Cutting back on cypionate

[LowFreeT]

I'd been experiencing symptoms of low testosterone for a while. Had tests for Total T - 410 (160-726) and Free T 53.5 (50.0-210). I'm 41 and probably should have been happy with the 410 but the low Free T really concerned me and my nurse practitioner was willing to let me try cypionate at 200mg every other week.

After 8 months, I had another Total T test done (different clinic - I have crappy insurance and take a free test when I can get one). The level was 1252 (241-827). They didn't test Free T saying it was "unreliable" so I'm still in the dark there. They were pretty skeptical about why I was taking the testosterone anyway since I had been at "normal" levels and recommended I cut back to 150mg every two weeks and retest in three months and do a PSA, etc.

This test was taken 5 days after my last injection. From what I understand, my levels should have peaked by then so I probably am off the charts as far as the normal range is concerned.

Should I be really concerned about that 1252 in the short term? Does it sound reasonable to bump back to 150mg for a couple months?

I can't say I got much out of the TRT at that dosage besides having more energy (and some of it nervous) so maybe my low Free T wasn't really the problem.

Thanks for any advice out there. I'm really thankful for a forum like this. It's next to impossible to get a straight/informed answer from most medical professionals. They look at me like I'm a martian or something.

[xtitan1]

Hey there LowFreeT (that name may become inaccurate soon!). Sorry you're having the low T symptoms. And no, you shouldn't have been happy with your poor Free T number considering you also were suffering from low T symptoms.

Now if you haven't read the stickies on the forums, I would highly recommend doing so as it will enable to you fill in a lot of the blanks as well as better understand the advice going around on the forums. They are a great resource.

Usually people recommend figuring out why it is you have low T before going on TRT. The thinking there is that TRT will suppress the pituitary hormones that indicate whether or not you have primary or secondary hypogonadism. So on that front I think you got some bad care by this guy jumping straight into therapy. Unless he came to a conclusion and you didn't include that, in which case definitely let us know!

The comment that the Free testosterone test is unreliable is frankly, bizarre. It is highly recommended even by the very conservative American Association of Clinical Endocrinologists guidelines.

Usually you want to do blood work the day before your next injection so you can see what the levels are when they get to their lowest. I see that you are taking your regimen on a bi-weekly dose, where most recommend instead a semi-weekly dose via self-injection if possible (your doctor can show you how to self-inject so you don't have to drive to the doctor's twice a week).

The concept is that instead of flooding your system with a whole bunch of testosterone and then waiting two weeks at which point you're really dragging because the testosterone has worked its way out of your system, small and frequent doses will instead give you steady levels. This may explain why you come up with a high total T level. It may also be that you are getting too much testosterone, but that doesn't change the recommendation that you should increase dosage frequency.

Definitely check out the "Finding a TRT physician" sticky, not only because you are in need of a competent TRT doctor, but because it also lists recommended blood work. Given your high T levels and remaining low T symptoms, I would be very interested to see your 'Estradiol, Sensitive' assay. As you will read in the stickies, Estradiol, a form of estrogen, almost always increases with the introduction of exogenous testosterone (testosterone converts to estrogen). If you have high estrogen, it will effectively undermine your TRT.

Also, in general, a full thyroid panel would be worth your while. Again, this is included in the "Finding a TRT physician" sticky.

The reason you are finding it hard to get a straight/informed answer from most medical professionals is because so many are not informed!

Stick around for the experts here to chime in.

[steroid.com 1]

When you tested at 1252 pg/ml you were just past peak but at 200mg I can see why it's where it was for total serum level.

At this point you really want to know Free and Bio Available.

You can cut back but to 150mg every two weeks BUT it's much better for you at 75mg per week if you were to cut back.

Did you get a PSA before you started your TRT protocol?

Can you post your last BW here complete with ranges.

Are you managing E2? hCG?

[LowFreeT]

Thanks xtitan1 for your response. I did get a bunch of general tests done when I originally had my testosterone checked as we wanted to rule out a thyroid issue. Eight months ago my TSH was 1.355 (0.40-5.0) Free T4 0.75 (0.56-1.64) and Free T3 3.0 (2.3 - 4.2). So everything was in normal range although a bit on the low side. After reading all the discussions about TRT, I'm not sure what to believe about "normal" levels of anything anymore.

The only out of bound results I had were cholesterol which was just a smidge over and low Vitamin D. I wasn't tested for estradiol at that time but it is something I'm concerned about now with the high total T.

[MRNJ1992]

should definitely hit your shots in lower doses bi weekly for steady levels of T instead of the peaks and valleys. I was on cyp 200 mgs per week. then upped me to 350 mgs per week.. after 2 years the urologist changed me to andro...levels went to 1500-didnt feel anything..dont know if these blood tests are truly reliable...my doc says get the blood drawn early morning...my last T test mine was 117 total T...waiting for my last bw results...good luck low T hope you fare better than I.

[LowFreeT]

Thanks for the info gdevine. Now that I know how high my Total T is surging from injecting every two weeks, I'm definitely going to go weekly. I'm thinking now that the Total T bloodwork I just had was pretty much useless since it was so close to peak as you point out and I don't know why they didn't test Free. Well, I guess I do - they probably have no idea what they're doing. I'm coming to understand to do this right, I would need to track down a TRT specialist and most likely pay more out of pocket than I can afford. I think we've basically just been throwing a little testosterone at this to see if it makes a difference. After 8 months, I'm not seeing what I had hoped to see but I'm realizing now that we've been going at this in a pretty shoddy way.

I didn't have a PSA (but scheduled for one in 3 months when they want to retest). I'm not doing anything with E2 or hCG.

[LowFreeT]

MRNJ1992, how long were you testing above the "normal" range with your total T? Did you ever feel like it helped you?

[MRNJ1992]

Quick info-had a thyroidectomy in 93.hormone levels have been wacky since. T level started at 180. after cyp for 3 months went to 450. raised the dose to 300 mgs and level went to 850 and went as high as 1000. went to a urologist 2 years later. he took me off cyp and put me on androgel. levels went as high as 1500-useless gel. now been off 3 months and waiting for more bloodwork. my total T was 117 but free T was 35.8 on a scale from 6.8-21.5 just had blood drawn and waiting. felt great on the Cyp.....had a ton of energy my doc wanted to keep my level close to a 1000...the doc who removed my thyroid...