T Nation

My Testosterone Readings


#1
     I just got some blood work back. I'm 43 and currently on trt, 300mg test cyp twice a month. The blood for this test was drawn right after an injection. I see my doc this thursday for another injection but I need some help understanding these results.

I know my doc is happy because everything is in range. I feel okay but not great and I want to start once a week injections at 150mg-200mg. From everything I've read more frequent injections seem to be better

 Total test 476         Lab normal 260-1000ng/dl
 % Free test 1.5        Lab normal 1.0-2.7%
 Total free test 71.9   Lab normal 50.0-210.0 pg/ml

                       Thanks

#2

Tell your doctor that you're a person and not a lab rat and that you don't give a shit what the lab work says, you want to feel better. It's your life and your body and he ain't running the show, you are.

At the same time, be a little smarter about what you're doing and "present" with better symptoms to get what you want. Quit telling him you feel ok. Tell him that a week after your injection, you start feeling like shit.

Read: "TRT: A Recipe for Success" by John Crisler and then give it to your doctor and demand that he discuss it with you.

http://www.allthingsmale.com/word_docs/TRT.doc

Sorry for the attitude, but my experience with doctors and TRT is that it's a war and they are the enemy.


#3

You're doctor is an ignoramus. Twice a month? Blood drawn right after an injection? A day after or an hour after? What?

Was the draw before 8 AM or so? If its not early in the morning, the reading is off (worthless).

Once per week injection; draw blood the DAY BEFORE as early in the day as possible. Get E2 checked and kept in check.

All of this from 3 years of hard experience and reading.
Google: Journal of Endocrinology and Metabolism


#4

Absolutely! Crisler knows his shit! Great post!


#5
The blood for this test was drawn immediately after my injection at about 10:00 am. Because the levels are not off the hook I really don't think they were affected by this fact. Usually blood is drawn before the injection but he was actually doing me a favor as the blood was for another doc regarding something else and I figured why not check the test as well. The numbers are within range but since I'm sure after being on TRT for almost two years now my body is making very little if any test. I know its more about how you feel and since I can't say I feel great than those numbers are not high enough.


  I have learned a great deal about TRT from allot of what has been written on this site. I plan on going to weekly injections at 150mg instead of 300mg twice a month or 75mg twice a week. I currently receive my injections from the doc but I'll save the copay and do it myself. I was never afraid of needles and the injections have been much more convenient than the gels but since I have never injected myself I'll take anyones advice on the best location for self injections. I know he uses a long thin needle and injects deep into the muscle. No pain really just a weird pressure feeling

 I'm not defending my doc or any doc for that matter but this guy has been a great help to me. I know everyone has been bashing him for the twice a month injections but allot of docs are told because of the half life they only have to inject once every three or even FOUR weeks. Even Upjohn who makes the test cyp I use states in the instructions that three or four weeks is fine. Before I met my current doc I couldn't get any help. I said I feel okay because I felt like absolute s#*t before.

 I consider myself very lucky. Allot of guys have the same problems as me and can't get insurance to cover the cost. I read the article from Dr Crisler and found it very informative. He seems quite conservative in some aspects but his use of AI's and HCG unfortunately are currently not in the main stream of TRT right now. I've read some good research articles on AI and TRT on line so maybe thats changing. I'll have my estrogen levels checked to see where I stand with that but as far as HCG I would be surprised if my doc will go for that. Thanks for any help you can give me I'm here to learn   


#6

I'm not going to defend most docs, because I think most docs are only driven by greed or fear. However, the docs in the trenches are not the enemy. The enemy is the AMA and the DEA, both of which are determined to stamp out HRT. They consider it solely as either a scheme to rip off older guys all wanting a harder johnson, or worse, a covert distribution scheme to sell bulk AAS and GH to younger, healthy bodybuilders and strength athletes. This of course DOES OCCUR, in the small minority of docs doing HRT, making things even worse for those who are trying to do the right thing.
The docs who are bought and paid for by the AMA and DEA are in fact the worst scum of all scum, as they lead the charge of calling out any age management docs as "quacks" and work covertly to have their offices raided by SWAT teams.
I am sorry if this sounds like a rant, but I am speaking both as a doc and a patient for whom HRT has been the difference between no life and life. I fear for the future of these docs in the trenches, because if nothing is done by a loud, vocal minority to make HRT known as credible, valuable and indispensible, it might well get a black box warning, or worse a Class I ruling, making it virtually the same as heroin and cocaine. As a doc all I can do is work with other docs to pressure the AMA to validate Age Management as a legitimate speciality, which would give protection to the docs who do it. The rest of you need to be clear on who the real enemy is, and figure out an effective strategy to make change. Good luck on that part.
BTW, I absolutely agree with the above posts recommending "educating" your docs about HCG and AI's. Those two drugs are just not in the "protocols" established by the three main organizations training the docs in Age Management. I'm learning everyday from reading T-Nation and suggested references.
Doc


#7

BTW, to further illustrate my point, the real bad guys (AMA/DEA) had NO PROBLEM whatsoever in approving and advocating the widespread use of harder johnson medicines like Viagra, Levitra, and Cialis. Anything BUT T. And they had no problem whatsoever in approving over a dozen antidepressants in the past decade, but heaven forbid a guy is depressed secondary to hypogonal T deficiency or related issues. No they don't want you getting T for that, either.
If I go on with conspiracy theories, I might end up dead. But just think Big Pharma and connect the dots. Doc


#8

And as voters,in the USA, we can work to elect our government representatives who support our agenda, and work to change the laws that prohibit it.

