Low free test on 300mg trt

[Maxy]

SHOULD SAY LOW TOTAL TEST!

Hey guys, so I’m on 300 mg once a week of test cypionate doctor prescribed TRT. On the seventh day right before my shot I got blood work and my levels were 640 ng/dL. That seems quite low and I’m wondering if anyone has insight as to why that might be. Thanks!

 

[justhere4comm]

Post your full bloods.
300 mg per week? I've never heard of such a dose for TRT. 200 mg is usually the max.

 

[FRITZFURY]

Just like justhere4comm said 300mg/week is unheard of. was there a constant increase? At 300mg/week you should have a TT of 1600 and a FT of about 140. your title says FT but you don't post what your FT was?

There are a few conditions I have only read about but never heard of ppl being susceptible but without full BW I don't want to speculate.

 

[Maxy]

 

[Maxy]

What do you mean? This is the panel I took. All of it.

 

[2kvette]

Pharm student here. Two things, one, you may have high esterase production, it is a genetic factor that is typically seen in less than 1% of patients. Two, you may have very high SHBG or an unusual albumin that is binding up the rest. All these things are uncommon, but have been reported in literature. Testing for them is not routine, and your doc may or may not know what to do about this.

 

[AnabolicGuru]

How many days after injection was your bloodwork done?

 

[Maxy]

7 days. Right before my next weekly injection.

 

[AnabolicGuru]

7 days. Right before my next weekly injection.

That’s why your test isn’t that high. I’d just drop to 200mg split into twice a week instead. 300mg is absurd for medical purposes, and you’d probably respond better to twice a week

 

[2kvette]

That’s why your test isn’t that high. I’d just drop to 200mg split into twice a week instead. 300mg is absurd for medical purposes, and you’d probably respond better to twice a week

I've seen it before a couple times. I've also seen it dosed at 50mg every 4 weeks.

 

[AnabolicGuru]

I've seen it before a couple times. I've also seen it dosed at 50mg every 4 weeks.

There’s some dumb doctors out there without a doubt lmao

 

[Maxy]

I’m wondering if my test clearance is just very fast. Twice a week would definitely be better for a more stable hormonal environment for sure.

 

[AnabolicGuru]

I’m wondering if my test clearance is just very fast. Twice a week would definitely be better for a more stable hormonal environment for sure.

Everyone is different. Twice a week is definitely optimal. Maybe try and drop it to 100mg twice a week (200mg week total) and see where that puts you.

 

[Maxy]

Yes that seems like the logical next step. Hopefully I’ll be high normal then. Thanks.

 

[kenpoengineer]

Since your doctor is not well trained in TRT, here is a great guide to proper protocols:
https://www.excelmale.com/content.php?317-ExcelMale-com-Guide-to-Testosterone-Replacement

 

[kenpoengineer]

If anyone has questions or is curious about TRT and Entourage Hormones (Entourage Medical), feel free to visit my log as a patient of them or message me. I’d be happy to answer questions or get you in contact with them.
First AM Patient
http://anabolicminds.com/forum/showthread.php?t=295946

 

[Maxy]

Thanks man but at this point my doc is quite open minded and everything is covered under insurance so I’ll just talk to him about twice weekly dosing.

 

[sarge40]

I'd recommend asking him to add a SHBG test, and/or add the free testosterone to the test and use your total and free levels to calculate SHBG. If your levels are that low on 300mg/wk, I strongly suspect very low SHBG levels leading to fast clearance. Low SHBG is characterized by (assuming one shot every 7 days for example) lower total testosterone and higher free testosterone. High SHBG will sequester the testosterone longer, and your total testosterone will likely be higher, but your free testosterone lower. If you are in fact low SHBG, I would split my dose into multiple shots throughout the week as suggested by others, as opposed to the high SHBG patients who do well with one higher-dosed shot for the entire week. You clearly don't have a problem with aromatizing (lab results don't indicate whether or not it was the sensitive E2 test, which is preferable for an accurate measurement - <20 can mean 0 or 19).

