Vets help..

[AH2261]

Hey Guys,

I'm hoping some of the more experienced guys can possible help me out. I've posted a few times on the board and haven't been on in a while. So quick background, been on low dose test for last 5 years, last 2 have been under doctor care. I've stayed within 150-200mg per week, most of this time frame at 2 shots per week. That said, i've gone through fluctuations where i've felt great and other times not so great. I don't feel i've ever really dialed in my T/E ratio. But overall felt good and i'm sure could feel better if i nailed down best protocal for body.

That said, i've also noticed that when i take a shot i felt best 6-7 days after the shot and a few times i did not take the second weekly shot and went at times 10 days and felt even better. Sex drive was great and i never understood why. First couple days after the shot not so great sex drive.

So i ended up these past feeks traveling for work and i went off cold turkey, to experiment how i would feel. I've been off for 3 weeks now, the first 2 weeks i felt great, waking up with morning wood, first time in YEARS! Sensitivity great and overall blood flow like i haven't seen in years.

I decided to get blood work after week 2 since i figured why not get labs during a time i feel great to see where those numbers were. My total test was 415, estridiol was 9 and free test was 70.9. This was roughly a few days over 2 weeks since my last shot.

Normal blood work has had me in the 900 range and estro in the 45-55 range over the years.

I'm finishing my 3rd week and no idea where my test is, it could be dropping by the day, who knows. I am noticing that my skin is starting to get oily and i'm thinking it may be due to my estro going up? Not sure how this all works for it to be at 9 and to go up....maybe it's the T starting to tank even lower?

I don't know if this is the beginning of me starting to feel a hell of a lot worse, and test is about to go rock bottom and i'll start to feel like all the horror stories i hear about when guys come off ( depressed, muscle loss, no libido, etc.).

All i know is that this was the first time in years that i was getting morning wood, great sex drive and not sure why. Maybe it was the first time my testes some what woke up from years of being shut off?

I know seeing my doctor is the best course of action, and i saw him few months ago and talked to him about possible coming off and he said most just come off cold turkey...not sure if i really want to come off for good, but figured i'd try. My main concern/goal is feeling good.

Am i in for a world of hurt coming my way ??

 

[Paco1973]

150mg to 200mg per week is not low dose test. Typically, guys are taking around 100mg per week. It's rare to see guys on high doses. I think those are typically the high SHBG guys. What I think may be happening is that you are taking a dose that is too large and your peak is too high. That's why you saw restored sexual function over time after injections. If your testosterone is typically 900, assuming you had it drawn at the trough, your testosterone right after injection may be simply too high.

Going cold turkey off of testosterone is not a bright idea. Your doctor is wrong. In my opinion, the longer you've been on trt, the lower your chances of recovery.

I'd suggest finding a different doctor, reading up everything you can about restarts, and then make a decision on which way your treatment should go. Chances are, you are going to end up back on testosterone. And, when you do, try a lower dose with HCG and a more frequent injection schedule.

 

[MarkM]

Stopping test cold turkey after years of being on it is not a good idea. Very bad advice from your doctor. It sounds like you have not been consistent in your protocol over the 5 years you have been on testosterone. Changing injections schedule and doses on a regular basis does not normally provide positive results and keeps the body in a state of change. You may not be giving you body a chance to normalize.

Your dose is likely too high and that is why you don't feel good until until 6 to 7 days after the injection. The testosterone will peak between 36 to 48 hrs after injection. Yours must be peaking so high that it is taking 6 days to come down to get to a level that you feel good at. Do you know what your SHBG is? That will determine what injection protocol you need to be on.

Is the estradiol number you are posting from the Estradiol Sensitive test or the Estradiol Roche ECLIA test? THe Roche ECLIA test is for women. You need the Estradiol Sensitive test, LC/MS/MS assay. Either way, that figure for estradiol is very low and can have some terrible symptoms.

You have a very high Free T to Total T ratio. Most people have a Free T percentage of 2 - 3% of Total T but your numbers indicate Free T of 70.9 against Total T of 415. That is a Free T percentage of over 17% which just doesn't sound right. Are you sure of that figure?

