Needing advice----normal Total T, low free T

[UnsureNewbie]

Also keep the following in mind. My solid total testosterone levels are somewhat deceiving IMO. My free testosterone levels have revealed rather lowish levels throughout the past 3 years. I took two tests at one laboratory where the free testosterone range went from 10-41 and both my results were just slightly above range (I think one was a 11 and one at 12). My doctor then switched laboraties for some reason and the new laboratory has ranges from 4-34 and my results were still in the 11-15 range (this looks ok on a range from 4-34 but low on a range from 10-41). I know you cannot compare different labs really but to me it still seems like the values are actually comparable. This is like some labs have total testosterone ranging from 250-800 and others from 350-1100, but if your level is at 600 , it won't change if you change labs....it will just look different in the scale (it will look solid on the first range but mediocre at most on the second scale). I urged my father, who is 72 to test hist levels as well and he had a total testosterone of 300 , but his free testosterone was still at 9.....so we only have like a 3-4 point difference in free testosterone which does not seem too much given the fact that he is almost 40 years older.

 

[Vince]

The duration of trt therapy and age of patient play a role in the recovery.

Younger men have an easier time recovering than older men.

The use of hcg/serms post trt can increase time of recovery 6-12 months as oppose to just stopping trt unaided which can lengthen recovery time up to 2 years.

Older men on long term trt have a lower chance of recovery.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5292276/

I know too many young men that abused anabolic steroids, I wouldn't want to see anyone go to recovery like they did. They made it but it was b****

 

[1Draw]

I would still get the full thyroid panel completed and post here since we have several thyroid experts, (not me) who can assist you. You have only posted TSH and FT4 and your doctor said they were perfect. Need the complete FT3, Reverse T3 and thyroid antibodies to get a full picture of what is going on. FT3 is the jet fuel for your body and extremely critical in well being, energy, libido, etc.

 

[madman]

I know too many young men that abused anabolic steroids, I wouldn't want to see anyone go to recovery like they did. They made it but it was b****

Of course many young men do not realize that hpta takes a significant blow and dysfunction can be permanent in a lot of cases....all they see is muscle/strength!

Or society is quite sad as steroid use/abuse is out of control and a majority of these young men do not even compete or play elite sports and it is purely for cosmetic reasons which is shameful as youth is temporary.

 

[Scram]

I will agree with Vince some guys shut down their natural production (HPTA) and can't get it restarted.
So for the rest of your life you will have to stick yourself a couple times a week whether you want to or not.

If you are still taking an AI I would not take more than .25/week and if you notice any of the low E2 symptoms stop taking it right away. You think you feel bad now crash your E2 and you will discover a brand new hell.

My doc originally prescribed me 1mg EOD... Did that for a month and wanted to jump off a bridge. Certainly was a brand new hell...

 

[Airborne Warrior]

Don't know if you're still using Rogaine but Rogaine is an antihypertensiave which raises SHBG, thus robbing you of free T.

 

[UnsureNewbie]

Sorry guys, been busy.Thyroid labs came back as follows:

TSH 0,91 (0,2 -3,1 µU/ml)
FT 4: 1,21 (0,8 -1,8ng/l)
FT 3: 5,4 (3,5-8,0 ng/l)

TPO-AK and TRAK antibodies negative. RT3 I could not get my doctor to take.

Quick side question: Does anybody have any experience here with the ESWT treatment? Where you basically get shockwave treatment for erectile function? From what I can gather online it may be a good treatment to gain an extra 20% in erectile function? The shock waves are said to break up microplaque in the arteries and also promote neovascularization and nerve regeneration. Anyone any experience with it?

 

[UnsureNewbie]

Don't know if you're still using Rogaine but Rogaine is an antihypertensiave which raises SHBG, thus robbing you of free T.

But does topical Rogaine do that in such a dramatic way that it would have any significant impact systemically? As an oral drug most anti-hypertensives do cause erectile problems, but as a topical?

BTW , I went off of Rogaine for 3 months during the winter and didn't really notice any change in erectile function unfortunately.

 

[Airborne Warrior]

Yes I believe it does. I was using it for years on my beard and I believe it is what killed my libido. Many others also agree with this as there are many posts on the web mentioning it.

 

[Systemlord]

Sorry guys, been busy.Thyroid labs came back as follows:

TSH 0,91 (0,2 -3,1 µU/ml)
FT 4: 1,21 (0,8 -1,8ng/l)
FT 3: 5,4 (3,5-8,0 ng/l)

TPO-AK and TRAK antibodies negative. RT3 I could not get my doctor to take.

Quick side question: Does anybody have any experience here with the ESWT treatment? Where you basically get shockwave treatment for erectile function? From what I can gather online it may be a good treatment to gain an extra 20% in erectile function? The shock waves are said to break up microplaque in the arteries and also promote neovascularization and nerve regeneration. Anyone any experience with it?

RT3 just happens to be the most costly thyroid test ($86 v.s $26 for Free T3), that's why you found resistance to running that particular test.

 

[UnsureNewbie]

Hey guys I took the dive and started TRT 18 days ago. Basically shortly after going in for thyroid labs.

I took one 60mg Testosterone shot along with 300IU HCG on Monday and then the same on thursday. Took labs on friday and got the following results:

Total testosterone 1258 (250-830)
Free testosterone 37 (10-41)
Estradiol 43 (12-40)

I was worried about my estradiol shooting up as my natural estradiol is usually around 35 , but fortunately it has just increased very slightly. Unfortunately I went on a short vacation shortly thereafter and forgot my meds. So I have been off of TRT after the second shot (which was 12 days ago). BTW , while I did not feel any difference in terms of libido I did feel a direct increase in energy. I had great energy throughout the day and all the brain fog and fatigue was gone.
I wanted to ask, how long does it take usually on such a regimen for naturaly testosterone to be shut down? Was there still endogenous testosterone in my body after the second testosterone shot?

