T Nation

8 Week Labs, High TT and FT

Hello,

I’ve been taking 210mg per week split into M/W/F 70mg doses. I feel good and have noticed improvement in energy, sleep, and sex drive. Hot flashes was the only side affect in the first couple weeks, but that has gone away.

Previous Labs
Testosterone, Serum 473 ng/dL (264 - 916)
Free Testosterone(Direct) 8.3 pg/mL (9.3 - 26.5)
Estradiol 22.9 pg/mL 7.6 - 42.6 01
Sex Horm Binding Glob, Serum 45.3 nmol/L 16.5 - 55.9

200mg Labs for 8 weeks, Tested on trough day (Monday)
Total Testosterone 1574 (240 - 950)
Free Testosterone 100.5 (9.0 - 30)

  1. Should i lower my dose to 150-175 to be within range for total and free testosterone?
  2. Can such a high free and total testosterone have any negative side affects.
  3. Should i be concerned about such a high free testosterone ?

****update, talked to my doctor and he wants to lower me down to 100mg per week and see where that puts me. He said that that both TT and FT are way to high and he wants to see me in range. I guess i’ll see where that puts me in 8 weeks and go from there…
Any input is appreciated.

Thanks

6/17/2020 Update

My dose was changed from 200mg to 100mg test Cyp weekly. I have stuck to the same MWF protocol with labs being performed Mondays (Trough day). The following labs are after 8 weeks on 100mg.

Total Testosterone 1103.8 (240 - 950)
Free Testosterone 44.6 (9.0 - 30)

  • I have no side effects, and overall i feel good/normal. During the last 4 months since i got on TRT i have lost 25lb (245lb to 220lb) by working out and counting calories. In the last month i have also started using a cpap machine for my moderate sleep apnea and snoring. These two changes combined with the TRT have made a big difference in how i feel.

08/25 Update: Saw an endocrinologists and it was a the worst experience. Rather than listening to the way i feel and running additional blood work to make sure everything looks good. He thinks its a good idea to stop treatment completely, wait 3-6 months, and try to recover my natural levels which were already low. I absolutely couldn’t believe this. I guess it does not matter if you feel good, all that matters is that you were within range at some point, even though at the bottom of the range and with symptoms…I dont know what my PCP will do with this information, if he will cut my prescription, or continue treating me. I might just have to go with the TRT clinic route and stop with all of this BS…


9/29 Update

My pcp decided to stop treating due to endocrinologists note, so i requested to get a second opinion. I went and saw a different endo and it literally was the same appointment as my first endo visit. He thinks after 7 months of treatment that i should stop for 3 months and get labs done again…I tried getting treatment the right way, so at this point I’m just going back to the mens clinic and maybe after a year try to get a different PCP to treat me, so i don’t have to pay out of pocket for TRT for the rest of my life. I have found going to an endo so far has done nothing for me. It does not matter that i feel better on TRT, they both want me to get off and run more labs before treating, and at this point i dont want to go through that.

No one can say for certain what will happen because everything that will happen will be determined by your genes. In time your body will find a new homeostasis and HCT levels may start to climb over time forcing you to adjust your protocol, then again you might not have any issues at all.

PCP is lowering my dose to 100mg per week. We will see what those labs look like. I’m hoping that my FT stays in the higher range and i feel the same.

I doubt -20mg is going to make a substantial difference, your levels will probably still be 1000> in 6-8 weeks. Your docs action are more than reasonable, be thankful he isn’t overreacting.

Don’t get overly concerned with the numbers because they only tell half the story, be concerned with symptoms resolution and feeling your best.

I’m going from 210mg to 100mg per week…not sure how you got 20mg difference., I would image that will be a huge difference. I still plan on doing MWF injections of 33mg instead of 70mg. Thanks you for your feedback, symptom resolution is my priority.

I have blurry vision right now from a medicine side effect, apologies.

How long have you been on the 210mg/week protocol? If you feel good consistently and see all these improvements, do you think it makes sense to change anything? I would at least complete 12 weeks on this protocol, then drop to whatever you want and reassess.

Honestly, I’m surprised you went from 8 FT to 100 FT. Highest FT I’ve heard TRT docs recommend are the 60 range. Basically you want the lowest levels that give you symptom-relief. Good chance it will be lower than 100 FT.

Im new to TRT and was on 210mg for 8 weeks. It’s not my choice to lower it to 100mg, that’s what my doctor wants to do. I expressed my concern about feeling worse by cutting the dose in half, but he want me in “range” because my FT is 3x the normal amount. According to him there is a risk of blood clots with such high levels. He thinks at 100mg my FT will still be high but closer to the normal range… After 4 weeks he wants to revisit how I feel and possibly make any adjustments from there. I’m surprised how well my body responded, especially considering my FT was 8 and jumped up to 100. I also have not seeing FT #s that high which is odd.

