T Nation

Advice for Proper Test E Protocol?

I live in Thailand and the doctors I’ve seen don’t really know jack about trt. They want me to take a high does every other week. I know just enough to know that’s utter bs. For a 33yo male who’s got decent years of training. What would you experienced guys recommend for just straight test e?
My blood work had my free test at 377. 300-900 was normal in their scale. I’d like to be more like 750-1000 yeah? What dose should I start with and how often should I increase it?
I’ve done test in the past twice with not any real results other than fucking like a bull with a rock hard woody. I think it was something like 100mg every 3.5 days (max, not minimum if I recall).
Thanks guys for any advice

Well, while it isn’t legal per se, I do believe you can purchase test otc there, get you’re own bloods… however physician monitored trt is always the smartest route to go if you can find a decently versed MD on the subject

Can you post your lab results? Did you get a full hormonal work up … TT, FT, E2, FSH, LH, SHBG. If that’s ng/dl then is probably total T not FT but who knows what units they are using since its Thailand.

Are you looking to cycle or perform TRT? There is TRT and then there is cruising which a lot of guys do and call it TRT. If their scale is 300-900 then anything above 900 is not normal. I would shoot for upper range during your trough day so somewhere in the 600-800 range for longevity. 200mg is common but sstill the upper range of TRT. IMO 100-150mg/wk is better off to start and then you adjust this dose after 4-6 weeks when you retake labs.

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Disagree, scales vary dramatically. I can show literature that shows the upper limit of normality within a male populace to be about 1250… Many ref ranges nowadays cut off at 600, to say 650 is abnormal would be absurd

Show me a lab that says 600 is the upper range of ng/dl for the average male populace. I won’t believe it until I see it.

You may disagree but the fact is we are talking about TRT. You have to establish a medically accepted baseline. We don’t have enough info from his tests, no units or real labs etc, but based on his ‘range’ this is all we have. Therefore he established the range of normalcy for his general populace. To partake in TRT he should be within that range. Outside of it is establishing pharma use for the greater population especially if he is truly referring to free T.

The old accepted range for T (normal populace) was 350-1150 or something like that. the notion that 1000ng/dl is off the norm is ludicrous, 300-1000 was the previously accepted medical norm. Justing type in “what is normal testosterone” the first abbreviated answer that comes up is (270-1070ng/dl)

I’ll look tomorrow, I’ve seen LOWER cutoffs than 600ng/dl (I think the lowest I’ve ever seen posted was like 50-550ng/dl)

I can link literature that demonstrates within a healthy male cohort the average TT is around 730ng/dl

Study finds ref range (acceptable) to be 348-1196 ng/dl (2SD method)

https://www.jwatch.org/na41377/2016/05/17/variability-laboratory-reference-ranges-testosterone

Most ref ranges are highly flawed in relation to testosterone… sometimes its literally as stupid as “we have compiled test results from everyone who came in for testing, this is the range”… in which case it’ll obviously be skewed far lower as people coming in are probably being tested for suspected T deficiency

Another study, states certain labs had upper limit of (1500ng/dl+), reference ranges have been progressively getting lower and lower, there’s a legitimate trend here. 300-900 is one of the better ones now

The ref range MY doc tests me on is literally like 140-720

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I realize that, I’ve watched it myself. I’ve been using LabCorp since I started and the range was higher when I first started. That still doesn’t change the fact of what’s medically acceptable TRT. So you could look at averages and medians all day long and you wouldn’t see guys consistently at 1000ng/dl. I think my advice is pretty solid to be in the upper 2/3 on your trough day for longevity purposes. Do you disagree with that?

This would likely put you above the limit on your peak. Probably not bad advice.

We have seen these numbers shift over time both on the high end and low end. The high end was close to 1200 just a few years ago. I have seen some at around 915 now.

Would your advice change if you saw the top of the range at say 600 ng/dL? I would say what’s even the point of TRT if I am at 2/3 of 600 ng/dL (400 ng/DL).

