2month bloods very high

Mill3r · Nov 1, 2024

Hi all.

Has anyway one had a simailar experience? I started TRT 2 months ago with a clinic in the UK. I started in test cyp 84mg per week injected daily. I am also on HCG 250iu 3 times a week.

After 1 month my level were elevated so was reduced down to 70mg per week. My results are all still elevated 2 months in. This was a blood draw via NHS from vein and before my injections on Wednesday.

I have hereditary spherecytosis blood condition and also under investigation for hemochromatosis. I have confirm type 1 carrier but I’m due to find out if I’m also type 3. My ferritin for the last 2
Years was around 700 now back in range which is good but also strange as my ferritin had been elevated since 2018.

Why is my testosterone and E2 so high on such a small dose?

Im waiting to hear back from the clinic. Iv also uploaded my doses on vial incase anyone thinks Iv got it wrong.

Thanks

Systemlord · Nov 1, 2024

Mill3r said:
I started TRT 2 months ago with a clinic in the UK. I started in test cyp 84mg per week injected daily.

Do you mean 84 mg weekly split up daily?

If you’re on biotin supplements that would artificially raise your hormonal values.

In any case, I don’t think these labs are accurate.

madman · Tuesday at 8:51 AM

@Nelson Vergel

This thread is missing the replies me and seppuku posted on Saturday just before the site went down?

The OPs replies are missing too as he stated in one of them that the strength of his TC is 200 mg/mL.

Scanning over the forum post it seems as though most of the threads/replies from Saturday are also missing.

Can you please look into this when you have time, thanks!

madman · Tuesday at 9:37 AM

Mill3r said:
View attachment 48600Hi all.

Has anyway one had a simailar experience? I started TRT 2 months ago with a clinic in the UK. I started in test cyp 84mg per week injected daily. I am also on HCG 250iu 3 times a week.

After 1 month my level were elevated so was reduced down to 70mg per week. My results are all still elevated 2 months in. This was a blood draw via NHS from vein and before my injections on Wednesday.

I have hereditary spherecytosis blood condition and also under investigation for hemochromatosis. I have confirm type 1 carrier but I’m due to find out if I’m also type 3. My ferritin for the last 2
Years was around 700 now back in range which is good but also strange as my ferritin had been elevated since 2018.

Why is my testosterone and E2 so high on such a small dose?

Im waiting to hear back from the clinic. Iv also uploaded my doses on vial incase anyone thinks Iv got it wrong.

Thanks

Sorry for the delay as me and seppuku already replied on Saturday just before the site crashed.

Going to break this down for you again!

@seppuku was bang on when he stated that you were injecting 175 mg T/week as the 5 unit mark on the U-40 insulin syringe would be 25 mg T if the strength of your T is 200 mg/mL as you stated in one of your replies that went missing from the thread after the site crashed on Saturday.

Not sure who would be at fault here for deciding to use a U-40 insulin syringe to inject your TC/hCG.

If it was the clinic then they are out to lunch as no one would use the U-40 especially when injecting testosterone or hCG let alone.

Even then hard to believe they would not explain the dosing when using such as this is critical.

There is a big difference here when it comes to drawing an accurate dose when using a U-100 vs U-40 LDS insulin syringe.

Pay attention to the mL/units.

(U-100) 1.0 mL syringe = 100 units
(U-40) 1.0 mL syringe = 40 units

Always need to know the strength of testosterone (TC/TE/TP/T-blend) you are injecting?

Most men on TRT are using TC or TE in the 200 mg/mL strength.

If using 200 mg/mL strength:

U-100 insulin syringe

1 ml = 100 units

0.01 mL = 1 unit = 2 mg TC/TE

Same for the 0.5 mL (50 units) or 0.3 mL (30 units) insulin syringes.

U-40 insulin syringe

1 mL = 40 units

0.025 mL = 1 unit = 5 mg TC/TE

Same for the 0.5 mL (20 units) or 0.3 mL (12 units) insulin syringes.

