TRT patient feeling better after lowering my prescribed dose

[MarkM]

I feel mediocre injecting twice weekly, yet when I start injecting EOD I feel like I'm on a whole other level feeling wise. I've been doing my new EoD protocol for almost 4 weeks and my muscles are harder and have that feel good burn you get when lifting weight, only sitting in my computer chair.

It's not like my numbers were low injecting twice weekly, they were higher than they are now. Weird.

Systemlord, when you say EOD does that mean M, W, F each week or M, W, F, SU, T, TH, SA and so on.........I guess I am asking is it a "three days a week" of truly every other day? Just trying to understand what EOD really means. Thanks

 

[Bentiger07]

MarkM, I believe that literally means every other day.

Guys,
I am still feeling well and plan to do bloodwork soon. My doc may not be aware I lowered my dose, stopped AI, and am taking shots more frequently until after I speak with him. So I'm wondering if you guys think any of those changes to my protocol warrants having any additional tests done for him to view. Vince suggested checking Free Estradiol which I can add.

Usual tests ordered:
CBC With Differential/Platelet
Lipid Panel w/ Chol/HDL Ratio
Testosterone,Free and Total
Dihydrotestosterone
Prostate-Specific Ag, Serum
Estradiol, Sensitive
Sex Horm Binding Glob, Serum
Dhea

 

[Systemlord]

Systemlord, when you say EOD does that mean M, W, F each week or M, W, F, SU, T, TH, SA and so on.........I guess I am asking is it a "three days a week" of truly every other day? Just trying to understand what EOD really means. Thanks

Every Other Day. Every Day is ED or in the correct context ED means Erectile Dysfunction.

 

[Vince Carter]

Vince,
Thank you. I didn't know testing for Free Estradiol could be useful. I'll include that. Because of T cyp's long half-life, I'm waiting a few more weeks to see if I continue to feel well. Figured I should wait 4-5 weeks before retesting for that same reason.

Just wanted to note here that SHBG overrides the half-life of Cyp. You'll "piss it out" well before you get to the ~6 day half-life. This is why you have to get on EOD shots if not daily (which I don't recommend except in tough cases).

 

[Coopsdaddy]

I seem to feel better on 80 mg than 100mg per week.

 

[fifty]

Its normal in the bloodwork shared under Dr.Saya’s supervision, but as mentioned, hair loss accelerated when a past urologist had me on high doses of dhea and clomid. That probably led to high DHT at that time, plus hairloss is genetic anyways. Before hair transplant, I occasionally used Nizoral and Lipogaine shampoo, because it contains ketoconazole which lessens DHT on the scalp. Now that I got a hair transplant, I may stop using that shampoo.

I went with Dr. Carlos Wesley for hair transplant. I probably wouldnt have mind Dr. Bernstein but I didnt want to visit too many top doctors when I already found one I liked, so I never saw him.

Just curious. What was your high dose of dhea? Did you have more hair loss with the dhea alone or with the test/hcg protocol you’re on now?

 

[Bentiger07]

fifty: I don't remember my dose honestly. That was many years ago, but at the time when I looked into it versus what I researched online, I realized it was high. Sorry.

For daily injectors of T cypionate, when is the peak and trough for T levels? I believe I read T cyp peaks after 24 hours. In that case, since I inject in the morning, does that mean my peak is in the morning, and my trough is at night? I tried to search for the answer on my own, but didn't find much when it comes to daily injectors.

Thank You.

 

[Vince Carter]

You still have a trough right before your injection just like any other protocol. Saying, and I'm inferring here that there's more stability in more frequent injections, is a bit of a misnomer. There are still peaks and troughs. Forget about what you read about Cyp half-life...forget it...throw it out; 24hrs peak. SHBG dictates and overrides that entirely.

 

[Bentiger07]

You still have a trough right before your injection just like any other protocol. Saying, and I'm inferring here that there's more stability in more frequent injections, is a bit of a misnomer. There are still peaks and troughs. Forget about what you read about Cyp half-life...forget it...throw it out; 24hrs peak. SHBG dictates and overrides that entirely.

Thank you Vince. I asked because I did a lab test in the morning before my next injection. Now I know the results will show my trough. This is the 1st time I did lab results while doing daily injections. I'll have the results soon which I'll share

 

[Bentiger07]

I've shared my 6 month old labwork while I was on my prior protocol of "62mg T cyp, 500IU HCG, and 0.3mg AI TWICE A WEEK. 1 click of 10% T gel to scrotum and 2-5mg tadalafil A DAY" in post#2 and 6 here.

I mentioned I joined the daily injector club and changed protocol to only "9mg T cyp, 40IU HCG, and 2-5mg tadalafil DAILY". I've been on it for last 2 months. New results to compare below. Both blood draws were done before next injection.