 

[UnsureNewbie]

And also, do you guys think I should lower my dose? 1258 is a little high longterm, right? Or did I still have natural production going on so the labs are a mix of natural testosterone along with the added exogenous T?

 

[MarkM]

And also, do you guys think I should lower my dose? 1258 is a little high longterm, right? Or did I still have natural production going on so the labs are a mix of natural testosterone along with the added exogenous T?

It's really too early to pull labs since you have only had two injections and you are right, the exogenous testosterone is having a honeymoon with your endogenous testosterone and that will settle down in a few weeks. Just keep taking the injections. You need to test in 6 weeks but since you skipped some time when you went on vacation, about 12 days, you need to go 6 weeks from when you restart taking your injections to get a true steady state.

Was your estradiol test the Estradiol Sensitive test, LC/MS/MS assay or was it the Roche ECLIA methodology? What is your SHBG?

 

[UnsureNewbie]

I think it was the estradiol sensitive test but I'm not 100% sure. My SHBG is usually around 40-50 on a range of 22-90 but I didn't take the SHBG this time around.

Is there any timeline as to when endogenous production (if you don't take HCG) starts to decline?

And how long does TRT "usually" take to show some benefit in regards to libido etc.? The lifted brain fog and increased energy was immediate for me. I was assuming that libido would also rise pretty quickly but I didn't experience any difference. I know that erectile function may take a very prolonged time to show improvement but I thought libido was much quicker?

BTW, one of my friends is about to finish medical school and he is a sports fanatic etc. also--we talked about libido and stuff and TRT and he suggested for borderline cases like me (with midrange natural production but lowish FT to try the following protocol): He said to inject 10 days TRT+HCG (three injections) and then skip for 7 days. Do this 3 months and then evaluate. He said that on the one hand levels will fluctuate obviously and I will not experience the full benefit of Testosterone (as I will have exogenous T for only 67% of the time but on the other hand I will make sure that my HPTA will remain intact. If after 3 months I overall feel better and have the impression that TRT is having a beneficial effect I can then go on and inject fulltime. And if I have the impression that T is not doing much despite being in my system 67% of the time, then I can go off with the risk of HPTA problems being minimal. What do you think?

 

[MarkM]

I really think that is a very flawed concept personally. Your HPTA is going to shut down even under your your friends suggested protocol and you will have your body on this crazy seesaw not knowing what to do. Your relatively young, 33, and your HPTA will likely restart after a month or two and you will return to pre-TRT levels if you stop TRT. How are you going to know the full effects of TRT on a protocol like that? How will you truly be able to judge? The up and down will most likely make you feel crappy and that it's not working when in fact it could work perfectly under a full TRT scenario.

Basically your are either all in for TRT or you're not. If you want to try your friends philosophy, that is not TRT, that is cycling or blasting and not what we do here. It sounds like you have only had two injections (then 12 days off) and are already second guessing yourself.

 

[UnsureNewbie]

Yeah you are right. I started today again and will keep at it with twice weekly injections of 60mg testosterone enanthate along with 250IU HCG and give an update in 2months. Is 2month long enough time to decide on TRT's effectiveness?

 

[MarkM]

8 to 10 weeks should give you an idea if the protocol you are on is working for you. You might need to tweak your protocol at that time to optimize how you feel.

 

[UnsureNewbie]

Hey guys, close to 4 weeks in. Here are the positives: Sleep quality improved and I do feel less tired throughout the day.

The negatives: haven't felt any difference in the sexual department. No change at all there. I know it is early but I was hoping for at least something positive here which would indicate future improvement, but so for I haven't been lucky. The better sleep and more energy throughout the day alone is pretty good to have though.

I am naturally a high estradiol guy (towards the high end of the reference range). I was thinking about adding low dose anastrozole. Is there any rule of thumb on how much .25mg anastrozole per week lowers estradiol? My estradiol has always been around 40 on a range of 10-40. If I take .25 anatrozole how much would it lower my estradiol? Does anybody know?

BTW I am injecting 2x 70mg Testosterone enantate along with 300 IU of HCG twice daily for overall 140mg testosterone and 600IU HCG.

Thank you very much for your time guys!

 

[Systemlord]

Libido can take the longest to come online as other systems must be optimal for this to happen. Erections can take 3-6 months weeks to show changes and a maximum of 1 year.

Labs should rule decision making on dosing anastrozole unless it's obvious E2 is low. If you change the anastrozole now, labs in 2 weeks will have less info and you'll never know where you were on E2.

Your testosterone and estrogen haven't reached a stable state yet, still swinging. You will notice energy and mood improvements, then muscle recovery will improve, then you'll notice libido and finally your erections will return.

This is a marathon, not a sprint.

 

[UnsureNewbie]

Libido can take the longest to come online as other systems must be optimal for this to happen. Erections can take 3-6 months weeks to show changes and a maximum of 1 year.

Labs should rule decision making on dosing anastrozole unless it's obvious E2 is low. If you change the anastrozole now, labs in 2 weeks will have less info and you'll never know where you were on E2.

Your testosterone and estrogen haven't reached a stable state yet, still swinging. You will notice energy and mood improvements, then muscle recovery will improve, then you'll notice libido and finally your erections will return.

This is a marathon, not a sprint.

Thanks for the reply. Lifted my mood and gives me some hope. When would be a fair point to make a first judgement/evaluation? At the end of the year?