I’ve been all over the place. 200mg, 150, 160,180.
I’ve noticed the norm on this forum is to not mess with your dose. I fully Agree. But my biggest issue is my clinic.
They have me (and swear by it) stop pinning 7 days before labs. I’ve done it 3 days before as well to see my peak.
Trough after 7 days was 557 on 160 mg
Peak was 1140
I’m 41, 5’11”, 270 lbs (good amount of muscle and some fat of course) , train Jiu Jitsu, do hiit kettlebell workouts.
Bottom line is i want To figure out if my dose is too high because i dont Trust that they base it off my trough level. Aka lowest effective dose which I’ve never been able to test because I fell into the clinic cookie cutter trap at 200mg.
This is a messy situation here!
Unfortunately you got caught up being treated by one of those clueless dime a dozen run of the mill T-clinics dishing out those high dosed 200 mg T/week cookie cutter protocols which have all those poor chaps jacked up on T from the get-go!
Shocking that they never threw an AI in there to boot!
Overmedicating everyone from the get-go!
Many may feel like superman off the hop only to be let down months later!
F**king shameful!
Keep in mind that although TT is important to know FT is what truly matters as it is the active unbound fraction of T responsible for the positive effects.
Depending on the weekly dose of T/injection frequency a high/absurdly high peak would be expected.
When injecting once weekly (every 7 days) there will be a big difference between in the peak--->trough (40-50%) from day 1--->7 let alone blood levels will not be as stable throughout the week.
@Systemlord is out to lunch when he stated there will be a rapid decline in T levels.
Sure as hell not when using medium-acting esters (TC/TE)!
Look up the PKs TC/TE vs TP let alone oral TU!
On a once weekly injection protocol peak T levels will start rising within the first 2 hours due to a burst release and peak T level will be achieved within 24 hrs post-injection/even as early as 8-12 hrs when using the medium-acting esters (TC/TE), T levels will be very high the first 2-3 days and then gradually decline over the following days reaching true trough (lowest point) before your next injection on day 7.
The main downfall when injecting once weekly is in most cases the peak will very high/sky-high (depending on the dose used) only to be followed by much lower levels come true trough (7 days post-injection) and even then some men are still hitting a high/very high trough (depending on the weekly dose used).
This big difference between peak--->trough can result in a roller coaster type effect which can have a negative effect on energy, mood, libido and erectile function.
Some men may struggle with sides from the big weekly swing in T levels.
The easy fix here would be splitting up your weekly dose and injecting more frequently which will clip the peak--->trough and result in more stable blood levels throughout the week.
Top it off that you can get away with minimizing your peak while at the same time still hitting a healthy/high trough.
The standard starting dose for TTh is 100 mg T/week or better yet 50mg T every 3.5 days.
The goal here is to start low and go slow on a T-only protocol as we want to see where said protocol (dose of T/injection frequency) has your trough TT and more importantly FT, estradiol let alone critical blood markers RBCs, hemoglobin and hematocrit.
Blood work will be done once blood levels have stabilized (4-6 weeks) when using TC/TE due to the PKs and you want to test at the true trough (lowest point before your next injection).
The goal here is to achieve a healthy trough FT level.
Dose of T should never be increased at the 4-6 week mark once labs are done unless your trough FT is too low (highly unlikely) in most cases.
There will always be time to increase the dose of T or add in hCG if need be.
Many make the mistake of tweaking a protocol 4-6 weeks in because they do not feel well and this is where they make the grave mistake as they lack the understanding of how exogenous esterified T works.
When first starting TTh or tweaking a protocol (increasing/decreasing dose/manipulating injection frequency) T levels will start rising over the following weeks until blood levels have stabilized (4-6 weeks TC/TE) and it is common for one to experience ups/downs during the transition as the body is trying to adjust to the rising T levels/increase dopamine, lighting up the ARs (androgen receptors).
Even then what is more critical here after blood levels have stabilized (4-6 weeks) it will still take a few more months for the body to adapt to its new set-point and this is the critical time period where one needs to gauge how they truly feel overall regarding relief/improvement of low-T symptoms and overall well-being.
Every protocol needs to be given a fighting chance (12 weeks) before claiming it was truly a success or failure.
Then you will decide on your next move when it comes to tweaking your protocol (dose/injection frequency) if need be.
Sounds like you have been overmedicated from the get-go and never even had a chance to start on a sensible dose 100 mg T/week from the get go!
200/180/160/150 mg T.
As I have stated numerous times on the forum the standard starting dose TTh across the board is 100 mg T/week or better yet 50 mg T twice-weekly.
Most men on TTh are injecting 100-200 mg T/week whether once weekly or more commonly split into more frequent injections as in twice-weekly (every 3.5 days), M/W/F, EOD or daily.
This needs to be stressed here.....the majority of men can easily hit a healthy let alone high trough FT injecting 100-150mg T/week especially when split into more frequent injections.
Yes some men meaning those outliers may need the higher-end dose 200mg T/week but it is far from common as in rare.
Unfortunately many are overmedicated from the get-go let alone brainwashed by the more T is better sheep mentality spewed on those so called HRT/men's health forums (Gootube, Facepalm, Bumnation, I just don't Geddit) loaded with all those blast n cruizzers let alone the so called gurus.
Throw in most of those dime a dozen run of the mill T-clinics to boot!
Shitshow at it's finest!
On your previous protocol 160 mg T/week you stated that you were hitting a very high peak TT 1140 ng/dL 3 days post-injection so your true peak (within 24 hrs) post-injection was most likely higher and you were hitting a descent true trough TT 557 ng/dL (7 days) post-injection.
Downfall here is you are missing the most important blood marker FT let alone we have no idea where your estradiol or SHBG sat let alone critical blood markers RBCs, hemoglobin and hematocrit.
TT means nothing without knowing where your FT sits.
You need to know where your trough FT sits on said protocol (dose of T/injection frequency) this is critical!
Although your trough TT 557 ng/dL is descent and far from high your trough FT may still be descent depending on where your SHBG sat but chances are if it is highish./high than your trough FT would be subpar but again this is a whopping 7 days post-injection so your peak FT (within 24 hrs) and during the early part of the week would be high.
If anything you would have been far better of splitting up the dose and injecting 80 mg T every 3.5 days which would clip your peak and bring up your trough.
You just made a big mistake increasing your dose from 160 mg T once weekly---->180 mg T (80 mg every 3.5 days) which is going to drive up your trough and still result in a very high peak TT/FT.
Hardest part here is you would have been far better off starting out on a lower weekly dose and working your way up if need be as it is always harder coming down than going up!
Even then every new protocol needs to be given 12 weeks in order to gauge whether it was truly a success or failure.
Need to bite the bullet and put in the time if you ever want to get anywhere!
Regardless you are missing critical blood markers FT, estradiol, SHBG and your RBCs, hemoglobin and hematocrit.
Need to know what true trough FT you are hitting on said protocol otherwise you will be chasing your tail
endlessly!