If your Free T is that high you could have very high DHT which will give you oily skin and acne.

All of this is purely guess work because there are no labs posted to give more accurate and solid information. You need to have the Estradiol Sensitive test run and you need to know what your SHBG is in order to get dialed in.

How is your thyroid? Have you run a full thyroid panel; TSH, Free T3, Free T4, Reverse T3, and both thyroid antibodies (ATA and TPO)?

Are you in for a world of hurt with going cold turkey? I think you are going to have some bad days heading your way and wish you had not gone cold turkey. You will probably get back on TRT and hopefully a better more consistent protocol once you get dialed in.

 

[Vince]

I think it's nice to be a steady protocol and if needed slowly make adjustments until you get dialed-in. Like members say it's not a sprint, it's a marathon when dealing with TRT.

 

[lexer]

I agree, your dose is too high ! If you are at 900 at trough, the 2 days following injection you are close to 1500. Thats crazy high.
also, every normal human with natural/ healthy T levels will have days or even weeks where libido or energy will seem a bit low. No one always has a high libido. No one always has high energy. No one is always in a good mood..
too many guys on T hyper focus on how they feel and thats one reason some guys dont do well on T.

 

[AH2261]

Stopping test cold turkey after years of being on it is not a good idea. Very bad advice fro your doctor. It sounds like you have not been consistent in your protocol over the 5 years you have been on testosterone. Changing injections schedule and doses on a regular basis does not normally provide positive results and keep the body in a state of chang. You may not be giving you body a chance to normalize.

Your does is likely too high and that is why you don't feel good until until 6 to 7 days after the injection. The testosterone will peak between 36 to 48 hrs after injection. Yours must be peaking so high that it is taking 6 days to come down to get to a level that you feel good at. Do you know what your SHBG is? That will determine what injection protocol you need to be on.

Is the estradiol number you are posting from the Estradiol Sensitive test or the Estradiol Roche ECLIA test? THe Roche ECLIA test is for women. You need the Estradiol Sensitive test, LC/MS/MS assay. Either way, that figure for estradiol is very low and can have some terrible symptoms.

You have a very high Free T to Total T ratio. Most people have a Free T percentage of 2 - 3% of Total T but your numbers indicate Free T of 70.9 against Total T of 415. That is a Free T percentage of over 17% which just doesn't sound right. Are you sure of that figure?

If your Free T is that high you could have very high DHT which will give you oily skin and acne.

ALl of this is purely guess work because there are no labs posted to give more accurate and solid information. You need to have the Estradiol Sensitive test run and you need to know what your SHBG is in order to get dialed in.

How is your thyroid? Have you run a full thyroid panel; TSH, Free T3, Free T4, Reverse T3, and both thyroid antibodies (ATA and TPO)?

Are you in for a world of hurt with going cold turkey? I think you are going to have some bad days heading your way and wish you had not gone cold turkey. You will probably get back on TRT and hopefully a better more consistent protocol once you get dialed in.

I'll get my lab results and post them. As far as free test, your comment about having oily skin is 100% spot on, i've noticed lately my skin has been extray oily , as well as hair. What causes free test to be so high? I'm assuming it's a bad thing to have it too high?

 

[MarkM]

I am guessing that you might have very low SHBG. If it is low it means your Free t will be higher than someone with high SHBG. Also, when you have high Free T, you are likely to have high Free Estradiol.

Having extremely high Free T does have its drawbacks.

 

[AH2261]

i have my labs from quest diagnostics app. I need to see the doc next week to review labs so i'd imagine there is more detail than what the app is showing me. Here is what i have.

Estrone,LC/MS/MS - 14
Estradiol,Ultra Sentative LC/MS/MS - 9
Estriol Serum - <.10

Total Free Test - 70.9
Test Total - 415

There is other detail, but not a lot on the app, but most else is in range, have high RBC which is normal and i donate blood often to keep that in check. This is roughly 2 or so weeks of going off cold turkey.

 

[AH2261]

I am guessing that you might have very low SHBG. If it is low it means your Free t will be higher than someone with high SHBG. Also, when you have high Free T, you are likely to have high Free Estradiol.

