NO MORE AI !!! FEELING AMAZING!

[madman]

Congratulations on feeling better. That's the holy grail.

I will say tho. My free T is at 21 and I am vaguely worried about testosterone resistance at my level. But your free T is 3x the upper normal range. I know I'd be worried at that level. Not sure if I would do anything different than you though. Like I said, feeling better is the holy grail.

If anything AR resistance would be a possibility in older men or men who have used/abused testosterone/AAS in high doses.....if you do not fall in this under this category highly doubtful you would experience such.

Yes his FT levels are very high and most would never need to run such levels and he may very well feel just as good overall running lower levels but he is using T cream scrotal application @ 200 mg/twice daily and his blood work was done 5 hrs post application so during his peak and although his FT levels are very high 60+ ng/dL as long as he feels great overall and blood markers are healthy I see no issues.

Most men do well having FT levels in the 30 ng/dL range and some may need/choose to run higher levels 30-50 ng/dL range.

As we know every individual is different in how they react to said dose of T and what FT levels they can tolerate.

If one chooses to run higher TT/FT levels so be it.....to each his own but in many cases men are chasing high levels when in fact one may feel just as well running lower levels but once one experiences the very high levels most never want to take the chance to see if they could feel just as well running lower levels.

Highly doubtful anyone needs to be over double the top end of the range to experience the full benefits of trt.

His doctor has stated that most of his patients do well having FT in the 30+ ng/dL range.

 

[Joe Sixpack]

Ya that’s what I thought it was. I thought it was when your labs show enough testosterone, but you could still be low on a receptor level.

So when you said you’re kind of worried about testosterone resistance with your free T of 21, you meant that you think your free T could be too low? And you don’t have enough free T at the receptor level possibly?

What I mean is that my worry is that my body would become accustomed to the high level of T which would require more T. To which my body would become accustomed, which would require even more T. ETC ETC. Similar to how one gets insulin resistant. Too much exposure to insulin and over the years you end up with insulin resistance.

It just seems like few men (my age) in nature would ever have these kinds of levels of free T. Which makes me wonder if I am having any unforeseen adverse affects slowly building up from these high levels of circulating androgens.

Granted, this has not stopped me from continuing keeping these levels. It's just something I think about.

 

[madman]

Yea, if you go by standard lab ranges then it can be a little unsettling, but my own doc follows this protocol and he says I'm good. I'll try get some more complete labwork to give everyone a better picture.

Had to fix this.....meant the reply for this post!

True but do understand that it does not mean one needs to be 3x the top end for FT!

Double maybe for some....triple nah!

 

[Gman86]

What I mean is that my worry is that my body would become accustomed to the high level of T which would require more T. To which my body would become accustomed, which would require even more T. ETC ETC. Similar to how one gets insulin resistant. Too much exposure to insulin and over the years you end up with insulin resistance.

It just seems like few men (my age) in nature would ever have these kinds of levels of free T. Which makes me wonder if I am having any unforeseen adverse affects slowly building up from these high levels of circulating androgens.

Granted, this has not stopped me from continuing keeping these levels. It's just something I think about.

Ohhh, I got ya. I see what you’re saying now. Definitely something to think about. Makes sense with the insulin analogy. So I wonder if dr Nichols is going to end up seeing this issue in his patients down the road. I know the guys on the TRT round table that are on creams, run a very high free T level, including himself. If hypothetically too high levels of free T for years and years may in fact cause testosterone resistance at the receptor level, I wonder if it’s less likely to happen with the creams due to the levels fluctuating more than while on injections.

Either way, why would you be worried, isn’t 21 either the top end of the range, or slightly below it? I wouldn’t worry at your level, but yes, hypothetically maybe it could eventually be an issue when you run a level 2-3x that.

 

[Gianluca]

What I mean is that my worry is that my body would become accustomed to the high level of T which would require more T. To which my body would become accustomed, which would require even more T. ETC ETC. Similar to how one gets insulin resistant. Too much exposure to insulin and over the years you end up with insulin resistance.

It just seems like few men (my age) in nature would ever have these kinds of levels of free T. Which makes me wonder if I am having any unforeseen adverse affects slowly building up from these high levels of circulating androgens.

