I am hoping to get some help and see if anyone else has had this problem. I have been on Trt for past 1.5 years and struggling to find right dose.
This problem has happened to me twice now. Get lab work done after 8 weeks of a protocol and results show good testosterone and E2 levels indicating that I have the proper protocol on place and no changes necessary. Get additional blood work a few months later and suddenly my testosterone has gone up significantly and same with E2. My understanding is that after 6 weeks the labs should have stabilized and shouldn’t changed so much in the future.
For example.
12/2019
16mg daily, total 112 mg per week
Testosterone, total - 865 ng/dL
Testosterone free - 158 pg/mL
Estradiol - 45 pg/mL
Keep the same protocol but 4 months later.
4/2020 same daily protocol but higher levels
16mg daily, total 112 mg per week
Testosterone, total - 1114 ng/dL
Testosterone free - 268 pg/mL
Estradiol - 58 pg/mL
Is this normal for the same dose to cause different lab results months apart? It has happened twice to me which has cause my doctor to change protocol and always chasing the right dose.
Are you using 200mg/mL vials? If so, it can be fairly difficult to be that precise with dosing. Not saying that is your case, but maybe? I have to wonder about some who talk about upping their dose 1mg when we are literally talking drops.
I’ve seen this even with 150-200mg once weekly (meaning a 10-20mg swing in dosing is not that significant) dosing. Often, there is no explanation.
Chasing a number is a mistake, in my opinion. None of those values are crazy and as long as you continue to do well, I wouldn’t mess with it.
By the way, it is not unusual for testosterone levels to swing as much as 100-200ng/dL daily.
Yes I am using 200mg/ml vial and using a .5cc syringe for injections.
My doctor wanted to put me on an AI which I am trying to avoid at all cost. I lowered my dose to 14mg daily which has cut my testosterone down to 545 and e2 to <15 after 8 weeks. Obviously not feeling as good and will be increasing my dose again.
I am struggling to find a doctor that isn’t guiding me in the wrong direction. I changed doctors because he was pushing me to an AI but my new doctor is concerned about low LH which should be expected with TRT from what I understand. Frustrating to say the least. Thank you for the help!
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OK, this is telling. When on TRT, FSH and LH will bottom out. In fact, even checking it while on testosterone is a waste of time and your money.
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Kind of funny, sometimes I get a new guy and he is hesitant to come clean and tell me he has been using black market test. If he had labs taken prior to his initial visit we’d have FSH and LH ordered as we wouldn’t have known of any recent testosterone use. They stop test for a few weeks, so levels are low. Then I see FSH and LH and ask “when did you take your last testosterone injection?”
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I was happy with the new doctor and the way the visit was going until she told me to change from daily injections at 16mg to 3x a week at 30mg in an attempt to increase my LH. In that moment I felt hopeless again for finding the right doctor. I will increase my dose again to 16mg daily and hope that I feel better and that my labs don’t increase past previous ranges. Thank you for your help. Can’t wait to have a stable protocol.
Were both of the bloodworks drawn at the same time in relation to your injections? And both were from the same lab?
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Yes same lab facility and both first thing in the morning before my daily injection.
It appears your doc doesn’t understand much about exogenous testosterone, whether it’s 10mg weekly or 100mg, your LH will be suppressed to about .1-.2 on TRT. Regarding testosterone increases, decreases when on the same dosage, your levels will not always be the same and that’s something you’ll have to deal with to time adjusting your dosage periodically.
If you are thinking once your levels are stable on a particular dosage that you can maintain this protocol indefinitely, sorry but not going to happen. You will have to adjust your dosage every now and again.
In the sick care system, it’s like finding a needle in a haystack or playing the lottery, privately you stand a better chance.
It would be nice if you could just get to where you are feeling good and stay there. With the range mindset and constant tinkering, “dialing in”, I wish you wouldn’t get blood work once you’re feeling good. I change the initial dose in less than 20% of the patients.
Good luck. Keep looking for a doctor to work with you.
Update from recent lab tests.
7/24/2020 12 weeks on new daily protocol
14mg daily, total 98 mg per week
Testosterone, total - 869 ng/dL (250 - 1100 ng/dL)
Testosterone free - 139 pg/mL (35-155 pg/mL)
Estradiol - 39 pg/mL (< OR = 39 pg/mL)
Here are first labs taken on new dose if needed again
6/2020 8 weeks on new daily protocol
14mg daily, total 98 mg per week
Testosterone, total - 545 ng/dL
Testosterone free - 116 pg/mL
Estradiol - <15 pg/mL
Has anyone else need 3 or more months before labs stabilize? This has happened a few times to me where I get tested 6 weeks after a new protocol change and again a few months later. Every time the test taking a few months later are significantly higher.
I have already switched back to 16mg daily since I was not feeling good even up to the day of these labs taken but I am wondering if maybe my body just needs 3-4 months before I can get an accurate gauge of how I feel on a new dose. Thank you for the help.
Are you doing the shots SQ? They say it’s a slower absorption, so maybe takes longer than 6-8 weeks before it really hits the peak?
Yes all injections have been SubQ.
Sub q can have a great variability in absorption as I now discover
Is there any way to control any variance that Subq may cause. Such as using same injection location, just rotating sides of the body. Any additional help is greatly appreciated.
Is there a reason you don’t want to do IM? It seems to be the most consistent
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I think no. The same spot that it worked fine when I started TRT at some point has stopped working
Ive read about subq being a slower more stable release plus I have been doing daily injections and would like to avoid daily IM shots.
Sub-Q offers a lot of variability in absorbtion. I read it in a lot of people on the boards. I see it on people I know in person who are on TRT.
Also I was very confident sub-q works awesome for me, but it stopped suddenly. If you use cypionate or enanthate probably EOD will work similar to ED for you. And even doing ED IM is not so bad if you rotate sites. Just dont make the HUGE mistake to do it with 1/2 inch needle unless you are like below 15 percent body fat and even so…Im not sure
1/2 inch might not work for you but many on this forum use half inch needles with great success. I only take 140mg per week and my last labs had TT of 1347 so I doubt their were any problems with absorption.