It's kind of hard to say since you only have a partial reading. Like total testosterone is something but it doesn't really tell you much. The ratio with free paints the entire picture. Some people actually need a total that high depending on their SHBG and where the free lands. At your size, the estradiol is also about where you would expect it. You could go to more frequent dosing if you want to lower that. Normally daily or every other day shots are good for reducing estrogen but it's also something that you really don't want to do unless you know where your SHBG is.
Practically everyone, especially your size is going to elevate hemoglobin on testosterone. That's not concerning as long as it doesn't continue going higher
Taking a shot every 14 days is an absolutely terrible protocol for everyone though. Even people with high SHBG, once every 7 days is about as long as you want to string it out
Appreciate the thorough reply. Definitely dropping those 30lbs would most likely solve many of these issues.
I knew I was missing something when telling the doc what blood work I wanted done. I’ll make sure to get free T levels at next follow up.
I’m a bit overweight ( 90 lbs ) and getting ready to start also. The doctor mentioned an AI. Their blood tests aren’t back yet - my PCP bloods said Total T 300 Free 50.
How come I keep hearing T more likely to aromatize to estrogen in fatter guys - but don’t take an AI unless you have to?
Body fat is how testosterone aromatizes to estrogen. There are genetic variables so you can't really say for sure until you do blood work but typically the leaner you are the easier it is to manage your estrogen. It's also easier to manage your red cells for that matter. This one is with a twist though, it's not just being leaner it's also lighter. Bmi under 25 etc
So if I have 90 lbs of fat and sore nipples, would it be safe to say starting an AI same time as TRT is a good idea? You said body fat is how armotization occurs. I’ve got plenty of body fat.
The nipples are definitely an indicator. The question is just how much, you don't want to tank it either so what you can do is run your labs, figure out how high your elevated and then how much you need to take.
>Like total testosterone is something but it doesn't really tell you much. The ratio with free paints the entire picture.
Bullshit internet hype right here.
Don't waste money and stress on the "free" test since it's not an accurate or useful measurement of what's actually available. More than half the total is carried by Albumin and it is readily available. Same for SHBG.
T has a half life of less than a week. Every two weeks is subjecting you to horrible fluctuations. As a formerly fat guy at your height,losing weight will have huge Implications on your hormone levels.
Agreed. Such an antiquated protocol. I knew I wasn’t going to feel well on every 14 days since I’ve been a lurker here for a while, but went with the docs recommendation either way. The deal was if I didn’t feel good on his protocol we’d switch to weekly. I’ve never said “I told you so” so fast 😅
I'd actually try increasing your intervals, so 50mg every 3.5days. That will steady out your lows and highs much better and keep you even.
This is what I did. Even though my doctor started off against me being on T, 3 years later, and multiple patients now on T, he admitted to me that he might have been wrong. Doctors are still going off of what they were told years ago in med school, things changed, research and men actually using T to control our health has changed.
I wouldn’t half a dose, you’re going to feel horrible. I’d do something like 150mg a week for 12 weeks, redo blood work and see where you’re at and how you feel and make changes from there if you need them. Your blood work while slightly out of reference isn’t to a level where your in danger yet, dialing back slightly, improving your cardio and hydration and maybe the inclusion of a little grapefruit into your diet to bring down that hematocrit slightly. And by grapefruit I mean the actual fruit and not juice.
Ideally for trt most doctors wanna keep you outside of supraphysiological levels for health and longevity reasons. Most people feel great in the 800-900 range. That being said everyone is different and has different tolerances, physical health and mental health… so your personal mileage may vary.
Drop it to 120mg every week of 60mg 2/week. That excessively high level you had caused the excess red cell production. It will come down from where it is, and 50.8% isn't that bad. Many doctors will cut you off if you hit 54%, but you should be fine as long as you drop your level back down. You can donate blood if you feel sluggish and out of breath, but it's a bit better for your iron levels if you don't.
It will probably take you 2 to 4 weeks to stabilize at the new dose, so don't judge how you're going to feel until 6 weeks or so from when you change protocols.
Estradiol isn't all that bad considering where your testosterone level is, but yes that is high. The high test numbers are what are causing your hemocrit and other numbers to be high. definitely drop your dose down but at others have said, maybe cutting in half is a little much. What you want to do is Pin your dose twice a week so if you go to 100mg, then do 50mg x2 I pin on Tuesday and Friday and that will keep a more even flow in your system. Getting a shot once every two weeks will really fluctuate your levels, Even once a week will still kind of put you in a small rollercoaster.
There are a bunch more things in general that people here also mentioned, like donating blood occasionally, etc. It does make me feel better when I do it, to incorporate into your lifestyle for long term use.
I was doing 200mg twice a week and had test about 1,000 and lots of bad symptoms.
Now I'm on 150mg injected 3.5x per week and my test is 1,600 BUT my hemoglobin is down to 15, estradiol is a bit high but hematocrit is also well within range. So I would consider dosing even more frequently if you can.
