TRT not changing Total T?

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    TRT not changing Total T?


    I'm 55.

    Tests in June showed Total T to be 593 ng/dl.

    Now after almost 8 weeks on TRT (100mg/ml gel, 1 ml per day), current lab tests show total T to be 596 ng/dl.

    How can this be?

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    At a 10% rate of absorption that yields you about 70mg a week, which by most accounts is about 600ng/dl

    cypionate question.................

    You've basically suppressed the testosterone you were naturally producing (BTW 600 is good for 55yo) and replaced it with exogenous testosterone.
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    Solution?
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    Seems odd to put a 55yo at the mean for TT on TRT to leave him a the same place he started.

    What prompted you (symptoms and diagnosis) to get TRT? Are you being treated by a physician? What are his/her thoughts on the matter?

    TT is not the only measure of effective TRT. There is also Free/%Free and SHBG and other values to consider.
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    Yes..W/physician. Added DHEA after latest labs. Free T was low. Still waiting on Estradiol and free T results.
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    Quote Originally Posted by Arbor View Post
    I'm 55.

    Tests in June showed Total T to be 593 ng/dl.

    Now after almost 8 weeks on TRT (100mg/ml gel, 1 ml per day), current lab tests show total T to be 596 ng/dl.

    How can this be?
    You are lucky that you still have yout 596.
    Few reasons why this happened.

    1#-the gel you are using do not contain testosterone

    2#-your body do not see the suppled testosterone (heavy duty thyroid/adrenal problems)

    3#-your body see testosterone that you have put on, promptly stopped your native production and testosterone that you have now comes from the outside.

    You should describe your situation fully in details,
    initial symptoms
    symptoms now after using T-cream
    all initial testing that you have done
    all follow up testing that you have done

    we need to know your history as complete as possible to figure you out and possibly help you.
    ----------------------

    If you are near zip 07410
    mikeyboyeee is having his second appointment with my doctor today
    he just had all tests done per my list (list signed by doctor, no problems)
    we will see how this will go.
    keep checking his posts.
    -------------------------

    8 months wasted is behind you.
    You should educate your self first
    and
    then
    make suggestions to yur doctor of what you may need

    You will be surprised, most doctors actually want to help.
    Many doctors need help, they do not have a clue how to do TRT,
    and usually know much less that people hanging around this boards.
    --------------------------

    Check my whole thread, here:
    Jan's BloodTest April13/2007

    pay particular attention to list on post #44, between blue lines

    but at this time you will need to post

    your complete history
    your blood test results from my list on post #44, between blue lines.
    -----------------------------------

    We have to remember that your original TT was TT=596
    that is very important information.

    Your next project will be to rebuild (possibly) your damaged testicles.

    Yes, by supplying testosterone without protection of HCG you have screwed up your testis.

    You really really want back your native 596
    Testiscles are producing other hormones and chemicals, other than testosterone.
    Now they are hanging dead, or they are shriveled and dead.
    -------------

    All above will take time.
    The best move you can do now is:

    keep using your current (100mg/ml gel, 1 ml per day)
    add
    (EOD) EveryOtherDay)
    HCG-shot=250iu

    If you are not shy about shots;
    do 125iu EveryDay

    If you can get it
    use Ovidrel
    I will tell you what to do with Ovidrel if you can get it (supposedly the best).
    I have not used, this is just a hearsay (about Ovidrel)
    ----------------------------------------
    If you are patient man, but count your $$,
    if you can get on HCG,
    do your first testing 2 months after you start HCG.

    Otherwise you will catch your testosterone related indicators in transient.

    No harm in doing that list right away.

    ..........