You are using a U-40 1 mL (40 unit) insulin syringe.

0.025 mL = 1 unit = 5 mg TC

5 units = 25 mg TC

Seeing as the strength of your TC is 200mg/mL and you are injecting 0.025 mL (5 units) = 25 mg TC daily then you would be injecting a fairly high weekly dose 175 mg TC.

Also keep in mind you are also injecting hCG 3x/week let alone a higher dose than you think to boot which can easily bump up ones T/estradiol further!

Just to put this in perspective most men on testosterone therapy are injecting 100-200 mg T/week whether once weekly, twice weekly (every 3.5 days), M/W/F, EOD or daily.

The majority of men can easily hit a healthy/high or in some cases absurdly high trough FT injecting 100-150 mg T/week especially when split into more frequent injections!

Yes there are some outliers who may need the higher-end dose 200 mg T/week but it is far from common as in RARE!

Such dose is pushed by the more T is better mentality crowd you know those dime a dozen run of the mill T clinics, blast n cruizzers loaded on those so called men's HRT/health forums let alone so called gurus polluting GOOTUBE!

Bottomline here is the 25 mg TC daily (175 mg/week) along with a higher dose of hCG then you think has you hitting an absurdly high TT 1499.8 ng/dL (52 nmol/L).

Even then 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.

Seeing as you are hitting an absurdly high TT roughly 1500 ng/dL with normalish SHBG 27-29.9 nmol/L then it is a given that your FT will be sky-high!

Unfortunately you never had your FT tested as you posted FAI (free androgen index) which is not used/relied upon when testing FT.

You need to have your FT tested using what would be considered the most accurate assay which is the gold standard Equilibrium Dialysis especially in cases of altered SHBG in order to know where your FT level truly sits.

If you do not have access to such which is most likely the case seeing as you are from the UK than you will need to use/rely upon the go to calculated method which would be the linear law-of-mass action cFTV.

Key point here:

* Seeing as you are hitting an absurdly high TT roughly 1500 ng/dL with normalish SHBG 27-29.5 nmol/L then it is a given that your FT will be sky-high!

Measuring insulin syringe

5. line would be 30 mg right? It’s a 0,5 ml insulin syringe 40 Iu. What’s confusing me it says 40 iu but then on the syringe it says 20 IU?!? So with my math 30 mg on these syringes would be 30 mg.

www.excelmale.com

madman · Tuesday at 1:08 PM

Mill3r said:
View attachment 48600Hi all.

Has anyway one had a simailar experience? I started TRT 2 months ago with a clinic in the UK. I started in test cyp 84mg per week injected daily. I am also on HCG 250iu 3 times a week.

After 1 month my level were elevated so was reduced down to 70mg per week. My results are all still elevated 2 months in. This was a blood draw via NHS from vein and before my injections on Wednesday.

I have hereditary spherecytosis blood condition and also under investigation for hemochromatosis. I have confirm type 1 carrier but I’m due to find out if I’m also type 3. My ferritin for the last 2
Years was around 700 now back in range which is good but also strange as my ferritin had been elevated since 2018.

Why is my testosterone and E2 so high on such a small dose?

Im waiting to hear back from the clinic. Iv also uploaded my doses on vial incase anyone thinks Iv got it wrong.

Thanks

Again just to put this in perspective.

You need to test your FT using what would be considered the most accurate assay the gold standard Equilibrium Dialysis especially in cases of altered SHBG in order to know where your FT level truly sits.

This is critical!

Even then seeing as you never had it tested you can easily calculate it using your TT, SHBG and Albumin.

This can be done online for free using the linear law-of-mass action cFTV.

If we take your absurdly high TT 1499.8 ng/dL, normalish SHBG 27-29.9 nmol/L and Albumin 4.3 g/dL (default) then your cFTV would be 44.2 or 42.5 ng/dL which is sky-high as in well beyond where a healthy young male would sit which would be 13-15 ng/dL using the cFTV method!

