Testosterone LOWER after 6 Weeks of treatment

[sammmy]

I suggested to test at 6 hours or next day morning because the OP trough looks suspiciously low for his weekly equivalent dose of 140mg (160mg for 8 days) and his trough is suspiciously close to his pre TRT level.

It could be that he is injecting fake or diluted testosterone. This is how I've red his implicit concern. The testing at non-trough would give him some clarity about that.

 

[madman]

I like sammmy's suggestion about 6 hours. I think the "you must run bloods at trough" mantra, which I see on this board and others, is shortsighted. In most cases it is the most important time, but the way that it is drilled home with no deviation is misleading.

For instance if you have high E2 symptoms you might want to see just how high your E2 is getting so you don't want to wait until trough, by which time it may've flatlined, especially if you're using an AI.

Even madman, who warns about letting FT get too high, says "test at trough" repeatedly and then points to a high trough FT and speculates how extremely high it would be at peak. Well, how about having an individual test at peak and see just how high his FT gets instead of hypothesizing by using a trough result?

I guess sometimes the always-test-at-trough directive is based on the idea that people might not have a lot of options when it comes to testing, but there are clearly members here who can test when they want and as often as they want. Telling them that only trough matters is handicapping them.

Are you done yet?

Better yet search all the posts/threads on here.

Never said there was anything wrong with someone testing at peak as long as they are always testing true trough.

Yes, it has been hammered home to test at the true trough with the critical point being made that you always need to keep in mind where your trough FT level truly sits whether injecting once weekly, twice weekly (every 3.5 days), M/W/F, EOD let alone daily.

Too many are gung ho about jacking up their FT level without taking into consideration peak--->trough on such protocols.

Going to be a big difference in someone running a trough FT 30+ ng/dL injecting once or twice weekly compared to EOD or daily.

The whole point of testing at the true trough is to make sure levels are not too low which can have a negative effect on overall symptom relief let alone too high which can have one struggling with sides till f**king cows come home!

Much easier getting one blood test done to see where your trough level truly sits as blood work is done just before your next injection.


TrueTrough (TC/TE)

*Once weekly (7 days post-injection)

*Twice weekly (3.5 days/84 hrs post-injection)

*M/W/F (Monday morning)

*EOD (2 days/48 hrs post-injection)

*Daily (24 hrs post-injection)


The issue with testing at the true peak is it's a guessing game as you would need to test every hour post-injection to see where your level truly sits.

Is your peak 8-12 hrs, 24 hrs?

Throw in IM vs sub-q and this could easily change things.

Sure you can get a rough idea but even then testing at the true trough is standard practice.

No one said there was anything wrong with testing at peak and trough but testing at true trough (lowest point) before your next injection is a F**KING must!

You can rest assured that if trough levels are too high then it is a given that peak levels will be very high/absurdly high depending on the protocol (injection frequency).

 

[acedia]

As the guys have implied, on an E4D injection schedule of cypionate/enanthate you could have peak serum testosterone that's at least 50-60% higher than trough. The more important question here is, what is free testosterone doing? Assuming cypionate, you're taking 14 mg of testosterone per day, which is well above the natural production range of 3-9 mg per day, with 6-7 mg typical for healthy young men. Chances are good that you need less testosterone, not more. It seems reasonably likely that you have crashed SHBG to low levels—androgens suppress SHBG production. This has the effect of reducing total testosterone to seemingly low levels, even while free testosterone is elevated. Free testosterone is the more important parameter, and is better correlated with the positive effects of testosterone. However, in my opinion, having above-range free testosterone is likely to be a net negative to overall health.

In any case, the priority is to start tracking free testosterone. Either measure it with a test using equilibrium dialysis, or calculate it by measuring SHBG along with total testosterone, or better yet use both methods.

Hi, my blood tests do track free test, aswell as SHBG

let me give some context, this clinic uses an APP, and they were supposed to call me after my blood test. I havnt heard from them yet but the app has my updated test.

Now, the night I noticed the app had my results, it showed TEST and FREE TEST ONLY.

Test was 389, and free test was like 7.?
(Blood test 12-16-2022 shows T 454 - FT - 9.27
Blodo Test 12-26-2022 shows; T 460 FT 9.41 )

The next day, the app was showing my free test at 8.93 and it included SHBG and Estradiol.

So my SHBG is 26.4, and it appears normal range is 16.5-55.9
(When I first got my blood tested 12-16-2022. SHBG was 33.8)

my Estradiol is 13.2, normal is 19-60.
(12-26-2022 blood test was 23.2)

===========================

As a further note, I have a vial of 10ml Test, from an online clinic (I plan on moving out of state soon, and I was going to use this then)

I went ahead and injected from that, its 100MG 0.5ML shot I filled myself.

 

[madman]

This is your trough level before the next injection. The levels after injection are expected to be much higher, assuming you are injecting a prescription testosterone, not something bought over internet.

You can test it 6 hours after injection, or the next day in the morning to verify that.

Give your head a shake!

