High HGB/HCT

[tareload]

to become normal or even hypogonadal? About 2-4 weeks?

Yep!

 

[tareload]

Are those numbers blast numbers or even higher than cycle numbers?

Hey who am I to judge? One person's blast is another person's cruise is another person's TRT . People are letting it all hang out nowadays!

 

[GreenMachineX]

Hey who am I to judge? One person's blast is another person's cruise is another person's TRT . People are letting it all hang out nowadays!

Yeah, I just didn't know what typical blood cycle levels looked like.

We'll see what my results are in a few days. When I was talking to the phlebotomist about the redraw, she said they spin it down right there and then send it off so she didn't know how the error could've happened. Just fun speculation, if actually an error and something in my body didn't just break, I wonder if it wasn't spun down correctly, or maybe there's a bodybuilder blasting in my city they mixed it up with

 

[GreenMachineX]

I recieved the results from the redraw, 6 days since my last daily injection. Clearly, those wild numbers were an error. But, that means on 5mg, my total T was somewhere around 414, maybe a bit higher by then, and only dropped to 337 over the course of 6 days. It's been 3 days since I had those levels of 337 and free test of 64 and still haven't used any testosterone (9 days now). Why do I feel better??? Much less anxiety and slept fantastic last night. And had excellent morning wood this morning

Quest Diagnostics Total Mass Spectometry
10mg daily trough, total T 550 (250-1100) 6 weeks
10mg daily 5 hours post, total T 664 (250-1100) 9w
10mg daily...3 weeks
7mg daily...no test 4w
5mg daily trough, total T 414 (250-1100) 2w
5mg daily trough, total T 3459 (250-1100) 2w (error)

6 days after last 5mg injection 337 (250-1100)

For reference, below are the free testosterone results corresponding with the above dose.

Quest Diagnostics Free Testosterone Dialysis
10mg daily trough, 147 (35-155)
10mg daily trough, 174 (35-155)
5mg daily trough, 105 (35-155)
5mg daily trough, 1232 (35-155) (Error)

6 days after last 5mg injection: 64 (35-155)

 

[GreenMachineX]

I recieved the results from the redraw, 6 days since my last daily injection. Clearly, those wild numbers were an error. But, that means on 5mg, my total T was somewhere around 414, maybe a bit higher by then, and only dropped to 337 over the course of 6 days. It's been 3 days since I had those levels of 337 and free test of 64 and still haven't used any testosterone (9 days now). Why do I feel better??? Much less anxiety and slept fantastic last night.

Quest Diagnostics Total Mass Spectometry
10mg daily trough, total T 550 (250-1100) 6 weeks
10mg daily 5 hours post, total T 664 (250-1100) 9w
10mg daily...3 weeks
7mg daily...no test 4w
5mg daily trough, total T 414 (250-1100) 2w
5mg daily trough, total T 3459 (250-1100) 2w (error)

6 days after last 5mg injection 337 (250-1100)

For reference, below are the free testosterone results corresponding with the above dose.

Quest Diagnostics Free Testosterone Dialysis
10mg daily trough, 147 (35-155)
10mg daily trough, 174 (35-155)
5mg daily trough, 105 (35-155)
5mg daily trough, 1232 (35-155) (Error)

6 days after last 5mg injection: 64 (35-155)

@Cataceous
Any thoughts on why I'm feeling better as my test keeps going lower? By no means perfect or normal, but improving. Maybe I'm converting too much to DHT even at low levels?

 

[Cataceous]

@Cataceous
Any thoughts on why I'm feeling better as my test keeps going lower? By no means perfect or normal, but improving. Maybe I'm converting too much to DHT even at low levels?

You need to be a little cautious about making judgements when you're in flux. Optimistically it could mean that you simply need lower levels. With your low SHBG you need to focus on the free testosterone. Your last measurement was between the first and second quartile of the reference range, so still not all that low. However, there could easily be a time lag between having testosterone drop too far and your experiencing a return of hypogonadal symptoms. You should decide if you want to remain off of exogenous testosterone or to instead resume with a low dose and give it sufficient time for evaluation.

 

[GreenMachineX]

You need to be a little cautious about making judgements when you're in flux. Optimistically it could mean that you simply need lower levels. With your low SHBG you need to focus on the free testosterone. Your last measurement was between the first and second quartile of the reference range, so still not all that low. However, there could easily be a time lag between having testosterone drop too far and your experiencing a return of hypogonadal symptoms. You should decide if you want to remain off of exogenous testosterone or to instead resume with a low dose and give it sufficient time for evaluation.

Great points. If I start gain, I'll likely start at 4mg daily.