If one were aiming for a high-end/high FT on TTh it would be around 20-25 ng/dL and we are talking the 90th+ percentile here!

Again you are hitting a cFTV 44.2 or 42.5 ng/dL here!

Free & Bioavailable Testosterone calculator

Also need to keep in mind that cFTV tends to overestimate FT.

As I have stated numerous times on the forum you always have the option of using/relying upon calculated FT which would be the linear law-of-mass action cFTV as it has already been validated twice (1st time was done using TT/SHBG assays no longer available) and was then eventually re-validated using current state-of-the-art ED method (higher order reference method) let alone more recently against CDCs standardized Equilibrium Dialysis assay.

Yes it tends to overestimate slightly but it is nothing to fret over!

* Calculated free T using high-quality T and SHBG assays has been considered the most useful for clinical purposes [99]. All algorithms suffer from some inaccuracies, including the variable quality of SHBG IAs [100], not replicating the non-linear nature of T-SHBG binding, different and inaccurate association constants for SHBG and albumin binding [101], and variable agreement with equilibrium dialysis results [99,100]. However, until further developments in the field materialize, the linear model algorithms [in particular, the most used Vermeulen equation [102]] appear to give, despite a small systematic positive bias, acceptable data for the clinical management and research[37,103].

What is critical here is that you are hitting a cFT 44.2 or 44.5 ng/dL so even if you had it tested using the most accurate assay (Equilibrium Dialysis) although it will be slightly lower it will still be sky-high!

Again just to put this in perspective most healthy young males would be hitting a FT 12 ng/dL tested using the gold standard Equilibrium Dialysis assay (most accurate) or a cFTV 13-15 ng/dL and this is a short-lived peak to boot!

Trough would be 20-25% lower.

More importantly a FT in the low-mid 20s whether cFTV or standardized ED assay would be high!

A FT 25 ng/dL would be in the 95th percentile!

Again everyone needs to hammer it in their heads that a TROUGH FT 30 ng/dL is absurdly high.

We are talking TROUGH here too not peak!

Just to be clear if one truly felt great overall, was not experiencing any sides and blood markers remain healthy then I see no issue if one chooses to run high/sky-high FT levels within reason!

Chances are though that many will end up struggling with issues especially when it comes to libido, erectile function and mood let alone hematocrit!

Critical point here is running to high a trough/steady-state FT level can be just as bad in many ways as running too low a FT especially when it comes to libido/erectile function!

If you are one of the lucky ones who tends to fare well running high levels go nuts!

Regardless of the advice you get on here do what you feel is BEST FOR YOU!

Age-stratified reference ranges for directly measured (ED LC-MS/MS) serum free testosterone in healthy men

Just to be clear up any confusion this is Fiers camps data for mFT reference ranges not the harmonized reference range being worked on by the CDC. *Serum samples were analyzed from healthy men participating in the SIBLOS/SIBEX and EMAS studies, both population-based cohort studies * mFT...

www.excelmale.com

*We established mFT reference ranges for healthy men aged 18 to 69 years

We present 95% mFT age-stratified reference ranges

Age category (years)	Median mFT (ng/dl)	95% mFT reference range (ng/dl)
18-29 (n=140) 30-39 (n=252)	12.0 9.8	6.7-25.3 4.9-18.5
40-49 (n=207)	8.1	4.3.14.2
50-59 (n=146)	7.1	3.8-12.8
60-69 (n=126)	6.4	3.4-11.7
70-79 (n=125)	5.6	2.7-8.7

*The gold-standard for the determination of FT levels is considered to be directly measured free testosterone (mFT) using equilibrium dialysis followed by mass spectrometry (ED LC-MS/MS). However, no widely accepted reference ranges are available for this clinical parameter. We established mFT reference ranges for healthy men aged 18 to 69 years

Mill3r · Tuesday at 3:23 PM

madman said:
Sorry for the delay as me and seppuku already replied on Saturday just before the site crashed.