As mentioned, symptom-wise, I feel a good deal better than my prior protocol, probably because I'm a low SHBG guy. I wouldn't say I feel perfect or else I wouldn't need tadalafil. I decided to test quitting tadalafil. Unfortunately, ED crept back 4 days later after stopping tadalafil, so looks like I still need it. I guess my dream of being natural but symptom-free might not happen, but I'm happy to have a solution. Now that I have a baseline of my numbers with daily injections, I may play around with lowering/increasing my T, HCG, and tadalafil dosage slightly to compare I feel. If you have any recommendations which way to go based on the numbers and my symptoms, feel free to share. Thank You.

New results (any easy way to share lab results? I had to do editing to post this.):

CBC With Differential/Platelet
WBC 5.8 x10E3/uL 3.4 - 10.8 01
RBC 5.48 x10E6/uL 4.14 - 5.80 01
Hemoglobin 16.6 g/dL 13.0 - 17.7 01
Hematocrit 48.4 % 37.5 - 51.0 01
MCV 88 fL 79 - 97 01
MCH 30.3 pg 26.6 - 33.0 01
MCHC 34.3 g/dL 31.5 - 35.7 01
RDW 13.6 % 12.3 - 15.4 01
Platelets 219 x10E3/uL 150 - 379 01
Neutrophils 50 % Not Estab. 01
Lymphs 36 % Not Estab. 01
Monocytes 5 % Not Estab. 01
Eos 8 % Not Estab. 01
Basos 1 % Not Estab. 01
Neutrophils (Absolute) 2.9 x10E3/uL 1.4 - 7.0 01
Lymphs (Absolute) 2.1 x10E3/uL 0.7 - 3.1 01
Monocytes(Absolute) 0.3 x10E3/uL 0.1 - 0.9 01
Eos (Absolute) 0.5 High x10E3/uL 0.0 - 0.4 01
Baso (Absolute) 0.0 x10E3/uL 0.0 - 0.2 01
Immature Granulocytes 0 % Not Estab. 01
Immature Grans (Abs) 0.0 x10E3/uL 0.0 - 0.1 01

Comp. Metabolic Panel (14)
Glucose 95 mg/dL 65 - 99 01
BUN 13 mg/dL 6 - 20 01
Creatinine 1.24 mg/dL 0.76 - 1.27 01
eGFR If NonAfricn Am 77 mL/min/1.73 >59 eGFR If Africn Am 89 mL/min/1.73 >59 1.00 1
BUN/Creatinine Ratio 10 9 – 20
Sodium 138 mmol/L 134 - 144 01
Potassium 4.5 mmol/L 3.5 - 5.2 01
Chloride 99 mmol/L 96 - 106 01
Carbon Dioxide, Total 25 mmol/L 20 - 29 01
Calcium 9.5 mg/dL 8.7 - 10.2 01
Protein, Total 6.9 g/dL 6.0 - 8.5 01
Albumin 4.4 g/dL 3.5 - 5.5 01
Globulin, Total 2.5 g/dL 1.5 - 4.5
A/G Ratio 1.8 1.2 - 2.2
Bilirubin, Total 1.3 High mg/dL 0.0 - 1.2 01
Alkaline Phosphatase 79 IU/L 39 - 117 01
AST (SGOT) 23 IU/L 0 - 40 01
ALT (SGPT) 21 IU/L 0 - 44 01

Lipid Panel w/ Chol/HDL Ratio Cholesterol,
Total 213 High mg/dL 100 - 199 01
Triglycerides 111 mg/dL 0 - 149 01
HDL Cholesterol 53 mg/dL >39 01
VLDL Cholesterol Cal 22 mg/dL 5 – 40
LDL Cholesterol Calc 138 High mg/dL 0 - 99
T. Chol/HDL Ratio 4.0 ratio 0.0 - 5.0

Testosterone,Free and Total Testosterone,
Serum 498 ng/dL 264 - 916 01
Free Testosterone(Direct) 13.4 pg/mL 8.7 - 25.1

Dihydrotestosterone 32 ng/dL 02 Reference Range: Adult Male: 30 - 85

Hemoglobin A1c Hemoglobin A1c 5.2 % 4.8 - 5.6 01

DHEA-Sulfate 202.6 ug/dL 138.5 - 475.2 01

TSH 1.410 uIU/mL 0.450 - 4.500 01

Prostate-Specific Ag, Serum Prostate Specific Ag, Serum 0.5 ng/mL 0.0 - 4.0 01

Estradiol, Sensitive 27.3 pg/mL 8.0 - 35.0 03 Methodology: Liquid chromatography tandem mass spectrometry(LC/MS/MS)

Sex Horm Binding Glob, Serum 20.2 nmol/L 16.5 - 55.9

 

[Systemlord]

Systemlord, when you say EOD does that mean M, W, F each week or M, W, F, SU, T, TH, SA and so on.........I guess I am asking is it a "three days a week" of truly every other day? Just trying to understand what EOD really means. Thanks

Just realized I left out an answer, EOD is M, W, F, SU, T, TH, SA.