Granted, this has not stopped me from continuing keeping these levels. It's just something I think about.

I believe this has happened to me in regards to the Thyroid and not sure what the mechanism is in here, maybe related to TBG. for most of my TRT journey my FT was around 30, when I went below that I thought all kind of trouble with my Thyroid started. Although I have to say I probably had symptoms all my life and not even realizing it. FT3 always around 3.3 and I really don't remember to have such as bad hypo symptoms before lowering my FT below 30, despite same FT3 level.

I brought up my FT3 to 4.5 and a little better, but still Hypo Symptoms, increased of 30mg my NP, did better for a week and now I'm back with same symptoms. I just went this am to pull blood and curious to see my FT3 and reverse T3. Currently my FT is at 24, this most likely needs to go up.

 

[Gman86]

I believe this has happened to me in regards to the Thyroid and not sure what the mechanism is in here, maybe related to TBG. for most of my TRT journey my FT was around 30, when I went below that I thought all kind of trouble with my Thyroid started. Although I have to say I probably had symptoms all my life and not even realizing it. FT3 always around 3.3 and I really don't remember to have such as bad hypo symptoms before lowering my FT below 30, despite same FT3 level.

I brought up my FT3 to 4.5 and a little better, but still Hypo Symptoms, increased of 30mg my NP, did better for a week and now I'm back with same symptoms. I just went this am to pull blood and curious to see my FT3 and reverse T3. Currently my FT is at 24, this most likely needs to go up.

So what are you saying, that when your free T level goes too low, you have more hypo symptoms? And when your free T level is higher, you need less thyroid medication?

 

[Gianluca]

So what are you saying, that when your free T level goes too low, you have more hypo symptoms? And when your free T level is higher, you need less thyroid medication?

I still have to try to bump up my FT again in the 30's so I don't know if I would need less Thyroid, but certainly when my FT went below that I started to complain allot of cold hands and such. I still think there has to be something related to it. It is impossible that when my FT3 was at 3.3 no complains and last blood work showed 4.5 and complains. I believe it is either related to Thyroid Binding Globulin or some chemicals in the environment that prevent Thyroid Hormone to bind to cells.

I had added a 30mg NP to the 60mg I was using 3 weeks ago, if my FT3 comes higher than 4.5, then I may need more FT and possibly less Thyroid, let's see. If adding more Thyroid further suppressed my own production and now my FT is below 4.5 then it is possible I need more Thyroid. Still it would not make sense why 3.3 were just fine.

But to my own experience, TRT has exacerbated a possible Thyroid/Adrenals issue that was there prior TRT.
Starting TRT was a quick fix to all, I felt great for the first 8 months, then things started to go down the road month by month.
I believe one need to Optimize Testosterone along with Thyroid, it can't be a FT super high and FT3 not optimal, I think they both need to be optimal. Pregnolone and DHEA are also part of the game, all of these need to be optimized. If someone thinks to get away just with Test is better to rethink Optimization.

 

[Simon7]

And yes, I know these numbers are "high" but I don't give a shit. I feel fucking excellent.. .

Someone high on drugs would probably say the same thing. You are running ft levels three times higher than the high range. You have no idea how high your hematocrit and E2 levels are. You're 34 years old and you seem to live for the moment's pleasure with no thought of what you are doing to your body's health long term. That's just plain reckless and is poor testimony for your doctor.

 

[_CTI_]

Someone high on drugs would probably say the same thing. You are running ft levels three times higher than the high range. You have no idea how high your hematocrit and E2 levels are. You're 34 years old and you seem to live for the moment's pleasure with no thought of what you are doing to your body's health long term. That's just plain reckless and is poor testimony for your doctor.

