in the ER with the worst anxiety, blood pressure, and scary chest pain/tightness ever. I then dropped to 7mg daily for a month, while fixing my b12 and my hct and hgb went up...so now at 5mg and anxiety is back along with other low e2 symptoms.

I've had the same hesitation about going back to EOD because of the sudden response of changing daily dose so quickly. If I could feel the difference going up 2-3mg per day in a matter of days, what happens if I try to go back to 25mg EOD? I'm riding out this out for now, but I see myself going back to 6-7mg daily as I believe I'm stuck here, or time to go natural restart. My free T 2 weeks into this 5mg was 100 at trough (morning). 2 weeks is too early to really make any decisions, but it does make sense to a certain degree. E2 was also cut in half by cutting dose in half. Ultrasensitive e2 was 15 at 5mg daily and 30 at 10mg daily. It's interesting though how I absolutely feel so much better the latter part of the day when levels would be rising.

I'll be following along.

 

[bixt]

My free T 2 weeks into this 5mg was 100 at trough

100 what? Please everyone, always try to post the units and the range.

 

[GreenMachineX]

100 what? Please everyone, always try to post the units and the range.

35-155, quests range. Pg/mL.

 

[JustPanicNoDisco]

I'm in a very similar situation right now. I started with 10mg daily, had top of range free T, extreme anxiety and couldnt sleep at all. I didn't understand what was happening because at 25mg EOD I slept and felt fine, so I increased to 12mg then 13/14mg daily just for a couple days and ended up in the ER with the worst anxiety, blood pressure, and scary chest pain/tightness ever. I then dropped to 7mg daily for a month, while fixing my b12 and my hct and hgb went up...so now at 5mg and anxiety is back along with other low e2 symptoms.

I've had the same hesitation about going back to EOD because of the sudden response of changing daily dose so quickly. If I could feel the difference going up 2-3mg per day in a matter of days, what happens if I try to go back to 25mg EOD? I'm riding out this out for now, but I see myself going back to 6-7mg daily as I believe I'm stuck here, or time to go natural restart. My free T 2 weeks into this 5mg was 100 at trough (morning). 2 weeks is too early to really make any decisions, but it does make sense to a certain degree. E2 was also cut in half by cutting dose in half. Ultrasensitive e2 was 15 at 5mg daily and 30 at 10mg daily. It's interesting though how I absolutely feel so much better the latter part of the day when levels would be rising.

I'll be following along.

Wow. We have scarily similar response patterns. Have you tried exogenous estradiol (creams, patches, shots)?

I’m scared to raise my T dose as well. It seems like once lowered the body needs far less (metabolism seems to slow). Very odd.

It just doesn’t make a lot of sense. My total testosterone is the same at 70 mg/wk as it was at 140 mg / wk.

Test numbers scale linearly for most, but certainly not for me.

I’d love to chat in PM a bit about our issues to see if we can come to any insights about what the hell is happening.

@readalot Thanks for all the information and the probing questions. I’ll do the math when I’m more level-headed. Right now my nervous system is in complete meltdown, insomnia is insane, and brain fog is thick enough to cut with a knife.

Can you give me a quick answer - do you think this free T determined by quest is plausible? I’ve only used direct or calculated in the past, and those were always close to the top of the reference range, not almost twice above it, even on much higher doses of test.

Also, what do you make of the above phenomenon, where TT (fT aside for now) isn’t scaling linearly at all with respect to dosage? (TT is just as high now as it was on 140 mg / wk, and this is not accounted for by difference in injection frequency (i.e. measuring at lower troughs)).

 

[GreenMachineX]

Wow. We have scarily similar response patterns. Have you tried exogenous estradiol (creams, patches, shots)?

I’m scared to raise my T dose as well. It seems like once lowered the body needs far less (metabolism seems to slow). Very odd.

It just doesn’t make a lot of sense. My total testosterone is the same at 70 mg/wk as it was at 140 mg / wk.

Test numbers scale linearly for most, but certainly not for me.

I’d love to chat in PM a bit about our issues to see if we can come to any insights about what the hell is happening.

@readalot Thanks for all the information and the probing questions. I’ll do the math when I’m more level-headed. Right now my nervous system is in complete meltdown, insomnia is insane, and brain fog is thick enough to cut with a knife.

Can you give me a quick answer - do you think this free T determined by quest is plausible? I’ve only used direct or calculated in the past, and those were always close to the top of the reference range, not almost twice above it, even on much higher doses of test.

Also, what do you make of the above phenomenon, where TT (fT aside for now) isn’t scaling linearly at all with respect to dosage? (TT is just as high now as it was on 140 mg / wk, and this is not accounted for by difference in injection frequency (i.e. measuring at lower troughs)).

I haven't tried injectable e2 yet. But if I have to, I will. I'll send a pm.

 

[bixt]

I’m scared to raise my T dose as well. It seems like once lowered the body needs far less (metabolism seems to slow). Very odd.

It just doesn’t make a lot of sense.

Theres an entire thread I think over 100 pages over at professional muscle. These guys have blasted grams of everything over the decades.
A lot of them them now use 70mg a week (10mg a day) and have FT top of the range. I dont want to post that link as they keep promoting a particular product in it ad nauseam. I mention this, as just like you, they now need far less than before

They all claim better libido than the grams of stuff, or even their cruises which were 300-500mg/week.

