Good to know
I’m curious about this too. I see guys on here posting about what their free and total t is. Some of the levels are higher than the olympics allow! I believe some guys are using trt as justification to cycle aas. A key to me is the term “replacement”.
@incline315
It’s all about what you want from life. It’s very similar to choosing a career. No one needs to make more than $40k. You can live a normal life at $40k and plenty of folks do. You can buy a small house, have children and get just enough food to survive. At $40k there’s things you aren’t able to do and places you aren’t able to live but if those things aren’t important to you then $40k is just fine. You can also choose to make $250k. No one NEEDS to make $250k and many choose not to pursue that route. Those that want to make that much money want different things. They have different goals. They could easily survive on much less but they want a larger house, a nicer car, ability to go on extravagant vacations and have what they believe is a more exciting life. Then there’s people in between that feel some things are more important than others. Neither is wrong or right. It’s a choice you make.
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I haven’t aspirated…ever
Careful with the zinc. With some guys it lowers E2 (when they are already on the low end) and can actually affect libido and erections. IF it happens to you, you’ll know why.
What happens if you are still symptomatic after you have achieved replacement levels? Will you not increase dose because you’re obsessed with the clinical range? This is where the majority of doctors fail. The numbers are more important than anything else and they have nothing to justify those numbers other than someone told them to.
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I wish I saw this before I ordered 28g syringes…I was debating between 27g vs 28g for everyday TRT…someone said scar tissue builds up more with 27g …idk I might exchange them when it arrives…it’s box of 100
Dude the difference is basically nothing. Not enough to make any difference.
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With everyday you will be fine as the amount is very small.
I hear you DB. Allow me to take the opposite position for sake of this conversation. First we’d need to define symptomatic. If by symptomatic we say we don’t feel like we once did, this can be a bit vague. A 50 year old man wouldn’t expect to “feel” and perform like a 25 year old regardless of replacement. We could always point to one or two ways we could feel better, perform better. So when is enough?
As for numbers and medicine, I agree many ranges for things can be flawed or outdated. But that’s what science/data is:numbers and data. Should we not use data and compare how we feel at particular points? Of course we should. Both go together: clinical symptoms vs blood lab data.
I just think it’s important for the community to ask ourselves what symptoms are we really having and at what point am I chasing something other than replacement?
If a man has 2k t, good free t, sex binding, estrogen all seem reasonable and he has some symptoms, is more t always the answer?
No… at this point you’d expect something systemic/neurological to be occurring absent of T
That being said if an individual has PAIS 2k might be like 300ng/dl for us
I agree with most of what you say here.
If total T is 2k, as per your example (free would be more important as total is irrelevant) and they still have symtoms, testosterone is likely not the issue here.
Symptomatic doesn’t mean, “I have no issues but I want to feel like I’m 18 years old and I’m 46.” Symptoms mean, “My libido is terrible, erections are so so, I feel drained of energy throughout the day, I suffer from brain fog, I have a hard time sleeping, etc etc” (one or several of those things). If this guy’s free T is 30, I’ll definitly tell him to try a higher dose to see if he feels better. If he does, great. If he doesn’t, address thyroid and move down the line from there.
Labs are just a small reference. It’s really just to give you an idea to see if something is terribly off. Lots of total T but little free T. Insufficient E2. Etc. It can help point you in the right direction as to what your protocol should be. However, I will never rely on these numbers as priority one in determining a protocol.
What would you do if you lived on a deserted island with no access to labs or bloodtests but had access to testosterone and had symptoms? You’d most likely experiment with different doses and administration frequencies, find a place where you feel best, and that would be that. Simple, right? Logically, that is precisely what would happen. The issue with us is that we have labs with numbers that are open to interpretation and we base any given symptom to some random number of our choosing, adjusting according to a number, and over complicating the entire thing. I say to hell with the numbers WITHIN REASON of course. Drinking a half bottle of wine with your meal is one thing. Drinking three bottles with each meal is something else entirely.
I say if you feel well, and there is nothing in your blood work outside hormonal levels that indicates an issue that needs to be addressed, then you’re doing something right.
Another good write up DB! I think you just need reasonable questions.
Thanks for clarifying your view on “symptomatic”. It seems simple to you but just a bit more explanation gives everyone a clearer picture.
Last hypothetical and I’ll let you go for the night. You mentioned TT : FT. Suppose I have high TT but relatively low FT. Suppose 1600 and 25 or 1800 and 30. Would you look at more testosterone as a solution? What are your thoughts?
1600 and 26…1800 and 30…now you get into tricky territory.
I do know some guys who had to approach total T of 2000 just to get symptom relief, and I can assure you these guys are not bodybuilders.
Men like this would typically have high SHBG. However Eric Serrano is always adamant to never purposely try to lower SHBG.
For cases like this, I’d probably send the lab work to Eric and get his thoughts. He sees stuff on labs that the rest of us would never see.
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Good news for me I scheduled an appointment with my first male Endo for next Thursday and he’s young too like early 30’s. Let’s see if he’s open minded lol
I’m not sure id count on it, the training in med school is still woefully inadequate, but its worth a shot.
Good luck
That’s what my PCP told me. But aren’t endos?
Trained in TRT? Nope, unless something’s changed or you found a guy who did his residency at a place that did it, or just randomly had an interest. You’d think they would be, or perhaps a urologist but typically it’s a big nope there too. It’s largely a blind spot for most docs.
I don’t want to get you down, but if you get a doc with more knowledge than just to give you 200mg e2w I’d be pleasantly surprised.
It’s really frustrating, I’ve seen it on here several times and it happened to me, too.
@Emcon456
You’re in the right frame of mind. Go into it with a positive but aware attitude. He could be the world’s greatest TRT endo ever and you are patient zero.
Well I could still use him for full lab work which they do . My PCP only checked total T lol.
So I just realized.
This Endo is most likely going to give me lab sheet for TRT blood work. My numbers are going to most likely be on upper end/above it. But my PCP has been giving me “100mg/week”. My guy who sold me source told me he usually takes 1-2 weeks no injections (he usually does 2x per week) depending on his 250mg TRT dose vs higher test dose/other stuff. So yeah what should I do not throw red flags…tell him “I feel like crap on 100mg.thays why I take 200mg cause I experimented dosing up on my own on several protocols? So if you don’t give me 200mg I’ll just use my own”? Lol.
Just tell him you started at 100mg and over the course of a year your dose was increased by 20mg every couple months until you reached a dose that made you feel normal and that dose is X.