Initial reaction?

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Scoot2300

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What would your initial reaction be to these levels at face value?

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I sleep 8-9 hours per night and am still tired all day. I have had thyroid checked (although I still think I may be hypothyroid), Iron, etc. I am feeling lower energy these days. I am 51 and been on TRT since 2020. Took a long time to try and get dialed in. I am having trouble pinpointing what the culprit could be.
 
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Scoot2300 said:
What would your initial reaction be to these levels at face value?

View attachment 47052

I sleep 8-9 hours per night and am still tired all day. I have had thyroid checked (although I still think I may be hypothyroid), Iron, etc. I am feeling lower energy these days. I am 51 and been on TRT since 2020. Took a long time to try and get dialed in. I am having trouble pinpointing what the culprit could be.
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These labs are 8 months old!

What was your protocol dose T/injection frequency and how many days post-injection were labs done?

We always want to test at the true trough (lowest point) before your next injection.

Although your TT 737 ng/dl is far from very high the more critical blood marker here is free testosterone and with a robust TT 737 ng/dL and low SHBG 10 nmol/L your FT is very high!

Look at where your estradiol sits.

If these are your FT levels at true trough than depending on your injection frequency your peak may very well be much higher!

Even then are you following the same protocol?

Post your current protocol and most recent labs!
 
madman said:
These labs are 8 months old!

What was your protocol dose T/injection frequency and how many days post-injection were labs done?

We always want to test at the true trough (lowest point) before your next injection.

Although your TT 737 ng/dl is far from very high the more critical blood marker here is free testosterone and with a robust TT 737 ng/dL and low SHBG 10 nmol/L your FT is very high!

Look at where your estradiol sits.

If these are your FT levels at true trough than depending on your injection frequency your peak may very well be much higher!

Even then are you following the same protocol?

Post your current protocol and most recent labs!
Click to expand...
I’ve been following same injection protocol for at least 3 years. I’m injecting 70mg per week on an EOD injection schedule. Very routine time of day that I inject which is in the early morning. My bloods you see are 8 months old but my protocol has not changed one bit. These were taken at true trough in the morning prior to my next injection. When I started at 150 mg per week, I had terrible insomnia so I reduced until I reached the point where I am at now and have stayed put. What could be causing the fatigue and low energy? Is my E2 too low now? Should I bump up mg per week slightly and see how I feel?
I can get new blood work in the next few weeks but was wondering what one might do or surmise based on these numbers.
 
Scoot2300 said:
I’ve been following same injection protocol for at least 3 years. I’m injecting 70mg per week on an EOD injection schedule. Very routine time of day that I inject which is in the early morning. My bloods you see are 8 months old but my protocol has not changed one bit. These were taken at true trough in the morning prior to my next injection. When I started at 150 mg per week, I had terrible insomnia so I reduced until I reached the point where I am at now and have stayed put. What could be causing the fatigue and low energy? Is my E2 too low now? Should I bump up mg per week slightly and see how I feel?
I can get new blood work in the next few weeks but was wondering what one might do or surmise based on these numbers.
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Compare your lab values over the past years. If you felt well at Dec 2023, then don't mess around with T until you get up to date lab results.
Obvious question to ask: Has anything in your life changed recently?
 
Seagal said:
Compare your lab values over the past years. If you felt well at Dec 2023, then don't mess around with T until you get up to date lab results.
Obvious question to ask: Has anything in your life changed recently?
Click to expand...
I didn’t feel well in Dec 2023. Been wrestling this for a few years now. There seems to be something with the low shgb and high free t. I feel like I need to increase my shgb somehow and I’m just not sure how to go about that.
 
Scoot2300 said:
I didn’t feel well in Dec 2023. Been wrestling this for a few years now. There seems to be something with the low shgb and high free t. I feel like I need to increase my shgb somehow and I’m just not sure how to go about that.
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I would try a reduction of the injection frequency (twice per week). This might increase your E2 and SHBG.
 