Why is this almost universally working for a lot of them? Crushed SHBG from decades of abuse? Multiplied AR density from the high doses prior? Excellent fitness and continual weight lifting with big weights (from previously gotten muscle memory)?

 

[tareload]

Wow. We have scarily similar response patterns. Have you tried exogenous estradiol (creams, patches, shots)?

I’m scared to raise my T dose as well. It seems like once lowered the body needs far less (metabolism seems to slow). Very odd.

It just doesn’t make a lot of sense. My total testosterone is the same at 70 mg/wk as it was at 140 mg / wk.

Test numbers scale linearly for most, but certainly not for me.

I’d love to chat in PM a bit about our issues to see if we can come to any insights about what the hell is happening.

@readalot Thanks for all the information and the probing questions. I’ll do the math when I’m more level-headed. Right now my nervous system is in complete meltdown, insomnia is insane, and brain fog is thick enough to cut with a knife.

Can you give me a quick answer - do you think this free T determined by quest is plausible? I’ve only used direct or calculated in the past, and those were always close to the top of the reference range, not almost twice above it, even on much higher doses of test.

Also, what do you make of the above phenomenon, where TT (fT aside for now) isn’t scaling linearly at all with respect to dosage? (TT is just as high now as it was on 140 mg / wk, and this is not accounted for by difference in injection frequency (i.e. measuring at lower troughs)).

n = 1. Repeat the measurements.

Prior blood work data at higher dosing with frequency/trough info?

 

[GreenMachineX]

Wow. We have scarily similar response patterns. Have you tried exogenous estradiol (creams, patches, shots)?

I’m scared to raise my T dose as well. It seems like once lowered the body needs far less (metabolism seems to slow). Very odd.

It just doesn’t make a lot of sense. My total testosterone is the same at 70 mg/wk as it was at 140 mg / wk.

Test numbers scale linearly for most, but certainly not for me.

I’d love to chat in PM a bit about our issues to see if we can come to any insights about what the hell is happening.

@readalot Thanks for all the information and the probing questions. I’ll do the math when I’m more level-headed. Right now my nervous system is in complete meltdown, insomnia is insane, and brain fog is thick enough to cut with a knife.

Can you give me a quick answer - do you think this free T determined by quest is plausible? I’ve only used direct or calculated in the past, and those were always close to the top of the reference range, not almost twice above it, even on much higher doses of test.

Also, what do you make of the above phenomenon, where TT (fT aside for now) isn’t scaling linearly at all with respect to dosage? (TT is just as high now as it was on 140 mg / wk, and this is not accounted for by difference in injection frequency (i.e. measuring at lower troughs)).

Hey man, sent you a PM. Also, had more bloodwork done, and my total test levels are even higher now than they were. I don't get what's happening at all with daily shots.

 

[Nocalves]

Did you happen to test SHBG? This can be used as a backup to calculate free testosterone and compare it to test results. Barring significant changes in underlying metabolism it's expected that average free testosterone should be roughly proportional to the dose rate.

I was just discussing OTC estradiol supplementation. I think it's worth considering given your lowish E2/T ratio. Low-and-slow, of course.

... Normal daily production [of estradiol] in men is said to be on the order of 50 mcg. In a test like this I might start at 10 mcg. Estradiol cream would be a convenient option, though you would need to find or make some that has a sufficiently low concentration. If the absorption rate of a topical is about 10% then you'd need to apply 100 mcg of estradiol in cream to absorb 10 mcg. You can get estradiol mixed with estriol on Amazon. But each pump of this product delivers 500 mcg of estradiol, five times more than a prudent starting dose.​

https://www.excelmale.com/forum/threads/is-“enclomiphene-citrate”-going-to-replace-hcg-in-the-usa.24887/post-219581

Does the estradiol injection add extra estradiol on top of e2 from tst->e2 convertion? Or it blunt that and replace whole E2..?

 

[Cataceous]

Does the estradiol injection add extra estradiol on top of e2 from tst->e2 convertion? Or it blunt that and replace whole E2..?

It should be additive for those on TRT. The effect could be blunted if there's a negative feedback effect on aromatase production, but I don't know that such a mechanism exists.

 

[GreenMachineX]

@JustPanicNoDisco
Any update?

 

[Willyt]

Theres an entire thread I think over 100 pages over at professional muscle. These guys have blasted grams of everything over the decades.
A lot of them them now use 70mg a week (10mg a day) and have FT top of the range. I dont want to post that link as they keep promoting a particular product in it ad nauseam. I mention this, as just like you, they now need far less than before

They all claim better libido than the grams of stuff, or even their cruises which were 300-500mg/week.

Why is this almost universally working for a lot of them? Crushed SHBG from decades of abuse? Multiplied AR density from the high doses prior? Excellent fitness and continual weight lifting with big weights (from previously gotten muscle memory)?

I have followed that thread. My take was that these AAS guys were finally discovering that libido responds better when T levels are kept within the physiological range. I am continually amazed at how little T it takes to hit the top of range.