Perplexing result.. thoughts?

[Willyt]

Hi @Cataceous, @Willyt,

By way of an update, please see my results since February attached.

I think my Peak result in May is incorrect - I think I missed the Propionate peak, somewhat evident by the higher estradiol value in the Trough result.

In terms of my most recent July result, this is on the Enanthate only protocol of 12.5mg / 9mg (actual T) per day. I tested only the Trough/AM result on the basis that there is very little variation on such a protocol.

@Cataceous, would you suggest that I test a PM / theoretical peak result on the Enanthate only protocol anyway? Any thoughts on the result (T: 25.4 nmol/L, E:140 pmol/L)? I'm not sure where to go from here e.g. reduce the dose? Reduce and combine with Gel to increase variation? (I'm not keen on introducing the Propionate due to its disproportional effect and the potential uncontrolled/questionable source)

Subjective results on the Enan only protocol:
++
- More controllable acne (although still present)
- Less erratic mood (On the Prop/Enan blend, I became quite morbid/pessimistic each evening)

--
- Much reduced erectile quality; much softer and less lasting
- Increased anxiety in social situations when I am presenting to senior folks at work
- Less zest/interest for outdoor activities e.g. on the Prop/Enan blend, I was partaking in outdoor hobbies much more than now
- Sleep quality is worse

Thoughts appreciated on how I ought to amend my protocol to increase variation before I dive into new changes. Many thanks

Can you post pic of the results? I could not open the spreadsheet. Also, are you subq or IM?

Sounds like you're still on high side. Have you tried lowering to the much heralded 10mg Enan? (7.2 actual T per day). This seems to be sweet spot for many and is in line with average daily levels of healthy male.

On the sleep front, this is one area where prop/enan blend shines. You peak during day and let levels drop overnight. I sleep so much better on the blend.

 

[Cataceous]

I agree with @Willyt. The lowest daily dose of testosterone you've tried so far is 7.5 mg. In case you haven't read it there's a new account by someone trying his lowest dose yet, with apparent success.

If your absorption rate for enanthate is typical then your serum levels should be relatively constant with daily injections; peak and trough variations should be small enough to ignore.

 

[R2D2]

Thanks @Willyt, @Cataceous

I've attached a screenshot of my results (opposed to the excel). I'm dosing daily subQ.

I can absolutely try reducing the dose - but any thoughts on the lack of variation? I'm not keen to blend Enan/Prop because my source of Prop is questionable and I think may be overly strong (more context in the attached results).

@Cataceous, I decided to go the Enan only route because we agreed that it may be useful to acquire clean results on the Enan alone (without Prop) in order to infer my linear pattern. Perhaps then we may be able to understand the degree to which the small propionate I was blending with the Enan may be contributing to the overall T result. Any thoughts based on my latest Enan only results? Is my absorption rate typical?

Instead of combining Enanthate with Propionate - are there other options? Is combining the Enanthate with Testosterone gel a bad idea? Based on the attached results, what do you think would be a good starting dose to try?

Many thanks

 

[Cataceous]

...
I can absolutely try reducing the dose - but any thoughts on the lack of variation? ...

There's nothing really concrete on the significance of a lack of diurnal variation in serum testosterone. We know that such variation is substantial in younger men and attenuates with age. From the Natesto data we know that peak testosterone levels have independent importance when it comes to avoiding symptoms of hypogonadism. There are at least a couple positive anecdotes about switching to a protocol that provides diurnal variation. I think the therapy has promise, but at this point it's mainly hypothetical and it's unclear under what conditions the possible benefits would be worth the extra effort.

The recent enanthate measurement seems sensible, though inconsistent with the ones five years ago. Ideally you'd have SHBG and albumin measurements to allow estimation of free testosterone. The working hypothesis is that free testosterone is proportional to dose. If we estimate your SHBG as 23 nMol/L and albumin as 4.6 g/dL then Vermeulen free testosterone is 0.656 nMol/L (18.9 ng/dL). Your predicted average free testosterone in nMol/L as a function of daily testosterone dose in milligrams is 0.0729 * D. My constant of proportionality is about a third larger; I have slower underlying metabolism and therefore see more free testosterone at the same dose. Your figure shouldn't be trusted too much because it's based on a single measurement and several assumptions.