Seagal said:
If it works for you that way, then forget about my comment.
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Dude, come on. You are making suggestions but when I simply mention what I have seen in just anecdotal research, you come back with that comment? Provide me with what your experience may have been or information contrary to what I presented and let’s have a meaningful discussion as I an open to trying some things to make this better. Otherwise, “ok well don’t do it” is just bs.
 
Scoot2300 said:
... I’m injecting 70mg per week on an EOD injection schedule. ...
Click to expand...
Contrary to popular perception, this is a mid-level dose, providing more testosterone than most healthy young men make naturally. Therefore it could easily be too much testosterone for your physiology. The low SHBG and high free testosterone are suggestive of excess. Ask yourself whether it makes sense to first try a dose that gives you physiological numbers. Unfortunately you have received poor guidance and likely suffered as a result. This is all too common. I had a similar experience, first rapidly finding that 100 mg TC/week was too much, then eventually realizing that even 63 mg TE/week was excessive. I ended up on the equivalent of 44 mg TC/week, which yields daily peak free testosterone that is just under mid-range for young men.

Your lowish E2/T ratio may or may not be related to current dosing. The high free testosterone could be a factor. If your DHT is elevated as a result then it could be reducing estradiol and overall estrogenic activity. If the E2/T ratio doesn't improve with lower testosterone dosing then you could consider adding hCG or a small amount of supplemental estradiol. It is through continued patient experimentation that you will eventually find a protocol that works for you. If you do try lower dosing then give it plenty of time; you may have temporary side effects, which are easily misinterpreted as a return to hypogonadism.
 
Thank you very much for the thorough reply. Been knocking around possible thyroid issues even though my TSH, T3 and T4 are in range. I had my ferritin and iron all checked along with all my essential vitamins and with the exception of vitamin D, which most people in New England are deficient in already, everything else checked out. I was looking at this bloodwork and scratching my head because I’m already down to 70 mg per week and just didn’t even consider thinking. I needed to reduce it any further based on the SGB and estrogen levels. I’m going to drop down to 60 and see if I notice any changes as I am sensitive to this stuff I should be able to.
 
Cataceous said:
Contrary to popular perception, this is a mid-level dose, providing more testosterone than most healthy young men make naturally. Therefore it could easily be too much testosterone for your physiology. The low SHBG and high free testosterone are suggestive of excess. Ask yourself whether it makes sense to first try a dose that gives you physiological numbers. Unfortunately you have received poor guidance and likely suffered as a result. This is all too common. I had a similar experience, first rapidly finding that 100 mg TC/week was too much, then eventually realizing that even 63 mg TE/week was excessive. I ended up on the equivalent of 44 mg TC/week, which yields daily peak free testosterone that is just under mid-range for young men.

Your lowish E2/T ratio may or may not be related to current dosing. The high free testosterone could be a factor. If your DHT is elevated as a result then it could be reducing estradiol and overall estrogenic activity. If the E2/T ratio doesn't improve with lower testosterone dosing then you could consider adding hCG or a small amount of supplemental estradiol. It is through continued patient experimentation that you will eventually find a protocol that works for you. If you do try lower dosing then give it plenty of time; you may have temporary side effects, which are easily misinterpreted as a return to hypogonadism.
Click to expand...
What are your thoughts on more frequent injections versus less injections?
 
Scoot2300 said:
Thank you very much for the thorough reply. Been knocking around possible thyroid issues even though my TSH, T3 and T4 are in range. I had my ferritin and iron all checked along with all my essential vitamins and with the exception of vitamin D, which most people in New England are deficient in already, everything else checked out. I was looking at this bloodwork and scratching my head because I’m already down to 70 mg per week and just didn’t even consider thinking. I needed to reduce it any further based on the SGB and estrogen levels. I’m going to drop down to 60 and see if I notice any changes as I am sensitive to this stuff I should be able to.
Click to expand...
I wouldn't make any changes without first checking your vitamin D levels. It would be a shame to discovery you're nearly deficient in vitamin D shortly after changing your TRT protocol.

