Need some advice.

[criggs]

I'm a 38 year old who's first testosterone test came back at 230 with a reference of 348-1197. Was put on testosterone. Cyponiate at 200mg a month. After 1 month I asked to be on bi weekly 100mg injection and the doctor agreed to it. 4 months into treatment my doctor wanted to recheck lvls because she said I was on a low dose. Test came back at 133 with same reference.
Doctor was out when my next shot was due so I went to another doctor and she upped my dosage to 200mg every 2 weeks.
Next Monday I have an appointment with my Dr and I'm going to ask to start doing weekly injections of 100mg. Btw the 2nd test was done at the end of my 2 weeks when I was due for my next shot. When I first started Injections I started feeling better and erections improved, but in the past month has declined considerably. I'm guessing due to my testicles shutting down.
Any advice would be appreciated, I'm. Wondering about the dosage I need to be on and the frequency of injections.

Thx

 

[Gene Devine]

Everything you need to know about TRT for men is in this website.

You need to be on weekly, if not twice weekly, injections.

Monitor Estrogen.

Post your most recent blood work with ranges if you can.

 

[Nelson Vergel]

Crigs

I am so sorry to hear that you were first prescribed a sub-optimal dose. I am so amazed about how many doctors fail to follow even package insert label information!! It is almost malpractice in my opinion.

I am glad you are switching to 100 mg per week of testosterone injections. Let us know what your next lab results are. Some men require 100-200 mg per week depending on how they metabolize testosterone and quality of life. Some feel better with 50-100 mg twice per week.

Have your doctor test for total and free testosterone, chemistries (which includes hematocrit), and estradiol by ultrasensitive test as a minimum.

 

[Vettester Chris]

Criggs, you're working with physicians that don't understand how the peak and half life works with your medication. Even the 2 week thing is going to be a downer. If you can get the 1x per week protocol going, great! If you can split that up to 2x per week, better yet!

As Gene mentioned, we need to see all of your labs. Your erection situation could be a variety of things, possibly E2 driven. Labs will tell the truth, post them up if you can. HCG will promote some endogenous production of test, and help keep testicular activity healthy. As also mentioned by Gene, ALL the topics you are inquiring about can be found on this forum. Invest some time to do some research here and it will pay you back more than you can imagine.

 

[James]

200 mg, once a month! Wow, amazing a Dr would follow an infrequent schedule like that. Read the stickies, learn half life and see what he says about weekly injections. If doc says no, probably time to find someone new. The 1st doc I spoke with wanted to do monthly shots. The 2nd doc said he would prefer that I do 2 shots per week (with a smaller dose), but said he would agree to once a week and see how I feel. I'm doing 1 per week.

 

[criggs]

The for the advice, will do. Just glad to find some place to be able to to talk and ask questions about trt.

 

[Gene Devine]

The for the advice, will do. Just glad to find some place to be able to to talk and ask questions about trt.

You should know:

Testosterone injected peaks at about 72 hours in serum and has a half life of about 6 days. This means by day 6 half of the drug is metabolized...think where it is at day 18!

And you were injecting once a month...just crazy.

Your Doc doesn't know what he is doing.

 

[criggs]

Went to Dr appointment agreed to weekly injections, and the labs that were recommended here. She asked me if I had been doing research on it, and I said I might as well get educated since I will be taking trt for life. So thx for the info!

 

[Gene Devine]

Went to Dr appointment agreed to weekly injections, and the labs that were recommended here. She asked me if I had been doing research on it, and I said I might as well get educated since I will be taking trt for life. So thx for the info!

Well at least she is will to learn from what you learn.

Tell her about our site and forums so she can start to learn as well.

And you are right, this is for life so you need to learn as much about it as you can...good stuff man

 

[criggs]

Got some test results back from last week, total Testosterone was 497.27 on a reference range of 240.27-870. Free test was 12.0 on a range of 2.3-10.3. I had asked for an e2 test but she ran a hormone binding test which came back at 25.4...Not sure about range on that one but nurse said it was perfect. That was at 120mg of test per week...after I took that test I moved up to 140 mg a week, figure I'll stay there for a few months and then retest, should put me at the higher end of the range, but may make my free test high...any advice would be appreciated and testing was done on the day I take my shot, but before I got it...

