Correct trt dosage?
- Thread starter JoePaul39
- Start date
justhere4comm
Banned
It all depends on when your blood was tested, and time of day. How soon after the shot? Morning? Afternoon?
You'd have to be on for a while longer just to find out a good average, then determine dose. 4 weeks is not enough time. 6 months.
That said, I wish I had your doctor. What about HCG or Aromasin? Are you on anything else but the T?
I ask because of a few reasons. It seems to me it's just T.
Your levels would have jumped from 100mg of T with HCG to very high range I think as HCG also raises your T but also aromatizes, hence Aromasin. I can see your T going up a bit with another 25mg but 200 points? maybe.
What does your Estradiol look like and other bloods? RBC? Hematocrit?
You'd have to be on for a while longer just to find out a good average, then determine dose. 4 weeks is not enough time. 6 months.
That said, I wish I had your doctor. What about HCG or Aromasin? Are you on anything else but the T?
I ask because of a few reasons. It seems to me it's just T.
Your levels would have jumped from 100mg of T with HCG to very high range I think as HCG also raises your T but also aromatizes, hence Aromasin. I can see your T going up a bit with another 25mg but 200 points? maybe.
What does your Estradiol look like and other bloods? RBC? Hematocrit?
kenpoengineer
Well-known member
Free testosterone and estradiol levels? There is much more to TRT than total testosterone.
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kenpoengineer
Well-known member
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JoePaul39
Well-known member
I get my shot once a week. It was taken in the afternoon a full 7 days after the last shot. I am wondering if the fact that it was drawn in the afternoon coupled with the fact that it had been a full 7 days since the last shot could account for only testing at 600? As for HCG, my doctor is cool and would be willing to prescribe HCG, but I told my doctor I don’t want to be on HCG because I have no interest in injecting myself (yes I know I am a wimp) and I can care less if I have hanging nuts lol. My estradiol sensitive test pre trt was a 15.7 which is low, thus I was not put on an Ai initially and won’t be on one unless warranted from high E bloodwork results. I am awaiting the result of the one month estrogen sensitive test. I have doctor prescribed Arimidex on hand if I get any symptoms of high estrogen. (I hope for health reasons I don’t have to utilize an Ai,
but if bloodwork warrants it I will). All pre trt bloodwork including Hematocrit was in level. To be honest, I do not know all the tests they performed at the 30 day mark, but was told all results came back normal. I am going to get copies of my all my bloodwork results when I go return for my shot on Friday. Money is an issue as I pay out of pocket so I only had total t tested at the 30 day mark, rather than also testing for free t. No lecutures on this choice would be appreciated unless someone wants to pay for my free t test lol. (I do have my initial pre trt free t result that was below range).
The Matrix
Well-known member
Should be those levels by 4/5 days not 7 days.
Doctor is playing number games. The real question is how do you feel and did symptoms get better or worse?
Doctor is playing number games. The real question is how do you feel and did symptoms get better or worse?
JoePaul39
Well-known member
Symptoms such as libido have greatly improved. I would prefer to be like 900 instead of 600 though. That is 50 percent more and is supposed to be the “optimal” range from what I have read.
The Matrix
Well-known member
Again stop playing the number games. Your symptoms improve do not get greedy. I seen guys push for higher numbers only ended up causing other issues. More is not better when it comes to hormones. It took me decade of intensive studying biochemical pathways and collaborating with doctors to appreciate how much medicine still doesn’t know. After you been on both sides of the table as a patient/Client and now clinician seeing thousands of cases, you think differently
JoePaul39
Well-known member
Thanks for your counsel. I know this may sound like I am being “greedy”, but this is the Anabolic forum, from a muscle building perspective, do you think I would notice any difference from being a 900 as compared to a 600? I realize the goal of trt is not muscle building. To be honest the doctor probably would have left me at my current dose because the nurse emailed me my results and said I was at a 600 which is good. I objected by replying before I started my total t levels were at a 400 (went on trt because free t was below range and symptoms such as low libido) and that the doctor had told me he dosed his patients at whatever dosage brings them into the optimal 800 to 950 range and that I could probably get to 600 using just over the counter test boosters. I “cc” the doctor in my relply to the nurse. She then replied we will up my dosage from 150 to 175 weekly and retest me in a month. I am kind of surprised that at 150 mg a week I was only at 600. I kind of feel like they may just be in it for the money because she said I had a good range, but nobody asked how I was feeling in treatment! Nevertheless, because they are reasonably priced at $125 a month and I am paying out of pocket I do not plan on switching doctors.