 

[Systemlord]

I don't think steady hormones are ideal for all low SHBG men who have problems dialing in on TRT. I think what you need @GreenMachineX is more frequent fluctuations in androgens like Test prop or Jatenzo gives you.

On Jatenzo my receptors aren't constantly being hammered (overstimulated) by high levels of androgens and believe this is why it works so well for me.

You basically prove my point because you say you felt much better after going 6 days without an injection.

 

[GreenMachineX]

I don't think steady hormones are ideal for all low SHBG men who have problems dialing in on TRT. I think what you need @GreenMachineX is more frequent fluctuations in androgens like Test prop or Jatenzo gives you.

On Jatenzo my receptors aren't constantly being hammered (overstimulated) by high levels of androgens and believe this is why it works so well for me.

You basically prove my point because you say you felt much better after going 6 days without an injection.

Interesting thought. Couldn't I just lower my dose enough to compensate for that?

 

[Systemlord]

Couldn't I just lower my dose enough to compensate for that?

It's a temporary fix, once levels reach a steady state...

A shorter duration half-life would give your levels more of a variation, a swing, kind of like what you got stopping injections for 6 days.

That kind of gave your body a break from a constant elevated hormone levels.

My levels on Jatenzo peak real fast, then start falling within the first two hours of dosing. I achieved what you did in 6 days is just a few hours.

 

[GreenMachineX]

It's a temporary fix, once levels reach a steady state...

A shorter duration half-life would give your levels more of a variation, a swing, kind of like what you got stopping injections for 6 days.

That kind of gave your body a break from a constant elevated hormone levels.

My levels on Jatenzo peak real fast, then start falling within the first two hours of dosing. I achieved what you did in 6 days is just a few hours.

I see. So, with that theory, EOD or twice per week is actually better?

 

[GreenMachineX]

You need to be a little cautious about making judgements when you're in flux. Optimistically it could mean that you simply need lower levels. With your low SHBG you need to focus on the free testosterone. Your last measurement was between the first and second quartile of the reference range, so still not all that low. However, there could easily be a time lag between having testosterone drop too far and your experiencing a return of hypogonadal symptoms. You should decide if you want to remain off of exogenous testosterone or to instead resume with a low dose and give it sufficient time for evaluation.

Theoretically, considering my lab results from 5mg and 10mg daily, could 10mg EOD be enough to keep me in range, if I were to start back? @Systemlord may be on to something with his swing theory. Or would starting back up at 4mg daily be better?

 

[Cataceous]

Theoretically, considering my lab results from 5mg and 10mg daily, could 10mg EOD be enough to keep me in range, if I were to start back? @Systemlord may be on to something with his swing theory. Or would starting back up at 4mg daily be better?

The "swing theory" has been around a while. It's based in part on the observation that young men have a pretty significant daily variation in testosterone, from the morning peak to the evening trough. This variation is attenuated with age.

Although imperfect, a reasonable imitation of this is achieved with daily injections of a blend of testosterone propionate and a longer ester. I've been doing this for going on three years now. I do prefer it to having constant serum testosterone, but the improvements I perceive are pretty subtle—possibly better sleep and less emotional flatness.

In any case, the longer the injection cycle the less natural the variation. It also depends on how fast you absorb the testosterone ester. I found that EOD injections of testosterone enanthate, basically equivalent to cypionate, provide very little variation in serum testosterone. This is in line with the nominal five-day half-life. However, there are reports from guys who are fast absorbers and see dramatic drops in even a day. Testosterone propionate has a nominal half-life of 0.8 days. Combining it with testosterone cypionate or enanthate allows one to tune the daily variation as needed. We discussed the nuts and bolts of this here:

Tips on how to blend propionate with enanthate (or cypionate)?

I have been having some success with low dose daily propionate for the last several months. Dose levels have ranged from 8-10 mg injected every morning after waking. Overall, it has been a far better experience than my previous cypionate protocol of 80-100 per week (split every 3.5 days)...

www.excelmale.com

I think 10 mg cypionate EOD would be a viable protocol for you, but you wouldn't necessarily see much variation in levels. Regarding 4 mg daily, I'd want to see where your free testosterone ends up and how you actually feel over a longer period. That's under 3 mg of testosterone daily, which is pretty low by any measure.

 

[GreenMachineX]

The "swing theory" has been around a while. It's based in part on the observation that young men have a pretty significant daily variation in testosterone, from the morning peak to the evening trough. This variation is attenuated with age.

Although imperfect, a reasonable imitation of this is achieved with daily injections of a blend of testosterone propionate and a longer ester. I've been doing this for going on three years now. I do prefer it to having constant serum testosterone, but the improvements I perceive are pretty subtle—possibly better sleep and less emotional flatness.