Another thing, is this compounded testosterone? Anecdotally, certain compounders aren't as good with their tolerances. I never had this experience with my compounding pharmacy personally, but others have reported this.

 

[Maxy]

Thank you for the insight. It is not compounded test. As for the e2 yeah I seem not to aromatize. And on the plus side, higher free T is good

 

[sarge40]

Free T is the real benchmark. Why doctors still operate in the stone ages looking only at total T, as if it really tells us anything, is a mystery to me.

 

[Maxy]

Agreed, I think it has to do with insurance. I’ll see what he can do though

 

[jmero2]

I have been doing 20 mg everyday. I absolutely love this protocol as I don't need an ai, libido is crazy and I'm not retaining water which I sometimes got with my old protocol of twice per week.

I get bloods done in april and I'm anxious to see the changes.

 

[Maxy]

Is that subQ or IM?

 

[jmero2]

Sub q with 29 ga .5 inch insulin syringe

 

[Maxy]

Sounds nice and easy

 

[jmero2]

I didn't buy in at first but I decided to give it a go a few months ago and couldn't be happier.

 

[FRITZFURY]

You need to get a FULL blood test and it should be 2 days after your 2/week shot. You absolutely need TT, FT, SHBG, E2, pregnenolone, progesterone. The reason is that chances are you're metabolizing your Test in an extreme way. Even if your Test is bound by SHBG it will still show up in TT numbers. What you need to find out is what it's metabolizing into; DHT, E2, pregnenolone, or progesterone.

 

[AnabolicGuru]

You need to get a FULL blood test and it should be 2 days after your 2/week shot. You absolutely need TT, FT, SHBG, E2, pregnenolone, progesterone. The reason is that chances are you're metabolizing your Test in an extreme way. Even if your Test is bound by SHBG it will still show up in TT numbers. What you need to find out is what it's metabolizing into; DHT, E2, pregnenolone, or progesterone.

He meant to title it “total test” to my understanding. He’s wondering why his total test is low at 300mg per week, which obviously will depend on the individual. He also had bloodwork 7 days after injection which is another reason his total test is low.

 

[FRITZFURY]

He meant to title it “total test” to my understanding. He’s wondering why his total test is low at 300mg per week, which obviously will depend on the individual. He also had bloodwork 7 days after injection which is another reason his total test is low.

I realize he is wondering why his TT is so low but even 7 days after a 300mg shot there is no way he would be at 640ng/dl unless he is metabolizing it in an extreme way. he could be turning it into DHT or the other hormones but since he does not have a lot of female like side effects I would bet that he is metabolizing it into DHT.

 

[Maxy]

I’m betting dht because my balding is speeding up and I’m growing more body hair. Not noticing estro sides such as water retention or gyno.

 

[FRITZFURY]

I’m betting dht because my balding is speeding up and I’m growing more body hair. Not noticing estro sides such as water retention or gyno.

There are compounds that inhibit the metabolization of test into DHT sorry I don't remember the names off hand. I don't know of a BW test for DHT but I really bet you converting Test at a very rapid rate. Like I said even after 7 days of a 300mg shot you should not be at 640 and your not seeing female sides so there is really no other hormone it could be converting to. And it's not like Test will just disappear it just gets converted into other hormones. I really suggest you get BW with all the hormones I previously mentioned.

 

[Maxy]

Would there be an issue with high dht conversion? I’d think that would be a positive for muscle building at least.

 

[FRITZFURY]

Would there be an issue with high dht conversion? I’d think that would be a positive for muscle building at least.