 

[MarkM]

Just realized I left out an answer, EOD is M, W, F, SU, T, TH, SA.

Thanks. That's what I thought.

 

[Systemlord]

I would prefer to be slightly above midranges myself, 550 -600 is a ideal for me. If I go any higher I get really bad acne and lumps on my head that just keep oozing out stuff.

DHEA-S while not low could see a benefit supplementing a small dosage. You could increase Test dosage a little bit, maybe 10mg added to your weekly dosage.

 

[Vince Carter]

I think you're technically or approaching a low T state on 9mg/Based on your numbers though I have no doubt that you're feeling better than you had been. I think the SHBG and E2 close together is possibly a good thing though E2 should possibly equal the SHBG or be a bit under as there's still a fair amount of Free E there.

speaking of, If funds allow you to you should consider adding this test to your next labs "Estradiol, Free". Do this in addition to the LC/MS/MS test.

When I tried 10mg/D I only did that for about 10 days...not enough for me and went up to 14mg where I atleast feel pretty good but still have E problems.

Also if you're still using that cream on your nuts you need to apply that ~2hrs prior to your labs in order to see how well it's working, I can tell youre not doing this by your abysmal DHT result.

 

[Bentiger07]

Thank you guys. I believe in following how I feel more than following numbers, but just to test, I may experiment with bumping up t cyp from 9mg daily to 10.5 and see how that feels. I think that may potentially take me from the low end of normal T to the mid/high end.

Vince, sorry. You actually told me to check my free estradiol before my last blood draw. I planned to but forgot. I'll consider it for next draw.For daily morning injections, are you certain testosterone levels are lowest right before the next injection that morning? I wonder because I know that for people who are not on testosterone, their testosterone levels are naturally highest when waking up and lowest before bed.

 

[Vince Carter]

on T and "natural" are two different things, the two are opposite, you're on Exo T, you're shutdown, you will be at the lowest point right before the next injection.

 

[Bentiger07]

on T and "natural" are two different things, the two are opposite, you're on Exo T, you're shutdown, you will be at the lowest point right before the next injection.

Thank you. I didn't think the answer was clear, because I didn't think I was fully shutdown with a lower than average dosage, plus I take HCG which tricks the body to making natural T.

Speaking of that, on a dosage of 9mg Tcyp and 40IU HCG daily, my boys have not decreased in size. I actually expected it to and planned to increase HCG if so, but surprisingly after a few months on this protocol, they appear the same size.

 

[MarkM]

Some people have testicular atrophy and some do not. I was on TRT for 12 years without HCG and best I can tell, I 've had no atrophy. I started using HCG about 6 months ago and have not noticed in change in the "boys". Effects everyone differently.

 

[BillyJ03z]

Just wanted to note here that SHBG overrides the half-life of Cyp. You'll "piss it out" well before you get to the ~6 day half-life. This is why you have to get on EOD shots if not daily (which I don't recommend except in tough cases).

Vince, I am a low SHBG guy.... For about 9 years of my TRT I have been around SHBG 10 - 13 (16.5 - 55.9) when doing inject 2xWK .... however the last 6 months I have been around SHBG 20-22 after moving to ED/EOD injects....

I have tried 2 1/2 months Test Prop 20mg ED SQ injects and exactly 24 hrs after inject my numbers were:

Total Test- 468 (198-679)
Free Test- 16.2 (6.8-21.5)
E2- 20 (20-53)
SHBG- 22

These are my numbers on Test Cyp 40mg EOD IM injects exactly 24hrs after inject (I know Im supposed to wait 48hrs to get blood labs when EOD injects but the plan with my doc was to get 24 hr and then 48 hr blood draws to see the clearance rate and difference in trough... for some reason I didn't get blood drawn at 48hr..)

Total Test-643
Free Test- 23.3
E2- <20 (20-53) (my e2 was lower than 20, I was on AI due to my previous blood labs showed my E2 had skyrocketed from DHEA supplementing.
SHBG- 21.10

As of now I am dosing test Cyp 20mg ED SQ (haven't had labs drawn yet. Do you think I should be on EOD instead of ED? What do you define as a tough case for ED routine?

 

[Vince Carter]

Youre getting the wrong E2 testing...needs to be the Ultra Sensitive LC/MS/MS, any other is for females.

I would defer changing anything given that wrong test. Too if it's affordable for you "Estradiol, Free" would be worth seeing. Given the proper E2 test is taken I like to suggest the low SHBG look to have his E2 and SHBG numbers mirror one another.

The tough case stems from negative/elevated Estrogen symptoms that persist even when having gone to low dose daily injections.