In any case, the longer the injection cycle the less natural the variation. It also depends on how fast you absorb the testosterone ester. I found that EOD injections of testosterone enanthate, basically equivalent to cypionate, provide very little variation in serum testosterone. This is in line with the nominal five-day half-life. However, there are reports from guys who are fast absorbers and see dramatic drops in even a day. Testosterone propionate has a nominal half-life of 0.8 days. Combining it with testosterone cypionate or enanthate allows one to tune the daily variation as needed. We discussed the nuts and bolts of this here:

Tips on how to blend propionate with enanthate (or cypionate)?

I have been having some success with low dose daily propionate for the last several months. Dose levels have ranged from 8-10 mg injected every morning after waking. Overall, it has been a far better experience than my previous cypionate protocol of 80-100 per week (split every 3.5 days)...

www.excelmale.com

I think 10 mg cypionate EOD would be a viable protocol for you, but you wouldn't necessarily see much variation in levels. Regarding 4 mg daily, I'd want to see where your free testosterone ends up and how you actually feel over a longer period. That's under 3 mg of testosterone daily, which is pretty low by any measure.

I'm not sure what to do, but I am leaning towards still attempting 4-5mg daily and sticking it out. I don't think I gave it enough time to truly know how it would feel.

Question, should a protocol that results in similar trough free test feel similar to another that results in the same free test? For example, if 5mg gives me 105 free test, and 50mg twice per week gives me the same trough, should they feel pretty similar or could they feel wildly different? I went back and looked over old labs from several years on 50mg twice per week and trough was 105 (35-155 range), and 25mg EOD gave a trough of 115. Both of those felt pretty similar, resulted in similar hct and hgb, but eod was better on blood pressure. If the 5mg daily held closely to the results from 2 weeks into it which was 105 free test, then maybe I was on the right track and just didn't give it long enough. Any thoughts there?

 

[Cataceous]

I'm not sure what to do, but I am leaning towards still attempting 4-5mg daily and sticking it out. I don't think I gave it enough time to truly know how it would feel.

Question, should a protocol that results in similar trough free test feel similar to another that results in the same free test? For example, if 5mg gives me 105 free test, and 50mg twice per week gives me the same trough, should they feel pretty similar or could they feel wildly different? I went back and looked over old labs from several years on 50mg twice per week and trough was 105 (35-155 range), and 25mg EOD gave a trough of 115. Both of those felt pretty similar, resulted in similar hct and hgb, but eod was better on blood pressure. If the 5mg daily held closely to the results from 2 weeks into it which was 105 free test, then maybe I was on the right track and just didn't give it long enough. Any thoughts there?

If trough testosterone is fixed then the longer the injection cycle the less correlation there would be with how you feel on a daily protocol. With typical absorption of cypionate, a twice-weekly injection cycle has peak levels that are about 50% higher than trough values. If you extend the injection cycle out to weekly then peak testosterone can be two to three times more than trough testosterone.

I'd agree that you didn't give 5 mg enough time to see how it would work out. Serum levels weren't stabilized, and even after that it can take a month or two for the body to fully adapt.

 

[GreenMachineX]

If trough testosterone is fixed then the longer the injection cycle the less correlation there would be with how you feel on a daily protocol. With typical absorption of cypionate, a twice-weekly injection cycle has peak levels that are about 50% higher than trough values. If you extend the injection cycle out to weekly then peak testosterone can be two to three times more than trough testosterone.

I'd agree that you didn't give 5 mg enough time to see how it would work out. Serum levels weren't stabilized, and even after that it can take a month or two for the body to fully adapt.

Thanks. Well, I'll be starting again in the next couple days most likely. It's almost 2 weeks since last 5mg injection. I'm finished this keflex antibiotic tomorrow so I won't be worried about interactions with the stuff I take for sleep and anxiety if I go right back into panic at 5mg. Since I did 4 weeks already at 5mg, 12 days of nothing, would I still need to give it another 12 weeks at 5mg to fully know what it feels like? Did the past 12 days of nothing reset that clock?

I do feel some hypo symptoms I'm noticing. Difficulty making decisions, lower focus and motivation, libido mildly down, but sleep and diurnal anxiety improved. A little shaky and weak feeling inside occasionally. I'm still getting worried over silly things, but the 4 hour long anxiety attacks in morning and night are gone. It's really not that bad which makes my hesitancy to start back up worse. Then again, low testosterone covid risk is a thing for me. If it wasn't for covid in the world, I'd absolutely attempt a cold turkey restart.

