It’s not TT i am worried about. It’s my FT that is too low. And my SHBG isn’t even high.
Pick something and wait 6 weeks. You’re going to feel like shit for 6 weeks. There’s a good chance after 6 weeks you’ll feel better than the protocol you just changed from (you obviously changed for a reason). 125mg is not much. It’s less than most guys on TRT take. If you don’t wait 6 weeks you’ll never know.
injecting 3x per week causes only about 60 ng/dl difference between peak and trough. Measured 580 to 600 peak and 520 to 530 trough.
Forget the free T if it wasnt measured by equilibrium dialysis. The cheaper methods consistently underestimate free T.
Now this changes things completely and makes above arguments on this thread meaningless. How do i know how it was measured though? Because my whole point to increase my dosage was low Free T despite high TT.
Yeah i def. want to wait 6 weeks but not with this poor sleep and feeling like living on the edge 24h due to new dosage. It really feels like i injected myself long acting adrenaline shot rather than T.
Anyways… I will just lower it to 130mg or 125mg and wait for 6 weeks.
I feel better vs. pre trt , that’s for sure. I also feel there is a lot of room for improvement. I think half of this improvement will be achieved when/if i optimize my thyroid levels and the other half is when i optimize my trt by reaching upper range at FT.
Maybe i am overly focused on numbers because i am yet to reach the recommended lvl of FT (by users on this forum) and how it will make me feel in general. I still have symptoms of low t and hypothyroidism despite feeling better.
I wish that was an option for me.
I travel overseas a lot due to my job (38 countries so far) and carrying syringes filled with T is a problem. Twice a week and i can manage the dates but ED or EOD is impossible.
Sometimes we sacrifice our quality of life for our careers.
Can all these sides when i up my dosage be due to because thyroids can’t keep up with high T ?
Like insomnia and palpitations?
@pita13
Dude you are going to have all these sides the first 6 weeks. It’s part of the game. A majority of people on TRT are doing close to 200mg. Many of the people that come to TRT forums (besides those looking to do cycles) are the ones that have issues. Lowering the dose isn’t always the answer. Having a total T of 500 isn’t ideal for many people. You do you but just keep in mind if after a few months in the 100mg range if you don’t feel like a much better version of yourself then you could be selling yourself short. No pain no gain. I say this because the same people told me 200mg was too much and dropped to 125mg for a while because the 200mg really messed with my sleep the first month. I felt ok at 125mg but feel like I always wished I could feel on 200mg. It’s your choice just giving you another opinion.
I travel with T & syringes in planes all the time. It’s never been a problem and they’ve never even asked for my prescription. I even just moved and had 7 5ml bottles and they didn’t give a shit.
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The sides are most likely do to infrequent injections, some guys just don’t tolerate a surge of androgens very well. It’s not natural to get a long gradual surge in hormones like that and doesn’t work well for everyone.
99% probability that it was measured not with the equilibrium method. This method is just too laborsome and time consuming for routine application.
Dont be too hooked up on numbers. Go with how you feel. People are very different in their response to exogeneous hormones. Take @dextermorgan, he feels good on a very high level of total T whereas I am feeling good on 550. I think you will have to find the dose which is good to you. TRT is not a ‘one size fits all’ thing.
Here is some info from a rel recent review paper Morales et al, 2012
a) Equilibrium dialysis, is a reference method which is based on the differential passage of low molecular weight substances through a membrane with a predetermined molecular weight. Thus FT moves through the membrane from the serum sample to the dialysate over time, but T bound to protein (e.g. albumin or sex hormone binding globulin,) is retained in the serum. The FT in the dialysate is measured by a radioactive isotope detection process. Results are affected by assay temperature, pH and sample dilution. Equilibrium dialysis is a manual time consuming and costly method, which is only done in a handful of reference or research laboratories across North America (http://www.mayomdicallaboratories.com/test-catalog/Performance/83686), and thus not routinely available to most clinicians.
b) Ultrafiltration is also considered a reference method. FT from the serum is forced by ultracentrifugation through a selective membrane into the dialysate and then measured by a radioactive isotope detection process. Although the method is faster than equilibrium dialysis and is more automated, it is still considered a manual and time consuming assay, which explains why it is also only available in a few laboratories.
c) Analog FT. Based on the limited availability and high cost of performing the reference methods for FT, “direct” measurement of FT by radioimmunoassay (RIA) was developed as commercially available kits for the diagnosis of hirsutism in women. In this single-step, non-extraction method, a radio-labeled testosterone “analog” competes with FT in the serum sample for binding to an antibody that has been immobilized on the surface of the assay tube. The premise of the test is that the T analog has a low affinity for sex-hormone bounding globulin (SHBG) and for albumin, and thus does not bind to them during the assay. However, values for healthy men are almost 10 fold lower compared to reference FT methods, necessitating method specific reference intervals as well as prompting serious concern about the accuracy of the method. The premise of the assay is that the T analog does not interact with other proteins in the sample, a requirement that most commercial kits fail to fulfill. There is a variety of FT immunoassays available.
Over a decade ago, Rosner6 was one of the first to call attention to the problems of the direct analog method for FT, concluding then that “evidence conclusively shows that the direct RIA (analog based assay] of FT is seriously inaccurate, underestimating T concentration by many-fold”. Subsequent comparative studies with equilibrium dialysis by Winters7 and Vermeulen8 confirmed these discrepancies, and in 2008, Fritz and coworkers9 again concluded that as the analoge-based assay “does not detect or quantify FT, it should not be used as a FT assay”. It is not entirely clear what constituent(s) are measured by the analog-based methods, but FT measured by this assay simply correlates with total T and not with FT as measured by other methods. Fritz et al9 speculated that the assay non-specificity may be due to protein-T complexes binding to the T antibody, while other studies suggest that the results are affected by the level of SHBG.
d) Calculated FT. The fourth method involves use of a simple formula (http://www.issam.ch) which permits the calculation of FT (cFT) from total T, SHBG, and sometimes albumin. This method is considered a good reflection of FT by equilibrium dialysis.3 As results may vary among laboratories based on their individual methodologies for total T, Figure 1, SHBG and albumin this problem may be compounded if a laboratory uses kits from different manufacturers. For this reason, it is particularly important for laboratories to validate their individual cFT reference intervals. Some laboratories don’t measure albumin directly, assuming normality (e.g.
43 g/L or 4.3 g/dL) instead. Although this assumption
is valid for most patients, men with severe hepatic or renal disease, may benefit from having measured albumin included in the calculation.
Yep. Your labs was fine.
Btw I would not treat thyroid now. ESP since u changed protocol again. It’s not like u have a tsh over 3. Repeat thyroid labs after you are stabilized.
I don’t think it’s wise to treat any hormone issues based on a single lab. Hormones fluctuate throughout the day.
AFAIK there is no chance for me to get a test with this equ. method at where live. Would you say it’s best for me to guess my FT with TT+Albumin+SHBG? Wasn’t there some kind of calculation with these parameters? Or am i making things up? Not sure.
So my Albumin 4.3 , TT 7.07 ng/mL and SHBG is 30.9 . What would be my FT?
Not questioning this but can you tell me the logic behind not starting thyroid meds when you change trt protocol? Is it because one wouldn’t be able to tell what causes him to feel good or bad?
Really? Even when you fly to another country? Because domestic flights is not a problem.
61.7 pg/mL
Thanks. What is the range though? Lab ranges over here is very different than US.
I calculated that from nmol/L, thought that is what I read initially. Can’t give you a range though, but with Quest it is 35-155pg/mL.
So according to that , we can say 61.7pg/ml is low-mid levels right?