Yes this is the reason I won’t increase my dosage before seeing labs. I have taken the advice of everyone here and that seems to be the smartest thing to do… adjusting protocols without labs could be a disaster and long road to recovery. Something I am going to avoid.
@systemlord @highpull & anyone else following along
Wanted to give an update, still no labs (waiting for them to become available online)
Here is a break down of how my last few days have went
Thursday - 50mg injection, rest of day mediocre, zero libido, mood numb not really happy or sad, anxiety minimal, spontaneous erections absent
Friday - Morning wood (basically get daily) Anxiety high, mood same or worse, spontaneous erections absent, libido absent
Saturday - Morning wood, anxiety high, low mood, spontaneous erections absent, low libido if any.
Sunday - 3rd day since my last 50mg shot… Morning wood, anxiety minimal or not noticed, spontaneous erections there, very easily achieved throughout the day. Mood is lowish, however not irritable and mood swings are not there. Libido is also apparent. Laying in bed with gf and cuddling makes me erect. Erection very strong and requires zero stimulation to keep.Physical symptoms of libido there such as heart racing, dopamine rush.
In summary: The only time my libido is strong, anxiety minimal, and erections are spontaneous/easier to achieve is the very day before my injection, when levels are supposed to be trough and lower/declining. This is something I have mentioned previously and is a trend for sure not just a one time thing. The last 3-4 weeks have been exactly like this. I log everything so the above is an accurate reflection… after my injection of 50 mg the cycle repeats and it takes another 3 days post injection to bring my libido back
Obviously still no labs so not making any changes to protocol just yet, but I don’t know what to think as far as an explanation goes for the above. Any insight into this is much appreciated.
As a side note: When my libido is gone and anxiety is high my flaccid almost shrivels up and lacks good blood flow. However when my anxiety is lower and libido is there my flaccid hangs very well/scrotum hangs well and blood flow is much stronger/more sensational. The reason for this is… Anxiety shunts blood flow by putting your body into fight or flight mode… it saves the blood for your core and organs therefore restricting blood flow to extremities including the flaccid penis. Its your bodies sympathetic response to danger or perceived danger. Heart rate goes up, blood pressure increases, and blood shunts to core. This is why most men will shrivel up down there when they run/exercise… the body is shunting blood flow to the places that need it most. This is what I learned in Paramedic school regarding patients in hypovolemic shock (severe blood loss)… the body will jack blood pressure up, (increase vasuclar tone) and shunt blood to the core to save your organs. Same principle…
Basically, increased anxiety will reduce blood flow down there, make it harder to achieve an erection/relax, and reduce penile sensation temporarily. This is what is happening to me when my anxiety is higher and persistent… I wonder if it is E2 related/timing related to my dosage/frequency.
You should realize you’re not feeling all of the affects from your injections on injections day, as time passes testosterone is released from the ester, so it’s easy to understand why there is a delay in you getting relief in your symptoms.
Then again it could be estrogen spiking days later. If it’s going to be this difficult to get your labs in the future, I would make other arrangements because this is ridiculous. There is nothing worse than a guy trying to dial-in and not able to get labs in a timely fashion.
The worst part is, my doc didn’t even write my initial script for long enough. I was prescirbed two 1ml vials for 6 weeks lol. I have been relying on my dads extra T to get me by until my doc can “review my labs” and write another script.
How could I eliminate the delay in symptom relief? Injecting more right to build to higher steady state levels? But then again like you said… it could be high E2.
You can’t rush your body to taking shortcuts, also the T has a half-life.
How does anyone manage to feel better if it takes 2 days to feel good on a protocol after every injection? My understanding was injecting twice weekly would lead to consistent T levels. Seems as if my T levels are low… then decent and back to low.
There is only 1 day between those 3 days that I feel pretty good… Labs will tell, but I am almost positive there is not enough T in my system constantly to feel good, but after injecting I feel the spike in T two days later and feel good. A higher dosage will likely bump me to higher levels in the range and keep me there. Its almost as if im bouncing from below range to in-range T levels. Thoughts?
Now one can understand why I like daily protools so much, FT goes up and continues to increase until my levels are stable. My daily protocol will see levels mostly only increasing, the decrease in hormone levels is almost non existent.
What you are experiencing is your levels are going up, then going down over and over again like a rollercoaster ride for 6 weeks.
but why is it that the majority of men are taking T once weekly and never join these forums looking for symptom relief? Most do not even know what SHBG is or what any of this stuff means. Taking my dad as an example, he takes T weekly and has zero complaints (feels great) and has been on TRT for a long time. Also my SHBG is midrange not low, I feel like twice weekly would at least have had a better effect than it has so far.