You most likely need smaller more frequent injections as men who claiming to be sensitive to Test ten times out of ten get better results injecting daily or EOD.

Checking iron is tricky, serum iron testing has limitations and is inherently inaccurate, you eat food with iron and iron testing will show normal iron even though you're severely deficient in iron.

Ferritin would be the test you want, possibly together with iron saturation.
 
Scoot2300 said:
Dude, come on. You are making suggestions but when I simply mention what I have seen in just anecdotal research, you come back with that comment? Provide me with what your experience may have been or information contrary to what I presented and let’s have a meaningful discussion as I an open to trying some things to make this better. Otherwise, “ok well don’t do it” is just bs.
Click to expand...
Hey Scoot, sorry that my response was not helpful, had little time at that moment. I had misunderstood that you tried/started with less frequent injections... Anyway, in my opinion regarding long esters, increasing T results in decreased SHBG. Increasing frequency results in less aromatization. If you wanted to keep your current free T with 70mg dosage per week, which is for most men very low, then I think reducing the frequency from 3.5 to 2 per week could increase your E2. Higher E2 could increase SHBG. I believe the fT to fE2 ratio, and the fE2 value itself is more relevant than the SHBG value. However, it might be different for you! As Cataceous mentioned, DHT is relevant too, unfortunately it's often not included in the labs. Many variables... T cream or oral T is also an option.
I'm glad that - as expected - someone responded who had a similar experience to yours.


Good luck!
 
Last edited:
Scoot2300 said:
What would your initial reaction be to these levels at face value?

View attachment 47052

I sleep 8-9 hours per night and am still tired all day. I have had thyroid checked (although I still think I may be hypothyroid), Iron, etc. I am feeling lower energy these days. I am 51 and been on TRT since 2020. Took a long time to try and get dialed in. I am having trouble pinpointing what the culprit could be.
Click to expand...
"Took a long time to try and get dialed in."
What did you try? And sounds like you felt well for a longer period of time. What were your protocols and lab values. Just curious what happened. It might help others.
 
Scoot2300 said:
What are your thoughts on more frequent injections versus less injections?
Click to expand...
With a longer ester such as cypionate, you can't come very close to a natural pattern of testosterone levels, regardless. With frequent injections, levels are almost flat, having minimal variation. With infrequent injections, there are relatively large variations taking place over days. In contrast, healthy young men see a modest amount of variation each day, with levels rising overnight to a morning peak. The differing patterns probably do have some influence on metabolite formation—e.g. DHT and estradiol—and subjective results. However, the anecdotes are inconsistent, so it's left to the individual to figure out which injection frquency works best for him. After finding long esters to be less than ideal, I switched to daily injections of a blend of testosterone enanthate and testosterone propionate. The addition of propionate allows for reasonable intra-day variation.
 
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Scoot2300 said:
What would your initial reaction be to these levels at face value?

View attachment 47052

I sleep 8-9 hours per night and am still tired all day. I have had thyroid checked (although I still think I may be hypothyroid), Iron, etc. I am feeling lower energy these days. I am 51 and been on TRT since 2020. Took a long time to try and get dialed in. I am having trouble pinpointing what the culprit could be.
Click to expand...
As I always say in situations like this, your tiredness could be due to a multitude of things, many of which are totally unrelated to testosterone or related hormones. You could have picked up some sort of infection or have mold exposure, you could be under-eating or over-training. Going too low in carbs or not getting good quality sleep could be an issue. All sorts of things. So...What have you ruled out other than vitamins? Have you eliminated seed oils? Have you had a work-up from a competent holistic doc? Testosterone alone is unlikely to fix an issue that has some other root cause and could actually make it worse so you have to cover off the basics first.
 
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