T has shot through the roof without change in dose. WTF???

[forrest_and_trees]

Over the past year, my T levels shot from 1200 to 2400 on the same dosage…

I've been on Test Cyp for about 5 years now. Original test levels were 145 before beginning HRT. Back then, I was pinning .6ml or 120mg twice a week and all was good, my T was in the 900s. I weighed around 435 lbs at the time. [...I found out after beginning TRT that I also had Hypothyroidism, but that's another story....] As I lost weight, my T levels increased *some* with the same dosage. Around 350 lbs, it was in 1100s, 300 lbs the 1200s, so at that point I dropped my biweekly dosage to .5 or 100mg and my T stabilized around 1000.

Then last year, I was down to 275 lbs and my T was back up to 1200 on .5ml x2 a week. My Doc wanted me to lower my dose again to get that number down, so I began pinning .4ml x2 weekly. After about a month or so, I started feeling crappy… lost noticeable strength, was benching 265lbs on the higher dose and after cutting back, I could barely get up 230lbs. My moods were dropping, I was having a hard time sleeping and even getting myself to the gym, so I bumped it back to .5ml x2 weekly and felt better.

6 months later, after my second to last test, I was back up to 1200 total T and the Doc asked me once more to try lowing the dose, which I did again. This time, I was no longer lifting weights due to a shoulder injury; I had switched to cycling for weight lose, but once again, my workouts suffered. My stamina diminished. I could no longer maintain the speed or duration/distances, which are vitally important to my ongoing weight loss needs; so I went back up to .5ml and things improved. Since the spring, I've been doing hard core cycling. I started with 15 miles 5x a week, M-F, but I plateaued. So during the summer I switched it up to 30 miles 3x a week. M-W-F. Now I'm up to 30-65 miles 3 times a week. Over the past 8 months, I've lost another 60 pounds , [so I'm down to 215 lbs.] and my T is now off the charts at 2400! Why would this last 60lbs make such a *huge* difference when the first 150 barely did?

Could it have anything to do with injecting into fat vs muscle? Until more recently, I'd often felt that I wasn't reaching the muscle through the fat layer, even with a 1 inch needle 3/4 of the way in or more. Now I know I'm hitting muscle every time I pin. Would this do it or is it possible the lab work was somehow wrong?

Along with the high T, I have some other anomalies... My IGF-1 in the crapper, my WBC is down, my platelets are low but RBC normal… I do drink LOTS of fluids [around 1 - 2 gallons a day; mostly water, but some diet soda too.] and take a diuretic, Hydrochlorothyazide. Could the high fluid levels be contributing to some of the other abnormal numbers? What about my more recent intense cycling, 40-65 miles 3x a week?

And while I know my E2 is really low, I have none of the symptoms of low E. If I take less AI (Anastrozol) I get moody, can't relax, puffy nipples and retain fluid.

Your thoughts on all of this would be greatly appreciated.

P.S. My Cholesterol numbers are lower than ever. They were high when all this began. My resting heart rate is also now only 58 bpm, which is considerably down from before. So some good has come of all this…

Latest Test Results from one week ago:

Test Name Result Flag Reference Range Lab
CBC With Differential/Platelet
WBC 2.6 LOW 3.4-10.8 x10E3/uL 01
RBC 5.21 4.14-5.80 x10E6/uL 01
Hemoglobin 15.1 12.6-17.7 g/dL 01
Hematocrit 45.1 37.5-51.0 % 01
MCV 87 79-97 fL 01
MCH 29.0 26.6-33.0 pg 01
MCHC 33.5 31.5-35.7 g/dL 01
RDW 12.9 12.3-15.4 % 01
Platelets 145 LOW 150-379 x10E3/uL 01
Neutrophils 42 % 01
Lymphs 40 % 01
Monocytes 12 % 01
Eos 5 % 01
Basos 1 % 01
Neutrophils (Absolute) 1.1 LOW 1.4-7.0 x10E3/uL 01
Lymphs (Absolute) 1.0 0.7-3.1 x10E3/uL 01
Monocytes(Absolute) 0.3 0.1-0.9 x10E3/uL 01
Eos (Absolute) 0.1 0.0-0.4 x10E3/uL 01
Baso (Absolute) 0.0 0.0-0.2 x10E3/uL 01
Immature Granulocytes 0 % 01
Immature Grans (Abs) 0.0 0.0-0.1 x10E3/uL 01
Comp. Metabolic Panel (14)
Glucose, Serum 94 65-99 mg/dL 01
BUN 18 6-24 mg/dL 01
Creatinine, Serum 0.75 LOW 0.76-1.27 mg/dL 01
eGFR If NonAfricn Am 109 >59 mL/min/1.73 01
eGFR If Africn Am 126 >59 mL/min/1.73 01
BUN/Creatinine Ratio 24 HIGH 9-20 01
Sodium, Serum 142 134-144 mmol/L 01
Potassium, Serum 4.1 3.5-5.2 mmol/L 01
Chloride, Serum 99 97-108 mmol/L 01
Carbon Dioxide, Total 27 18-29 mmol/L 01
Calcium, Serum 10.5 HIGH 8.7-10.2 mg/dL 01
**Verified by repeat analysis**
Protein, Total, Serum 6.8 6.0-8.5 g/dL 01
Albumin, Serum 4.2 3.5-5.5 g/dL 01
Globulin, Total 2.6 1.5-4.5 g/dL 01
A/G Ratio 1.6 1.1-2.5 01
Bilirubin, Total 1.4 HIGH 0.0-1.2 mg/dL 01
Alkaline Phosphatase, S 85 39-117 IU/L 01
AST (SGOT) 29 0-40 IU/L 01
ALT (SGPT) 30 0-44 IU/L 01
Lipid Panel
Cholesterol, Total 135 100-199 mg/dL 01
Triglycerides 60 0-149 mg/dL 01
HDL Cholesterol 50 >39 mg/dL 01
According to ATP-III Guidelines, HDL-C >59 mg/dL is considered a
negative risk factor for CHD.
VLDL Cholesterol Cal 12 5-40 mg/dL 01
LDL Cholesterol Calc 73 0-99 mg/dL 01Thyroid Panel With TSH
TSH <0.006 LOW 0.450-4.500 uIU/mL 01
Thyroxine (T4) 16.3 HIGH 4.5-12.0 ug/dL 01
T3 Uptake 39 24-39 % 01
Free Thyroxine Index 6.4 HIGH 1.2-4.9 01
Testosterone , Serum
Testosterone, Serum 2411 HIGH 348-1197 ng/dL 01
Results confirmed on
dilution.
Comment: Comment 01
Adult male reference interval is based on a population of lean males
up to 40 years old.
Prostate-Specific Ag, Serum
Prostate Specific Ag, Serum 0.5 0.0-4.0 ng/mL 01
Roche ECLIA methodology.
According to the American Urological Association, Serum PSA should
decrease and remain at undetectable levels after radical
prostatectomy. The AUA defines biochemical recurrence as an initial
PSA value 0.2 ng/mL or greater followed by a subsequent confirmatory
PSA value 0.2 ng/mL or greater.
Values obtained with different assay methods or kits cannot be used
interchangeably. Results cannot be interpreted as absolute evidence
of the presence or absence of malignant disease.
IGF-1
Insulin-Like Growth Factor I 56 LOW 67-205 ng/mL 02
Estradiol, Sensitive
Estradiol, Sensitive 3.0 LOW 8.0-35.0 pg/mL 02