Aside from reasons already stated on this thread, a poor testimony of my doc would be coming back to this forum week after week complaining of symptoms and begging for advice on how to fix the protocol that I was given. I don't even think about my protocol these days unless I'm trying to help out another guy that might be suffering. That was not the case when I was chasing lab ranges and numbers all over the place. I was worried about so many different ranges and ratios that I would overthink myself out of an erection. I'm not saying that we should toss labs and I'm not saying that we should disregard peer reviewed evidence. What I'm saying is that I have found a protocol that works for me and I wanted to share that experience. I'm no stranger to the hell brought on by hormonal irregularities and I don't wish that on any man. Period. I want us all to be out there living the life that we want; I'm finally starting to do that and I just want other guys to know that there's another way, if what they're doing isn't working for them.

 

[Gman86]

You seem to feel entitled to regulate how others live. Where’s that come from?

Ranges are bullshit for reasons mentioned on here. Guy is new to this protocol. The bloodwork needed to determine if this dose will work out for health is going to have to wait until he’s on it for a few months.

These lab ranges for hormones are such a loose indicator of what is optimal. I’ve been way over the range with TT over 1500, and my lipids and hct seemed to be less of an issue that some have on 150/wk. at 200/wk my TT is about 1100, and hct is a non issue. Lipids come back perfect. But but ranges. Some people think everything in life is an exact science. Same people will be “perfecting” their protocol in 10 years.

I completely agree with you on this. He feels great, that’s one of the main goals of TRT. Even if his other values are slightly out of range, why should we care? It’s his body. Even if he is putting his health at risk ever so slightly, why should we care? To me, TRT is all about the balance of helping to make people happy and healthy. That balance is going to be different for everyone. Look at the rock. His whole career is based off of using steroids, and everyone loves the rock. The guy also seems like he literally couldn’t be happier. Should he stop using steroids, go on TRT, and be less happy just because his numbers are too high? I think we should just let people figure out that balance for themselves, and we shouldn’t be judging others based off of how we want our numbers to look. But I agree with user_joe, the ranges are a loose guideline. If this guy’s numbers are elevated, and assumably it does hinder his health slightly, I’d take that slight risk anyday if I woke up everyday feeling amazing. It’s all about the pros and cons. Those are going to be different for everyone. Even if his other numbers come back more elevated than what we’re used to seeing, I say let the guy live and make his own choices. This forum is about helping people, not judging people.

 

[Vince Carter]

Its listening to the unconventional that improved so many things for me in TRT, we need that part of this. I'd by a factor of 1000 much rather hear what works for real guys than all the BS studies that you guys hang your hats on.

 

[Simon7]

I'm not saying that we should toss labs and I'm not saying that we should disregard peer reviewed evidence.

In your message that I responded to you wrote just that.

I want us all to be out there living the life that we want; I'm finally starting to do that and I just want other guys to know that there's another way, if what they're doing isn't working for them.

This goal can certainly be achieved without supra-physiological levels of 2 or 3 times the normal high level of FT and without disregarding standard medical guidelines. The False prophets who preach to raise FT to such high levels while tossing out E2 management and disregarding high HCT are jeopardising your long term health.

Responsible practice of medicine is not about living only for today but rather about optimising short+long term health. Responsible participation of members in a forum such as this is not to encourage fellow members to follow reckless Doctor advice just because they feel good at this moment.

 

[Simon7]

I strongly recommend to read the thread in the link below from 2017, where Dr. Nichols and Dr. Saya present their arguments and counter-arguments regarding the controversies discussed here too. It's a most educational thread.

If you don't have the time to read the entire thread, read at least responses 75-77 on page 4 that contain the bottom line gist.

Should We Be Managing Estradiol and Hematocrit in Men on Testosterone Replacement?

Ask yourself which of the two Doctors would you trust with your long term health and whose medical advice you would follow. I certainly found Dr. Saya much more persuasive and committed to his patients long term health.

 

[DragonBits]

I believe this has happened to me in regards to the Thyroid and not sure what the mechanism is in here, maybe related to TBG. for most of my TRT journey my FT was around 30, when I went below that I thought all kind of trouble with my Thyroid started. Although I have to say I probably had symptoms all my life and not even realizing it. FT3 always around 3.3 and I really don't remember to have such as bad hypo symptoms before lowering my FT below 30, despite same FT3 level.

I brought up my FT3 to 4.5 and a little better, but still Hypo Symptoms, increased of 30mg my NP, did better for a week and now I'm back with same symptoms. I just went this am to pull blood and curious to see my FT3 and reverse T3. Currently my FT is at 24, this most likely needs to go up.