The Matrix
Well-known member
Free t is low often due to elevated SHBG which can comes from multiple pathologies. As I have mentioned numerous times one can have low normal estradiol and still have a cellular estrogen dominance..
John Smeton
Legend
600 after 7 days is incredible! On day 1,2,3 I bet your 1,000 or higher but not to guess bc bloods are the only way to for sure know.
You do realize that if your injecting once a week that on average day 1,2,3,4 are the highest and after day five it drops off. Day six drops more and day seven more?
also the higher your levels the higher hematocrit and globin can raise, which isn't good.
I think 75 mgs Im twice a week would keep you more steady, or 20 mgs a day sub-q
You do realize that if your injecting once a week that on average day 1,2,3,4 are the highest and after day five it drops off. Day six drops more and day seven more?
also the higher your levels the higher hematocrit and globin can raise, which isn't good.
I think 75 mgs Im twice a week would keep you more steady, or 20 mgs a day sub-q
JoePaul39
Well-known member
Hi John, yes from what I read more frequent dosages is preferable to keep stable levels. Unfortunatly I go to the office for injections and due to overnight travel from work this makes getting dosages more frequent not possible. I was not aware that levels drop off each day after the injection, but definetly makes sense. The nurse emailed me that I was good at 600 and I recalled that my doctor said he would get me in the 800 to 950 optimal range. So when she told me 600 was good I was upset (not knowing this means levels are probably at a 1000 after the injection). I’m glad you explained this to me. I guess in light of this when they retest me in 3 weeks I will not try to get the dose increased again.
From what I have read 175 mg per week is actually a generous dose for someone on trt. I want to avoid having issues with blood thickenin and estrogen. My dr would probably accommodate if I asked if I could get one last increase after they test me in 3 weeks up from 175 mg to 200 mg a week, would you not advise this for health reasons?
John Smeton
Legend
its up to you. I can tell you from being on trt over four years now, getting blood work every 3 months, donating blood every three months, in the beginning. Now I ve been going every six months for lab results, and cut down on donating to once or twice a year. My Doctor asked me what dose do i want to do....I told him 150 mgs, when I could have gotten 200..... as Jerry brainum has a video out somewhere where there's some research showing over 150mgs raises hematocrit and globin so the conclusion was 150 mgs and under. That said its probably no big deal, as long as you get your labs done, and make sure youre healthy.
JoePaul39
Well-known member
Ya I think I will keep it at 175. Really don’t want to have take an AI or have blood thickening issues. My symptoms of low t have disappeared and that is the important thing. Chasing numbers can just make things go down hill with side effects.
The Matrix
Well-known member
After years of being at 60 mgs 2 times a week for 10 years then finally focusing working on my Gi tract,
liver pathways, gene expressions and receptor signaling, I am at 60
Mgs a week with no need for an AI as I was battling in the past. My sex drive is that of a 20 year old and don’t need to worry about estrogen issues. Finally starting to figuring this out after a decade of reseach and being a clinician.
liver pathways, gene expressions and receptor signaling, I am at 60
Mgs a week with no need for an AI as I was battling in the past. My sex drive is that of a 20 year old and don’t need to worry about estrogen issues. Finally starting to figuring this out after a decade of reseach and being a clinician.
John Smeton
Legend
What are you doing im or sub-q
NAO1255
Banned
That's all that Matters, Long as you are Feeling Well!!!
JoePaul39
Well-known member
Get injections in butt.
The Matrix
Well-known member
Insulin in pin in ass = sub Q LOL
JoePaul39
Well-known member
Thanks I learned something lol
The Matrix
Well-known member
I have found the best teachers are the students them selves.
JoePaul39
Well-known member
It is in the muscle
NAO1255
Banned
That means its in IM; intramuscular.
JoePaul39
Well-known member
So I just got back my estradiol sensitive test results after being on my new increased dosage of 175 mg test a week for three weeks. The lab was drawn the day after my once a week shot. The range was an 8 to 35 and I came in at 29. Is this a good reading? I get more test bloodwork done soon. If I get bumped to 200 mg test a week do you think this could up my e where I would need an ai? I want to avoid an Ai for health reasons and would even take less test to do so. At about what level on a sensitive test would an AI be warranted?