It is ok but I think you're converting too much. Diff ppl have diff amounts of DHT conversion. That's why some ppl are naturally more aggro and masculine, But there needs to be at least a descent balance. Yes your high DHT will give you more strength and hardened muscle but you will need a decent amount of Test along with the DHT to gain size. That's why I mentioned the compound the inhibits DHT conversion. You may just have to include a small amount into your set of Meds/drugs

 

[AnabolicGuru]

I’m not too familiar with how exactly the conversion of test to dht works, but if it’s a real concern, just get dht checked next time as well. Definitely would try and lower the test dose though and go to less mg per week. 1 big shot a week is going to spike hormones such as dht and estradiol more, and the test wont be as steady. 2x a week is the way to go :]

 

[FRITZFURY]

I’m not too familiar with how exactly the conversion of test to dht works, but if it’s a real concern, just get dht checked next time as well. Definitely would try and lower the test dose though and go to less mg per week. 1 big shot a week is going to spike hormones such as dht and estradiol more, and the test wont be as steady. 2x a week is the way to go :]

The enzyme 3-oxo or 5AR is responsible for the conversion of Test to DHT. These enzymes are produced and activated as a response to high levels of Test very similar to how aromatase is produced once high levels of Test are detected. I totally agree that 2/week shots are superior but the underlying problem still remains and even with the more balanced serum levels there will still be a extreme conversion rate that is unwanted. and will keep Test levels unbalanced. Once he gets bloods testing all the hormones that Test can convert to he can figure out where it's going but my money is on DHT

 

[John Smeton]

Hey Maxy,

Seven days after a 300 mgs injection of test and a total test level of 640 isnt bad. Mine was 240 seven days after 150 mgs. Some people are slower metabolizes and some faster. I seem to metabolize testosterone faster. Ive seen some guys bloodwork that were still 600 after seven days on 150 mgs.

Ive done a research on this and this is generally how it works on an ester like cyp day 1 it raises, day 2, 3, good, day 4 it drops some, day 5 is usually the drop off point where it drops off significantly and day 6 and 7 are quite lowered than day five. Everyone wont respond like this; however from my research this is about "normal"

Ive done once 100 once a week, 150 once a week, 100 mgs once every five days, 100 mgs once every three or four days. 20 mgs sub-q, 10 sub-q. Ive been doing 20 mgs then cut down to 10 and really enjoyed it. Change things up when I feel my body gets used to 10 sub-q, Ill up it to 20 mgs , then start injections etc.

 

[Maxy]

Thanks for the input! yeah I’m definitely going to do at least 2 shots per week now. Probably get my dht and shbg levels checked out as well.

 

[Sbell71]

I’m a low SHBG guy and I metabolize and excrete Test quickly. Being at 650 for your trough level may seem low but it’s not horrible. At my worst my trough was 81, believe it or not. Since splitting my dose e3d my trough is 642 at last pull. I agree with the others about trying to get more thorough blood work if you can. How is your fasting glucose and a1c? Insulin resistance can interfere with TRT too.

 

[Maxy]

A1c last checked was 5.1. Not sure about fasting glucose but as I am on the heavier side so I am probably a bit insulin resistant currently.

 

[trn450]

That's total test, and it isn't quite as low as one might expect. It's a solid trough value. On 100 mg/wk my trough is about 300-350ng/dL. I'm a fan of using only the lowest effective dose.

300mg/wk is also not "unheard of". Just very uncommon. I know a few people at 250mg/wk and 300mg/wk. But, the vast majority of people will be satisfactorily replaced between about 75mg/wk and 125mg/wk.

If you want to have a great idea of where your levels are, just also check a peak value. If you want to know SHBG and free test, you can easily order that stuff online.

If your hemoglobin A1c% is 5.1 as you say later in the thread, then insulin resistance is unlikely. A person can have a mildly elevated fasting blood glucose value in the context of good insulin sensitivity if the liver is in a state of robust glucose production in response to the fast. A simple way to check insulin sensitivity with existing labs is to look at the triglyceride to HDL ratio, or pay an extra few dollars to check your insulin level next time you get a basic or complete metabolic panel (which includes glucose) and calculate HOMA-IR.

 

[John Smeton]

Maxy I did a video

https://www.youtube.com/watch?v=0EkKdu38zHg

 

[Maxy]

Thanks dude!