Where to go from here?

[klepp0906]

So the TLDR version is i tried to make the switch to subQ.

Im highish SHBG ~57 but ive seen it as low as 33 depending on protocol and whether im eating at a surplus or deficit at the time.

I seem to lose libido and morning wood almost entirely if my freeT is below the top 20 percent, which unfortunately requires my TotalT to be oor. Fortunately my doctor has seen it as high as 1280 on trough and said nothing - thus far. So he either gets it (relative to shbg) or doesnt care. /shrug

That all being said, my end-game (have been on over a year already) is keeping the libido and other benefits that come from a high freeT, avoiding going back to IM (if possible) while keeping my hematocrit in range (its always been just barely in range with all my tested protocols thus far) and to have my protocol as simple as possible within reason. (obviously 1 dose of T and 1 dose of anastrozole a week is simple, but not reasonable ;p)


I had my first labs on subQ a couple of weeks back, and as I surmised during the interim, they were lower than on the equivalent IM dose.

I tried several times before to make the switch, and each time - I felt like total crap and within a couple weeks i went back to IM. This last time, I frontloaded a bit to offset the transition and I made it out the other side - but I had bad ED and libido/lack of morning wood the entire 6 week stretch.

Real talk, trt has been exceptional for mood and energy, but the libido is hit or miss, and boy did it ever set the hairloss in motion. Ive resigned to having to shave my dome within the next few years at best. One hell of a tradeoff but its the price i get to pay I suppose.

Anyhow, here are the labs. What would you guys suggest to get free T higher? Simply stay on the (current) E3D and up the dose? or change up frequency? While infrequent is more simple, I know you can only pump so much oil under the skin before discomfort or potential abscess comes into play. Plus im unsure how IM vs SubQ breaks down as far as dose size vs peak T/time etc. I know, as the results below show, for me, on an E3D frequency, SubQ results in less T and more E.

From earliest to latest. Missing results are because some things werent tested till later in some cases, other cases even though I tell the doc to test for what he tested for "last time" he still leaves stuff out. I always get a different set of labs /sigh.

The "labels" if you will, is my dose/frequency of test/arimidex followed by the purported peak/trough levels determined by using steroidcalc. Followed by how my arimidex dosage breaks down on a daily/weekly level. About half way through I started to keep a running diary so some stuff I had to backfill as best I could between memory and lab results.

Pre-Trt
----------
Total Testosterone 198 (400-1080 ng/dl)
Free Testosterone 40 (49-212 pg/ml)
SHBG 55 (10-80 nmol/L)
Hematocrit 48.3 (41-35%)
PSA .54 (0-2.50 ng/ml)
Cholesterol 139 (140-199 mg/dl)
HDL 64 (40-75 mg/dl)
LDL 63 (60-99 mg/dl)





11/17/18 (80mg E3.5D/.25EoD) Peak 19.91 Trough 13.11 .125/d (.875 wk) IM ---- felt incredible. strong libido. morning wood.
----------------------------
Total Testosterone 1137
Free Testosterone 216
SHBG 33
E2 26
Hematocrit 50.1
PSA .87
Cholesterol 126
HDL 52
LDL 59





2/22/19 (60mg E3D/.25EoD) Peak 16.88 Trough 11.94 .125/d (.875 wk) IM ---- probably overall best feeling. energy level, libido, morning wood.
-----------------------------
BP 117/69
Total Testosterone 1280
Free Testosterone 192
SHBG 47
E2 <25
E2 Serum 14.9
Hematocrit 51.2
PSA .9
DHT 660
Cholesterol 119
HDL 46
LDL 60


5/11/19 (50mg E3D/.25E3D) Peak 14.03 Trough 9.91 .0625/d (.583 wk) IM ---- cant recall, close'ish to the former i think?
----------------------------------------------
Total Testosterone 1192
Free Testosterone 179
SHBG 46
E2 27
E2 Serum 28.2
Estrone 26.3
Total Estrogens 54.5
Hematocrit 50.9
PSA .74
DHT 480
Cholesterol
HDL
LDL


8/27/19 (50mg E3D/.25E3D) Peak 14.03 Trough 9.91 .0625/d (.583 wk) SUBQ ---- not great. no morning wood. minimal libido. ed issues.
------------------------------------------------------------------------
Total Testosterone 895
Free Testosterone 152
SHBG 38
E2 30 pg/ml
E2 Serum -
Estrone -
Total Estrogens -
Hematocrit 49.2
PSA .88
DHT - 517
Cholesterol 121
HDL 50
LDL 60


Seems to me that returning to 60mg e3d IM would be the clear ez out, but Id like to avoid the pig stickers for the rest of my life if possible. SubQ seems to be 20% less effective for me, and seems to have no positive effect on estrogen level.

