Wondering if I Need to Adjust Protocol - 2.5 yrs T-Cyp

[Jake_from_StateFarm]

Quick 2.5yr update: I'm 52y/o 5'10" 175lbs and have been lifting weights for max strength 4 days per week since beginning TRT (very little cardio). My drive, confidence, well being, mood, morning wood/performance have all greatly improved and I consider TRT a great success. Libido is improved but I am bummed the honeymoon period from month 3 through month 6 did not last. Those months were like being 18y/o again and I was only on 75mg/week T-Cyp. I'm pretty sure my production wasn't completely shutdown yet as I was at 1100 ng/dL Total Test.

Once my own production shutdown the honeymoon ended and my Total Test dropped to 750 ng/dL and I asked my Urologist to bump me up to 100mg/week which has kept my blood work consistently at 970 ng/dL and Estradiol at 34 pg/dL. I currently pin 50mg 2x per week. My Uro will not increase me above 100mg/week.

As I stated, libido could be better and morning wood is fairly consistent at 4 to 5 nights per week. Oddly, the two days that MW are most predictable are on the mornings of the days when I'm scheduled to pin ... ironically when I'm at my trough. I had been thinking I needed to increase my dose above 100mg/week in order to improve libido and MW ... but, given the MW consistently on my trough days could I actually need to lower my dose?

 

[Systemlord]

I'm pretty sure my production wasn't completely shutdown yet as I was at 1100 ng/dL Total Test.

You were mostly shutdown soon after starting TRT, it didn’t take 3 months.

Once my own production shutdown the honeymoon ended

The honeymoon period can be explained as sensory adaptation, when you take a warm shower, your body is used to a set temperature which your adjust every time you take a shower.

Now imagine your wife or significant other were to come in, increase the temperature and at first it’s too hot, but spend enough time at the higher temperature and your body adapts by dialing down sensory input.

Chasing the honeymoon period is a fool’s errand.

I asked my Urologist to bump me up to 100mg/week which has kept my blood work consistently at 970 ng/dL and Estradiol at 34 pg/dL. I currently pin 50mg 2x per week. My Uro will not increase me above 100mg/week.

This is an incomplete hormone panel for diagnostic purposes. No Free T, SHBG to calculate the Free T, no DHT which is very important for libido and wellbeing.

If your Free T is very high, this can actually hinder libido as too much T can be almost as bad as not enough. Sometimes less is more.

I don’t think more T is the answer, unless your SHBG is really high and Free T suboptimal, but again with limited labs testing, we are just shooting in the dark.

 

[Jake_from_StateFarm]

Thanks. Yes, I'm not thrilled with the Uro's testing protocol. He orders labs 48hrs after most recent injection and does not order Free T or SHBG. He's concerned (as am I) with PSA because of family prostate issues, mine is .9.

If I dial back to 85mg/wk, how long before I judge impact?

 

[Systemlord]

He's concerned (as am I) with PSA because of family prostate issues, mine is .9.

If you’re destined for prostate cancer, better to have high Free T.

Impact of Low Free Testosterone on Prostate Cancer

 

[Systemlord]

If I dial back to 85mg/wk, how long before I judge impact?

It’s a little different for everyone, I would say give it 6-8 weeks.

If you were on Jatenzo, I would tell you give it a week.

 

[madman]

Quick 2.5yr update: I'm 52y/o 5'10" 175lbs and have been lifting weights for max strength 4 days per week since beginning TRT (very little cardio). My drive, confidence, well being, mood, morning wood/performance have all greatly improved and I consider TRT a great success. Libido is improved but I am bummed the honeymoon period from month 3 through month 6 did not last. Those months were like being 18y/o again and I was only on 75mg/week T-Cyp. I'm pretty sure my production wasn't completely shutdown yet as I was at 1100 ng/dL Total Test.

Once my own production shutdown the honeymoon ended and my Total Test dropped to 750 ng/dL and I asked my Urologist to bump me up to 100mg/week which has kept my blood work consistently at 970 ng/dL and Estradiol at 34 pg/dL. I currently pin 50mg 2x per week. My Uro will not increase me above 100mg/week.