Male baby boomers account for 28.02% of the male population in the U.S. and female baby boomers account for 27.64%. We are a majority that cannot be ignored if we exercise our power.


#9

Nice post! Where'd you get the numbers?

Politicians, being mostly rats in human form, WILL respond to stimuli --- like taking away their jobs.


#10

From AARP, of course! Power to the people!


#11

Doc, the fact that everything in your rant is true doesn't make it, in my mind, any less irrelevant.

Forming a Political Action Committee isn't going to get me better treatment today and getting the best possible treatment is my concern. EVERYONE standing in the way of that, Congress, the AMA, and my poor ol' doc in the trenches is my enemy.

If I didn't understand that, I'd have let my doctor blow smoke up my ass and pawn it off as medical advice.

Your argument is that the soldier shooting at me isn't really my enemy because he's only following the orders given to him by the generals. Bullshit. If he shoots me, I'm dead and that's all that matters.

Why my doctor is trying to give me crappy treatment is only relevant in that knowing why helps me fight him better. He's the enemy and I never forget that, even if I sympathize with his situation. Sympathy isn't doing anything for my HPTA.


#12

If TRT is working, the PHTA is shut down. In that situation I would not expect to see any difference with the time of day.

If on HCG, best taken as 250iu SC EOD. The T level changes will be very low. Testing is probably best 1/2 way between HCG injections. With the T production of the testes controlled by the HCG, I would not expect that AM vs PM testing would be an issue at all. And for weekly or longer injection cycles, EOD HCG would create a T level floor [assuming that the testes are still HCG/LH responsive] higher than zero.

Twice a month will leave one with very low T. E will be elevated and SHBG increased. As the T levels fall, the free testosterone will then have effects diminished by the E and SHBG.

Testing after two weeks will show a meaningless number... lowest of the injection cycle. Testing just before or after injecting will have little effect as the release of T esters and conversion of T esters to T takes time.

Most of the time, the best time to do T testing is 1/2 way through the injection cycle. But that is probably not good on a two week cycle. Probably need to inject once a week at least to get decent level control and testing.


#13
Thanks to everyone for their advice and for sharing their experiences. I see my doc tomorrow and will discuss the once a week injections and have some blood taken for the estrogen levels. I'll report back with the results


                                  Thanks

#14

Gotta track Estradiol (aka "E2") along with this. I do shots twice a week. It was every other day, but my curr. doc, who's up on Dr. Crisler's protocol for the most part, wants a little more less often. But every other week is just not ideal.


#15
   Had a visit with my doc the other day and received an injection of 150mg instead of the usual 300mg. He had no problem with once a week injections. I talked to him about possible high levels of estrogen and although he doubted it after an exam he agreed to a blood work up to make sure.

I did not mention the possibility of using an AI at this time but I did mention HCG and he was not to receptive regarding that. If my estrogen is raised I'm sure he will prescribe an AI but as far as HCG I doubt it. Regarding raised estrogen levels I was wondering if anyone has had any success or knowledge of combating estrogen with zinc.

  Anyway I'll post with my results soon

                              Thanks

#16

Hey Happy Dog, nice counter. It made me reflect that I also had several "enemy" docs standing in the way of me getting proper diagnosis and treatment of my spinal trauma and unusual radiculopathies. But I had no success in coercing or changing bad doctors opinions or behavior.

I had to keep trying new docs until I found one who would help me, and if it wasn't for him, I wouldn't be lifting again. And to find the one good doc out of a dozen, I had to get out of town, out of state, and go through a hell of a lot of red tape.

Have you tried every doc possible, or are you limited by an insurance or other factors? What's keeping you tied to an "enemy"?  Doc

#17

I'm tied to an enemy doc because I don't fit the profile. My T was initially 250 so not below "normal" and my E was 32 so also not out of range, but trust me, a T to E ratio of eight sucks. Insurance ties me to a few choices and I burned through most of them before I found one that was willing to talk to me like the educated man I am and not some ignorant child.

On my first visit he tried to give me the "all part of the normal aging process" speech and I told him I had two problems with that. 1) I'm here for medical advice, not your philosophy on aging. 2) Fuck normal. He looked me in the eye for a time and said, "I can see that you're not like my normal patients and I like that."

We have a truce and it's working ok. Like I said, I understand his situation. I've read the Anabolic Steroids Control Act and the American Association of Clinical Endocrinologists Medical Guidelines for Clinical Practice for the Evaluation and Treatment of Hypogonadism in Adult Male Patients. He has his priorities and I have mine.


#18

I am currently on 150mg test cyp once a week after taking the advice I read on the board and switching from 300 mg twice a month. Today was my third week can't say I feel that much different yet. My real reason for posting today is to share the results of my recent blood work.

 Total free test    496    range 260-1000ng/dl
 Total % free       2.0%   range 1.0-2.7%
 Test free         100.1   range 50.0-210.0pg/ml

 Prolactin         12.4    range 2.0-18.0 ng/ml
 progesterone        .5    range <1.4

Estrogen,Total Serum 208 range 130 or less pg/ml
(from what I just found on a
lab value guide <130 is for
a post menopausal woman. A
male should be 20-80)

  I was expecting the levels to be high. I have had many side affects related to high estro but even I am surprised at just how high it is. Before I started trt my E level was not checked so there is nothing to compare this number to but I don't think this raised level is solely caused by trt. My TT and % free are up from the starting point of 120 and .8 % but no where near the levels of the raised level of E to blame trt for causing this.

Obviously something has to be done to bring down this estrogen level and my doctor agreed as much. I have received nothing but good info from very knowledgeable people on this site so any help you can give will be greatly appreciated

                               Thanks