Greetings,

The only thing to do is to run the protocol for the 8 weeks until the next labs.
Since your new to TRT, it does take awhile to get “dialed in.” And you seem like your pretty close to getting dialed in. It takes some people years to even get close to that point. Remember, your in it for the long haul (presumably.)
Also it seems like you got yourself a decent Doctor.

Stay strong

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Seems like tis doc is too afraid to get you optimal. You dont wanna be in normal range, you wanna be where you feel best.
It is not a numbers game, but the cut from 210 to 100 is too drastic and absurd. I would go at around 150-170mg if I were you
3 times a week should work well with your SHBG

We dont know in what method is this 100 measured. I trust only calculated free t(and not the new FDA bulshit tru-tru calculator)

Oh boy, youre gonna crash. He figures if I cut the dose a little over half, it should bring ur levels to half and then work back up. This means weeks of feeling shitty. 160mg sounds better, and you might come down to within range. In my view, he’s not that great of a doctor. He aimed too high and it reeks of inexperience. Now he’s aiming too low…

That’s true. I’m assuming OP calculated the FT with the same facility (i.e. Lab Corp). More likely than not 100 pg/mL is an error. His SHBG isn’t even that low.

Is it too high? You’ll get lot’s of differing opinions from this forum. Your total dose of 210mg per week is much higher than I would have recommended for a starting dose, and your Free T is way out of range. Total T is high, but I’ve had higher. Bottom line is that I would have started at 100-120 per week and then evaluated every 6 weeks with labs and symptom abatement. I think your doc will undershoot the mark now, seems like 120mg might have been a better choice.

Negative Side-effects? The main side-effects will be excessive conversion to E2 and DHT, but your 3X per week dosing schedule should help to minimize the spikes in T and thus the spikes in conversion. Your E2 probably won’t cause any severe side-effects. Guys are way too paranoid over this hormone. Going high out of range is not necessarily a bad thing when it is balanced with healthy T levels. Personally, I like to see it stay under 80 pg.mL, which I think you will be (don’t see the new labs posted).

Conversion to DHT is a different animal. It drives 3 main side-effects, hair loss, BHP, and high hemoglobin production. Unless you are willing to use finasteride to lower the conversion rate, which is a very contraversial topic in this forum, your only other alternative is to decrease the dose. I suspect that your DHT is way out of range now but will come closer to being in range once you get your T within range.

Should you be concerned? Your main concerns are the side-effects discussed above. There is also lipids and cholesterol levels to consider, which can be driven out of range by TRT. Again, frequent injections of smaller doses is the main way to prevent side-effects.

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It wasn’t the same facility. The first time I had labs done was through a men’s clinic that utilized lab Corp. This time it was through my PCP who utilizes the local hospitals lab. I’m not sure how any of these values are calculated or if my results might be an error.

Below are the result with the actual units.

100.5 ng/dL - Standard Range 9.0 - 30.0 ng/dL

|Reference ranges are not established for patients <16 years.

This test was developed and its performance characteristics determined by Spectrum Health Toxicology Laboratory. It has not been cleared or approved by the FDA.

I hope this change doesn’t cause me to crash. I will give it 4 weeks and go from there. Hopefully this doctor hears me out and is willing to adjust the dose if I run into issues.

Thanks for all the feed back.

DHT will not cause you to loose hair. It will only accelerate the process if you are prone to hair loss. In that case you should only accept it. DHT is not causing BHP neither prostate cancer.

The prostate has a very limited size to be saturated with androgens.

From that point no matter how much more you have it doesnt make a difference

Whether DHT exactly raises hemoglobin I gotta check. What we know for sure is yes testosterone causes rise in red blood cells dose dependent. But with most people they raise the first few months, then settle down to lower levels.

A guy has told me his RBC also moved closer to the top range when he started TRT years ago and after that they came down. Now he is blasting with 500mg test and tren and his RBC are again on the top range but nothing dramatic

What was your estrogen andhgb/hectic at 210 mg. . Very curious.

I would be interested in seeing the source of this information. Can you please post?

Google the work of dr Abraham Margantaller sumarizing enough studies. Everyone following the data in the area knows about the saturation model. Fearing DHT is a thing of the past

I wanted to give you guys an update, i will make a separate thread with my experience, but for anyone who read this thread and commented, below are my current labs after 8 weeks of 100mg test cyp split into M/W/F. Labs were done the following Monday. See above thread for initial labs without TRT and after 200mg for 8 weeks. Thanks

Total Testosterone 1103.8 (240 - 950)
Free Testosterone 44.6 (9.0 - 30)