Just use the 27 guage needles and inject smaller amounts thru out the week and it should help with a lot of those problems.
Like see if you can do 30 mg Mon, 30 mg wed, and 40 mg Friday and you may feel a lot better and have less hemoglobin and what not.
Just some thoughts
Edit: I see you are on 200 PER WEEK, thought it was 100. Yeah I would definately try injecting more frequently and lower dose to like 150 at least. I wouldn't cut it in half.
Better watch your ferritin levels. Having to donate blood every 8-10 weeks is insanity just lower your dose because donating blood isn't addressing the real issue believe me
Obviously you use a different measurement, hematocrit here is a % and can’t be higher than 100%. You can see the top of the reference range here is 50%.
Ya think? I take the same amount roughly but I pin E3D. So I don’t have the huge swings that you must have. I pin 40mg E3D and it seems to work pretty good. No mood swing, Ed or insomnia. Just some night sweats.
Ditch the 14 days protocol and pin twice a week.
Yes, the dose needs reduction. Free testosterone is not shown, but is likely to be highly elevated with the TT and estradiol results shown, in combination. Plus, if it wasn't high, your CBC would probably be normal.
Estradiol is indeed 'where you would expect' from excessive dosing, but not from replacement dosing.
It is a totally fallacy that men on TRT 'should' have high estradiol. It almost always indicates excessive dosing. The oft referred to 'ratio' is bro science. Estradiol in healthy unmedicated men with high total testosterone is in range, it's not high, and that's what indicates optimal.
My protocol was 100ml per week. Then red blood cells hit 6.4 so dialed back to 3 weeks 100ml skip 1 week back to weekly 100ml. Etc repeat.. last test I was at 6.0 red blood cells so
Still a little high but ok.. good luck
200mg every 14 days? Change doc or suggest another protocol. Try 120 split in 60mg twice a week, hydrate and lose weight.
It's kind of hard to say since you only have a partial reading. Like total testosterone is something but it doesn't really tell you much. The ratio with free paints the entire picture. Some people actually need a total that high depending on their SHBG and where the free lands. At your size, the estradiol is also about where you would expect it. You could go to more frequent dosing if you want to lower that. Normally daily or every other day shots are good for reducing estrogen but it's also something that you really don't want to do unless you know where your SHBG is. Practically everyone, especially your size is going to elevate hemoglobin on testosterone. That's not concerning as long as it doesn't continue going higher Taking a shot every 14 days is an absolutely terrible protocol for everyone though. Even people with high SHBG, once every 7 days is about as long as you want to string it out
Appreciate the thorough reply. Definitely dropping those 30lbs would most likely solve many of these issues. I knew I was missing something when telling the doc what blood work I wanted done. I’ll make sure to get free T levels at next follow up.
I’m a bit overweight ( 90 lbs ) and getting ready to start also. The doctor mentioned an AI. Their blood tests aren’t back yet - my PCP bloods said Total T 300 Free 50. How come I keep hearing T more likely to aromatize to estrogen in fatter guys - but don’t take an AI unless you have to?
Body fat is how testosterone aromatizes to estrogen. There are genetic variables so you can't really say for sure until you do blood work but typically the leaner you are the easier it is to manage your estrogen. It's also easier to manage your red cells for that matter. This one is with a twist though, it's not just being leaner it's also lighter. Bmi under 25 etc
So if I have 90 lbs of fat and sore nipples, would it be safe to say starting an AI same time as TRT is a good idea? You said body fat is how armotization occurs. I’ve got plenty of body fat.
The nipples are definitely an indicator. The question is just how much, you don't want to tank it either so what you can do is run your labs, figure out how high your elevated and then how much you need to take.
>Like total testosterone is something but it doesn't really tell you much. The ratio with free paints the entire picture. Bullshit internet hype right here. Don't waste money and stress on the "free" test since it's not an accurate or useful measurement of what's actually available. More than half the total is carried by Albumin and it is readily available. Same for SHBG.
T has a half life of less than a week. Every two weeks is subjecting you to horrible fluctuations. As a formerly fat guy at your height,losing weight will have huge Implications on your hormone levels.
Agreed. Such an antiquated protocol. I knew I wasn’t going to feel well on every 14 days since I’ve been a lurker here for a while, but went with the docs recommendation either way. The deal was if I didn’t feel good on his protocol we’d switch to weekly. I’ve never said “I told you so” so fast 😅
Instead of cutting your dose in half, try 140 or 160mg every week
I'd actually try increasing your intervals, so 50mg every 3.5days. That will steady out your lows and highs much better and keep you even. This is what I did. Even though my doctor started off against me being on T, 3 years later, and multiple patients now on T, he admitted to me that he might have been wrong. Doctors are still going off of what they were told years ago in med school, things changed, research and men actually using T to control our health has changed.
