Should I lower my TRT dose?

[Ragnar73]

Hi all.

Just had labs done after many months of 125mg Test Enanthate E5D (IM).
As you can see I am at 35,94 nmol/L (scale used in my country) and the norm is from 9.70 to 31.80.

So I am above the norm, but should I change it since I am feeling fine?
Am I in a particular risk beeing 4,14 nmol/L above the normal range?

 

[madman]

Hi all.

Just had labs done after many months of 125mg Test Enanthate E5D (IM).
As you can see I am at 35,94 nmol/L (scale used in my country) and the norm is from 9.70 to 31.80.

So I am above the norm, but should I change it since I am feeling fine?
Am I in a particular risk beeing 4,14 nmol/L above the normal range?


View attachment 16357

So I am above the norm, but should I change it since I am feeling fine?
Am I at particular risk of being 4,14 nmol/L above the normal range?


If you feel great overall, minus sides, and blood markers are healthy then there is no need to fret over numbers being above the top-end of the reference range.

Although TT is important to know FT is what truly matters as it is the active unbound fraction of testosterone responsible for the positive effects.

Although you are hitting a robust trough TT 35.94 nmol/L (roughly 1036 ng/dL) it is far from being considered absurdly high mind you with a TT 1000s you will most likely have a high-end or very high FT level depending on your SHBG.

The only way to know where your FT level truly sits is to have it tested using the most accurate assays such as the gold standard Equilibrium Dialysis or Ultrafiltration (next best).

Even then as I stated above if you feel great overall and blood markers are healthy then leave it be and enjoy the ride!

 

[Ragnar73]

Thank you for your input, madman.
I think I will stay the course then, maybe lower frequency to E6D.

The blood test was taken the day before my next injection on the E5D schedule.

The only slight concern with the bloodtests are hemoglobin.
It should be between 8,3 - 10,5 and it was 10.6
Bloodpressure was 133/71.

 

[ivkonst2017]

Hi all.

Just had labs done after many months of 125mg Test Enanthate E5D (IM).
As you can see I am at 35,94 nmol/L (scale used in my country) and the norm is from 9.70 to 31.80.

So I am above the norm, but should I change it since I am feeling fine?
Am I in a particular risk beeing 4,14 nmol/L above the normal range?


View attachment 16357

Your numbers are totally fine if you feel good and dont have issues with blood pressure, blood counts and cholesterol. The reference range for total t nowadays is flawed and it is absurdly low. For free t the most precise measuring methods are not available in most countries in the world, I bet in yours as well. Keep things reasonable and follow your health markers and how you feel.

Just as an example I try to keep my total t around 43-46 nmol/l, with SHBG hovering around 40 usually below 40 I start to feel a bit worse, above 50 is not OK for me as well getting anxiety.

By the way your TSH doesnt look great, if you are just starting TRT is normal keep an eye on it and on FT3.

 

[Cataceous]

Since you've got someone making silly assertions about normal reference ranges let me give you a different perspective. The 125 mg of testosterone enanthate you're taking is giving you an average of 18 mg pure testosterone per day. That is more than double the amount produced by the average healthy young man. Furthermore, with E5D and E6D injections your peak serum testosterone could be approaching double the trough values. This puts it in the ballpark of 70 nMol/L or 2,000 ng/dL. This absolutely puts you at higher risk of side effects down the road. I advocate starting at more normal levels and giving them plenty of time. In this way you'll have a baseline for comparison if you decide to experiment with higher doses later on.

Many men have found out the hard way that it's better overall to keep serum testosterone closer to what's normal for your physiology. Some examples:

Anyone combine injections and cream? How do you feel?

I’m a long term TRT patient, 39 years old. I’ve been on cypionate and inject a total of 154mg weekly in EOD subQ shots of 44mg each. I have been doing some thinking about the potential benefit of keeping dosing the same but experimenting with using a low cypionate base around 80-100mg weekly...

www.excelmale.com

Anyone combine injections and cream? How do you feel?

I’m a long term TRT patient, 39 years old. I’ve been on cypionate and inject a total of 154mg weekly in EOD subQ shots of 44mg each. I have been doing some thinking about the potential benefit of keeping dosing the same but experimenting with using a low cypionate base around 80-100mg weekly...

www.excelmale.com

Anyone combine injections and cream? How do you feel?

Interesting anecdote. I’m curious what what your SHBG and current protocol are? @JoeMatts im curious for this as well

www.excelmale.com

Hello, 60yo starting TRT.

Hi All. I'm 60yo, lucky with relatively few health problems so far. Total T 350-400. After about a year of research/consideration, about to start TRT, plan is just Test C, 150mg per week separated into two subq injections/week into delts/VGs, draw/inject using 29G 1ml. Get labs in ~8 weeks...

www.excelmale.com

Have you ever DECREASED your dose?