    .
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    first off, im 26 and my test is 350. i never touched anything before my TRT. why is doc perscribing a dude with 600 ng/dl? definitly sounds like an anti aging clinic (which is what i use). im just amazed. if a 55 year old is getting test rx at 600ng/dl, maybe something is really wrong with me if im 26 and have 350? when i was 23-24 i had 450 so its steadily dropping. now im on 200mg a week of test and some HCG once in a while.
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    Quote Originally Posted by DT5 View Post
    first off, im 26 and my test is 350. i never touched anything before my TRT. why is doc perscribing a dude with 600 ng/dl? definitly sounds like an anti aging clinic (which is what i use). im just amazed. if a 55 year old is getting test rx at 600ng/dl, maybe something is really wrong with me if im 26 and have 350? when i was 23-24 i had 450 so its steadily dropping. now im on 200mg a week of test and some HCG once in a while.
    Do not overdo, 200mg/week is usually to much.
    Once a week is not often enough.

    You do not judge your testosterone status by TotalTestosterone.

    You do that by checking BioAvailableTestosterone.

    There is no need to be jealous is somebody is getting what he needs and you cannot.

    Make sure that you get yours,
    look for better doctor,
    vote for proper politicians,
    judge by results not by promises.
    make your own, do not take ready made by others.

    From your (to short) description it looks like your treatment can be improved.

    If you have your own tread, we can discuss it there.

    .............................. ...
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    Yes my Total T was just under 600, but my Free T was 58.6 pg/ml. I was advised that my free was low by my GP and should be watched. I experienced mild, but bothersome symptoms (libido, drive, energy) and sought TRT. I should note that I am also a fairly heavy lifter and also run several times a week and generally am in as good shape as some guys 20 years younger.

    Initially the TRT gave me a boost, then levelled off after a few weeks to a little better than normal, but a few libido issues returned. I inquired here because I was somewhat surprised with my latest lab results, but now realize I shouldn't be.

    JanSz, I'm not sure I understand some of your statements....where did I refer to 8 months, "wasted" as you say?......I started this TRT about 7 weeks ago. Also, my testicles are by no means "hanging dead" or shriveled", not sure where you came up with that.

    I provided my Dr with Dr. Crisler's papers on TRT and HCG. She was interested, receptive, and started me on HCG today. So I will see how this goes from here. Thank you to everyone for your comments.
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    Quote Originally Posted by Arbor View Post
    Yes my Total T was just under 600, but my Free T was 58.6 pg/ml. I was advised that my free was low by my GP and should be watched. I experienced mild, but bothersome symptoms (libido, drive, energy) and sought TRT. I should note that I am also a fairly heavy lifter and also run several times a week and generally am in as good shape as some guys 20 years younger.

    Initially the TRT gave me a boost, then levelled off after a few weeks to a little better than normal, but a few libido issues returned. I inquired here because I was somewhat surprised with my latest lab results, but now realize I shouldn't be.

    JanSz, I'm not sure I understand some of your statements....where did I refer to 8 months, "wasted" as you say?......I started this TRT about 7 weeks ago. Also, my testicles are by no means "hanging dead" or shriveled", not sure where you came up with that.

    I provided my Dr with Dr. Crisler's papers on TRT and HCG. She was interested, receptive, and started me on HCG today. So I will see how this goes from here. Thank you to everyone for your comments.
    Replace months with weeks.

    If you do not support your testicles with HCG and supplement with external testosterone, your LH and FSH will drop, your testicles will stop producing testosterone.

    If you get proper amount of HCG and a proper schedule, your testicless after restart time, should again start producing testosterone.

    As result you should expect a rise in TotalT value.

    ========
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    Quote Originally Posted by JanSz View Post
    if you can get on HCG,
    do your first testing 2 months after you start HCG.

    Otherwise you will catch your testosterone related indicators in transient.



    ..........

    .
    Janz...what exactly do you mean by the statement "catch your testosterone indicators in transient"?

    Is this meaning that if he tested perhaps one month after starting hcg, potentially high (or optimal) level of testosterone may not be reflective of how he feels?
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    Quote Originally Posted by Arbor View Post
    Yes my Total T was just under 600, but my Free T was 58.6 pg/ml. I was advised that my free was low by my GP and should be watched. I experienced mild, but bothersome symptoms (libido, drive, energy) and sought TRT. I should note that I am also a fairly heavy lifter and also run several times a week and generally am in as good shape as some guys 20 years younger.