Having extremely high Free T does have its drawbacks.

what would cause low SHBH? And is this a bad thing?

 

[MarkM]

i have my labs from quest diagnostics app. I need to see the doc next week to review labs so i'd imagine there is more detail than what the app is showing me. Here is what i have.

Estrone,LC/MS/MS - 14
Estradiol,Ultra Sentative LC/MS/MS - 9
Estriol Serum - <.10

Total Free Test - 70.9
Test Total - 415

There is other detail, but not a lot on the app, but most else is in range, have high RBC which is normal and i donate blood often to keep that in check. This is roughly 2 or so weeks of going off cold turkey.

That is the correct Estradiol test. Your E2 is very low. Most people don't feel well with it being that low. Are you taking anything at all to reduce E2 such as anastrozole, calcium d-glucarate, DIM, I3C, or is it naturally that low?

Be careful on donating too much blood. Many do it to control hemoglobin and hematocrit and don't realize it can crash your iron and ferritin levels. Low ferritin can play havoc on your thyroid and overall health and energy. I donated for years and years and did not realize I was depleting my iron and ferritin and until it was almost non-existent.

 

[madman]

Hey Guys,

I'm hoping some of the more experienced guys can possible help me out. I've posted a few times on the board and haven't been on in a while. So quick background, been on low dose test for last 5 years, last 2 have been under doctor care. I've stayed within 150-200mg per week, most of this time frame at 2 shots per week. That said, i've gone through fluctuations where i've felt great and other times not so great. I don't feel i've ever really dialed in my T/E ratio. But overall felt good and i'm sure could feel better if i nailed down best protocal for body.

That said, i've also noticed that when i take a shot i felt best 6-7 days after the shot and a few times i did not take the second weekly shot and went at times 10 days and felt even better. Sex drive was great and i never understood why. First couple days after the shot not so great sex drive.

So i ended up these past feeks traveling for work and i went off cold turkey, to experiment how i would feel. I've been off for 3 weeks now, the first 2 weeks i felt great, waking up with morning wood, first time in YEARS! Sensitivity great and overall blood flow like i haven't seen in years.

I decided to get blood work after week 2 since i figured why not get labs during a time i feel great to see where those numbers were. My total test was 415, estridiol was 9 and free test was 70.9. This was roughly a few days over 2 weeks since my last shot.

Normal blood work has had me in the 900 range and estro in the 45-55 range over the years.

I'm finishing my 3rd week and no idea where my test is, it could be dropping by the day, who knows. I am noticing that my skin is starting to get oily and i'm thinking it may be due to my estro going up? Not sure how this all works for it to be at 9 and to go up....maybe it's the T starting to tank even lower?

I don't know if this is the beginning of me starting to feel a hell of a lot worse, and test is about to go rock bottom and i'll start to feel like all the horror stories i hear about when guys come off ( depressed, muscle loss, no libido, etc.).

All i know is that this was the first time in years that i was getting morning wood, great sex drive and not sure why. Maybe it was the first time my testes some what woke up from years of being shut off?

I know seeing my doctor is the best course of action, and i saw him few months ago and talked to him about possible coming off and he said most just come off cold turkey...not sure if i really want to come off for good, but figured i'd try. My main concern/goal is feeling good.

Am i in for a world of hurt coming my way ??

You state you have been on trt for 5 years, last 2 under a doctors care.

Have kept your dose in the 150-200mg/week range most of that time and splitting dose twice weekly (every 3.5 days).

Gone through fluctuations where you felt great and other times not so great.....ups/downs could be due to many reasons too low/high TT/FT, too low/high e2, overall protocol (dose/injection frequency) related to ones SHBG as it is critical to know your SHBG as it will dictate ones dose/injection frequency an the overall effectiveness of ones trt protocol.

Trying to understand that " i've also noticed that when i take a shot i felt best 6-7 days after the shot" when you stated earlier that you are injecting twice weekly so you are basically injecting every 3.5 days yet you say you noticed you felt better 6-7 days after the shot.....makes no sense unless you were injecting once weekly?