For whatever its worth to explain this again.

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We are going to need more labs, this isn’t enough. You can shoot in the dark as far as protocol desicions go, but if you really want to start out on the right foot, you’ll get these tests.

  • Total T
  • Free T
  • SHBG -> This one is critical and is the balance of Total T, Free T, Free E2 and E2.
  • Estradiol (E2)
  • LH-Luteinizing Hormone
  • FSH-Follicle stimulating hormone

No not blindly. As @johann77 posted there as been debate already on these ranges that I am privy too. I feel 900 ng/dl is a responsibly high level and if they suddenly lowered to 600 ng/dl I would say there must be a reason for it requiring further evaluation.

Interesting, I will pointtt out my qualms with any study of this nature however. The avg BMI (in the study you’ve posted) is overweight (BMI avg above 25) vs “lean young men”, this alone will skew results lower. Secondly, the notion of the study saying men using medications known to effect androgen status… It’s still not particularly recognised that SSRI’s, some of the most widely prescribed medications in the developed world, are implicated within the development of hypogonadism/decreased testosterone. Furthermore, systemic exposure to environmental toxins, the fact that I presume, given this is a representation of the general populace, the majority of these men led sedentary lifestyles (unlike the initial study comprising of lean young men) results would be further skewed lower.

Yes, I’m aware this is supposed to be representative of the general populace, but the health status of the general populace nowadays is abysmal… do we really want to be basing standardisation of health on that?

However I will give credit where credit’s due, I was unaware of the change of method used to measure hormonal concentration, this can change up results quite a bit…

Once again I apologise for any grammatical errors, I’m using a keyboard of which is completely broken… letters duplicate themselves, sometimes spaces appear between words that aren’t required, sometimes random letters will jump in between wording

It is, but I wouldn’t go as far as saying “1000 is supraphysiological, will kill you” etc

900 is a perfect cavg to target for most

I would start with 150mg once a week. Give it a couple of months and see how you feel. If happy with the results, stay with it. If not, change it. Go ahead and get the labs, but don’t focus on the numbers over any symptoms or benefits.

Keep in mind that very few PCPs, urologists, endocrinologists will even consider SHBG, E2 and maybe even free testosterone. Most TRT patients (you can include gym/underground/black market guys here) using injections take them once weekly of twice monthly. This includes TRT clinics which predominately use weekly dosing. The dose is 150-200mg for 90% of them with most at 200mg.

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Apologies for being more vague than I realized. I’m not really wanting to do TRT. I’m looking for moderate, long term, healthy, enhancement. Here is my blood work. I only got test blood work done.

I can get Bayer Test E over the counter in 250mg bottles. They don’t have a rubber seal though, they’re the break off vials. So I’d rather not have an open container just chillin for too long.

Lab ranges:
SHBG: 18.3 - 54.1
TOTAL: 249 - 836
FREE: 5.71 - 17.48 / 1.53 - 2.88
BIO: 125 - 412 / 35 - 66.3%

Lab Results:
SHBG: 26.22
Total T: 377
Free T: 8.41 / 2.2%
Bioavailable T: 207 / 55%

Sorry guy, it’s replacement or nothing. You take Exogynous test, your natural production shuts down. Period. You replace production plus what you need that wasn’t being made. There is no supplementing with any form of testosterone.

What are other options then? I feel like I’m too young for shutting down. Unless it comes back after

You could try supplements that won’t work. You could take Clomiphene Citrate or Nolvadex for a month or two and see if that leaves you with a higher end result when you stop. It probably won’t. You can adjust your diet and exercise to try and maximize things.
BTW, you can put a piece of tape over the glass amp after you break it, but most of us with that problem just backfill several insulin syringes at once and store it that way - in the syringes.

Well, of course I don’t want to do that. What’s a good set point then? 150mg a week?

A good set point is wherever you feel best