[Simon1972]

you taking 240mg/week? if so that sounds fair,

imtaking 150mg /week and am at 1100 at 1 day post pin- with no AI, so id be freeing up total T with an AI- so my guess would be 1200+

any chance you could tell us what dose of AI, when the test was taken after pinining ( days)

alot of what you wrote is incidental and glosses over the straight facts.

[forrest_and_trees]

I've been taking *200mg a week*, not 240mg.

Blood draw for the lab work was on a Thursday morning, the most recent test cyp injection was 4 days prior, on Sunday morning. [100mg]

I take 1mg of Anastrozole on the 2 days following an injection and an additional 1mg as needed.

[Paragon73]

Two things come to mind. Some men do absorb better with IM shots, which you are finally getting now that you lost the fat layer. Also, your blood volume is less than it was when you were so much heavier. So now you may be getting more T into your blood, and it's more concentrated because of less blood volume.

[Low Testosterone]

First guess would be at a higher body fat you were aromatizing more of your testosterone , therefore your testosterone levels were lower than they are now with the same dose. Higher body fat can cause more aromatization. Now this is not something that always holds true...I've seen plenty of very overweight men who do not aromatize much at all, but more often than not body fat can play a role.

Your dosing changes, 100mg/2x/wk vs. 80mg/2x/wk (I'm assuming your testosterone is 200mg/ml) it's hard to imagine that this little change in dose would make such a dramatic change in how you feel so quickly...that's not common at all, not to the extent you described.

You did mention your E2 is very low despite no low E2 symptoms, I'm taking a guess but saying you do have some symptoms...meaning...for a slight change in testosterone dose to have that big of a negative impact on you, your testosterone to estradiol ratio must be riding on the edge and you're throwing it completely out of whack with the slight drop in testosterone dose....that's not something you want to continue. On a good TRT program if you're short 20mg here and there on an injection it should negatively affect you. On a good TRT program you should not really notice, at least not all that significantly, if you miss an injection once in a blue moon. If you do it's either placebo or the overall plan is lacking in some way.

Just because you have puffy nipples does not mean your E2 is too high. I wish all doctors would stop RX'ing AI's just because their patient complains of puffy nipples. In my opinion, it's the worst reason to RX an AI. Nipples can become a little puffy or sensitive due to an increase in libido, which has nothing to do with E2. Secondly, if E2 is low and then it goes up into normal range, you may experience short term puffy nipples or water retention as the body normalizes. Lastly, and I'll never be able to say this enough, puffy nipples, itchy nipples and sore nipples do not mean gynecomastia and it is impossible for gyno to occur unless estrogen levels are high and remain high for long periods of time. (This is excluding things like progesterone induced gyno).

And yes, some people absorb better either IM or SubQ...there's no one perfect way for all to inject.

[forrest_and_trees]

Hey, thanks for the detailed response. You make some really good points. Come to think of it I believe some of my negative effects to lowering my dose in the past may have been due to maintaining the same AI usage. That may have been just enough to throw me below the E2 line and what I was experiencing may have been more due to low E2 than lower T. Since last week, I lowered my T dose to 80mg each pin, or 160mg for the week, *and* I've not taken nearly as much AI [only 1mg on day of pin] and I'm feeling pretty good. Better than I usually do with this little AI. I think you're right about letting my body readjust too. And for the record, the puffy nipples are only one symptom. I'd lived with elevated E for many years before I figured out what was going on. Definitely had some gyno going on, but it's gotten much better with the AI and weight loss. I've also had an issue with water retention for ages. Without the AI, I'm like a freakin camel.