You state " a few times i did not take the second weekly shot and went at times 10 days and felt even better" so if you were injecting 150-200mg/week of testosterone
split into twice weekly injections (every 3.5 days) than you were injecting 75-100mg of testosterone twice weekly so if you skipped the second weekly shot a few times than you basically injected 75-100mg once weekly for a few weeks.....there would be too much fluctuation in your T levels let alone e2.

You state "so i ended up these past feeks traveling for work and i went off cold turkey, to experiment how i would feel. I've been off for 3 weeks now, the first 2 weeks i felt great, waking up with morning wood, first time in YEARS! Sensitivity great and overall blood flow like i haven't seen in years".

Of course you would still feel ok within the first 2 weeks after stopping since the exogenous T is still in your system but your levels will crash after the exogenous T is out of your system and a week after your last injection levels are already starting to decline.

After week 2 you had blood work done and your TT 415 is in the low normal range and I would say your FT would also be lower even though you state FT is 70.9.....we need to know the reference range on your labs?

You have finished your 3rd week of trt and you are going to experience low t again and negative effect on energy/mood/libido/erectile function are to be expected as your hormones are low.....and as far as muscle loss highly doubtful unless one was abusing testosterone in high doses as in steroid doses to gain significant muscle.

You need to have full blood work done and assess the situation to decide what is the best approach to improving your situation and you need a good doctor such as Dr. Saya from Defy.

 

[madman]

Stopping test cold turkey after years of being on it is not a good idea. Very bad advice fro your doctor. It sounds like you have not been consistent in your protocol over the 5 years you have been on testosterone. Changing injections schedule and doses on a regular basis does not normally provide positive results and keep the body in a state of chang. You may not be giving you body a chance to normalize.

Your does is likely too high and that is why you don't feel good until until 6 to 7 days after the injection. The testosterone will peak between 36 to 48 hrs after injection. Yours must be peaking so high that it is taking 6 days to come down to get to a level that you feel good at. Do you know what your SHBG is? That will determine what injection protocol you need to be on.

Is the estradiol number you are posting from the Estradiol Sensitive test or the Estradiol Roche ECLIA test? THe Roche ECLIA test is for women. You need the Estradiol Sensitive test, LC/MS/MS assay. Either way, that figure for estradiol is very low and can have some terrible symptoms.

You have a very high Free T to Total T ratio. Most people have a Free T percentage of 2 - 3% of Total T but your numbers indicate Free T of 70.9 against Total T of 415. That is a Free T percentage of over 17% which just doesn't sound right. Are you sure of that figure?

If your Free T is that high you could have very high DHT which will give you oily skin and acne.

ALl of this is purely guess work because there are no labs posted to give more accurate and solid information. You need to have the Estradiol Sensitive test run and you need to know what your SHBG is in order to get dialed in.

How is your thyroid? Have you run a full thyroid panel; TSH, Free T3, Free T4, Reverse T3, and both thyroid antibodies (ATA and TPO)?

Are you in for a world of hurt with going cold turkey? I think you are going to have some bad days heading your way and wish you had not gone cold turkey. You will probably get back on TRT and hopefully a better more consistent protocol once you get dialed in.

One needs to know his SHBG in order to calculate his FT% as there is no way one could have a FT of 17%.

We also need to see the reference range for his FT to truly know where his FT of 70.9 sits in the reference range to state whether it is high or low as depending on the assay used for FT that he had done reference ranges can vary between assays and labs.

 

[AH2261]

Thanks madman for detailed response. I have been in the 150-200 range during the entire time and as far as not second the second shot, there have been instances due to travel/schedule where i have not taken my second shot and i noticed a trend of day 5-7 of feeling better , libido wise mainly and i've done this a handful of times over the years.

as far as the total free test range, it states 250-827 ng/dl. As i mentioned, i believe the details of the labs will be available when i see my doc on Tuesday, since in the past i had SHBG and many other values not present in the quest app i'm using on my phone. Hopefully that range gives you a more detail if my free is really as high as it appears.

and i agree, i have not stuck to a steady protocal and been dilligent with labs to really dial in my dose. I have a feeling based on what others have mentioned on this thread and what i've noticed that i may be taking too much, for my labs historically to be 900 and even 1100 range at times, and that's 3-4 days after an injection. Maybe i should dial it down to 100-125 a week. I am not taking anything else at this time. I have AI on hand from doc but don't take it consistently to really comment on it's results.

