Lab results came back

[slyster117]

I am 60 year old on TRT doing 200mg testosterone cyp every 2 weeks and have ED issues.Labs came back as follows: test@335 and E2 ultra sensitive at 35 which were drawn on day 13 (fasting) in the morning. Will increasing 200mg every 7 days help or is there another answer?

 

[CoastWatcher]

Welcome to Excelmale. You are on a protocol that never had a chance to bring you relief. Two hundred milligrams of testosterone every two weeks is absurd: the half-life of the drug is such that by the time you're due for your next injection your levels are miserable. Your labs bear this out. At the very least, you should adopt a protocol calling for weekly injections, every 3.5 days (such as Monday morning/Tuesday night, Thursday morning/Friday night). I would urge you to start with a lower dose, 50 or 60 milligrams twice a week may get you where you want to be. Smaller, more frequent doses are the ticket. Finally, find a new doctor. You aren't being served well.

 

[Vince]

slyster, Welcome to Excelmale. I agree with CW, you need to inject at least every 3 1/2 days. You will feel better and have less problems. I'll show you my last labs. My latest testosterone panel from 3-21-16

Read more at: https://www.excelmale.com/forum/showthread.php?6502-My-latest-testosterone-panel-from-3-21-16
here's Nelson's protocol

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[slyster117]

more results and questions

Welcome to Excelmale. You are on a protocol that never had a chance to bring you relief. Two hundred milligrams of testosterone every two weeks is absurd: the half-life of the drug is such that by the time you're due for your next injection your levels are miserable. Your labs bear this out. At the very least, you should adopt a protocol calling for weekly injections, every 3.5 days (such as Monday morning/Tuesday night, Thursday morning/Friday night). I would urge you to start with a lower dose, 50 or 60 milligrams twice a week may get you where you want to be. Smaller, more frequent doses are the ticket. Finally, find a new doctor. You aren't being served well.

What tt and E2 numbers should i get to to eliminate my issue? How does the TT/E ratio figure into this?

 

[CoastWatcher]

What tt and E2 numbers should i get to to eliminate my issue? How does the TT/E ratio figure into this?

The ratio is simply one metric to help you and your doctor evaluate your progress. Try not to chase numbers, look to how you feel. You also need to keep in mind that any protocol change, such as you're considering, must be given time. Adopt a change and wait four to six weeks, four is the absolute minimum, with no other alterations, to see how you feel and then test again. As your total testosterone rises your estradiol should increase accordingly. The good news, however, is that you may well see your E2 drop a bit with smaller, more frequent injections. Most of us have. Your current protocol runs up estradiol while doing nothing to help you maintain testosterone levels.

 

[ecdysone]

Will increasing 200mg every 7 days help or is there another answer?

As others have said, increase your frequency, decreasing the dose proportionately. Test levels won't generally correlate with ED issues, so yes, there are other answers that your physician could explore with you.

 

[Vettester Chris]

All the above is great advise, can't really add too much more than what's been said. Your doctor is winging it! Your total serum was probably 1,200ng/dl (it's a guess, +/-) ... 335ng/dl at day 14, what a roller coaster ride!

 

[slyster117]

So from what I am hearing here the 1ml of 200mg Test cyp i have been injecting every 2 weeks for the last 6 months has raised my E2 levels and put me on a roller coaster of 1000+ng day 1 dropping to 335 ng on day 13. So injecting 1/4 of that 1ml every 3.5 days will even out my Test numbers and slowly lower my E2 number in the process? At this point is a .25 mg A1 needed to be added in to lower the E2 or none at all right now?

 

[CoastWatcher]

So from what I am hearing here the 1ml of 200mg Test cyp i have been injecting every 2 weeks for the last 6 months has raised my E2 levels and put me on a roller coaster of 1000+ng day 1 dropping to 335 ng on day 13. So injecting 1/4 of that 1ml every 3.5 days will even out my Test numbers and slowly lower my E2 number in the process? At this point is a .25 mg A1 needed to be added in to lower the E2 or none at all right now?

Doses should always be referenced in milligrams, never in milliliters. The former is a dose, the latter a volume. It has been suggested that you should inject 100mg of testosterone per week. Not in one, weekly injection, but 50mg every 3.5 days. Change nothing else, test your levels no sooner than four weeks later and evaluate your results - how you feel, what your lab results show. There is no need at this point to add Anastrozole to the protocol since there is an excellent chance that smaller, more frequent dosing will produce solid testosterone levels while controlling your estradiol.

 

[slyster117]

Thanks CW I have a question on the best needle size to use for the Im injections. Nelson mentions a 27 gauge 1/2 inch syringe in his video so is this size the preference by the current protocols or are there various options? Thanks in advance for your info…….

 

[CoastWatcher]

Thanks CW I have a question on the best needle size to use for the Im injections. Nelson mentions a 27 gauge 1/2 inch syringe in his video so is this size the preference by the current protocols or are there various options? Thanks in advance for your info…….

Whatever you feel,comfortable with. Many use an insulin needle; it takes some time to fill, but is almost impossible to feel.

 

[Jackie Treehorn]

Thanks CW I have a question on the best needle size to use for the Im injections. Nelson mentions a 27 gauge 1/2 inch syringe in his video so is this size the preference by the current protocols or are there various options? Thanks in advance for your info…….

Agree with Coastwatcher. Your personal preference is what matters here.

A lot of guys here on this forum use a 1/2"/27ga insulin pin. I use a 1/2"/29ga insulin pin, and I inject shallow IM into my quads. Plenty of guys inject shallow IM into their delts/quads, and some guys inject SubQ into the abdomen or glute fat pads.

Whether the injection ends up being SubQ or shallow IM largely depends on your body composition. If you're lean and muscular, those injections are probably going to be shallow IM (delts/quads). If you have more body fat, they'll probably end up being SubQ. You don't have to inject deep into the muscle to get good bioavailability...I'm living proof of that.

Remember that it takes a while to draw the testosterone into an insulin syringe. If you're drawing .25mLs (50mg), it's probably going to take you about a minute to draw that amount. Just be patient. Remember to take your time, and inject slowly.

You're going to be very happy switching to a twice a week (every 3.5 days) protocol...no more rollercoaster ride for you. When you re-check your labs in 4 to 6 weeks, remember to have your blood drawn on a trough day. Example: if you inject testosterone on Monday mornings and Thursday evenings, have your blood drawn on Monday morning BEFORE your injections. Thursday late morning would be ok also, but it would be a few hours shy of your true trough. Good luck to you.

 

[slyster117]

Another question

I am 60 year old on TRT doing 200mg testosterone cyp every 2 weeks and have ED issues.Labs came back as follows: test@335 and E2 ultra sensitive at 35 which were drawn on day 13 (fasting) in the morning. Will increasing 200mg every 7 days help or is there another answer?

Endo has come back with 2 options he is comfortable with and they are 240mg every 2 weeks or 120mg every 1 week. What is the feeling on this protocol from the Forumn?

 

[PAUL-E]

120mg a week is better than 240mg every two weeks but IMHO still not good.

 

[CoastWatcher]

Endo has come back with 2 options he is comfortable with and they are 240mg every 2 weeks or 120mg every 1 week. What is the feeling on this protocol from the Forumn?

A single dose of 120mg every week is certainly better than 240mg every two. Why not divide it into 60mg every 3.5 days? That way you receive the same amount of testosterone every week that he has prescribed, but delivered in a way that will minimize spikes and troughs. Your chances of success are much greater that way.