Hey guys. I've only been on TRT for about 9 months. I'm on Test Cyp 100 mg Q3.5d with 350iU of HCG IM. I recently (this week) lowered my Anastrozole from 0.5 mg on injection days to 0.25mg to see how it will effect me (side effects, changes in libido, and also then lab values). ****I'm happy...

www.excelmale.com

Hello, 60yo starting TRT.

Hi All. I'm 60yo, lucky with relatively few health problems so far. Total T 350-400. After about a year of research/consideration, about to start TRT, plan is just Test C, 150mg per week separated into two subq injections/week into delts/VGs, draw/inject using 29G 1ml. Get labs in ~8 weeks...

www.excelmale.com

TRT patient feeling better after lowering my prescribed dose

Hey Guys, Hope all's well and Happy 4th! I'm looking for feedback. As a young male battling ED and low T, hopefully sharing my experience on what worked helps someone too. Almost 32 now and I use to have severe ED as long as I can remember, maybe late teens. No clue on cause. Maybe it's...

www.excelmale.com

Dose Change Side Effects

Hi guys, I just switched to a daily protocol of 24mg after spending a few weeks on 100mg E3D. This E3D protocol kicked the shit out of me, I dont think I respond well to having so much T at one time. The anxiety and thoughts were nightmarish plus the lethagy is real. Is there anything that...

www.excelmale.com

 

[ivkonst2017]

That is double the amount produced by the average healthy young man.

This argument is totally irrelevant when it comes to TRT. I dont know why I see it only in this forum, but anyway.

First thing - there is an ester attached to this testosterone that you conveniently miss.

Second there is no average or normal level that is rellevant for the individual(biggest pitfal of the nowadays common endocrinologist). Everything is individual. My normal level where my body feels best can be doble to yours or vice versa. One guy feels best at 30ng/dl free t, another with 15.

Third levels on TRT should not be sirectly compared to levels on endogenous production. The best TRT clinicians know that. Usually on TRT guys would need 20-30 percent more in comparison to the endogenous levels where they would feel best.

If somebody suggest to this guy lowering his dose to fit into the so called "normal" range he is doing him harm and trying to cause him possible misery of screwing up his treatment. I hope the OP will not fuck up his protocol and continue reap the benefits of his HRT.

 

[Cataceous]

This argument is totally irrelevant when it comes to TRT. I dont know why I see it only in this forum, but anyway.
...

So the amount of hormone you'd produce naturally when young and healthy is irrelevant? Maybe if you have the "more is better" mentality and can't be bothered with considerations of normal physiology.

...
First thing - there is an ester attached to this testosterone that you conveniently miss.
...

Please attempt to explain this and dig yourself into a deeper hole.

...
Second there is no average or normal level that is rellevant for the individual(biggest pitfal of the nowadays common endocrinologist). Everything is individual. My normal level where my body feels best can be doble to yours or vice versa. One guy feels best at 30ng/dl free t, another with 15.
...

Normal ranges give us an indication of what's natural and healthy. You seem to be dismissing the idea of starting with physiological dosing, and instead want to jump immediately to the supraphysiological, as long as you think it feels good initially. Well hardly a day passes when someone's not on the forum complaining about the eventual side effects from this approach.

Third levels on TRT should not be sirectly compared to levels on endogenous production. The best TRT clinicians know that. Usually on TRT guys would need 20-30 percent more in comparison to the endogenous levels where they would feel best.
...

We've been through this. Lack of diurnal variation in TRT could mean that 20-25% more testosterone is needed to maintain the peak level all the time. The extreme outliers in natural production are making 9 mg T per day. When you add 25% it's equivalent to 113 mg T cypionate weekly. On the other hand, the average is around 6.5 mg, which equates to 81 mg TC per week. This is close to the middle dose of the Xyosted product, which you studiously refuse to comment on—due to its success and its maximum dose of 100 mg TE per week.

...
If somebody suggest to this guy lowering his dose to fit into the so called "normal" range he is doing him harm and trying to cause him possible misery of screwing up his treatment. I hope the OP will not fuck up his protocol and continue reap the benefits of his HRT.

Who's doing the harm: The one encouraging him to stay at testosterone levels that may be double what's natural for him and well into supraphysiological territory? Or the one suggesting he try physiological levels before he jumps into a long-term experiment on the safety of excessive serum testosterone?

 

[ivkonst2017]

Please attempt to explain this and dig yourself into a deeper hole.

Very cheap manipulation bro. So you say average male body bla bla produces x amount of testosterone. But when you inject cypionate for example 200mg per week the actual mg of testosterone is around 180(dont remember the exact number).