What say you, seasoned pro's? up the T and stay subQ. Return to IM? Change frequency SubQ?

 

[Vince Carter]

What size is a "pig sticker"...25g 1", or some thing larger?

How lean are you, could you hit muscle with a 29g 1/2"?

What you experience is very common, you've found something that apparently worked/s but try to find a silly reason to not do it and plow thru trying to make something work that isn't working.

 

[Vince]

I also use an easy touch 29g 1/2" syringe, for a nice shallow IM. Pretty painless and simple.

 

[klepp0906]

now THAT is an approach i didnt consider in all fairness. Something small as a shallow IM. Perhaps a good middle ground.

Pig sticker was exactly a 25g 1" actually lol. I get that in the scheme of things, some people are using 23g 1.5's and 25g 1" is reasonable, I just became acclimated to the insulin pins I guess.

I am lean. A bit less-so in the winter, but even during those months, the overwhelming majority is carried around my midsection. I was actually trying to grab skin on my upper thighs the other day figuring if i could do SubQ there and it wasnt looking likely.

As for my reasoning, ill admit some is preferential and more likely to be viewed as valid than others. Ultimately, ive beaten cancer and it gave me a huge reality check at my age so im super anal about my health and I dont like putting something foreign in as it is, but if I had to do something - this is certainly gonna be it. I know hematocrit can be managed with blood donation, but I have a couple toddlers and between the chaos that is raising them, work, the gym, appointments with my doctors, I really need as much simple as I can get.

Its only once every few months, but so are some of my scripts, and my CT scans etc. Just one more thing to keep track of

Im even trying to find a dose of arimidex that is not only sufficient, but can be taken at injection time so I dont have to keep track of separate days for that too. (would be easier if it was liquid or I was willing to bother dilluting it in something or another, but again - simple!)

Either way, before I digress further - I think a shallow IM might in fact be the way to go. When i initially wanted to try subQ - it was half the easier injections and half the desire to see if i could maintain my T levels, while reducing or eliminating my need for an anti-e.

Seems neither is the case, and in the end I also feel worse.

I wont lie - the numbers show its wholly capable, and probably way preferred perhaps for lower shbg folks - but id need at least 25% more testosterone to get similar numbers to IM and thats without taking into account the effect that would have on my estrogen levels since theyre already higher on subQ (could argue same'ish though - unsure what the margin of error is on that stuff).

Either way, thank you for the reply guys. I know it was a ton to read through. Contrary to what probably is as you say, common - I do want to get to that "place" and be done. ive heard stories of it taking guys 3 years to do so. God forbid, but I am a year in, and im getting close.

 

[Vince]

Here's my protocol and labs.

Vince's testosterone panel from 8/27/2019

 

[klepp0906]

thanks for the link. Those look to be some pretty solid numbers. Not sure how my doc would feel about my free T being high OOR but we'll see some day i imagine lol.

My DHEA-S is only 234mcg/dl in a range of 89-427, is this something I should try to get up? Honestly one item im completely unfamiliar with.

My albumin is high at 5 as well, but I did train and do cardio that morning which from what I understand can send some protein markers up a bit. (i think AST was elevated too). Ive also been eating a bit too much protein for awhile, especially for someone who had kidney cancer. I just struggle with getting it down consistently.


More and more is pointing towards swapping back to IM in a smaller/more shallow capacity.

Ironically, before I started the SuBQ venture - as you can imagine I did a fair about of research. I forget the forum, but someone had compiled a bunch of posts spread all over the place into one thread, all showing labs for subQ relative to IM and how in each case the numbers were lower.

I cant recall specifics like dose or frequency, as I mostly "in one ear and out the other(ed)" it, considering the general consensus everywhere is its MORE efficient not less, and helps control E2.

Well, low and behold - they can add my experience to that thread. It doesnt seem to be ideal for me.

 

[Gman86]

So the TLDR version is i tried to make the switch to subQ.