    Initially the TRT gave me a boost, then levelled off after a few weeks to a little better than normal, but a few libido issues returned. I inquired here because I was somewhat surprised with my latest lab results, but now realize I shouldn't be.

    JanSz, I'm not sure I understand some of your statements....where did I refer to 8 months, "wasted" as you say?......I started this TRT about 7 weeks ago. Also, my testicles are by no means "hanging dead" or shriveled", not sure where you came up with that.

    I provided my Dr with Dr. Crisler's papers on TRT and HCG. She was interested, receptive, and started me on HCG today. So I will see how this goes from here. Thank you to everyone for your comments.
    I have been using HCG alone for the past 3 years with great results. My TT was 475 before starting, and since I've maintained a range in the 900s. This was after a year on the cream and total testicular shutdown. Had I your numbers, I may not have used HCG, let alone testosterone. I think you need to get off of everything - reestablish your baseline, and find out what is keeping free T down. You probably have higher free T numbers now, but at a cost of shutting down your testicles.
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    Quote Originally Posted by JanSz View Post
    You are lucky that you still have yout 596.
    Few reasons why this happened.

    1#-the gel you are using do not contain testosterone

    2#-your body do not see the suppled testosterone (heavy duty thyroid/adrenal problems)

    3#-your body see testosterone that you have put on, promptly stopped your native production and testosterone that you have now comes from the outside.

    You should describe your situation fully in details,
    initial symptoms
    symptoms now after using T-cream
    all initial testing that you have done
    all follow up testing that you have done

    we need to know your history as complete as possible to figure you out and possibly help you.
    ----------------------

    If you are near zip 07410
    mikeyboyeee is having his second appointment with my doctor today
    he just had all tests done per my list (list signed by doctor, no problems)
    we will see how this will go.
    keep checking his posts.
    -------------------------

    8 months wasted is behind you.
    You should educate your self first
    and
    then
    make suggestions to yur doctor of what you may need

    You will be surprised, most doctors actually want to help.
    Many doctors need help, they do not have a clue how to do TRT,
    and usually know much less that people hanging around this boards.
    --------------------------

    Check my whole thread, here:
    Jan's BloodTest April13/2007

    pay particular attention to list on post #44, between blue lines

    but at this time you will need to post

    your complete history
    your blood test results from my list on post #44, between blue lines.
    -----------------------------------

    We have to remember that your original TT was TT=596
    that is very important information.

    Your next project will be to rebuild (possibly) your damaged testicles.

    Yes, by supplying testosterone without protection of HCG you have screwed up your testis.

    You really really want back your native 596
    Testiscles are producing other hormones and chemicals, other than testosterone.
    Now they are hanging dead, or they are shriveled and dead.
    -------------

    All above will take time.
    The best move you can do now is:

    keep using your current (100mg/ml gel, 1 ml per day)
    add
    (EOD) EveryOtherDay)
    HCG-shot=250iu

    If you are not shy about shots;
    do 125iu EveryDay

    If you can get it
    use Ovidrel
    I will tell you what to do with Ovidrel if you can get it (supposedly the best).
    I have not used, this is just a hearsay (about Ovidrel)
    ----------------------------------------
    If you are patient man, but count your $$,
    if you can get on HCG,
    do your first testing 2 months after you start HCG.

    Otherwise you will catch your testosterone related indicators in transient.

    No harm in doing that list right away.

    ..........

    .
    By the way JanSz, The EOD protocol for HCG during TRT will increase his E2. HCG does not act like testosterone. Frequent stimulation of the testes doesnt result in stable T levels. He will only block HCG receptors. I posted a pretty good study a few months ago.
    Last edited by colkurtz_spf; 09-01-2009 at 11:56 PM.
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    Thanks for the info kurtz....I feel great with the HCG (2.5 ml every 3rd day) and will see what my next labs show. My Estradiol(sensitive) a couple weeks ago, after being on the TRT w/no HCG was 13 pg/ml. I'll see what my next tests show. My goal is/was to get into the higher/optimal T range. The only changes I've noticed since starting this is stronger libido, I'm leaner and have real good energy in the gym. I usually travel to Michigan in the Fall and will probably vist Dr. Crisler while there.
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    Quote Originally Posted by colkurtz_spf View Post
    By the way JanSz, The EOD protocol for HCG during TRT will increase his E2. HCG does not act like testosterone. Frequent stimulation of the testes doesnt result in stable T levels. He will only block HCG receptors. I posted a pretty good study a few months ago.
    Well, my testis feel better on EOD schedule. Switching from E3D to E2D was improvement for me.
    Actually I tried EOD, T-shot one day and HCG-shot next day,
    it worked ok,
    but
    now I do (T & HCG) shots on same day next day free,
    small difference, but I like better this one.