I have an email out to Defy. Thanks for your note and the previous times you've taken the time to message me.

You state you have been on trt for 5 years, last 2 under a doctors care.

Have kept your dose in the 150-200mg/week range most of that time and splitting dose twice weekly (every 3.5 days).

Gone through fluctuations where you felt great and other times not so great.....ups/downs could be due to many reasons too low/high TT/FT, too low/high e2, overall protocol (dose/injection frequency) related to ones SHBG as it is critical to know your SHBG as it will dictate ones dose/injection frequency an the overall effectiveness of ones trt protocol.

Trying to understand that " i've also noticed that when i take a shot i felt best 6-7 days after the shot" when you stated earlier that you are injecting twice weekly so you are basically injecting every 3.5 days yet you say you noticed you felt better 6-7 days after the shot.....makes no sense unless you were injecting once weekly?

You state " a few times i did not take the second weekly shot and went at times 10 days and felt even better" so if you were injecting 150-200mg/week of testosterone
split into twice weekly injections (every 3.5 days) than you were injecting 75-100mg of testosterone twice weekly so if you skipped the second weekly shot a few times than you basically injected 75-100mg once weekly for a few weeks.....there would be too much fluctuation in your T levels let alone e2.

You state "so i ended up these past feeks traveling for work and i went off cold turkey, to experiment how i would feel. I've been off for 3 weeks now, the first 2 weeks i felt great, waking up with morning wood, first time in YEARS! Sensitivity great and overall blood flow like i haven't seen in years".

Of course you would still feel ok within the first 2 weeks after stopping since the exogenous T is still in your system but your levels will crash after the exogenous T is out of your system and a week after your last injection levels are already starting to decline.

After week 2 you had blood work done and your TT 415 is in the low normal range and I would say your FT would also be lower even though you state FT is 70.9.....we need to know the reference range on your labs?

You have finished your 3rd week of trt and you are going to experience low t again and negative effect on energy/mood/libido/erectile function are to be expected as your hormones are low.....and as far as muscle loss highly doubtful unless one was abusing testosterone in high doses as in steroid doses to gain significant muscle.

You need to have full blood work done and assess the situation to decide what is the best approach to improving your situation and you need a good doctor such as Dr. Saya from Defy.

 

[MarkM]

One needs to know his SHBG in order to calculate his FT% as there is no way one could have a FT of 17%.

We also need to see the reference range for his FT to truly know where his FT of 70.9 sits in the reference range to state whether it is high or low as depending on the assay used for FT that he had done reference ranges can vary between assays and labs.

Correct..........I have asked OP about his SHBG and that it is needed for proper protocol and I have questioned the high Free T as it did not sound accurate. As far as calculating his Free T, Ii am familiar with the Free T and Bioavailable Calculator but one normally needs the Albumin, as well, which I have not seen. At least the calculator I use requires it to make the calculation. That being said, LabCorp takes the Free T percentage without taking SHBG and Albumin into consideration. It simply divides to get the percentage. Next time LabCorp gives me a percentage for Free T without calculating it with SHBG and Albumin I will tell them they are wrong.

 

[madman]

Correct..........I have asked OP about his SHBG and that it is needed for proper protocol and I have questioned the high Free T as it did not sound accurate. As far as calculating his Free T, Ii am familiar with the Free T and Bioavailable Calculator but one normally needs the Albumin, as well, which I have not seen. At least the calculator I use requires it to make the calculation. That being said, LabCorp takes the Free T percentage without taking SHBG and Albumin into consideration. It simply divides to get the percentage. Next time LabCorp gives me a percentage for Free T without calculating it with SHBG and Albumin I will tell them they are wrong.

