I started TRT back in Aug 2019 (205ng/dl), my urologist prescribed 200ml IM every 2 weeks. was changed to .75ml (150mg) a week after 3 months because it was not lasting 2 weeks, so went to once a week and up the dosage… I felt great no problems, did Bloods, peak was 2012ng/dl, trough was 530ng/dl. Doc freaked and loered the dosage to .5ml (100mg) a week, again I still felt great, bloods were peak=3000ng/dl low= getting done this Friday. Doc freaked and now i’m on .5ml every 2 weeks. Why am i getting these big spikes after injection (24hours after injection bloods were drawn). Is this normal? .5ml every2 weeks is not going to work for me, 100mg a week was perfect, what the hell is going on?
Thanks for any help.
Most people have a pretty big spike at peak, but that isn’t what docs normally test, so it seems like a crazy number when it’s really just reality for everyone not dosing often.
Trough is what everyone goes by… and how you feel. Obviously, 50mg a week is a joke. If you felt great at 150mg a week then that’s probably where you should be
You need to find a doctor that will let you stick with that protocol.
Because you just injected testosterone and it has not metabolized yet.
He would really freak if he saw your levels 24hrs post this injection.
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Thanks for the feed back, I think I may need a new “doc”. I will post the trough levels when I get them back. Sucks because I was feeling so good after feeling like shit for so long, I totally relate to men who have lost girlfriend because of low T, that will never happen again, Doc or no Doc. Thank for the info.
I’ve never seen such a huge difference between peak and trough before, but peaks are short lived as you can see in your testing which is why you’re supposed to test at trough.
The doc is creating a headache for himself by testing at peak, it makes him look irresponsible even though he isn’t doing anything wrong, he is just testing at the wrong time.
He’ll figure out sooner or later.
Yea, I almost feel out of my chair when I first saw that 2012ng/dl peak, but went down to 530 in a week. I’m going to get bloods Friday then call my Primary and them him I want a different urologist. Sucks because he seems like he really wants to help, but 50mg every 2 weeks will probably give me low T again!
Not unusual at all. I see it all the time.
Me: “Did you get your labs right after your injection”?
Pt: “Yes, the next day, just like you said.”
Me: “No, you were supposed to go the day of your injection, before you take it.”
Pt: “I thought you meant the day after the shot.”
Me: “Let’s go over this again…”
530 is a pretty good drop though, would have put you around 900-1000. One of the guys dropped into the 300s, seven days post a 400mg injection!
Definitely try to find another doctor that will take insurance but if you aren’t able to you should do like many of us do and go the telemedicine route. Mine is $150/month for 220mg/week that you do what you want with. It sucks having to pay out of pocket but the plus side is you never have to worry about getting cut off for a stupid reason. Plus you get your T, syringes, swabs, etc shipped in the mail so you don’t have to think about it. Finding a regular doc that is up to date on TRT can be a struggle.
Maybe I misunderstood him, but I went over it with him twice. I would inject Thursday morning at 7:30am and draw bloods the next day on Friday same time. The following week I would get bloods on Friday 7:30am, after blood is drawn then I would take my weekly dose. I will call tomorrow and clarify, but I’m sure that is what he said. I think the .75ml a week was spot on for me, if comes to it I will just do it myself and get bloods from my Primary doctor to check things out. I know someone who said I can get my medicine from him if I need it, don’t won’t to go that route but I’m not going back to low T ever again. Thanks for your input.
Yea, It should’t be this hard, I’m beginning to think the medical community hate men…
Thanks, If he doesn’t know that, then I definitely need a new doc.
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I found this on a medical site it reads: The Endocrine Society Clinical Practice Guidelines for testosterone therapy recommend serum testosterone levels should be measured one week after receiving a dose of TC or TE, targeting a therapeutic level of 400 to 700 ng/dL (3). For TU, levels should be measured prior to each subsequent injection (3).
So Highpull is correct, levels should be checked 1 week after injection not 24 hours like my Doctor told me…I’m pissed right now.
I did not think you misunderstood, I was just reporting instances where total testosterone came back very high. His reaction clearly demonstrates he is trying to put you in a particular range throughout the week and perhaps without consideration of the half life of testosterone cypionate. If that is his approach, he should recommend using a cream or daily injection.
It is interesting how testosterone is individually metabolized differently, which I think underscores the argument that treatment should be directed more towards symptoms rather than numbers.
I was about to say. If he wants to keep you in a tight range between peak/trough then more frequency injections would def. help in keeping things stable. Like… daily or EOD
It really sucks he literally found what works for you, you felt way better, then he totally changes it because of a lab test taken at a time he really shouldn’t have even been testing. Sucks.
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You must have sky-high SHBG to get such a high Total Serum Testosterone level with that dosage.
What is your Free Testosterone level?
Not sure, I’m getting full bloods on Friday so I will post the numbers next week. Thanks.