    My guess is that there is personal variability and one should figure out among alternatives.

    BTW, for a year I was without AI
    may27/09 I drew blood and though that my E2 was bit high, so I added 0.1mg/EOD Anastrozole

    week ago, (with out blood tests) I dropped AI, fel better without it.

    In my case EOD schedule works real well (for me).
    I am into 3rd year doing this schedule.

    ..
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    I still don't understand the overall advantage of HCG monotherapy vs. TRT + HCG. Seems like with TRT + HCG you would use less HCG, with less aromatizing estrogen and testicular desensitation. You could have adaquate test levels from the testosterone injections and your nuts would still be full from the HCG. Only downside would be fertility from the lack of FSH.

    So let me get this clear...HCG monotherapy is practical when your T levels aren't that low, like above 500's?
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    Quote Originally Posted by monsterbox View Post
    I still don't understand the overall advantage of HCG monotherapy vs. TRT + HCG. Seems like with TRT + HCG you would use less HCG, with less aromatizing estrogen and testicular desensitation. You could have adaquate test levels from the testosterone injections and your nuts would still be full from the HCG. Only downside would be fertility from the lack of FSH.

    So let me get this clear...HCG monotherapy is practical when your T levels aren't that low, like above 500's?

    The better condition of ones testis the better the chance for HCG to work on its own.

    Pure Secondaries have the best chance.
    Pure Primary have no chance at all.

    Pure Secondary= testicles are 100% but no signal to produce.

    Pure Primary=balls may as well be cut off.
    .
    .
    There is very few pure secondaries, very few people can sustain on HCG alone.
    .
    ============================== =====
    If you have 500 and low LH, better chance to be good with HCG alone
    than
    500 and very high LH.
    .
    ============================== ============================== ========
    But some people have rather decent TT levels naturally,
    but
    they have high SHBG

    what counts is BioAvailableTestosterone (BAT)

    With high SHBG, TotalT have to be pushed to much higher levels,
    levels that are not obtainable naturally.

    So whae someone have high SHBG, he may have excellent testicles, excellent signal to produce testosterone,
    and
    still require additional testosterone over and beyond natural levels.
    ============================== ===

    With high SHBG
    one needs not only more Testosterone
    he also needs more
    E2 and DHT
    ============================== ===
    Reverse is true for low SHBG
    .
    .
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    well at 10 weeks of 25mg of clomid, I only came out with 500 total T. So can I assume that HCG wouldn't work too well alone?
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    Haven't posted in awhile....Switched from gel to Cyp inj 100mg/wk and HCG 250 2 to 3 times per week for past 5 months. Latest labs (not complete until I change my insurance in May) are:

    Total T- 964 ng/dl, Ref range: 250-1100

    Free T- 193.2 pg/ml, Ref range 35-152

    DHEA- 870 ng/dl, Ref range 61-1636

    SHBG- 40, Ref range 18-47 nmol/L

    Feel good, strong in gym. Went from 217 to quite lean 197. Only negative I notice is occasional problem maintaining wood....libido is very strong, starts out OK but then lose it. Any obvious reason for that? Realize I need more tests, can't get the Estradiol til insurance changes. I would really appreciate input/comments. Thank you.
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    Quote Originally Posted by Arbor View Post
    Haven't posted in awhile....Switched from gel to Cyp inj 100mg/wk and HCG 250 2 to 3 times per week for past 5 months. Latest labs (not complete until I change my insurance in May) are:

    Total T- 964 ng/dl, Ref range: 250-1100

    Free T- 193.2 pg/ml, Ref range 35-152

    DHEA- 870 ng/dl, Ref range 61-1636

    SHBG- 40, Ref range 18-47 nmol/L

    Feel good, strong in gym. Went from 217 to quite lean 197. Only negative I notice is occasional problem maintaining wood....libido is very strong, starts out OK but then lose it. Any obvious reason for that? Realize I need more tests, can't get the Estradiol til insurance changes. I would really appreciate input/comments. Thank you.
    You numbers look perfect. I would be willing to bet its the estradiol being too high. The test injections + hcg will cause higher E2. I would start at .25mg of arimidex E3D. This will also bring your SHBG down which will raise your free T even more!
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    Thanks for the reply. With test only, no HCG, my estradiol was 13. Haven't checked it since then, but have no symptoms of excess. Can low estradiol also cause the problem?
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    PS: It was no problem at all this morning, according to my wife....lol! Seems to occur only certain time of week like a day or two after my test inj. Maybe I'll split it up to twice a week.
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    Quote Originally Posted by Arbor View Post
    Haven't posted in awhile....Switched from gel to Cyp inj 100mg/wk and HCG 250 2 to 3 times per week for past 5 months. Latest labs (not complete until I change my insurance in May) are:

    Total T- 964 ng/dl, Ref range: 250-1100

    Free T- 193.2 pg/ml, Ref range 35-152

    DHEA- 870 ng/dl, Ref range 61-1636

    SHBG- 40, Ref range 18-47 nmol/L

    Feel good, strong in gym. Went from 217 to quite lean 197. Only negative I notice is occasional problem maintaining wood....libido is very strong, starts out OK but then lose it. Any obvious reason for that? Realize I need more tests, can't get the Estradiol til insurance changes. I would really appreciate input/comments. Thank you.
    If you are able, use Quest Diagnostics, blood drawn at Quest.

    You have a problem.
    Your SHBG=40
    Good range is about (15-20) stretching (15-25)

    Higher SHBG, for all kind of reasons goes with older age.
    At 55, it is catching up with you.
    No offence, I am 70.

    You need proper SHBG levels for at lest two reasons.
    High SHBG eats too much TT, (your beloved BAT, BioAvailableTestosterone)
    But also hogh SHBG says that you have problem somewhere.
    Quickest way is to look at your metabolism.
    Quicker, glucose/insulin, body weigh, waist size.

    You want to look at this chart:

    http://www.andropause.org.uk/nomo_tas.pdf

    On that chart you want to have
    FreeT(300-350)

    With SHBG you have to extrapolate, you need TotalT~1400 or better.

    100mg/week is not going to cut it.

    Use EOD schedule
    use these needles
    BD Ultrafine II U-100 Insulin Syringe 31 Gauge 3/10cc 5/16inch Short Needle

    T-shot=60mg=30units=210mg
    HCG-shot=250iu

    After 2-3 months check

    on Quest
    Estradiol [4021X](13- 54 pg/mL)
    Estrogens, Fractionated, LC/MS/MS (36742X)
    Testosterone, Free, Bio/Total (LC/MS/MS) Code: 14966X
    Dihydrotestosterone
    3a-Androstanediol Glucuronide


    anywhere else
    Estradiol, sensitive 140244
    Estrone, Serum
    Total Testosterone
    SHBG
    Albumin
    Dihydrotestosterone
    3a-Androstanediol Glucuronide

    If your SHBG is falling down, you have a good dose.
    If your SHBG stays put, increase
    T-shot=80mg=40units
    HCG-shot=250iu
    get 50 units syringes (for test)

    ============================== =========

    You should consider investigating other health areas.
    Start with my list of tests, post #44, link:

    Jan's BloodTest April13/2007

    between blue lines.




    //
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    All of the tests were done at Quest.
    My glucose was 101, range 65-99 mg/dl.
    I am 5-8, 197 lbs and my waist is 33".
  

  
 

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