Imo you need to figure out why free t was low when total t was good. Doing trt in these cases seems to create issues. There may have been other underlying issues.
Perhaps adrenal related? Shbg being to low or high because of various conditions you can research??
You may already have investigated this so if that’s the case ignore.
No idea and that was after optimizing everything I could plus over the counter supplements and foods to naturally increase testosterone. Without all that I’d definitely be even lower.
Could be. Do you know any good sources for looking further into this?
Blood test
Am cortisol - take blood within 1 hr of getting up
Acth
Dhea s
You can also do urine cortisol test throughout day. But most drs order blood.
Not adrenal related but you can check DHT if you never checked.
Adrenal issues may cause symptoms similar to low t but in your case your free t was low.
DHEA S was on the lower end of the normal range and DHT currently is in the middle. Will look into the other two.
Dhea s is made by adrenals. So if that was low end pre trt…
Actually have no idea pre-TRT. Got it checked a little while after TRT, then supplementing with DHEA rose it a little bit. I always felt worse after taking the supplement though.
Update: Consulted with Dr Saya, he basically said the same thing as @dbossa and @dextermorgan - that I need FT at 30+ and that I may need more DHT than what I have at 54 ng/dL (30-85).
Prior to dailies, I was doing 2x/week injections. However, I felt great at some points and shitty at other points of the week - usually the day of injections and often the day before.
With dailies, I’ve just felt consistently shitty. His reasoning was that at 22 it’s like I’ve been on a trough everyday (when I used to feel shitty) and by increasing the dose, I hypothetically should be feeling like the peak I used to feel while on my 2x/week injections everyday.
Doc recommends I start 22mg/everyday - will update if I feel symptom relief.
Nice!
That’s good news @marcus007. I’ve been on 22mg daily for almost 7 weeks now. I was in 42mg EOD and I could feel more of a test peak than I do now, but overall I feel okay. Haven’t done blood work yet, but still staying the course and will see how I feel at 8 weeks.
Good luck!
Thanks, hopefully I make some progress with this.
Have you checked your FT?
@marcus007 - No blood yet on 22mg daily, but on 42mg EOD, my FT was 249 (or 24.9 depending on measurement) with a 35 -155 range.
Top test number is free, bottom is total -
I might have to eat my words.
Yeah, I would wait a couple more weeks. If not, then raise to 24-25mg and see how it compares.
He did mention my thyroid was suspect, but will need more data points to make a clear assessment.
I did feel really good at certain points of my other protocols despite the thyroid so he heavily leans on low FT being the culprit of my problems. I’ll keep updating everyone here.
4 week update:
Feeling way better, finally. Still tired at times of the day, although nothing like how I felt on the 15mg protocol and feeling very consistent so far thanks to the dailies. Still experiencing brainfog at times and I’d like to improve this, but manageable as is.
In summary, the above hypothesis by my doctor and @dbossa were correct. I was suffering from a constant trough at 15mg dailies and needed more FT (more than 22 pg/mL). At 22mg dailies so far I’m feeling descent but not “great”. I’m thinking I’m at about 30 pg/mL FT. Also noticing my body a little more bulky and muscular over the past month (6’2 nearly 200 lbs). In the past I’d kind have a skinny fat type look when I bulked, but 150+ mg and a descent workout routine seems to be the cure for body composition. One negative, however, is my balls have been hanging high all the time - sometimes a bit bothersome.
Will likely get basic bloodwork like TT and FT at the six weeks mark and planning on sticking with 22mg until at least 8 weeks per the above recommendations. Good chance I might feel even better during the second month on 22mg. If not I’ll increase my dosage with the intent to raise my FT by 5 points a time (i.e., next time striving from 30 pg/mL to 35 pg/mL). I’ll keep doing this until I feel full symtom relief or until I get to the point where the dosage is higher than I can handle. Then, once I find my optimal FT level, I’ll go ahead and look into optimizing my thyroid.
Awesome news!!
8 week update with bloodwork.
Testosterone, Serum 1060 ng/dL 264-916
Free Testosterone(Direct) 30.4 pg/mL 9.3-26.5
Vitamin D, 25-Hydroxy 90.2 ng/mL 30.0-100.0
About 8 and a half weeks since starting my 22mg dailies protocol. Bloodwork right at 8 weeks at a trough.
I added in Vitamin D just to see where it’s at and it’s obviously too high at 90 (at a trough, didn’t even take Vit D that day). I take 5000 ius a day of Vit D so maybe I should only take it every other day or lower the amount I take, not sure.
Overall felt some ups and downs during week 5-8. Noticed I didn’t feel the same after taking my dose late at night instead of early in the morning - for a week straight felt like kind of shitty. Now, back to feeling ok. Since I felt always felt shitty on 15mg and descent on 22mg even after 8 weeks, thinking I should go to 28mg to feel my best if still feeling the same by week 12. Thoughts @dextermorgan?
Also, still often feeling bodyaches. Not sure if this is from working out or might need more e2? Only felt like this back when I used to take AIs or now while on daily injections.
I felt like crap after a while on 5,000iu/day Vit D. Switched to 1,000iu and felt much better. It kind of felt like it did when TRT isn’t right. It just so happened johann77 posted something about too much Vit D so I have it a try and that worked.
I also just started injecting at night (3 days now) but may go back. Don’t even know why I did it honestly. I think 28mg sounds like a good bump after 12 weeks since your levels are steady at 1000 now. It would help get the estrogen higher.
Hmm ok, will give 1,000iu/day a try from now on.
Will do, hopefully this becomes the final change I have to make for TRT.
Thanks for the comment my man.
Yeah man it sounds like you’re almost there
