Need help with testosterone dosage

[DennisH]

I am age 59, and have been on testosterone cypionate injections for the past 6 or 7 years. I started out at 100mg/week, with increases as I aged, then decreases as my numbers increased -- apparently from getting in shape and improving my health, and possibly from taking progesterone and boron. My target total is 750. I have not been taking any HCG or aromatase inhibitors. I have not had a problem with testicular shrinkage.

Here are my results from March. I was taking 120mg per week in one injection:



I decreased to 100mg per week spread across two injections. Now this is where I am:

A 20% decrease in testosterone, with no significant decrease in my levels. I am also concerned about the low FSH. My wife doesn't want testicular shrinkage, and I don't either! The estrogen is too high, and my dosage decrease did not lower that either.

I am seeing the doctor this week, but I wanted to see what ya'll say. This forum was recommended by a friend who is also a member.

In the meantime, I have reduced my dosage to 60 mg spread across two shots per week. My performance has actually improved.

I started taking women's topical progesterone cream, about 7 mg per day, about a year ago. That did more to help my erections and preejaculate than anything since initially starting testosterone. About 6 months ago, I started taking 6 mg of boron per day. I feel that that may be what increased my natural production. Could it be that a lot of my low testosterone is caused by a simple mineral deficiency?

Also note that I sprung for the sensitive estradiol test that the guys on a marriage forum I belong to rave about. The results and reference intervals are different, but both show me high-normal. So no need to spend money on that again.

Thanks in advance for any guidance you can provide.

Dennis

 

[Kirk001]

The numbers are hard to read but it looks like your Estradiol, Sensitive is 33.1, which is not high unless you are experiencing some estrogenic symptoms. Nelson's target range is 20 - 40, and a lot of guys on here have numbers that are much higher that that.

Your LH and FSH are practically zero, but this is to be expected when you are taking testosterone. Assuming fertility is not a concern, the main reason for HCG would be to prevent testicular atrophy. So this is an option for you although you said you have not had problems with this in the past so I don't see how lowering your T dose would change anything in that regard.

 

[ReillyJ]

I started taking women's topical estrogen cream, about 7 mg per day, about a year ago. That did more to help my erections and preejaculate than anything since initially starting testosterone.
Dennis

Dennis, did you mean progesterone instead of estrogen? I know the guys on here will give you great advice!

 

[DennisH]

Thanks Kirk. Yes, you read the number correctly. This is my first post to this board. Is there a way to get the board software to not shrink it so much?

No, no symptoms of estrogen such as man boobs or anything like that. When it was higher -- around 50 with the standard test, my erections weren't as good. For my wife, sex actually improved after menopause. I was told it was because of an improved testosterone/estradiol ratio. I am thinking maybe men work the same way....

It is my understanding from discussions with my doctor is that that FSH will be high if you have primary hypogonadism and are not treating it. Your brain says "give me more testosterone" and your testicles are ignoring the FSH. You start supplimentation, the FSH comes down. If you control the dosage, your FSH will stay at normal levels and prevent shrinkage. Too much, the FSH drops too low and you get shrinkage.

I decrease my dosage and my testosterone rises or stays the same, where would it be coming from?

I also notice that I am hornier when we are on a marital high. So I presume that the testicles are producing something?

Does HCG prevent shrinkage by telling the testicles to produce, and therefore raising your testosterone levels?

Thanks in advance for your comments.

 

[DennisH]

Thanks ReillyJ.

Yes, I did! Thanks for catching that. I'll fix my original post.

 

[Kirk001]

Welcome. I don't know about attaching images for labs, I usually just type out the info rather than trying to use an image.

So I think maybe you are confusing LH and FSH. The pituitary makes both and they go to the testicles. There the FSH stimulates Sertoli cells for sperm production and the LH stimulates Leydig cells for testosterone production.

HCG is a mimic of LH. The Leydig cells in the testicles see the HCG and think it is LH, which tells them to produce testosterone. However if you are primary hypogonadal, which is a failure of the testicles, then neither HCG nor LH are going to result in much T production. But HCG should help prevent testicular atrophy, even in primary hypogonadal men, as far as I know.

As far as decreasing your T dosage and your lab numbers staying the same or increasing, that is a story that many guys have told. Lots of guys have said that for instance if they switch from one injection of 100mg per week, to two injections of 50mg per week, their total testosterone numbers on labwork may increase. Even though the weekly dose remains the same. If you increase the frequency of injections you can often lower the total weekly dose.

 

[DennisH]

Thanks Kirk -- you did indeed educate me on LH vs FSH.

I must have been producing something before I started injections. I was 270 total, and could manage an erection and intercourse on occasion. I would like to keep them producing as much as possible. Cheaper if nothing else :lol:

Thanks,

Dennis

 

[Vince Carter]

Once you started on Testosterone, and it's replacement, not supplementation, your LH and FSH are going to be zero. No way around that and it's normal. Stop paying money to test those.

 

[MarkM]

Your Estradiol Sensitive at 33.1 pg/ml looks fine to me. Of course, if you are having symptoms of high estradiol that is what is important regardless of the numbers. If no symptoms, you are sitting just fine. My Estradiol Sensitive is at 35.3 pg/ml and I don't take any type of AI. Your SHBG at 46.8 is right in the middle of the range and two injections per week is a good protocol with that SHBG. I wouldn't get to hung up on the Total Testosterone number 940 even though it is above the range. Most of it is bound up and inactive. It is your Free T that does all the heavy lifting and it is at 18.3 which is fine and could even go up a little bit. I like to be in the upper normal range on Free T, but overall your numbers look pretty good as long as you feel good.