So the amount of hormone you'd produce naturally when young and healthy is irrelevant? Maybe if you have the "more is better" mentality and can't be bothered with considerations of normal physiology.

My mentality is to use enough in order to get maximum benefits without causing harm. This is called optimization. The replacement is the pathethic thing that the endocrinomogists tend to do: -"Now you are at 600ng/dl in the normal range, so you are fine" -"But doc I feel like shit" -"No, your numbers are NORMAL so you are fine".

Normal ranges give us an indication of what's natural and healthy. You seem to be dismissing the idea of starting with physiological dosing, and instead want to jump immediately to the supraphysiological, as long as you think it feels good initially. Well hardly a day passes when someone's not on the forum complaining about the eventual side effects from this approach.

35nmol/l total t is NOT surpaphysiological. 46nmol/l is NOT supraphysiological.
I DONT say we SHoULDNT care about the range. But it also doesnt mean we should be WITHIN it. The normal range shows the average of the population and most of these people are far from healthy. This range is FLAWED and it has lowered even since 4 years ago! Yesterday when I was walking with my girfriend in the park around 10 percent of the guys I saw werent fat. What testosterone levels do you think they have? Also believe it or not most guys that go to test for testostetone have soms complains. I've met in the last 2 weeks 2 people with over 40nmol/l natural testosterone.

it's equivalent to 113 mg T cypionate weekly

The dose you inject doesnt have ANY meaning outside of giving you consistency to achieve X serum concentration. I get 1200-1300 total t with 140mg per week. A guy I know gets the same levels with 250mg per week. Other guy gets similar levels with 170mg. So?

Who's doing the harm:

The one proposing him to fuck up his treatment just to fit in a piece of paper. His levels are totally physiological, he has no side effects and lowering his dose will cause unnecessary stress to the body.

 

[ivkonst2017]

This is close to the middle dose of the Xyosted product, which you studiously refuse to comment on—due to its success and its maximum dose of 100 mg TE per week.

I dont comment it because I dont know anyone using it. And what does it mean success - it is well marketed by the doctors? Do we know how happy are its users in comparison to other guys taking more mg?

I have seen A LOT people on TRT getting optimized, both in my country and in the forums mostly from USA, UK, Australia but also from all over Europe. In the back of my mind I like to keep statistics of certain numbers. I dont remember anyone who has optimized below 120-130mg per week. All I know that have started lower have increased and are feeling better ever since. I would say the majority use between 130 and 200mg per week achiving total t serum concentrations of 1000-1400ng/dl to feel best at without getting side effects and issues.

The best doctors that I know in the field try to bring their patients around these levels with no matter mg are needed to get maximum benefits of the treatment. And we've talked with them that usually the guys who have side effects and cannot tolerate optimal levels of t have other health issues that should be fixed(thyroid, fatty liver, progesterone these 3 most often) and work with them to fix these issues.

 

[Cataceous]

Very cheap manipulation bro. So you say average male body bla bla produces x amount of testosterone. But when you inject cypionate for example 200mg per week the actual mg of testosterone is around 180(dont remember the exact number).
...

You previously said "... there is an ester attached to this testosterone that you conveniently miss." You didn't explain where it was missed. In fact it wasn't, and your error betrays a questionable comprehension of the subject.

...
My mentality is to use enough in order to get maximum benefits without causing harm. This is called optimization. The replacement is the pathethic thing that the endocrinomogists tend to do: -"Now you are at 600ng/dl in the normal range, so you are fine" -"But doc I feel like shit" -"No, your numbers are NORMAL so you are fine".

35nmol/l total t is NOT surpaphysiological. 46nmol/l is NOT supraphysiological.
I DONT say we SHoULDNT care about the range. But it also doesnt mean we should be WITHIN it. The normal range shows the average of the population and most of these people are far from healthy. This range is FLAWED and it has lowered even since 4 years ago! Yesterday when I was walking with my girfriend in the park around 10 percent of the guys I saw werent fat. What testosterone levels do you think they have? Also believe it or not most guys that go to test for testostetone have soms complains. I've met in the last 2 weeks 2 people with over 40nmol/l natural testosterone.
...

35 nMol/L of testosterone is effectively supraphysiological when SHBG is normal or low. Use any free T calculator to verify that free testosterone is excessive in these cases. For example, Tru-T with TT of 1,000 ng/dL and SHBG of 30 nMol/L yields FT of over 36 ng/dL. This is above the normal range that tops out at 31 ng/dL. The guys who naturally have such high total testosterone almost always have high SHBG. High SHBG drives up total testosterone even when the production rate is normal. 46 nMol/L of total testosterone is supraphysiological, period.

