T Nation

Free Serum Levels, What Do They Mean?

Greetings! I’m starting TRT Monday.

My doctor prescribed me 100mg every two weeks to start. I really appreciate tour time and I put while I try to wrap my head around all of this.

My levels are:

Testosterone, Free Serum
15.6 ng/dL µIU/mL

Testosterone, Total, S
390 ng/dL

LH (Luteinizing Hormone)
4.1 mIU/mL

FSH (Follicle Stimulating Hormone)
3.0 mIU/mL

Thyroid Stimulating Hormone (TSH)|Your Value1.92

Thyroxine, Free (FT4)
0.73 ng/dL|

We need lab ranges with the numbers, and I’ll tell you up front that protocol is doomed either way. The problem with it is twofold. First, 50 mg is not enough for anyone except @systemlord. And second, every two weeks is a terrible idea for pretty much any ester, but you haven’t said what he prescribed you.

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Hi, welcome to the forums.

I don’t want to be a downer, but 100mg e2w is, most likley, way to little too infrequently.

That’ll put your test levels lower than you currently have, that second week after your injection will be miserable once your natural production shuts down.

100mg /week would be better or divided doses of 50mg e3.5d even better.

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Testosterone, Free Serum
15.6 ng/dL µIU/mL
Standard Range
4.65 - 18.1 ng/dL

Testosterone, Total, S
390 ng/dL
Standard Range
240 - 950 ng/dL

LH (Luteinizing Hormone)
4.1 mIU/mL
None Given

FSH (Follicle Stimulating Hormone)
3.0 mIU/mL
Standard Range
2.5 - 17.7 mIU/mL

|Thyroid Stimulating Hormone (TSH)|Your Value1.92 µIU/mL|Standard Range0.34 - 5.66 µIU/mL|

|Thyroxine, Free (FT4)|Your Value0.73 ng/dL|Standard Range0.52 - 1.21 ng/dL|

I guess I’m unsure of how to approach my doctor with these dosing concerns.

Your free T isn’t terrible, although I’m at 20ng/dL and still feel only ok. I assume you’re showing symptoms of low T, which is why you approached him?
Your Total T is fairly low. I’d guess you have low SHBG which means not much of your total T is being bound up.
At 50mg/week, once your natural T shuts down, which it will, I would guess your levels may be even lower than what you’re on now depending on what happens to your SHBG. I’d look at starting at 100-150mg/week. Bloods again and reevaluate after 8 weeks or so.
In terms of your Dr. just tell him. Go do research, talk to him about the half life of the test he’s suggesting, assuming it’s an estrified version. Visit steroid calc website and show him the huge peaks and troughs on that protocol compared to once, twice weekly and every day, etc etc. build an argument backed by facts. Lastly if he insists, tell him to provide the research showing this is the optimum protocol. After that take your money elsewhere. Good luck.

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Thanks for the info! It’s much appreciated. I have all the signs of low/not optimal T. It’s been a ride. Therapists and medicines for depression that don’t work, weight gain despite putting in the work both in the gym and kitchen, and more. I’m tired of being tired and not being able to sleep.

I’ll dig into the dosings and chat with my doctor. From what I’ve gleaned over, 100mg weekly split into two 50mg doses would be an ideal starting point.

Thanks again for the info! If you have any links or other info to pass along I’d appreciate that!

Cheers!

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Your doctor will be unable show you research that your current prescribed protocol is effective, in fact I’m going to let the study below do the all the talking.

Hormone profiles after intramuscular injection of testosterone (200mg) enanthate every 2 weeks in patients with hypogonadism

In fact, the present study confirmed serum levels of T which were lower than pre-ART value levels on day 14 after administration. Therefore the further decrease in serum T levels on day 14 after administration is considered to relapse of hypogonadal symptoms and to reduce the patients quality of life.

Graph B

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The first time I was put on injections that was my starting dosage. Worst 8 weeks of my life.

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Your doctor is an idiot. TRT will not help you. Your free testosterone is high-normal.
Get your Free T3, Free T4 and Reverse T3 checked.
Also, do a 24 Hour Saliva cortisol test. You will have problems in the near future by putting in exogenous androgens. You cannot exceed your weakest link so to speak. You need to figure out what is really causing your symptoms.

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This definitely brings things into perspective, your Free T levels were good and the only way you could have good Free T with Total T lower is if you have low SHBG. I would be doing great at these Free T numbers because I also have low SHBG.

I’m surprised you’re getting these numbers with poor sleep, I can only imagine what your hormones would look like if your sleep was better, I would dive deeper into what’s causing your poor sleep.

I would suggest to your doctor to do a sleep study to see if you have sleep apnea, sleep apnea can create conditions of exhaustion which could mimic the symptoms of low-T and even kill off libido.

You would expect to see high hematocrit in people with sleep apnea. If you do have sleep apnea, TRT will more than likely make it worse.

Agree with the prior replies. This is a terrible protocol and shows that your your doctor doesn’t have a clue for administering male hormone replacement.

I would not start this protocol. It will probably make the situation worse. 100mg every 2 weeks is just enough to shut down internal production of T and not enough to keep your hormones stable for 2 weeks.

As per prior comments, with such a high Free T and low Total T, you more than likely have low SHBG. I would have that tested. I predict on this protocol that you will feel better for about 4-5 days and then crash and feel worse than before on days 6-14.

I would suggest to your doctor that he consider a starting dose of 100mg per week broken up into 2 or more injections per week. I like the every 3 day protocol. You can easily load into your computer or phone calendar to help you keep track of injection days. In this case 40mg (0.2mL of a 200 mg/mL solution) E3D delivers about 93mg of T-cyp per week. Close enough to 100mg.

You might want to present your doctor with the following graph which show the release kinetics of 40mg of T-cyp E3D. It releases an average of 9.3mg per day of T from the ester (range 7.9-11.2mg). Keep in mind that the average healthy adult male secrets about 7mg of T per day.

Where’s you find that graphing system?

Took my first dose today. My doctor listened. He put me on 50mg every 3 days.

Unfortunately, the graphing site went down a few days ago and I haven’t been able to reach it. I have a lot of T release graphs on file and these were a few of them. Here’s the link in case it comes back up: steroidcalc.com.

Would love some of those charts! Would you send me an email?

Sorry I don’t use private email for T forums or post my name. I sometime dabble and post about medications that I’ve used that are obtained from less than legal overseas suppliers. For example, I recently posted on my experience with very low dosing of Winstrol or Anavar to suppress SHBG.

That’s a heck of a lot better that what was originally suggested. Good job talking to him.

Now we’ll just have to see if in a couple of months if you feel better.

I understand!

I’m feeling a lot better about it now. Thanks!