 

[Deleted member 16042]

Echo what's been said, just to add, you've been on TRT 6-7 years. Your testicles shut down production 6-7 years ago. As unlikely as it is, if any at all is produced in your testicles, it is certainly inconsequential. I don't really see any reason to worry about it at this point in your game.

 

[DennisH]

Thanks everyone for your posts. I apologize for the delay in my response. I was waiting until after my doctor's appt.

Once you started on Testosterone, and it's replacement, not supplementation, your LH and FSH are going to be zero. No way around that and it's normal. Stop paying money to test those.

Both my prior doctor, (who has been doing bHRT for 30 years and whom I have confidence in and is now retired), and my current doctor, who also seems to know what he is doing, say that controlling the testosterone dosage will prevent testicular shutdown. I specifically asked my current doctor about this. He said that my LH is practically zero because my testosterone levels are too high, and that they will come up as my decreased dosage takes effect.

Indeed, I have had little or no shrinkage, despite my too-high levels. We compared me to a picture my wife took of me when I was in my 20's :lol:.

So, I don't know who to believe at this point. People on this forum have a reputation for knowing more than most doctors. The doctor approved my guestimate of 0.15 cc of testosterone cypionate twice a week (60 mg/week of testosterone). I am doing well on the new dosage. I will give it time and retest, including my LH, and post back here.

It seems reasonable that if your LH is high due to low testosterone prior to TRT, there should be SOME level of supplementation you could do that would not suddenly push your LH to zero. Probably different people are affected differently.

Thanks,

Dennis

 

[Systemlord]

Thanks everyone for your posts. I apologize for the delay in my response. I was waiting until after my doctor's appt.

Both my prior doctor, (who has been doing bHRT for 30 years and whom I have confidence in and is now retired), and my current doctor, who also seems to know what he is doing, say that controlling the testosterone dosage will prevent testicular shutdown. I specifically asked my current doctor about this. He said that my LH is practically zero because my testosterone levels are too high, and that they will come up as my decreased dosage takes effect.

Indeed, I have had little or no shrinkage, despite my too-high levels. We compared me to a picture my wife took of me when I was in my 20's :lol:.

So, I don't know who to believe at this point. People on this forum have a reputation for knowing more than most doctors. The doctor approved my guestimate of 0.15 cc of testosterone cypionate twice a week (60 mg/week of testosterone). I am doing well on the new dosage. I will give it time and retest, including my LH, and post back here.

It seems reasonable that if your LH is high due to low testosterone prior to TRT, there should be SOME level of supplementation you could do that would not suddenly push your LH to zero. Probably different people are affected differently.

Thanks,

Dennis

I hate to break it to you but your current doctor is no better than all the clueless doctors out there in the world, you are shutdown at any dosage so lowering your test dosage will not change LH and FSH. It's not uncommon for guys to come in here claiming that their doctors specialize in TRT, then the doctor makes some sort of ridiculous statement that bring the whole house of cards crumbing down, then reality sinks in and you realize he's no better than all the rest of the pool of clueless doctors.

Pure and utter nonsense, run from this doctor!

 

[CoastWatcher]

Thanks everyone for your posts. I apologize for the delay in my response. I was waiting until after my doctor's appt.

Both my prior doctor, (who has been doing bHRT for 30 years and whom I have confidence in and is now retired), and my current doctor, who also seems to know what he is doing, say that controlling the testosterone dosage will prevent testicular shutdown. I specifically asked my current doctor about this. He said that my LH is practically zero because my testosterone levels are too high, and that they will come up as my decreased dosage takes effect.

Indeed, I have had little or no shrinkage, despite my too-high levels. We compared me to a picture my wife took of me when I was in my 20's :lol:.

So, I don't know who to believe at this point. People on this forum have a reputation for knowing more than most doctors. The doctor approved my guestimate of 0.15 cc of testosterone cypionate twice a week (60 mg/week of testosterone). I am doing well on the new dosage. I will give it time and retest, including my LH, and post back here.

It seems reasonable that if your LH is high due to low testosterone prior to TRT, there should be SOME level of supplementation you could do that would not suddenly push your LH to zero. Probably different people are affected differently.

Thanks,

Dennis

Your doctors are...poorly informed, to be polite. Exogenous testosterone will shut down your HPTA. Your LH and FSH values will drop to the - essentially - unmeasurable state that you see reflected on your lab results. This will happen, as night follows day. Of course, your doctors, unlike ever other physician treating hypogonadal men, may have come upon an astonishingly new insight into HPTA, but I think it unlikely.mWhen my initial, poorly designed protocol was in place and my total testosterone barely topped 400 I was shut down. As I should have been.

Quit worrying about something that's part of the natural order once TRT has initiated.

 

[DennisH]

Thanks guys.

So is shrinkage inevitable without HCG?

Thanks,

Dennis

 

[Vince]

Thanks guys.

So is shrinkage inevitable without HCG?

Thanks,

Dennis

No not all men gets testicle shrinkage, most do though. I inject 500 IU of HCG twice a week, I really enjoy injecting it. I've never had any issues with high estradiol and never needed to use an AI.