 

[James]

Got some test results back from last week, total Testosterone was 497.27 on a reference range of 240.27-870. Free test was 12.0 on a range of 2.3-10.3. I had asked for an e2 test but she ran a hormone binding test which came back at 25.4...Not sure about range on that one but nurse said it was perfect. That was at 120mg of test per week...after I took that test I moved up to 140 mg a week, figure I'll stay there for a few months and then retest, should put me at the higher end of the range, but may make my free test high...any advice would be appreciated and testing was done on the day I take my shot, but before I got it...

Free test looks strong. Most importantly, how do you feel? A super high TT number isn't necessarily a good thing for every guy. I tend to feel better at the lower range of normal, other men feel best a little higher.

 

[criggs]

Felt better before my body quit making test and I bottomed out at 119..but have had a lot of stress since then, found out wife was cheating and going through a divorce with 2 kids, so I'm sure that has an affect on it.

 

[James]

"Felt better before your body quit making test," meaning before starting TRT? Sounds like you definitely have some stress in your life.

 

[criggs]

After trt but before body shut down production, it was also before the stress started.

 

[Smokey]

Hi Folks, 15 years on TRT. I switch back and forth from cream in the winter to injection in the summer.

Current Protocol: 100 mg every third day of Cypionate injectable IM, and I cycle HCG every 2-3 months for 2 months on. Below results tested without HCG.

Latest labs at 48 hours

Total T 1915
SHGB 53
Free T 250
E Sensitive - wating for results

Everything is good except for bloated face.

 

[madman]

Hi Folks, 15 years on TRT. I switch back and forth from cream in the winter to injection in the summer.

Current Protocol: 100 mg every third day of Cypionate injectable IM, and I cycle HCG every 2-3 months for 2 months on. Below results tested without HCG.

Latest labs at 48 hours

Total T 1915
SHGB 53
Free T 250
E Sensitive - wating for results

Everything is good except for bloated face.

You are clearly overmedicated here.

100 mg TC every 3 days (roughly 233 mg/week) is beyond a therapeutic dose of T!

Although we always want to test at the true trough (lowest point) before your next injection which in your case would have been 72 hrs post-injection.

Even then you are hitting a ridiculous TT 1915 ng/dL 48 hrs post-injection which would mean your true trough (72 hrs) post-injection would still be absurdly high.

More importantly with a ridiculous TT 1915 ng/dL and high SHBG 53 nmol/L (not very high) your FT is sky-high as in 43.3 ng/dL.

This is on a T-only protocol to boot!

Throw in in the hCG and your TT and more importantly FT would be higher.

All you need to do here is calculate your FT using the linear law-of-mass action Vermeulen.

Free & Bioavailable Testosterone calculator

Not sure what method was used to test your FT but even if it was the most accurate assay the gold standard Equilibrium Dialysis there is no way you are only hitting a FT 25 ng/dL with a whopping TT 1915 ng/dL even with fairly high SHBG!

If such was the case I would say lab error here.

A FT 20-25 ng/dL is high!

Most healthy young natty males would be hitting a cFTV 13-15 ng/dL and this is a daily short-lived peak to boot!

Those natty outliers running around with a top-end FT 25 ng/dL would be far and few and again this would be a daily short-lived peak.

Most men on TTh are injecting 100-200 mg T/week whether once weekly or split into more frequent injections.

More importantly the majority of men can easily hit a healthy let alone high trough FT injecting 100-150 mg T/week especially when split into more frequent injections.

Yes as I have stated numerous times over the years there are those outliers who may need the higher-end therapeutic dose 200 mg T/week but it is far from common as in rare!

You are missing critical blood markers RBCs,hemoglobin and hematocrit let alone iron/ferritin?

Even then I would find it hard to believe that you were not struggling with elevated hematocrit running around with a ridiculous TT 1915 ng/dL with FT through the roof.

Your FT levels are sky-high 24/7!

Bottomline here is if you feel great overall, minus any sides and overall blood markers are healthy then do what you feel is best for you!

