Peaks and troughs

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gwpos

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I am new to trt. Started 8weeks ago, but now I had to change dr. In doing so I went and had my blood work done for the new dr. I am currently taking IM 100mg e3.5d. I made the mistake of going to lab just 2 days after last injection. I now no better, but my peak TT was 1920 and free was 350 (this also led to slightly high dht and e2). I started at 450 and free of 35. Is this a normal jump, seems realy high to me...even for a peak. Am going in in a week or 2 to get tested on day I take next injection, but giving blood test first.
 
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I am new to trt. Started 8weeks ago, but now I had to change dr. In doing so I went and had my blood work done for the new dr. I am currently taking IM 100mg e3.5d. I made the mistake of going to lab just 2 days after last injection. I now no better, but my peak TT was 1920 and free was 350 (this also led to slightly high dht and e2). I started at 450 and free of 35. Is this a normal jump, seems realy high to me...even for a peak. Am going in in a week or 2 to get tested on day I take next injection, but giving blood test first.

Testosterone levels will peak 24-48 hrs post injection and I would say peak is closer to 24 hrs.

You basically had bloods done 48 hrs after injection and your TT is sky high as well as your FT and seeing as you are injecting 100mg every 3.5 days (every 84 hrs) even when you get retested at trough (just before your next injection) you may still even be at 1500+.

Even though there is always a peak/trough regardless of injection frequency.....the more frequent one injects the less variation between peak/trough resulting in more stable testosterone levels.

The variation between peak/trough will be much greater for one who injects once weekly as oppose to injecting twice weekly (every 3.5 days).

If one were injecting daily or EOD peak/trough levels would be greatly reduced compared to to injecting once weekly or every 3.5 days.

Ofcourse ones SHBG plays a big factor to the above as it will dictate ones injection frequency.

What is your SHBG (including reference range) and what is the reference range for your FT.

Although TT is good to know and one may be startled by high levels.....FT is what truly matters as it is the unbound active fraction of testosterone responsible for the positive benefits.

In cases where one has high SHBG.....higher TT levels sometimes well into the supra-physiological range are needed in order to obtain a healthy FT level.

Most men need FT in the 2-3% range of TT to experience relief/improvements of low t symptoms.
 
Testosterone levels will peak 24-48 hrs post injection and I would say peak is closer to 24 hrs.

You basically had bloods done 48 hrs after injection and your TT is sky high as well as your FT and seeing as you are injecting 100mg every 3.5 days (every 84 hrs) even when you get retested at trough (just before your next injection) you may still even be at 1500+.

Even though there is always a peak/trough regardless of injection frequency.....the more frequent one injects the less variation between peak/trough resulting in more stable testosterone levels.

The variation between peak/trough will be much greater for one who injects once weekly as oppose to injecting twice weekly (every 3.5 days).

If one were injecting daily or EOD peak/trough levels would be greatly reduced compared to to injecting once weekly or every 3.5 days.

Ofcourse ones SHBG plays a big factor to the above as it will dictate ones injection frequency.

What is your SHBG (including reference range) and what is the reference range for your FT.

Although TT is good to know and one may be startled by high levels.....FT is what truly matters as it is the unbound active fraction of testosterone responsible for the positive benefits.

In cases where one has high SHBG.....higher TT levels sometimes well into the supra-physiological range are needed in order to obtain a healthy FT level.

Most men need FT in the 2-3% range of TT to experience relief/improvements of low t symptoms.
I am getting the whole panel of trt blood work done in 2 weeks. So now she of SHGB yet.
As for ranges via Quest labs is
TT 250-1100. Mine was 1920
FREE T 35-155. Mine was 350.7
I understand these are from peak time frames and was going to get another T and free T done just to see my trough.
 
I'm as new as you at this and I take 50mg every 3.5 days. I myself would be afraid of managing all the side effects from that high of a dose. But maybe your SHBG is so high you need that much? I'm a rookie so take it like a grain of salt. lol
 
I guess I am going through the learning curve. My new dr. wants me to cut dose in half based on my high numbers, but I am re-testing following the right protocols first then dr. Will reevaluate hard on what we find out. But I was concerned too when I seen TT of 1020 and free being 350. We been though it was taking after 2 days and not on day of next injection.
 
I'm as new as you at this and I take 50mg every 3.5 days. I myself would be afraid of managing all the side effects from that high of a dose. But maybe your SHBG is so high you need that much? I'm a rookie so take it like a grain of salt. lol

My guess would be he has low SHBG. I have rarely seen posted labs with free T that high with high SHBG.

But, until his labs come back it is all just a guess.
 
Conventional wisdom says that you should be on the some protocol for a minimum of 6 weeks, preferably 8 weeks before running new labs so that you are at a steady state.
 
Conventional wisdom says that you should be on the some protocol for a minimum of 6 weeks, preferably 8 weeks before running new labs so that you are at a steady state.
Was just checking. I screwed up and did blood work 2 days after injection and now dr. wants me to lower dose from 2x100mg a week to 2x50mg a week. It was my fault not there's because they was going off of what I told them which was wrong. So i figured i would lower dose and test via discount labs to check my levels.
 
Anytime you do blood work to see your test levels you should do it the day of your next injection prior to the injection preferably early morning between 8 AM and 10 AM.

Even if you took your last blood draw at trough instead of early your T levels, both Total and Free, would be extremely high. 100 mg twice a week is a gigantic dose for most people and based off the lab results you provided, you fit into that category.

You do need to have your SHBG and Estradiol Sensitive tested. You can lower your dose but it won't be until 6 weeks until you truly know what that lowered dose is going to level out at. If you lower the dose and take labs in two weeks it is not going to provide you with an accurate picture.

I do believe you should lower your dose and then retest at a minimum of 6 weeks. I would lower the dose to 60 mg or no more than 70 mg twice a week. This will bring your levels down to more realistic levels and lower your E2 as well and you will likely not need to take an AI at all.

It's really impossible to give you accurate injection protocols because we do not know what the SHBG is so the twice weekly I reference above is strictly because that is what you are already doing.
 
Thank you Mark, I was going to do what you suggested and lower my dose. Based on some basic calculations my numbers would still be high even on trough like you said. So i will go ahead and do what i was planning and you recommended, then do a complete trt panel of blood work to see what I am at in 6-8 weeks. I know this is my dr.'s job, but I like to be well informed and be active in taking care of my health. Thanks again
 
You're welcome. Most of us here like to take charge of our health and run necessary labs as we feel necessary. Part of why we are here on the forum is to get educated and stay informed. Keep us posted!

Thanks for joining the forum and participating!!
 
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