The Matrix
Well-known member
Which lab did you use for the e2 testing lab Corp?
If your symptoms are improving then you are going in proper direction.
You need to look at bioavailable and free levels not just totals. Often if shbg is an issue I had doctors push 1400 to get symptoms relief. It appears you may be a rapid metabolizer ..
JoePaul39
Well-known member
DaeshDontSurf
Member
My E2 is at 31 using Labcorp Sensitive - I, and my Doctor are happy at that. 35 is top-of-range, and I'd be fine there too, frankly - E isn't the demon it's made out to be sometimes (not talking WAY out of range here, LOL). There was an All Cause Mortality study done on males and E2 levels, and 30's was where you would want to be. Test Cyp Dose is 0.45ml (90mg) 2x/week Sub-Q, with 10 Units HCG/day.
The Matrix
Well-known member
I looked at 10,000’s of labs over a 10-15 year period from Joe Off the street to the death bed. E2 should be around 22-28 when shbg is 20-25 which was the norm 10-15 years ago.
Now I am seeing shbg over 35 is the new norm which is linked to enviromental toxins, but doctors are missing th boat. I just had enlightening conversation with Dr Seneff, Director of AI department at MIT where I shared presenting my findings. These new findings will help to open up doors to further her research on glyphosates.
Now I am seeing shbg over 35 is the new norm which is linked to enviromental toxins, but doctors are missing th boat. I just had enlightening conversation with Dr Seneff, Director of AI department at MIT where I shared presenting my findings. These new findings will help to open up doors to further her research on glyphosates.
JoePaul39
Well-known member
Thanks for the info. I get my one month bloodwork back Monday or Tuesday for my 175 mg a week dosage. If it doesn’t get me to at least 800 I am going to ask for one last bump to 200 mg since hemacrit and estrogen hasn’t been an issue so far. Don’t want to go over 200 a week because that starts nearing a small cycle dosage and I want to be able to avoid taking N ai. If e goes up too much at 200 I will go back down to 175.
The Matrix
Well-known member
are they looking at other factors from making the testosterone works more effective? You could just be a hyper metabolizer of testosterone too.
JoePaul39
Well-known member
To be honest I don’t think they are too in depth in their analysis. No SBHG testing, no free t testing. They said they normally don’t even do an estradiol sensitive test unless patients have symptoms of high e, but I told them I always want to have that done. The main reason I go there is they are only 125 a month and will do the injections in the clinics (don’t want to self inject). All the other places I inquired about were above
My budget. I do like the fact that they are liberal in dosages, but even so I would never go over 200. I also told them I wanted to have an ai on hand just in case I need it and he didn’t hesitate to call in a years worth of arimidex prescriptions. Will come in handy for future anabolic cycles lol!
DaeshDontSurf
Member
Free Test is just a mathematical calculation from Total Test and SHBG... I actually can't believe they charge for it (if they do, it's bundled with the other two for me, so no idea). It's also unlikely that a Doc would go after SHBG directly with something like Danazol - I'd say 99.9% deal with SHBG by increasing the Testosterone dose.
The Matrix is right though, you should try to get a complete picture by pulling those values - if you have super high SHBG and your free T is low, you're not getting bang for the buck. On the other hand, if you feel great, that's the whole point, right?
kenpoengineer
Well-known member
Proper TRT bloodwork includes these tests:
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kenpoengineer
Well-known member
For the $125 per month, what medications do you receive? You might want to check out our board sponsor Entourage Medical for TRT. Here is a link to the forum here on AM:
Entourage Medical
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Entourage Medical
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JoePaul39
Well-known member
Free Test is just a mathematical calculation from Total Test and SHBG... I actually can't believe they charge for it (if they do, it's bundled with the other two for me, so no idea). It's also unlikely that a Doc would go after SHBG directly with something like Danazol - I'd say 99.9% deal with SHBG by increasing the Testosterone dose.
The Matrix is right though, you should try to get a complete picture by pulling those values - if you have super high SHBG and your free T is low, you're not getting bang for the buck. On the other hand, if you feel great, that's the whole point, right?
That is true. Dr. will run any tests I want, it his standard test doesn’t include free t unless the patient requests. I do feel much better on treatment and notice a definite difference so I am not too worried about it.