Im highish SHBG ~57 but ive seen it as low as 33 depending on protocol and whether im eating at a surplus or deficit at the time.

I seem to lose libido and morning wood almost entirely if my freeT is below the top 20 percent, which unfortunately requires my TotalT to be oor. Fortunately my doctor has seen it as high as 1280 on trough and said nothing - thus far. So he either gets it (relative to shbg) or doesnt care. /shrug

That all being said, my end-game (have been on over a year already) is keeping the libido and other benefits that come from a high freeT, avoiding going back to IM (if possible) while keeping my hematocrit in range (its always been just barely in range with all my tested protocols thus far) and to have my protocol as simple as possible within reason. (obviously 1 dose of T and 1 dose of anastrozole a week is simple, but not reasonable ;p)


I had my first labs on subQ a couple of weeks back, and as I surmised during the interim, they were lower than on the equivalent IM dose.

I tried several times before to make the switch, and each time - I felt like total crap and within a couple weeks i went back to IM. This last time, I frontloaded a bit to offset the transition and I made it out the other side - but I had bad ED and libido/lack of morning wood the entire 6 week stretch.

Real talk, trt has been exceptional for mood and energy, but the libido is hit or miss, and boy did it ever set the hairloss in motion. Ive resigned to having to shave my dome within the next few years at best. One hell of a tradeoff but its the price i get to pay I suppose.

Anyhow, here are the labs. What would you guys suggest to get free T higher? Simply stay on the (current) E3D and up the dose? or change up frequency? While infrequent is more simple, I know you can only pump so much oil under the skin before discomfort or potential abscess comes into play. Plus im unsure how IM vs SubQ breaks down as far as dose size vs peak T/time etc. I know, as the results below show, for me, on an E3D frequency, SubQ results in less T and more E.

From earliest to latest. Missing results are because some things werent tested till later in some cases, other cases even though I tell the doc to test for what he tested for "last time" he still leaves stuff out. I always get a different set of labs /sigh.

The "labels" if you will, is my dose/frequency of test/arimidex followed by the purported peak/trough levels determined by using steroidcalc. Followed by how my arimidex dosage breaks down on a daily/weekly level. About half way through I started to keep a running diary so some stuff I had to backfill as best I could between memory and lab results.

Pre-Trt
----------
Total Testosterone 198 (400-1080 ng/dl)
Free Testosterone 40 (49-212 pg/ml)
SHBG 55 (10-80 nmol/L)
Hematocrit 48.3 (41-35%)
PSA .54 (0-2.50 ng/ml)
Cholesterol 139 (140-199 mg/dl)
HDL 64 (40-75 mg/dl)
LDL 63 (60-99 mg/dl)





11/17/18 (80mg E3.5D/.25EoD) Peak 19.91 Trough 13.11 .125/d (.875 wk) IM ---- felt incredible. strong libido. morning wood.
----------------------------
Total Testosterone 1137
Free Testosterone 216
SHBG 33
E2 26
Hematocrit 50.1
PSA .87
Cholesterol 126
HDL 52
LDL 59





2/22/19 (60mg E3D/.25EoD) Peak 16.88 Trough 11.94 .125/d (.875 wk) IM ---- probably overall best feeling. energy level, libido, morning wood.
-----------------------------
BP 117/69
Total Testosterone 1280
Free Testosterone 192
SHBG 47
E2 <25
E2 Serum 14.9
Hematocrit 51.2
PSA .9
DHT 660
Cholesterol 119
HDL 46
LDL 60


5/11/19 (50mg E3D/.25E3D) Peak 14.03 Trough 9.91 .0625/d (.583 wk) IM ---- cant recall, close'ish to the former i think?
----------------------------------------------
Total Testosterone 1192
Free Testosterone 179
SHBG 46
E2 27
E2 Serum 28.2
Estrone 26.3
Total Estrogens 54.5
Hematocrit 50.9
PSA .74
DHT 480
Cholesterol
HDL
LDL


8/27/19 (50mg E3D/.25E3D) Peak 14.03 Trough 9.91 .0625/d (.583 wk) SUBQ ---- not great. no morning wood. minimal libido. ed issues.
------------------------------------------------------------------------
Total Testosterone 895
Free Testosterone 152
SHBG 38
E2 30 pg/ml
E2 Serum -
Estrone -
Total Estrogens -
Hematocrit 49.2
PSA .88
DHT - 517
Cholesterol 121
HDL 50
LDL 60


Seems to me that returning to 60mg e3d IM would be the clear ez out, but Id like to avoid the pig stickers for the rest of my life if possible. SubQ seems to be 20% less effective for me, and seems to have no positive effect on estrogen level.