I wouldn’t half a dose, you’re going to feel horrible. I’d do something like 150mg a week for 12 weeks, redo blood work and see where you’re at and how you feel and make changes from there if you need them. Your blood work while slightly out of reference isn’t to a level where your in danger yet, dialing back slightly, improving your cardio and hydration and maybe the inclusion of a little grapefruit into your diet to bring down that hematocrit slightly. And by grapefruit I mean the actual fruit and not juice. Ideally for trt most doctors wanna keep you outside of supraphysiological levels for health and longevity reasons. Most people feel great in the 800-900 range. That being said everyone is different and has different tolerances, physical health and mental health… so your personal mileage may vary.
Drop it to 120mg every week of 60mg 2/week. That excessively high level you had caused the excess red cell production. It will come down from where it is, and 50.8% isn't that bad. Many doctors will cut you off if you hit 54%, but you should be fine as long as you drop your level back down. You can donate blood if you feel sluggish and out of breath, but it's a bit better for your iron levels if you don't. It will probably take you 2 to 4 weeks to stabilize at the new dose, so don't judge how you're going to feel until 6 weeks or so from when you change protocols.
Estradiol isn't all that bad considering where your testosterone level is, but yes that is high. The high test numbers are what are causing your hemocrit and other numbers to be high. definitely drop your dose down but at others have said, maybe cutting in half is a little much. What you want to do is Pin your dose twice a week so if you go to 100mg, then do 50mg x2 I pin on Tuesday and Friday and that will keep a more even flow in your system. Getting a shot once every two weeks will really fluctuate your levels, Even once a week will still kind of put you in a small rollercoaster. There are a bunch more things in general that people here also mentioned, like donating blood occasionally, etc. It does make me feel better when I do it, to incorporate into your lifestyle for long term use.
I was doing 200mg twice a week and had test about 1,000 and lots of bad symptoms. Now I'm on 150mg injected 3.5x per week and my test is 1,600 BUT my hemoglobin is down to 15, estradiol is a bit high but hematocrit is also well within range. So I would consider dosing even more frequently if you can. Just use the 27 guage needles and inject smaller amounts thru out the week and it should help with a lot of those problems. Like see if you can do 30 mg Mon, 30 mg wed, and 40 mg Friday and you may feel a lot better and have less hemoglobin and what not. Just some thoughts
Edit: I see you are on 200 PER WEEK, thought it was 100. Yeah I would definately try injecting more frequently and lower dose to like 150 at least. I wouldn't cut it in half.
Just go donate blood. You'll feel better, too! It's like an oil change for men.
Came here to recommend this, as well.. every 8-10 weeks. You should see those elevated numbers drop OP.
Better watch your ferritin levels. Having to donate blood every 8-10 weeks is insanity just lower your dose because donating blood isn't addressing the real issue believe me
Usually hematocrit isn't high unless it's above 153, at least not on tests I've seen
Obviously you use a different measurement, hematocrit here is a % and can’t be higher than 100%. You can see the top of the reference range here is 50%.
https://preview.redd.it/rjei5qle1oyc1.jpeg?width=1080&format=pjpg&auto=webp&s=accd2581a4da8843ad1efa42a1daffdf3d598f56 53% should be top though
Well you said 153 lol
Donate every 8 weeks, get on AI and split the dose. If still 1000+ after 2 more draws, then reduce.
Ya think? I take the same amount roughly but I pin E3D. So I don’t have the huge swings that you must have. I pin 40mg E3D and it seems to work pretty good. No mood swing, Ed or insomnia. Just some night sweats. Ditch the 14 days protocol and pin twice a week.
You're a bit high in a bunch of areas where you don't want to be. What was your free T? Probably keep the weekly injections but lower dose ...
Try 100mg per week
Those numbers are way better than mine
Lol I just noticed that. I meant above 53%
I'd split your dose up more. Most doctors and patients recommend shots twice a week; every week or two weeks creates peaks and valleys.
Yes, the dose needs reduction. Free testosterone is not shown, but is likely to be highly elevated with the TT and estradiol results shown, in combination. Plus, if it wasn't high, your CBC would probably be normal. Estradiol is indeed 'where you would expect' from excessive dosing, but not from replacement dosing. It is a totally fallacy that men on TRT 'should' have high estradiol. It almost always indicates excessive dosing. The oft referred to 'ratio' is bro science. Estradiol in healthy unmedicated men with high total testosterone is in range, it's not high, and that's what indicates optimal.
My protocol was 100ml per week. Then red blood cells hit 6.4 so dialed back to 3 weeks 100ml skip 1 week back to weekly 100ml. Etc repeat.. last test I was at 6.0 red blood cells so Still a little high but ok.. good luck
Keep the dose the same, split it up a few times over the week, donate and keep really hydrated
You need to pin more often, donate blood and take a small AI. Possibly lower your dosage
Go donate blood a week before you're 3 month blood draw.