T Nation

TRT: Should I Adjust My Dose?


#1

My doc just called me and said she was happy with my trough levels (6 days after injection, injecting every 7 days) which were above 600. I know that she wants me to be at the upper level so she wouldn't mind me being there, but I don't know where my peak levels are. Do you think I have room to add more test or should I ask her to test me again three days after injection?


#2

Well, it depends on how you want to feel.

Letâ??s assume that your T is at 1100 (or 900 or anything higher than 600 really) on Day One after the shot. Why would you want your hormones to swing that much over the course of a week?

   T Levels

Shot Day T=1200
Day 1 T=1100
Day 2 T=1000
Day 3 T=900
Day 4 T=800
Day 5 T=700
Day 6 T=600
Shot Day T=1200
Day 1 T=1100
Day 2 T=1000
Day 3 T=900
Day 4 T=800
Day 5 T=700
Day 6 T=600

Why would you want to feel good, then feel ok, then feel less ok all within a week, when you have the option of EOD or E3D? Are human bodies suppose to produce T with wild weekly swings? What does the swings do to your Estradiol, SHBG, Thyroid, etc.

Why not inject more often with a lower dose?

Shot Day T=1000
Day 1 T=900
Shot Day T=1000
Day 1 T=900
Shot Day T=1000
Day 1 T=900

If you are going to stay with the weekly injections, why would you increase the amount before you know what you readings are on Day 1 after the shot? I would definitely recommend a blood test for day 1 or 2 after the shot to catch it as high as possible. It could be at 1,500+ like I was.

Are you taking anything for Estradiol control, HcG, etc. or just T shots?


#3

THis is why gels are so much more convient it will not cause that huge of a hormonal shift in vast majority of patients. Once in a while you may get a fast metabolism and then you have to apply the gel twice a day to keep levels more stable other then that once application with 250 ius every 2 or 3 days is plenty.
Upper level at the trough is not really a good thing because that means your ceiling is much higher which will cause a potential problem with other hormones such as adrenals and thyroid. This why we like to keep men as stable as possible so that the shift is a maxium of only 250 -to 300 points from crest to trough. This also will offset the huge estrodial swings as well.


#4

I'm taking just T shots by itself, don't think there is a need for anything else because my labs look fine. And honestly, I dont feel much of a difference throughout the week...strange. I have noticed more oily skin, pimples and arousal. Oh yeah, some body recomp too :slightly_smiling:


#5

hardasnails - gels do work fine for some, but others like me can't absorb anything through their skin. I started off doing just fine on Androderm, but then it stopped working after a few months and no other cream, patch, or gel would work after that. (and yes, I am hypothryroid).

Jon - everything posted here is just people's opinions based on personal experience and personal research. Feel free to disgregard anything you like.

A couple of side notes:

You state your labs look fine, but we don't know what was run and what the results are. After hearing from doctors time and time again "you are fine and your results are 'in range'" and then finding out that the results really weren't in range, it was just the doctor who had no idea what the real ideal range was or that the doctor didn't even run the right tests to begin with. so people here (or at least me personally) are skeptical when we hear that "my labs look fine".

It is also very rare for just one system (i.e. - Testosterone) to be out of balance by itself. Normally when one hormone is out of balance there are two or three others that are also thrown off to some degree (Thyroid, DHEA, Pregnenelone, Vitamin D, Ferritin, Cortisol, Estradiol, SHBG, etc. etc. etc.)

Also do you know why you have low T? Is it caused by low LH/FSH? If yes, did you have an MRI to confirm that the low LH/FSH is not being caused by a pituitary tumor?

And as far as not feeling much difference throughout the week, you may be correct, and you may be fine. The two reasons that seem most logical as to why you feel fine (at least to me) are:
1) your genetic code/mutations allows for greater T fluctuations then the normal person, or
2) your system is eating up the extra T and loving it fow now, but the constant swings will eventually stress out your adrenals, Thryroid, HPT? axis, and other systems, and you will crash in the coming weeks or months, and you will be in a lot worse shape then you were to begin with.

As far as not taking anything else (assuming you have read the stickies), then I have to assume you are good with the possibility of shrinking/disappearance of your testicles, loss of fertility, and the possible physical/mental changes caused out of control estrogen. Again, not everyone experiences these things because we all have different dna mutations/genetic abnormalities, but a large number of men on TRT do experience these things personally and are trying to warn others so that they don't experience the same issues. It is your call if you want to listen or not.


#6

Thanks for the response! My LH and FSH were both low, and my prolactin was always elevated, but it was only one point out of range on my previous test. I've been taking B6 as well. I had an MRI that came out negative, 2 MRI's actually. My thyroid was tested and it fine.

I'm not against HCG or anything else, however, I've been on TRT albeit not always effective since January 2010, and have had no shrinkage. My doctor and I are on a 'dont fix it if it's not broken' mindset, and while we aren't opposed to estradiol control or HCG, there has been no need for it now.

And by 'in range' I'm referring to the ranges printed on the labs.

I have a feeling that adding hcg at the moment will just complicate things.

On a side note- I'm planning a cycle and you seem very knowledgeable, I was wondering if I could PM you regarding that for some quick info if you have experience with cycles. Thanks man!


#7

Also, your 2nd reason as to why I'm feeling fine is a bit scary lol Care to elaborate? Make me feel like I'm awaiting my demise...


#8

I am not an expert. Ksman, hardasnails, and others know more than I do (in my opinion). I have only researched HRT due to my personal condition and have zero nada zip experience with cycles. I am pretty passionate about it because you have to become your own advocate if you want to get better and you have to educate yourself on everything or else you are at the mercy of a random doctor who has random facts or practices that he like for whatever reason that may have no basis in reality.

HRT can be scary when you read all of the horror stories out there, and everyone's personal experience with weekly or every other week shots, or bad doctors causing more harm than good. Have you read through all of the other posts on what other people have experienced, and why they are recommending a certain approach? There are tons of stories out there on this site and other sites (like mine that I just posted).

What is in range for Estradiol? The lab says 13 to 54 is "In range". Is that what your doctor is going by? I had Estradiol at 50, and was told I was fine because I was "in range", but I was FAR from being fine. Have you read the Estrogen sticky, and what excess Estradiol can do to you?

You are right that you should not just add things just for the sake of adding things, but there are things that could be happening to your body that you are not 100% aware of initially that can cause long term damage (i.e. - testicle shut down due to TRT = no kids in the future unless you take HcG to maintain testicle function).


#9

In order to proper evaluate this I would have to have a complete medical history and there is no way just from one line forums can people provide the necessary information that is needed to nail things down. I like to have the lab work phyiscally infront of me as well as the person conducting an indept interview I can probably come up with a solution so much faster then just reading stuff on line. With in first 15 minutes current labs and few specific asked question then one can have a better idea of what they are dealing with and come up with further testing and also modifcations to HRT needed to make the person feel better. Some times its just something simple that gets over looked that I usually pick up on where other dr's do not then look into.

Lower shbg lower e2 has to be
Higher the shbg more slack you have to play with.

e2 18-25 is for people with shbg of 18-25 because of higher bio T

We have people that shbg are 10 and need to have e2 of 15 to feel well.


#10

I can get all of my blood work results from my doctor and request new tests. I'll head to the office today, please get back to me! thanks