 

[madman]

I like sammmy's suggestion about 6 hours. I think the "you must run bloods at trough" mantra, which I see on this board and others, is shortsighted. In most cases it is the most important time, but the way that it is drilled home with no deviation is misleading.

For instance if you have high E2 symptoms you might want to see just how high your E2 is getting so you don't want to wait until trough, by which time it may've flatlined, especially if you're using an AI.

Even madman, who warns about letting FT get too high, says "test at trough" repeatedly and then points to a high trough FT and speculates how extremely high it would be at peak. Well, how about having an individual test at peak and see just how high his FT gets instead of hypothesizing by using a trough result?

I guess sometimes the always-test-at-trough directive is based on the idea that people might not have a lot of options when it comes to testing, but there are clearly members here who can test when they want and as often as they want. Telling them that only trough matters is handicapping them.

This all went over your head!

 

[acedia]

This all went over your head!

can you argue about this shit somewhere else

 

[madman]

can you argue about this shit somewhere else

Come again?

He called me out and needs to get his facts straight!

 

[acedia]

Come again?

He called me out and needs to get his facts straight!

stop derailing my thread please, how old are you anyway? some of you guys act like children.

 

[JmarkH]

Oh, boy, more name-calling. --stomp feet--fling hands around-- Because only MEN resort to derogatory name-calling. Nice. It has been so good to meet you.

 

[Systemlord]

If you really want to check to see if the Test is working, check LH, because exogenous T suppresses LH. If the LH is low (<1), then the test is good. If you’re not getting symptom relief, then increase the T dosage.

It’s highly unlikely Test being prescribed by a doctor or someone licensed to do so is providing you with fake or bunk Test.

 

[Simbarn]

As the guys have implied, on an E4D injection schedule of cypionate/enanthate you could have peak serum testosterone that's at least 50-60% higher than trough. The more important question here is, what is free testosterone doing? Assuming cypionate, you're taking 14 mg of testosterone per day, which is well above the natural production range of 3-9 mg per day, with 6-7 mg typical for healthy young men. Chances are good that you need less testosterone, not more. It seems reasonably likely that you have crashed SHBG to low levels—androgens suppress SHBG production. This has the effect of reducing total testosterone to seemingly low levels, even while free testosterone is elevated. Free testosterone is the more important parameter, and is better correlated with the positive effects of testosterone. However, in my opinion, having above-range free testosterone is likely to be a net negative to overall health.

In any case, the priority is to start tracking free testosterone. Either measure it with a test using equilibrium dialysis, or calculate it by measuring SHBG along with total testosterone, or better yet use both methods.

As usual, excellent points.

 

[tareload]

You all do realize it is much easier to test trough than peak, right?

Trough is simple and same for every individual on a given injection frequency.

How would you find peak without some methodical testing at intervals?

Sure for TC/TE then 18-30 hours (24+/- 6 hr) post injection will give you idea. For TP, 4-6 hours post injection. Looks up calculation of tmax on here for more info. Nice energy displayed on the topic of pharmacokinetics...I like the enthusiasm!

 

[sammmy]

@readalot

This thread was never about finding the peak. The OP concern was that his trough is too low so the goal was to verify he was injecting actual testosterone and that can be tested at a wide interval after injection.

Wasn't there some online calculator that was giving theoretical curve of peaks and troughs depending on the dosing schedule and type of ester? I remember I've seen it somewhere but cannot find it.

 

[Fortunate]

I like how its my problem this guy has no life and is trolling on a testosterone blood test forum... How about you stay on topic, Why are you lobbing personal attacks at me now? I dont need help managing my emotions, the guy was clearly trolling, im not here for that. I joined to ask what others thought about my blood test.

He’s not trolling. Whether or not his comments are helpful, he’s legitimately trying to help. I say this because I’ve been around here long enough to know.

That said, we need to get your situation figured out. I don’t remember all of the basic facts, and I’m on my phone, which makes it a pain to look upwards in the thread. Are you taking brand-name testosterone from a reputable source? I agree with the notion that you should wait and check your level 6 to 8 weeks after starting. it may also be helpful to make sure that each time you get it, you are either getting a peak, a trough, or both, but when you make comparisons, make sure it’s apples to apples. Also, you may already know this, but it is best to be fasting and check first thing in the morning. Finally, the lab itself, as well as how the lab orders are written matter. Lots of information on that around here.

 

[George9]

Someone may have already referenced the following study that showed 25 mg per week of testosterone had negative results, 50 mg had little to no effect, and only at 125 mg were the gains positive. Since everone is different, perhaps increasing your dose may be the answer.

 

[tareload]

@readalot

This thread was never about finding the peak. The OP concern was that his trough is too low so the goal was to verify he was injecting actual testosterone and that can be tested at a wide interval after injection.

Wasn't there some online calculator that was giving theoretical curve of peaks and troughs depending on the dosing schedule and type of ester? I remember I've seen it somewhere but cannot find it.

@acedia see this post and posts linked therein if you want to understand your situation better. Your comment about your levels now being 20% lower than before TRT are wrong assuming all your blood work quoted is correct. Your mean TT level on TRT is most likely higher now than prior to TRT. The material below will help you understand why.