As I stated, libido could be better and morning wood is fairly consistent at 4 to 5 nights per week. Oddly, the two days that MW are most predictable are on the mornings of the days when I'm scheduled to pin ... ironically when I'm at my trough. I had been thinking I needed to increase my dose above 100mg/week in order to improve libido and MW ... but, given the MW consistently on my trough days could I actually need to lower my dose?

Stop chasing the honeymoon it is a dead end!

The only time you will experience such is when first starting trt or tweaking your protocol (increasing T dose).

Hormone levels will be in flux as T levels are rising/dopamine boost during the weeks leading up until blood levels have stabilized (4-6) and it is common for many to experience a euphoric feeling along with a strong increase in libido/erections.

Unfortunately, it will be short-lived and temporary.

Once blood levels have stabilized it will take a while for the body to adapt to your new set-point.

This will be the critical time period when one should gauge how they truly feel overall regarding relief/improvement of low-T symptoms.

Every protocol/new protocol should be given 12 weeks before claiming whether it was a success or failure.

On your previous protocol of 75 mg T/week, your hpta would have been shut-down long before the 3-month mark!

You stated that you were hitting a very high TT 1100+ ng/dL which does not mean too much as you never mentioned when blood work was done.

Blood work should always be done at the true trough (lowest point) which would have been 7 days post-injection on such protocol (75 mg T once weekly).

Top it off that although TT is important to know FT is what truly matters as it is the active unbound fraction of T responsible for the positive effects.

You are missing critical labs (FT, SHBG) and are shooting in the dark.

We always want to know where TT, FT, and estradiol levels sit at the true trough let alone other critical blood markers such as CBC which includes RBCs, hemoglobin, and hematocrit.

You then go on to state that your TT level dropped to 750 ng/dL.

Again means nothing when we have no idea how many days post-injection your blood work was done let alone where your FT, estradiol, or SHBG sat.

Your dose was bumped up to 100 mg T/week split into twice-weekly injections (50mg T every 3.5 days).

Now you are hitting a high-end TT 975 ng/dL (48 hrs post-injection).

Again you never even tested at the true trough which would be 84 hrs post-injection let alone we have no clue where your FT or SHBG sit.

Knowing where your FT trough level truly sits is critical!

You would need to have your FT tested using the most accurate assays (Equilibrium Dialysis or Ultrafiltration).

You are flying blind here.

I would not even consider decreasing let alone increasing your T dose until you have a full set of labs done at the true trough on the such protocol.

Forget relying on your moronic doctor and you would be far better off paying out of pocket and getting your own set of labs using the most accurate assays TT/estradiol (LC-MS/MS) and FT (Equilibrium Dialysis or Ultrafiltration) through Nelson's discounted labs.


This one! ($91.35)

Testosterone (Total + Free), Ultrasensitive Estradiol plus Hematocrit

This economical lab test panel includes the four tests more frequently ordered by men on TRT: Total Testosterone, Liquid Chromatography/ Mass Spectrometry (The most accurate testosterone test with no lower or upper limit).-Free Testosterone, Equilibrium D

www.discountedlabs.com

Or at the very least up the $43.00!

Testosterone, Free (Dialysis) and Total, MS

Get an affordable and accurate testosterone test results with our Total Testosterone, M and Free (Equilibrium Dialysis) test. Visit DiscountedLabs.com for more information.

www.discountedlabs.com

 

[madman]

Jake_from_StateFarm said:
If I dial back to 85mg/wk, how long before I judge impact?

It’s a little different for everyone, I would say give it 6-8 weeks.

If you were on Jatenzo, I would tell you give it a week.

6 weeks means nothing when looking at the bigger picture.

A week on transdermal T, Jatenzo, let alone Natesto means f**k all!

 

[Systemlord]

A week on transdermal T, Jatenzo, let alone Natesto means f**k all!