What say you, seasoned pro's? up the T and stay subQ. Return to IM? Change frequency SubQ?

Did you already have some hair loss by the time you were 30? I’ve heard that if you don’t experience hair loss by around 30, there’s a good chance you’ll have your hair for most of your life.

 

[klepp0906]

Did you already have some hair loss by the time you were 30? I’ve heard that if you don’t experience hair loss by around 30, there’s a good chance you’ll have your hair for most of your life.

probably a little. I had a bit of recession at the temples I guess. It hadnt moved in a very long time and i didnt look balding or thin for my age. Certainly didnt bother me.

The flipside is my dad definitely has severe recession at 60, so I know I have the male pattern baldness/dht sensitivity gene. My lower testosterone and DHT probably kept it in check. Once i bumped things up a notch, well - I had to pick. Lethargy and no interest in sex, or the opposite at the cost of my hairline.

I still struggle with it, and i lather on the rogaine, use nizoral shampoo, and all that - probably to no effect whatsoever.

Realistically i could pony up a few thousand, fly to turkey, and have it fixed - but being married, im just short of caring enough to do that

Plus, I'm headed for bald'dom anyways, so if i have to do it a little early at the cost of feeling better in most other areas - it is what it is.

Certainly jealous of the guys that can pump 4x trt levels into their bodies and still have a thick full head of hair, but it wasnt in the cards for me I guess.

From what my wife says (admittedly a biased and small sample size) women view it as a certainty. Basically, declaring im going bald as a man is like declaring the sun will rise in the morning.

 

[Gman86]

Here’s a few things I came across that will give you some hope. Apparently there’s some peptides that have great potential in regards to hair loss

-56 mins in

-59 mins in

 

[klepp0906]

i appreciate the links - but not gonna hold my breath for two reasons. One, if something like this is out there - or legitimately on the horizon, it will be fast tracked to market like nothing youve ever seen.

The demand would outstrip supply and prices would be astronomical almost certainly, but thats besides the point.

Reason 2, Even if it were, and undoubtedly one day will be - it will likely be too late for me. I imagine the overhwelming majority of any treatment in the remotely distant future will require remaining living follicle and while the top and back of my head is full of thick hair, the front is dying and receding rapid mode. Nothing is gonna grow back whats already gone. For me its transplant or bust.

Not trying to be a pessimist, its just the way I see it. Lord knows id be elated to be proven wrong. A lot of guys are even able to get by on the shaved head look, unfortunately im not one of em. I'll be rocking a hat or simply not caring ;p

I'll be sure to keep you guys posted on how things go with the shallow IM. Unfortunately my pins are 30g 5/16 atm so ill have to order some more. While the gauge doesnt really concern me, the length is probably too short for a reasonable "shallow IM". I imagine getting it too near the surface of the muscle is probably a bad idea.

 

[fifty]

All current hairloss treatments have been discovered by accident. Basically a total fail thus far.

 

[wondering]

probably a little. I had a bit of recession at the temples I guess. It hadnt moved in a very long time and i didnt look balding or thin for my age. Certainly didnt bother me.

The flipside is my dad definitely has severe recession at 60, so I know I have the male pattern baldness/dht sensitivity gene. My lower testosterone and DHT probably kept it in check. Once i bumped things up a notch, well - I had to pick. Lethargy and no interest in sex, or the opposite at the cost of my hairline.

I still struggle with it, and i lather on the rogaine, use nizoral shampoo, and all that - probably to no effect whatsoever.

Realistically i could pony up a few thousand, fly to turkey, and have it fixed - but being married, im just short of caring enough to do that

Plus, I'm headed for bald'dom anyways, so if i have to do it a little early at the cost of feeling better in most other areas - it is what it is.

Certainly jealous of the guys that can pump 4x trt levels into their bodies and still have a thick full head of hair, but it wasnt in the cards for me I guess.

From what my wife says (admittedly a biased and small sample size) women view it as a certainty. Basically, declaring im going bald as a man is like declaring the sun will rise in the morning.

Are you on T cream (scrotal) to elevate DHT?