100mg Cypionate every 2 weeks

I am 58 years old and my Dr wanted me to inject Cypionate 100mg 1x weekly, but with recommendations from this forum I injected Cypionate 50mg two times a week with 29g Insulin syringe into my delts. After 7 weeks my Testosterone is 941 ng/dl (Reference Range: 250 ng/dL - 1100 ng/dL) and Free...

www.excelmale.com

Tool to Assess your TT Dose Response -- Percentile Curves

Summary: Tools to estimate your individual dose response for injectable testosterone ester in comparison to a normal distribution (95 percentile confidence estimate) of adult males (Ref). Plot below shows a summary of data from (1) clinical trials gathered from the literature + (2)...

forums.t-nation.com

Finer points of peak endogenous level vs trough TRT level. Diurnal variation, pharmacokinetics, etc.

Why all TT measurements are not created equal with apple to oranges timepoint comparisons.

'Natural' Levels vs TRT Levels?

Define “1000” (assuming you are referring to 1000 ng/dl) with TRT vs “1000” natural. As properly measured 1000 natural would be peak. 1000 on TRT could be (often is) trough. Is that trough with weekly injection, E3.5D injection, EOD injection, ED injection? The mean TT levels for those 4 TRT...

forums.t-nation.com

 

[Cataceous]

...
Test was 389, and free test was like 7.?
(Blood test 12-16-2022 shows T 454 - FT - 9.27
Blodo Test 12-26-2022 shows; T 460 FT 9.41 )

The next day, the app was showing my free test at 8.93 and it included SHBG and Estradiol.

So my SHBG is 26.4, and it appears normal range is 16.5-55.9
(When I first got my blood tested 12-16-2022. SHBG was 33.8)

my Estradiol is 13.2, normal is 19-60.
(12-26-2022 blood test was 23.2)

===========================

As a further note, I have a vial of 10ml Test, from an online clinic (I plan on moving out of state soon, and I was going to use this then)

I went ahead and injected from that, its 100MG 0.5ML shot I filled myself.

It looks like they are using Vermeulen calculated free testosterone, which is good. In spite of appearances, your testosterone has improved some, though it is lower than expected for the dose. Are you sure you were taking 80 mg every four days? What is the concentration of that testosterone (mg/mL) and what volume were you taking? Beyond the dose, other explanations for low results at trough include an above-average metabolic clearance rate of testosterone or unusually fast absorption.

Here's how to tell that your testosterone actually improved: First, SHBG did decline some, which had a depressing effect on total testosterone. The decline in SHBG itself is an indicator of higher androgen levels. If SHBG had not declined then your current trough total testosterone would be 438 ng/dL, not far from the baseline values. Second, the baseline values are presumably morning values, targeting natural peaks. Is this correct? If so then after accounting for diurnal variation your average testosterone level could have been 10-20% lower, say 360-410 ng/dL. Third, on TRT you are measuring troughs. If the peak levels are 60% higher than these troughs then the peak and average levels are roughly 620 ng/dL and 510 respectively. The bottom line is that TRT has probably raised your average free testosterone by 25% or so.

To rule out fast absorption you could try every-other-day injections for a month or two. I have seen data from a couple guys who have documented relatively large drops in testosterone even within two days. If you are in this category then you don't want to be pushing troughs higher only to end up with more extreme peaks. More frequent injections can help you avoid this situation.

 

[tareload]

One other observation after watching this same thing play out over years and years and posting the same answers for about as long.

• SHBG, TT, FT, calculated Vermeulen/Tru-T FT?
• What is this direct FT measurement? Peak endogenous level, trough or peak TRT levels? Diurnal variation vs age?
• WTF is all this?
• What is free testosterone (FT) and how do we accurately measure it?

Find a Doctor whom you trust and go about your life + or - TRT. There are a handful of people on this board (similar to other boards) who understand the material explained by Cataceous above. There are dudes on here (who will remain nameless who have thousands of posts and still don't get it).

Most don't want to get into this level of detail or just don't have the mental bandwidth to do it. Ignorance is bliss so go forth and be happy.

 

[sammmy]

There was in the past an online injectable simulator for testosterone similar to this one for estradiol:

Injectable Estradiol Simulator

A simulator for estradiol levels with injectable estradiol esters.

transfemscience.org

Does anyone know where that is or what happened to it?

 

[tareload]

There was in the past an online injectable simulator for testosterone similar to this one for estradiol:

Injectable Estradiol Simulator

A simulator for estradiol levels with injectable estradiol esters.

transfemscience.org

Does anyone know where that this is or what happened to it?

Nice. At some point I will have to do this for the transmen.

Examples.

Mathematical Question about Frequency Dosing

This would be great and a worthwhile project for someone with the time and inclination to see it through. I worked through a fair chunk of this book a few weeks back. Highly rate and recommend it, really well written and approachable text. Appreciate the link. I use R now and again it’s a...

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Mathematical Question about Frequency Dosing

There you go. 200 mg/week with rough distribution volume per your request. Details of model in links above.

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