T Nation

Therapy Options: 30 Y/O Male


#1

I'm a 30 year old male and only in the past 2 months discovered significantly reduced total testosterone levels (total T = 175.5 ng/DL) . I was started on testosterone cypionate injections, 200mL per week (administered in two shots over a week).

Just yesterday I went in to obtain more specific bloodwork to see how and/or the extent to which the testosterone injections are working - so I'm waiting on SHBG and free and total testosterone levels. I'm also a type 1 diabetic and have celiac, and autoimmune thyroiditis (inducing hypothyroidism).

I exercise everyday, including 3-5 times per week of 1 hour or more of moderate to high intensity cardio as well as weight lifting 30-45 minutes 3x per week. I'm a big guy (6'1), broad shoulders, deep voice, lots of hair, high libido. I bench 310 lbs in sets of 5, and I've been weight lifting more or less regularly (since periods of lower intensity, of course) since I was 15.

When I saw my testosterone levels though some recent changes in my mental status and general energy level started to make sense.
In any event, I realize how insanely low my total testosterone is. Based on what I've learned, I very much doubt that at the 6 week mark my current protocol for testosterone replacement therapy has sufficiently increased my testosterone (but we'll know shortly).

My questions: (1) Based on the duration of action for testosterone cypionate does this injection schedule of 2x per week at 100mL make sense? (2) Based on the severity of my testosterone levels, and assuming levels are still under the 400 mark or so, should I consider a switch to the shorter acting testosterone enanthate and/or ask my doctor for increased dosage of the testosterone cypionate?

I've noticed over the six weeks since beginning the injections some improvement in energy levels, reduced frequency of feeling like I want to lay in bed, and increased libido, not to mention some influence on social anxiety (it seems reduced). But I still don't feel like it's enough, and I wanted to get other TFT-experienced users' opinion on my level, my current therapeutic protocol, etc.


#2

[quote]DPrice21885 wrote:
I’m a 30 year old male and only in the past 2 months discovered significantly reduced total testosterone levels (total T = 175.5 ng/DL) . I was started on testosterone cypionate injections, 200mL per week (administered in two shots over a week).

Just yesterday I went in to obtain more specific bloodwork to see how and/or the extent to which the testosterone injections are working - so I’m waiting on SHBG and free and total testosterone levels. I’m also a type 1 diabetic and have celiac, and autoimmune thyroiditis (inducing hypothyroidism).

I exercise everyday, including 3-5 times per week of 1 hour or more of moderate to high intensity cardio as well as weight lifting 30-45 minutes 3x per week. I’m a big guy (6’1), broad shoulders, deep voice, lots of hair, high libido. I bench 310 lbs in sets of 5, and I’ve been weight lifting more or less regularly (since periods of lower intensity, of course) since I was 15.

When I saw my testosterone levels though some recent changes in my mental status and general energy level started to make sense.
In any event, I realize how insanely low my total testosterone is. Based on what I’ve learned, I very much doubt that at the 6 week mark my current protocol for testosterone replacement therapy has sufficiently increased my testosterone (but we’ll know shortly).

My questions: (1) Based on the duration of action for testosterone cypionate does this injection schedule of 2x per week at 100mL make sense? (2) Based on the severity of my testosterone levels, and assuming levels are still under the 400 mark or so, should I consider a switch to the shorter acting testosterone enanthate and/or ask my doctor for increased dosage of the testosterone cypionate?

I’ve noticed over the six weeks since beginning the injections some improvement in energy levels, reduced frequency of feeling like I want to lay in bed, and increased libido, not to mention some influence on social anxiety (it seems reduced). But I still don’t feel like it’s enough, and I wanted to get other TFT-experienced users’ opinion on my level, my current therapeutic protocol, etc.
[/quote]

Hi.

  1. To me it sounds bit high dosage for trt unless you’re so called hyper metabolizer and that’s unknown before your lab result. I predict your levels will be well in the green with this amount bro. Cypionate apparently has approx 8 days half life i cannot confirm this though. After a while you will start to have probs with atleast elevated E2 aka estradiol so you should monitor it frequently, better yet ask for Ai from your doc ( i have that road ahead of me next week ). Also i’m not totally sure what you meant with duration of action you wrote in the 1st question? Forget about active life of test cyp if you meant that.

  2. I fail to see what shorter acting test would accomplish in this case.
    I’m surprised if 200mg per week isn’t working for you. From what i’ve learned here, your condition that’s leaning towards hypothyroidism is a obvious factor to your sense of well being and generally causes symptoms similar to low testosterone too, which you have been diagnosed though.
    I don’t know if you’ve used gear in the past, but i’d want to note that these amounts of testosterone still doesn’t make you fly and suddenly feel tireless and immortal beast. You will best notice the difference if you let it taper off completely. I don’t suggest it though ( i become cranky as hell personally and get irritated by anything and everything ). However, if your levels are far off still, then yes you might need more.

Have you done comprehensive laboratory tests recently?
Everything from liver to ferritin, hemoglobin such?
Thyroid hormone tests? Did doc take your LH and prolactin before ordering trt?


#3

[quote]DPrice21885 wrote:

My questions: (1) Based on the duration of action for testosterone cypionate does this injection schedule of 2x per week at 100mL make sense? [/quote]

I don’t think so, considering T cyp is long acting, and many men do just fine with injections done once per week, like myself. I use 100 mg per week in one shot. 200 mg is twice the starting dose for TRT. Many men can reach the 700 to 900 range with 100 mg per week. Also, changes in T while being in the 500 to 1000 likely result in no appreciable differences in well being, I believe. I also believe most are hypochondriacal with TRT and make things more complicated than necessary.

[quote]

(2) Based on the severity of my testosterone levels, and assuming levels are still under the 400 mark or so, should I consider a switch to the shorter acting testosterone enanthate and/or ask my doctor for increased dosage of the testosterone cypionate? [/quote]

Do you seriously think you are going to measure at below under 400 with 200 mg of cyp per week?!

There is pretty much no need for a short acting ester with TRT and cyp can have you at a supra physiological level overnight.

A good range to be in for most men is 500 to 1000. Life does not change for most whether they are at anywhere in this range.

There might be no need for an AI with 100 mg per week. I don’t use one. A good E2 number is less than 50 with T at 500 to 1000.

Quite a few men complain of symptoms while on TRT in this forum. If you test in the high normal range for T and with normal E2, then something else might be wrong.

What do you mean by “not enough?” TRT is not going to produce a state of well being beyond what eugonadal people have on the regular.

Also, if you have been untreated while hypogonadal for a long time, it may take some time to feel 100% like your old self. It was after six months till all symptoms were resolved for me.

You might also have problems because of high E2 because medicinally speaking, your dosage is high, which will cause supraphys levels of E2, and you likely can have better results with less medication (T in the 500 to 1000 range and E2 in the normal range too).