JoePaul39
Well-known member
It only includes my test dosage. He called in Arimidex generic to the pharmacy for me to have on hand just in case. I have insurance so it was only a few bucks so no big deal. It was also a whopping 15 1mg pills a month with 12 refills so I am more than set in that department. The 125 a month doesn’t include HCG. He would call it in if I wanted it though and more than likely insurance would pick that up too, but I don’t want to be on it. Before I selected a dr. I thought about using Entourage, but I don’t want to pin myself and my wife refuses to do it for me because she is suspicious of the company since I found it on what basically is at least in part a steroid/anabolics forum. She is convinced it is a mill and their click on add on the forum of the roided up bodybuilder didn’t help my case either. I know Entourage is legit and a good value that has helped many board members feel better again, but believe me I cant persuade her. I have tried.
The Matrix
Well-known member
Then just ride things out and don’t worry about numbers. 600-1000 is what I recommend doctors shot for at the mid to trough range with reduction in symptoms. Usually seeing guys need 20-30 mg every other day as long as other factors are addressed.
DaeshDontSurf
Member
You probably know this, but just in case you don't: Subcutaneous administration works 100% fine, and is, I'd honestly say, 98% painless. That fat band above the glutes and below lower back is perfect on me. 26G 3/8" is what I use.
kenpoengineer
Well-known member
If you want more information or want your wife to see the number of patients Entourage has, feel free to join the Testosterone Replacement Therapy Community and Entourage Testosterone Patients Facebook groups.
The Matrix
Well-known member
This is IM not sub Q
JoePaul39
Well-known member
Got my 4 week bloods back at the 175 mg dose. Nurse says still at around the 600 mark total t. Gonna up me to 200mg and retest in 4 weeks. Told her this will be my last increase even if test levels don’t increase much again because don’t want to go over 200 due to probability of potential sides increasing. Perhaps like you said I am more of a nonresponder since increasing from 150 to 175 a week didn’t increase total t much.
The Matrix
Well-known member
A lot of doctors TRT patient are doing intermittent fasting with ketogenic diet. Just had one 2 weeks ago with shbg of 150. Doctor wanted to jack testosterone up, I suggested to Dr to hold off and let’s do a heavy refeed every 3-4 days. Just got email back from Client saying improved libido and putting on muscle and getting learner. Been only 10 days. More testosterone was not the answer looking out side hormone was..
DaeshDontSurf
Member
This anecdotally jives with what I've seen on my own bloodwork. I'm one of those 'perma-cutters' (not really, but it seems like it) SHBG in a deficit (hate keto, so just about 150g carbs) was 55 and 48. Free test was around 16 and 20. This last draw I was at maint or slightly above (300g carbs) and my SHBG was 36 and free test was at 23.8 (out of 24 max lab value). CARBS=GOOD!
Same 180mg (90x2) of testosterone.
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The Matrix
Well-known member
Insulin does the body good in right amounts lol
I bet if they did a 200-300 carb refeed every 4-5 days with IF they would get just as good as results.
I bet if they did a 200-300 carb refeed every 4-5 days with IF they would get just as good as results.
JoePaul39
Well-known member
Free Test is just a mathematical calculation from Total Test and SHBG... I actually can't believe they charge for it (if they do, it's bundled with the other two for me, so no idea). It's also unlikely that a Doc would go after SHBG directly with something like Danazol - I'd say 99.9% deal with SHBG by increasing the Testosterone dose.
The Matrix is right though, you should try to get a complete picture by pulling those values - if you have super high SHBG and your free T is low, you're not getting bang for the buck. On the other hand, if you feel great, that's the whole point, right?
So I got back my actual number total t today from Labcorp (nurse had told me that I was around at 600 again). Looks like I tested at 574 total t at the 175 mg dose whereas I had previously tested at 600 total t at a lower 150 mg dose. Weird I tested higher at a slightly lower dose. Will be staring 200 mg this Friday. I think I am going to take your and the THEmatrix advice and have them test for both SHBG and free t next time.
DaeshDontSurf
Member
Just make sure you are getting the lab draw done at the exact'ish same time, each time. For hrt, that is usually in the "trough" right before (as close as you can get) the next injection. Since i inject monday am and thurs pm, i get mine drawn at 10am on thursday every time.If you are taking DHEA, dose it 2 hours before the draw.