 

[GreenMachineX]

You need to be a little cautious about making judgements when you're in flux. Optimistically it could mean that you simply need lower levels. With your low SHBG you need to focus on the free testosterone. Your last measurement was between the first and second quartile of the reference range, so still not all that low. However, there could easily be a time lag between having testosterone drop too far and your experiencing a return of hypogonadal symptoms. You should decide if you want to remain off of exogenous testosterone or to instead resume with a low dose and give it sufficient time for evaluation.

Regarding this time lag you mentioned, did you mean I might be feeling the effects of what my levels were a week or 2 ago, and not how low they currently are?

 

[Cataceous]

Since I did 4 weeks already at 5mg, 12 days of nothing, would I still need to give it another 12 weeks at 5mg to fully know what it feels like? Did the past 12 days of nothing reset that clock?
...

Twelve weeks would be prudent, but you could just call it after experiencing a few weeks with no changes.

For a sense of what's happening with levels, assume the standard half-life of five days for testosterone cypionate. If you had reached steady state with 5 mg daily then you would always have approximately 34 mg of cypionate stored in your injected depots. After stopping, this would gradually be absorbed and used. After twelve days the stored cypionate is down to about 6 mg, not much more than a single dose. This shows you're currently absorbing about a sixth of the testosterone you were absorbing at steady state. If you resume injections then it will take time to rebuild your reservoir of cypionate and reach a point where you are absorbing testosterone at the same rate you're injecting it. Sometimes a loading dose is used to speed up the process.

Regarding this time lag you mentioned, did you mean I might be feeling the effects of what my levels were a week or 2 ago, and not how low they currently are?

Something like that. In reality it's probably much more complex. For example, various functions might correspond to a weighted average of your daily peak testosterone for the past few weeks. Other functions might be more sensitive to average levels, trough levels, etc. And that's not even getting into interactions with levels of other hormones.

 

[GreenMachineX]

Twelve weeks would be prudent, but you could just call it after experiencing a few weeks with no changes.

For a sense of what's happening with levels, assume the standard half-life of five days for testosterone cypionate. If you had reached steady state with 5 mg daily then you would always have approximately 34 mg of cypionate stored in your injected depots. After stopping this would gradually be absorbed and used. After twelve days the stored cypionate is down to about 6 mg, not much more than single dose. This shows you're currently absorbing about a sixth of the testosterone you were absorbing at steady state. If you resume injections then it will take time to rebuild your reservoir of cypionate and reach a point where you are absorbing testosterone at the same rate you're injecting it. Sometimes a loading dose is used to speed up the process.


Something like that. In reality it's probably much more complex. For example, various functions might correspond to a weighted average of your daily peak testosterone for the past few weeks. Other functions might be more sensitive to average levels, trough levels, etc. And that's not even getting into interactions with levels of other hormones.

Gotcha. That sounds good actually, because I'd rather have a slow build up than a wham on my first dose. The last dose I used was kind of scary (unless it wasn't testosterone but instead the vitamin k2 mk7 which causes similar issues of insomnia, anxiety, etc in some people).

I'll resume tomorrow...I think.

It would probably only take a few days to get out of hypogonadal territory, according to that graph from readalot, correct? But a couple weeks to get back to 34mg in Reservoirs? How do you figure this out? What would 50mg twice per week and 25mg eod do to steady state reservoirs?

 

[Cataceous]

Again using the assumption you have a five-day half-life, the key figure is 13% per day. That is, each day you absorb 13% of your injected depots. If your current reservoir is 6 mg then you will absorb 0.8 mg of that today. If you inject 5 mg then your reservoir is 11 mg instead and you would absorb 1.4 mg over the day. The next day your starting reservoir is ( 11 - 1.4 = 9.6 mg ). If you inject another 5 mg then you increase the reservoir to 14.6 mg. The second day's absorption is then 1.9 mg. This is still only 1.3 mg of pure testosterone. This is why it takes time to regrow the reservoir: Half of the remaining deficit is filled every five days.

We don't know your threshold dose rate for hypogonadism. Therefore we can't say how long it will take to get above it. If you want to guess that it's three mg of testosterone per day, the bottom of the range of normal production, then you'll need to be absorbing at least 4.3 mg of cypionate daily to surpass that, which takes about two weeks with the current assumptions.

In the case of longer injection intervals there is a bigger drop in the reservoir between injections. The equation for the loss fraction is ( 1 - exp( - ln(2) * interval / half_life ) ). If the interval is 3.5 days with twice weekly injections then the loss fraction is 38%. The trough reservoir is then 62% of the sum of the current reservoir and the 50 mg injection. For EOD injections the loss fraction is 24%.

Also bear in mind that the model used here is simplistic; you can't expect tremendous accuracy, even if you measure your own apparent half-life for testosterone cypionate.