Albumin is a set number on the Free & Bioavailable T calculators 4.3 g/dL.....hence one does not need albumin as it is a set standard

https://www.nebido.com/en/hcp/research/testosterone-tools/free-calculator.php
..................................................................................................

http://www.issam.ch/freetesto.htm

 

[madman]

Thanks madman for detailed response. I have been in the 150-200 range during the entire time and as far as not second the second shot, there have been instances due to travel/schedule where i have not taken my second shot and i noticed a trend of day 5-7 of feeling better , libido wise mainly and i've done this a handful of times over the years.

as far as the total free test range, it states 250-827 ng/dl. As i mentioned, i believe the details of the labs will be available when i see my doc on Tuesday, since in the past i had SHBG and many other values not present in the quest app i'm using on my phone. Hopefully that range gives you a more detail if my free is really as high as it appears.

and i agree, i have not stuck to a steady protocal and been dilligent with labs to really dial in my dose. I have a feeling based on what others have mentioned on this thread and what i've noticed that i may be taking too much, for my labs historically to be 900 and even 1100 range at times, and that's 3-4 days after an injection. Maybe i should dial it down to 100-125 a week. I am not taking anything else at this time. I have AI on hand from doc but don't take it consistently to really comment on it's results.

I have an email out to Defy. Thanks for your note and the previous times you've taken the time to message me.

You listed the reference range for TT.....I want to know the reference range for FT?

 

[MarkM]

Albumin is a set number on the Free & Bioavailable T calculators 4.3 g/dL.....hence one does not need albumin as it is a set standard

https://www.nebido.com/en/hcp/research/testosterone-tools/free-calculator.php
..................................................................................................

http://www.issam.ch/freetesto.htm

While 4.3 is listed for Albumin like you state, it is not set and can/should be adjusted if one is going to use to calculator. The cell is not blocked and it should be adjusted as everyone's is different.

 

[madman]

Thanks madman for detailed response. I have been in the 150-200 range during the entire time and as far as not second the second shot, there have been instances due to travel/schedule where i have not taken my second shot and i noticed a trend of day 5-7 of feeling better , libido wise mainly and i've done this a handful of times over the years.

as far as the total free test range, it states 250-827 ng/dl. As i mentioned, i believe the details of the labs will be available when i see my doc on Tuesday, since in the past i had SHBG and many other values not present in the quest app i'm using on my phone. Hopefully that range gives you a more detail if my free is really as high as it appears.

and i agree, i have not stuck to a steady protocal and been dilligent with labs to really dial in my dose. I have a feeling based on what others have mentioned on this thread and what i've noticed that i may be taking too much, for my labs historically to be 900 and even 1100 range at times, and that's 3-4 days after an injection. Maybe i should dial it down to 100-125 a week. I am not taking anything else at this time. I have AI on hand from doc but don't take it consistently to really comment on it's results.

I have an email out to Defy. Thanks for your note and the previous times you've taken the time to message me.

The reference range 250-827 ng/dL you stated is for the TESTOSTERONE, TOTAL (Immunoassay) from Quest Diagnostics

https://www.questdiagnostics.com/testcenter/BUOrderInfo.action?tc=873&labCode=SKB

 

[madman]

While 4.3 is listed for Albumin like to you, it is not set and can/should be adjusted if one is going to use to calculator. The cell is not blocked and it should be adjusted as everyone's is different.

It is set on all Free & Bioavailable Testosterone calculators and only changes if one had a presence of significant hypoalbinumenia which is not common in most men!

That is why 4.3 is already set in there.....yes it can be changed but only in the presence of significant hypoalbinumenia which is not a common condition in most men.

 

[madman]

While 4.3 is listed for Albumin like to you, it is not set and can/should be adjusted if one is going to use to calculator. The cell is not blocked and it should be adjusted as everyone's is different.

You would be correct in the sense that ones albumin can vary slightly (higher/lower) and although ones albumin can be ordered on a blood test to improve the calculation when using the Free & Bioavailable Testosterone calculator, it has little impact unless the albumin levels were markedly lowered (not common).....hence why 4.3 is already set in there.