 

[madman]

Hi Folks, 15 years on TRT. I switch back and forth from cream in the winter to injection in the summer.

Current Protocol: 100 mg every third day of Cypionate injectable IM, and I cycle HCG every 2-3 months for 2 months on. Below results tested without HCG.

Latest labs at 48 hours

Total T 1915
SHGB 53
Free T 250
E Sensitive - wating for results

Everything is good except for bloated face.

Opening post from your 2018 thread:

S

Thread 'Transitioning from Inj to TD’s'

Feb 28, 2018

I searched everywhere with no luck. If one is on weekly 200 T and would like to transition to daily 200mg transdermal, would I start the 200mg TD on day 8 after last injection? Or would I use a gradual increase scale starting day 8 with a TD smaller dose.

• Smokey
• Replies: 10
• Forum: Testosterone Basics & Questions

I searched everywhere with no luck. If one is on weekly 200 T and would like to transition to daily 200mg transdermal, would I start the 200mg TD on day 8 after last injection? Or would I use a gradual increase scale starting day 8 with a TD smaller dose.

Sounds like you have been caught up on that more T is better mentality!




post #6

I have experimented with many injection protocols from 1x weekly to 2x weekly with and without arimidex and they work for a while and then I go downhill. The main reason is that I do not like the change in the face area that injections seem to give when combining with hcg. The area on either side of my nose seems to hold water which looks abnormal.....and I notice this with many others using injection but do not notice with those that use creams. I am however going to give the injections one more chance with a much lower dose like Nelson uses (50mg x2 plus 500 hcg x2 per week) since the lowest I have used is 65mg x2 per week which built me up to 1227 total T and 41E. Will let you know results.

130 mg T split (65mg twice-weekly) way back when only to end up running an absurd weekly dose 100 mg TC every 3 days (roughly 233 mg TC/week) which clearly has you overmedicated!

Looking over most of your previous replies in threads on the forum you have tried numerous protocols (dose T/injection frequency) low--->high struggling with numerous sides, ED, elevated, hematocrit, acne and bloat.

160 mg T/week seemed to be your sweet spot yet you somehow have ended up banging a whopping 233 mg TC/week!

Who the hell is treating you?

No one in their right mind would need a weekly T dose higher than the top-end therapeutic dose 200 mg T/week to experience relief/improvement of low-T symptoms and overall well-being!

Top it off the majority of men would never even need 200 mg T/week to achieve a healthy/high trough FT let alone experience relief/improvement of low-T symptoms and overall well-being!

 

[Smokey]

Doc said because I have been on for so many years that my receptors are not as good anymore and needed to increase dose. Thanks for the great reply and I will drop back down to 70 twice per week for 8 weeks and see. Thanks again

 

[Phil Goodman]

Doc said because I have been on for so many years that my receptors are not as good anymore and needed to increase dose. Thanks for the great reply and I will drop back down to 70 twice per week for 8 weeks and see. Thanks again

Did symptoms return while you stayed at the same dose, or did he just arbitrarily say “well, you’ve been on trt for a while so let’s increase your dose”? If it’s the latter then you would constantly end up running higher and higher levels indefinitely. Lots of users here have been on for multiple years without a need to significantly increase dose(or even increase at all really). I’ve heard that the body can compensate by reducing the number of receptors but haven’t dove into that topic too deeply. But based on anecdotal reports(and personal experience in which I haven’t had to increase dose beyond around 120/week or so after almost 4 years) I’d say the bodies adjustment likely wouldn’t be enough to warrant a dramatic increase in dose. And theoretically it makes sense that the body wouldn’t adjust to a level where it became detrimental to the point of causing a return of symptoms, though obviously everyone is unique. I’d say it’s likely that you can get away with a much smaller dose, though there may be some growing pains during the adjustment period but that’s certainly not a given.

 

[madman]

Doc said because I have been on for so many years that my receptors are not as good anymore and needed to increase dose. Thanks for the great reply and I will drop back down to 70 twice per week for 8 weeks and see. Thanks again

This is pure nonsense.

We are using therapeutic doses of T here.

Again do what you feel is best for you!