Going to break this down for you again!

@seppuku was bang on when he stated that you were injecting 175 mg T/week as the 5 unit mark on the U-40 insulin syringe would be 25 mg T if the strength of your T is 200 mg/mL as you stated in one of your replies that went missing from the thread after the site crashed on Saturday.

Not sure who would be at fault here for deciding to use a U-40 insulin syringe to inject your TC/hCG.

If it was the clinic then they are out to lunch as no one would use the U-40 especially when injecting testosterone or hCG let alone.

Even then hard to believe they would not explain the dosing when using such as this is critical.

There is a big difference here when it comes to drawing an accurate dose when using a U-100 vs U-40 LDS insulin syringe.

Pay attention to the mL/units.

(U-100) 1.0 mL syringe = 100 units
(U-40) 1.0 mL syringe = 40 units

View attachment 48603

Always need to know the strength of testosterone (TC/TE/TP/T-blend) you are injecting?

Most men on TRT are using TC or TE in the 200 mg/mL strength.

If using 200 mg/mL strength:

U-100 insulin syringe

1 ml = 100 units

0.01 mL = 1 unit = 2 mg TC/TE

Same for the 0.5 mL (50 units) or 0.3 mL (30 units) insulin syringes.

U-40 insulin syringe

1 mL = 40 units

0.025 mL = 1 unit = 5 mg TC/TE

Same for the 0.5 mL (20 units) or 0.3 mL (12 units) insulin syringes.

You are using a U-40 1 mL (40 unit) insulin syringe.

0.025 mL = 1 unit = 5 mg TC

5 units = 25 mg TC

Seeing as the strength of your TC is 200mg/mL and you are injecting 0.025 mL (5 units) = 25 mg TC daily then you would be injecting a fairly high weekly dose 175 mg TC.

Also keep in mind you are also injecting hCG 3x/week let alone a higher dose than you think to boot which can easily bump up ones T/estradiol further!

Just to put this in perspective most men on testosterone therapy are injecting 100-200 mg T/week whether once weekly, twice weekly (every 3.5 days), M/W/F, EOD or daily.

The majority of men can easily hit a healthy/high or in some cases absurdly high trough FT injecting 100-150 mg T/week especially when split into more frequent injections!

Yes there are some outliers who may need the higher-end dose 200 mg T/week but it is far from common as in RARE!

Such dose is pushed by the more T is better mentality crowd you know those dime a dozen run of the mill T clinics, blast n cruizzers loaded on those so called men's HRT/health forums let alone so called gurus polluting GOOTUBE!

Bottomline here is the 25 mg TC daily (175 mg/week) along with a higher dose of hCG then you think has you hitting an absurdly high TT 1499.8 ng/dL (52 nmol/L).

Even then 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.

Seeing as you are hitting an absurdly high TT roughly 1500 ng/dL with normalish SHBG 27-29.9 nmol/L then it is a given that your FT will be sky-high!

Unfortunately you never had your FT tested as you posted FAI (free androgen index) which is not used/relied upon when testing FT.

You need to have your FT tested using what would be considered the most accurate assay which is the gold standard Equilibrium Dialysis especially in cases of altered SHBG in order to know where your FT level truly sits.

If you do not have access to such which is most likely the case seeing as you are from the UK than you will need to use/rely upon the go to calculated method which would be the linear law-of-mass action cFTV.

Key point here:

* Seeing as you are hitting an absurdly high TT roughly 1500 ng/dL with normalish SHBG 27-29.5 nmol/L then it is a given that your FT will be sky-high!

Measuring insulin syringe

5. line would be 30 mg right? It’s a 0,5 ml insulin syringe 40 Iu. What’s confusing me it says 40 iu but then on the syringe it says 20 IU?!? So with my math 30 mg on these syringes would be 30 mg.

www.excelmale.com

Thank you for this very comprehensive reply it is
Much appreciated!