It's possible that testosterone gel could be used in place of propionate. Personally I'm biased against transdermal products. The pharmacokinetics seem more variable, with some data showing really stable levels over 24 hours, but other reports suggesting high variation. The considerable DHT production is a confounding factor. Regarding dosing, I'd say to initially assume 10% absorption and go from there. But I have no idea on the variability factor needed to select the ratio versus the injected ester. You'd have to gather some data to get an idea.

 

[Willyt]

@R2D2 - The main benefit that I have experienced from daily fluctuations using Cat's blended approach is better sleep. This is a big deal at least for me because sleep > T. The idea is that Prop portion of blend helps you peak early in day but decreases by night while Enan provides a relatively stable baseline overnight.

One thought if you want to add variation - why not stick with Enan for your steady base and then use nasal gel (instead of cream) for your variation? I thought about during my experiment with Empower nasal gel but never did try it.

 

[Hyrulewarrior1978]

There's nothing really concrete on the significance of a lack of diurnal variation in serum testosterone. We know that such variation is substantial in younger men and attenuates with age. From the Natesto data we know that peak testosterone levels have independent importance when it comes to avoiding symptoms of hypogonadism. There are at least a couple positive anecdotes about switching to a protocol that provides diurnal variation. I think the therapy has promise, but at this point it's mainly hypothetical and it's unclear under what conditions the possible benefits would be worth the extra effort.

The recent enanthate measurement seems sensible, though inconsistent with the ones five years ago. Ideally you'd have SHBG and albumin measurements to allow estimation of free testosterone. The working hypothesis is that free testosterone is proportional to dose. If we estimate your SHBG as 23 nMol/L and albumin as 4.6 g/dL then Vermeulen free testosterone is 0.656 nMol/L (18.9 ng/dL). Your predicted average free testosterone in nMol/L as a function of daily testosterone dose in milligrams is 0.0729 * D. My constant of proportionality is about a third larger; I have slower underlying metabolism and therefore see more free testosterone at the same dose. Your figure shouldn't be trusted too much because it's based on a single measurement and several assumptions.

It's possible that testosterone gel could be used in place of propionate. Personally I'm biased against transdermal products. The pharmacokinetics seem more variable, with some data showing really stable levels over 24 hours, but other reports suggesting high variation. The considerable DHT production is a confounding factor. Regarding dosing, I'd say to initially assume 10% absorption and go from there. But I have no idea on the variability factor needed to select the ratio versus the injected ester. You'd have to gather some data to get an idea.

Not sure if dht blood readings from topicals even means anything. This directly from Wikipedia:
DHT was the last major sex hormone, the others being testosterone, estradiol, and progesterone, to be discovered, and is unique in that it is the only major sex hormone that functions principally as an intracrine and paracrine hormone rather than as an endocrine hormone.

Speaking from anecdote, I felt the most natural using scrotal creams.

 

[Cataceous]

Not sure if dht blood readings from topicals even means anything. This directly from Wikipedia:
...

You neglect other Wiki statements: "Relative to testosterone, DHT is considerably more potent as an agonist of the androgen receptor (AR)." "... DHT may play a function in skeletal muscle amino acid transporter recruitment and function. ... Metabolites of DHT have been found to act as neurosteroids with their own AR-independent biological activity." " In bioassays, DHT has been found to be 2.5- to 10-fold more potent than testosterone."

In addition, DHT is systemically anti-estrogenic. It has aromatase-inhibiting ability, and it also works through competitive inhibition at estrogen receptors.

We've repeatedly seen lab work showing that transdermal testosterone can elevate serum DHT well above normal ranges, and sometimes manyfold above. Given the possible wide-ranging effects of such high levels I think it's unwise to suggest they don't mean anything.

Anecdotally, when I was on Androgel I experienced explosive facial and body hair growth in spite of relatively low serum testosterone. This was not in the application areas, demonstrating a clear systemic effect of higher serum DHT.