I guess it would depend on who we are talking about. Someone very sensitive like myself can dial in quick! Some members had stated they feel very well at the 4th week.

 

[bixt]

... but, given the MW consistently on my trough days could I actually need to lower my dose?

In this statement, lies the most important clue

 

[Jake_from_StateFarm]

Stop chasing the honeymoon it is a dead end!

The only time you will experience such is when first starting trt or tweaking your protocol (increasing T dose).

Hormone levels will be in flux as T levels are rising/dopamine boost during the weeks leading up until blood levels have stabilized (4-6) and it is common for many to experience a euphoric feeling along with a strong increase in libido/erections.

Unfortunately, it will be short-lived and temporary.

Once blood levels have stabilized it will take a while for the body to adapt to your new set-point.

This will be the critical time period when one should gauge how they truly feel overall regarding relief/improvement of low-T symptoms.

Every protocol/new protocol should be given 12 weeks before claiming whether it was a success or failure.

On your previous protocol of 75 mg T/week, your hpta would have been shut-down long before the 3-month mark!

You stated that you were hitting a very high TT 1100+ ng/dL which does not mean too much as you never mentioned when blood work was done.

Blood work should always be done at the true trough (lowest point) which would have been 7 days post-injection on such protocol (75 mg T once weekly).

Top it off that although TT is important to know FT is what truly matters as it is the active unbound fraction of T responsible for the positive effects.

You are missing critical labs (FT, SHBG) and are shooting in the dark.

We always want to know where TT, FT, and estradiol levels sit at the true trough let alone other critical blood markers such as CBC which includes RBCs, hemoglobin, and hematocrit.

You then go on to state that your TT level dropped to 750 ng/dL.

Again means nothing when we have no idea how many days post-injection your blood work was done let alone where your FT, estradiol, or SHBG sat.

Your dose was bumped up to 100 mg T/week split into twice-weekly injections (50mg T every 3.5 days).

Now you are hitting a high-end TT 975 ng/dL (48 hrs post-injection).

Again you never even tested at the true trough which would be 84 hrs post-injection let alone we have no clue where your FT or SHBG sit.

Knowing where your FT trough level truly sits is critical!

You would need to have your FT tested using the most accurate assays (Equilibrium Dialysis or Ultrafiltration).

You are flying blind here.

I would not even consider decreasing let alone increasing your T dose until you have a full set of labs done at the true trough on the such protocol.

Forget relying on your moronic doctor and you would be far better off paying out of pocket and getting your own set of labs using the most accurate assays TT/estradiol (LC-MS/MS) and FT (Equilibrium Dialysis or Ultrafiltration) through Nelson's discounted labs.


This one! ($91.35)

Testosterone (Total + Free), Ultrasensitive Estradiol plus Hematocrit

This economical lab test panel includes the four tests more frequently ordered by men on TRT: Total Testosterone, Liquid Chromatography/ Mass Spectrometry (The most accurate testosterone test with no lower or upper limit).-Free Testosterone, Equilibrium D

www.discountedlabs.com

Or at the very least up the $43.00!

Testosterone, Free (Dialysis) and Total, MS

Get an affordable and accurate testosterone test results with our Total Testosterone, M and Free (Equilibrium Dialysis) test. Visit DiscountedLabs.com for more information.

www.discountedlabs.com

Great point regarding my own labs. I've asked him before about testing at trough instead and adding Free and SHBG he's set on Peak T/Total T/PSA/Estradiol/Hematocrit and others. My trouble is finding another Dr in MD that's worth the headache of the search. Getting my own labs may help if I need to lower my dose or increase pin frequency as my Dr has no issues with that ... he just will not increase me. Pretty sure he has a ~ 1,000 ng/dL limit.

 

[Systemlord]

Pretty sure he has a ~ 1,000 ng/dL limit.

I can only imagine a poor guy with very high SHBG and low FT trying to dial in on TRT only to be told 1000 ng/dL is the limit!

The Free T should be the treatment goal, not the TT.