Still need to see labs, but I am expecting to see lower FT levels at trough. What do you think is better moving to 50mg 3x weekly or 75mg 2x weekly? Both totaling 150mg/weekly. This 50mg twice weekly is a good place to start as recommended, but for me is clearly not high enough to maintain stable blood levels of optimal T.
I don’t think so, not anymore its not. TRT decreases SHBG is just about everyone, you’ll see. Your SHBG is probably going to be in the low 20’s or maybe even lower in a couple more weeks.
There was a guy recently pre-TRT had his SHBG at 70, after starting TRT his SHBG is now 28.
Ok my next move really depends on what my labs show… Really at this point both you and I and everyone else reading have no idea what the numbers are. This is really frustrating having to wait on my labs to make a move. If estrogen needs to be controlled I will likely move to 3x weekly, AND if Free T is low which im assuming it will be on current dosage (100mg weekly) I will bump the dosage up. Likely to either 40 or 50 mg 3 weekly. If estrogen is fine I will probably keep 2x weekly and go for 75mg each injection. I am going to call docs office now and see what I can do regarding labs…
This makes sense to me.
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Attached is my blood work from 50 mg every 3.5 days… These labs were pulled
3.5 days after my injection (trough)
Key takeaways:
SHBG stayed the same at 30, TT went from 382 ng/dl to 712 ng/dl
free testosterone went from 53 pg/ml to 106 pg/ml… Was still experiencing symptoms… likely because free T was not optimal and not even mid range on a scale of (46-224 pg/ml). I have since upped dosage to 75 mg every 3.5 days. Would you agree with this after seeing my 50 mg blood work?
Also Sensitive E2 was 22, perfect. (However this was the ultra sensitive test)
Another key finding is my MPV platelet is high and total platelet count is low… signaling something could be wrong… possibly iron deficient, zinc deficiency’s, cancer, malnutrition, epstein barr. Thoughts?
Alkaline Phosphatase is also low signaling that my diet might be poor (liver function is great, already ruled this out) and I could be deficient in vitamins/minearls (B12, Zinc??). (This could be contributing to lower platelet count and higher mean platelet voluem)
I literally wake up tired every single day regardless of sleep. The fatigue is overwhelming.
- What do you think of my blood work? Still tired all of the time… blood work is pointing at maybe a vitamin/minearl deficiency such as Zinc… Zinc deficiency could have cause my Hypogonadism in the first place. Or B12…
To be fair, I have not eaten a healthy diet all my life… I have actually not eaten a single green vegetable since I was a baby… I also do not supplement with a multi-vitamin
- Do you agree with my dosage change after seeing Free T, TT, and E2 on 50 mg E3.5 days
Being B12/Folate deficient could certainly be causing thicker platelets and lower platelet volume, and could be the reason I am extremely tired all of the time. What is the definitive solution to this? Start eating my veggies? lol
The only thing is… my red blood cell count and hemoglobin are both good. I would expect to see these values skewed if I truly was B12/B9 deficient.
I suggested this previously and I have not changed my mind.
I’d eat healthier, maybe take some vitamin supplements, and recheck.
I think you were absolutely right since the labs showed my Free T at 106 pg/ml (46-226pg/ml)… 50 mg every 3.5 days was just not enough. Since changing dosage I am already feeling much better. Where does 200 mg week put your Free T?
Runs between 180-220 (range 35-155pg/mL with Quest).
I wonder why the ranges are so different? I use Quest as well. I didn’t know they used two different ranges.
Different methods?
Free testosterone is best calculated based on the LC/MS/MS-derived total testosterone and equilibrium dialysis-derived percent free levels.
Alternatively, free testosterone can be calculated based on total testosterone, SHBG, and albumin measurements. Bioavailable testosterone is calculated similarly. This method, however, does not account for estrogens or other compounds that displace testosterone from SHBG.
From my understanding the 46-226 pg/ml range from Quest was equilibrium dialysis measured.
One last note… if I truly was suffering from B12 or folate deficiency, I would expect to see my Mean corpuscular volume (MCV) higher (size of my red blood cells)… and hemoglobin would be different as well. Very strange I have lower white blood cells, lower platelets, and low ALKALINE PHOSPHATASE. I need some expertise on the matter…