Mechanisms controlling thyroid hormones are more complex than testosterone, and thyroid hormones are more critical to life.

So I can see where thyroid hormones tend to rebalance by compensating for changes, while testosterone is pretty straightforward.

Not trying to ever analyze what is happening with the thyroid as it's very complex, just something to keep in mind.

 

[Joe Sixpack]

This goal can certainly be achieved without supra-physiological levels of 2 or 3 times the normal high level of FT and without disregarding standard medical guidelines. The False prophets who preach to raise FT to such high levels while tossing out E2 management and disregarding high HCT are jeopardising your long term health.

Responsible practice of medicine is not about living only for today but rather about optimising short+long term health. Responsible participation of members in a forum such as this is not to encourage fellow members to follow reckless Doctor advice just because they feel good at this moment.

Given what you wrote, would you recommend that he lower his free T in order to be in the normal range, even while knowing that he would feel sub-par at the lower level?

 

[Gianluca]

I strongly recommend to read the thread in the link below from 2017, where Dr. Nichols and Dr. Saya present their arguments and counter-arguments regarding the controversies discussed here too. It's a most educational thread.

If you don't have the time to read the entire thread, read at least responses 75-77 on page 4 that contain the bottom line gist.

Should We Be Managing Estradiol and Hematocrit in Men on Testosterone Replacement?

Ask yourself which of the two Doctors would you trust with your long term health and whose medical advice you would follow. I certainly found Dr. Saya much more persuasive and committed to his patients long term health.

I certainly agree that Dr Saya is committed to his patient long term health, I can say that first hand, but this is 2 years old thread, things have changed. Dr Neal Rouzier presented allot of data in regards to these 2 topics. Even Dr Crisler changed his mind on this, the last consult or the 2 last consult I had with him, I don't exactly remember, he advised to get off AI. certainly not everyone may need to have FT of 50 to feel good, but you seem a little bit stuck in the reference ranges game, reference ranges of who? to my own experience with TRT I feel best about 30 of FT, till a couple of years a go the max on LabCorp scale for FT was 28 now is 21? wait a few more years and having a FT of 20 will be supraphysiological.

 

[DragonBits]

I certainly agree that Dr Saya is committed to his patient long term health, I can say that first hand, but this is 2 years old thread, things have changed. Dr Neal Rouzier presented allot of data in regards to these 2 topics. Even Dr Crisler changed his mind on this, the last consult or the 2 last consult I had with him, I don't exactly remember, he advised to get off AI. certainly not everyone may need to have FT of 50 to feel good, but you seem a little bit stuck in the reference ranges game, reference ranges of who? to my own experience with TRT I feel best about 30 of FT, till a couple of years a go the max on LabCorp scale for FT was 28 now is 21? wait a few more years and having a FT of 20 will be supraphysiological.

I took a look at my last T test with labcorp which was on 7/.22, the ref range for free T was 6.6-18.1.

 

[fifty]

Free T ranges are based on age ranges.

Phlebotomy roundtable video is highly questionable. What's the best possible outcome? I save 2 hours of my life per year?

 

[cigpk]

I would be a little hesitant to proceed on a certain protocol without tracking hematocrit regularly. You may be doing this though and I could have missed that post.

I may be a little neurotic about it because I work one on one with stroke/heart attack/etc patients on a daily basis and I know that is something I want to Avoid at all costs, even if it means adjusting my dose down slightly.

I may have an outdated view though, as others have mentioned. I’m young, 28, and want to ensure I’m doing all I can to preserve my long term health while also feeling good at the same time.

 

[Blashy]

Ask yourself which of the two Doctors would you trust with your long term health and whose medical advice you would follow. I certainly found Dr. Saya much more persuasive and committed to his patients long term health.

I've only seen Dr. Nicholls from how he interacts in a FB group I participate in. But seeing a person give so much of his time to ensure people are adequately informed based on the most recent science gives me the impression he makes his patient's care his priority.

As well, some people are now his patient on the group and are very happy with him.