Your totally right I can’t believe how stupid I was as I literlly asked my doctor if I can start TRT lower than he suggested which he wanted to me start at 100mg and titrate up or down which was reasonable but I opted for 84mg. So it’s crazy Iv made this mistake lol and I just assumed the syringes were smaller and just went up to 40 without even looking at the U-40 or U-100.

My clinic has replied confirming everything everyone have said. I followed the advice given on here and I’m taking a week break and also ordered the correct hardware needed going forward.

Thank you.

seppuku · Thursday at 7:10 AM

Mill3r said:
Thank you for this very comprehensive reply it is
Much appreciated!

Your totally right I can’t believe how stupid I was as I literlly asked my doctor if I can start TRT lower than he suggested which he wanted to me start at 100mg and titrate up or down which was reasonable but I opted for 84mg. So it’s crazy Iv made this mistake lol and I just assumed the syringes were smaller and just went up to 40 without even looking at the U-40 or U-100.

My clinic has replied confirming everything everyone have said. I followed the advice given on here and I’m taking a week break and also ordered the correct hardware needed going forward.

Thank you.

Fwiw, i currently do 84mg/week, spread across two injections per week (42mg Sun AM, 42mg Wed PM). I don't use a clinic by the way. My last blood test, taken at a trough, so just before an injection came back at:

Total T - 25.4nmol/l (732ng/dl)
Free T - 0.517nmol/l (14.9ng/dl).

So it was a good request by you to start off at that dosage and titrate up, as it's totally possible to get good results from that kind of dosage. Plus, it's better to work your way up rather than have to work your way down due to side effects etc (i realise that's what you're having to do now, but that was down to an unfortunate miscalculation, not what you intended to do).

By the way, just curious - with your clinic recommending daily shots, are you with Dr Stevens at 'The Mens Health Clinic'?

Mill3r · Thursday at 9:54 AM

Thanks for the heads up!

Since I have hereditary spherocytosis and hemochromatosis, I’m aware that my risk for blood clots is higher, so I wanted to ease into things more cautiously. I initially sought TRT through the NHS, but after some back-and-forth, they ultimately declined since my last blood test before starting TRT was at 9 nmol. Previously, my levels had been at 3 nmol and 8 nmol, with low E2, FSH, and LH—all signs pointing toward secondary hypogonadism.

I decided to go with the Leger Clinic since TMHC felt more like a cult. The doctor at Leger prescribed three injections per week, but I opted to start with daily dosing to ease in gradually. If all goes well, I may reduce the frequency. While I understand the half-life of testosterone cypionate, daily dosing feels a bit more reassuring, trying the best i can on managing my blood conditions as carefully as possible.

I also take daily baby aspirin split into doses and i always take 5mg tadalafil daily also. I take all the usual normal vits and minerals.

seeker2114 · Thursday at 6:45 PM

Mill3r said:
View attachment 48600Hi all.

Has anyway one had a simailar experience? I started TRT 2 months ago with a clinic in the UK. I started in test cyp 84mg per week injected daily. I am also on HCG 250iu 3 times a week.

After 1 month my level were elevated so was reduced down to 70mg per week. My results are all still elevated 2 months in. This was a blood draw via NHS from vein and before my injections on Wednesday.

I have hereditary spherecytosis blood condition and also under investigation for hemochromatosis. I have confirm type 1 carrier but I’m due to find out if I’m also type 3. My ferritin for the last 2
Years was around 700 now back in range which is good but also strange as my ferritin had been elevated since 2018.

Why is my testosterone and E2 so high on such a small dose?

Im waiting to hear back from the clinic. Iv also uploaded my doses on vial incase anyone thinks Iv got it wrong.

Thanks

If you are using a standard insulin syringe ( units) then what ever you are drawing into the syringe is going to be doubled example 20 units will net you 40mg of actual testosterone. Also if you are using HCG to help prevent testicular shrinkage then that will also help your body to create testosterone

2month bloods very high

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