You offer no proof that the test ranges are flawed. We have population studies from decades ago to compare to. You're just trying to normalize high serum levels to justify your excessive dosing, which you laughably describe as "optimizing". It's your body, so you are free to experiment as you like. But don't pretend that you have any idea about the long-term safety of high levels, and don't discourage others from starting with more reasonable levels. Doing otherwise is irresponsible.

 

[ivkonst2017]

...35 nMol/L of testosterone is effectively supraphysiological when SHBG is normal or low.

expand...

I cannot believe I read this from a guy that is supposed to be knowledgeable in TRT.
I end my participation in the current discussion, really I see no point in wasting more time on this.

 

[Match]

Nonsense want to increase too much testosterone, as already many complaints here in the forum. Contrary effects, etc. Everything has a price

 

[JRos895]

So the amount of hormone you'd produce naturally when young and healthy is irrelevant? Maybe if you have the "more is better" mentality and can't be bothered with considerations of normal physiology.

Please attempt to explain this and dig yourself into a deeper hole.

Normal ranges give us an indication of what's natural and healthy. You seem to be dismissing the idea of starting with physiological dosing, and instead want to jump immediately to the supraphysiological, as long as you think it feels good initially. Well hardly a day passes when someone's not on the forum complaining about the eventual side effects from this approach.

We've been through this. Lack of diurnal variation in TRT could mean that 20-25% more testosterone is needed to maintain the peak level all the time. The extreme outliers in natural production are making 9 mg T per day. When you add 25% it's equivalent to 113 mg T cypionate weekly. On the other hand, the average is around 6.5 mg, which equates to 81 mg TC per week. This is close to the middle dose of the Xyosted product, which you studiously refuse to comment on—due to its success and its maximum dose of 100 mg TE per week.

Who's doing the harm: The one encouraging him to stay at testosterone levels that may be double what's natural for him and well into supraphysiological territory? Or the one suggesting he try physiological levels before he jumps into a long-term experiment on the safety of excessive serum testosterone?

I think the Xyosted product and it’s studies show how warped peoples conceptions are of normal TRT doses. People think 100mg is low because they compare to the standard 200mg doses by the low grade T clinics. In reality, it’s a high dose and maybe doctors should reconsider it as a starting dose.

 

[SkyWarn]

So I am above the norm, but should I change it since I am feeling fine?
Am I at particular risk of being 4,14 nmol/L above the normal range?


If you feel great overall, minus sides, and blood markers are healthy then there is no need to fret over numbers being above the top-end of the reference range.

Although TT is important to know FT is what truly matters as it is the active unbound fraction of testosterone responsible for the positive effects.

Although you are hitting a robust trough TT 35.94 nmol/L (roughly 1036 ng/dL) it is far from being considered absurdly high mind you with a TT 1000s you will most likely have a high-end or very high FT level depending on your SHBG.

The only way to know where your FT level truly sits is to have it tested using the most accurate assays such as the gold standard Equilibrium Dialysis or Ultrafiltration (next best).

Even then as I stated above if you feel great overall and blood markers are healthy then leave it be and enjoy the ride!

I was at the range (around 1000) and I felt much better than I do now (around 600). So yea I do agree with you. I was injecting 40mg 2 x a week and was in the 900 to1000 range . Now I am down to 15mg EOD and I feel like crap. I just had my labs checked. I never even considered free T. Looks like I may be low. See attached.

 

[madman]

I was at the range (around 1000) and I felt much better than I do now (around 600). So yea I do agree with you. I was injecting 40mg 2 x a week and was in the 900 to1000 range . Now I am down to 15mg EOD and I feel like crap. I just had my labs checked. I never even considered free T. Looks like I may be low. See attached.

FT 5-10 ng/dL would be considered low.

FT 16-31 ng/dL (top-end) is healthy.

Many will do well with FT 20-30 ng/dL.

Some may choose to run higher levels.

Comes down to the individual.

Not sure where your SHBG sat on your previous protocol 80 mg T split (40 mg every 3.5 days) but with a trough TT 900-1000 ng/dL and low/lowish SHBG your trough FT would most likely be over the top end (mid-high 30s).

Even if you had highish/high SHBG your trough FT would most likely be near/just over the top end (the high 20s/low 30s).

Peak FT levels will be higher.

On your current protocol, 49 mg T/week (15 mg EOD) you are hitting a much lower trough TT 597 ng/dL, and seeing as your SHBG is only 24 nmol/L than your trough FT would most likely still be healthy (high teens/low 20s) far from being low.

Peak FT levels will be higher.

You easily have room to increase your dose and bring up your trough FT.

Knowing where your trough FT level truly sits is critical.

The only way to know is to have it tested using the most accurate assays (ED or UF).