cannot get testosterone over about 400. Need advice and help.

I am currently a patient at Defy Medical and seem to be stuck at around a 400 testosterone level.

In the past I have tried clomiphene, shots, cream, implanted pellets, patches and roll on underarm. No matter what form I take, my testosterone never gets much above 400.

I have been with Defy for 6 months and they are great. My problem is that I have been with them for 6 months and the testosterone is not going up much past 400. My thought was to increase my testosterone dose, but it doesn't seem as if they want to do that.

About me:
48 year old male. 6', 200 pounds. I should lose about 10 pounds.
Poor diet... mainly cereal, steak, few vegetables, lean cuisine and fast food.
High stress job.

Health Conditions:
1. Migraines
2. Sleep apnea
3. Depression - hard to tell if this is caused by lack of sleep and/or low testosterone or both.
4. Allergies being treated with allergy shots


Symptoms:
1. Always exhausted
2. Weak
3. Brain fog with poor memory
4. I get winded walking up a flight of stairs, especially when carrying something like a laundry basket.


My questions:
1. Is there anything that can prevent my testosterone from increasing?
2. I always do my shot in my thigh. Should I do it elsewhere?
3. Is the solution to take a higher dose each week?


My current dosing:
The box the testosterone came in says: inject 0.4 cc 2 x per week. CMP Test CYP W/GRP 200 MG/M. The syringe shows 0.4 as ml/cc.
I injected twice per week in my thigh and drew to the 0.4 line. I was also on DHEA and HCG.
I also take 4 fish oil pills each day and fiber supplements

Here are my most recent blood test results:
Testosterone: serum - 410, range: 348-1197
Free testosterone: 12.8 pg/ml: range 6.8-21.5
DHEA Sulfate: 277 ug/dl, range 71.6-375.4
TSH: 2.53 uiU/mL, range 0.45-4.5
estradiol, sensitive: 16.5 pg/ml, range 8-35
Other tests that are out of range:
platelets 135 x10E3/uL, range 150-379
protein, total serum 5.9 g/dL, range 6-8.5
A/G Ratio 2.5, range 1.2-2.2
Bilirubin, total 1.5 mg/dL, range 0-1.2
HDL CHOLESTEROL 23 mg/dL, range >39
LDL Cholesterol 116 mg/dL, range 0-99
T. Chol/HDL Ratio 7.2, range 0-5

Hopefully that will show something that may cause the issue.
I guess I don't understand how my testerone stays so low even with taking testosterone.

Thank you for any and all help and suggestions.

This is a job for bizzaro or super Kelkel. I have zero clue how that is possible.

What was your initial testosterone level?

In September 2016, my testosterone was 486. It was 408 in February 2017 and 410 now.

Prior to starting with Defy in September of last year, I was taking clomiphene

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Originally Posted by Chocula

My current dosing:
The box the testosterone came in says: inject 0.4 cc 2 x per week. CMP Test CYP W/GRP 200 MG/M. The syringe shows 0.4 as ml/cc.
I injected twice per week in my thigh and drew to the 0.4 line.

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I'm a bit perplexed with your actual dose of T. If we make the assumption that it is a standard 200 mg/mL solution in oil, then 0.4 mL X 200 mg/mL = 80 mg injected twice per week = 160 mg per week total. I have no idea about the GRP part of it.

At 160 mg per week in a split dose regimen, your T levels should be excellent, or at least elevated beyond starting levels. I am beginning to question the quality/legitimacy of the stuff they are selling you. I have no other explanation. Have you discussed this with them?

Kel will get to ya eventually

I spoke to the doctor today and they are increasing my testosterone to 200 mg per week for the next round.

Maybe you are a hyper-excreter/hyper-metabolizer? You are in range, but definitely nothing to write home about, especially given the way you are feeling.I don't see a SHBG or DHT level, am I overlooking it?

Edit: Also, ditch the fast food. I know it is convenient, but opt for more leafy greens, poultry and fish, and do your best to make water your primary fluid intake. Don't get discouraged, it took me a while to get dialed in.

While I was on break, I grabbed an older thread of a somewhat similar scenario.

http://forums.steroid.com/hormone-re...excretion.html

Quote:

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Originally Posted by Chocula

I spoke to the doctor today and they are increasing my testosterone to 200 mg per week for the next round.

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Is this a compounded product issued to you by Defy?

Quote:

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Originally Posted by almostgone

Maybe you are a hyper-excreter/hyper-metabolizer? You are in range, but definitely nothing to write home about, especially given the way you are feeling.I don't see a SHBG or DHT level, am I overlooking it?

Edit: Also, ditch the fast food. I know it is convenient, but opt for more leafy greens, poultry and fish, and do your best to make water your primary fluid intake. Don't get discouraged, it took me a while to get dialed in.

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I predict his SHBG to be between 10-15.

It would also be worth knowing at which point respecting to pin day bloods were taken.

Either he excretes the Test really fast or the very ester is released much slower than normal. Krueger was having the same issue with nebido.

Mine was 21.5 nmol/L on a scale of 19.3-76.4 nmol/L if I recall correctly.. Total T was 750-ish and free T was just over the upper end of the range @ ~ 24ng/dL and IGF-1 was just over the top end as well.
TRT is definitely not a "one size fits all" type of thing.

Quote:

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Originally Posted by bizzarro

I predict his SHBG to be between 10-15.

It would also be worth knowing at which point respecting to pin day bloods were taken.

Either he excretes the Test really fast or the very ester is released much slower than normal. Krueger was having the same issue with nebido.

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Ah dang, that sucks.

If your serious about feeling better.
Start with a better life style..

#1 - Diet.. Eat garbage and that's how you'll feel..
#2 - Sleep - A big deal to get at least 7-8 hours..
#3 - Training - Get some cardio in.. No reason to be winded..

You can start with these , it'll take time to notice changes but well accepted when they come

Kyle

Thank you for the responses.

Yes, this is done through Defy. I get everything from them.

My SHGB is 22.9 with a range of 16.5-55.9.

I am working on improving the diet. I want to exercise, but am always so exhausted. It is so bad that I feel like a zombie most of the time. I do have sleep apnea, but my CPAP machine does not seem to help much. I just started going to a new doctor so hopefully he can help with that.

Quote:

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Originally Posted by Chocula

Thank you for the responses.

Yes, this is done through Defy. I get everything from them.

My SHGB is 22.9 with a range of 16.5-55.9.

I am working on improving the diet. I want to exercise, but am always so exhausted. It is so bad that I feel like a zombie most of the time. I do have sleep apnea, but my CPAP machine does not seem to help much. I just started going to a new doctor so hopefully he can help with that.

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Do they tell you what exactly is in your Testosterone? You posted "CMP Test CYP W/GRP 200 MG/M". What is CMP? GRP? I've never seen this before and an internet search comes up with nothing other than Gastrin Releasing Protein, which I'm sure it's not.

Wonder if the CMP is a funky way of saying it comes from a compounding pharmacy since his TRT provider supplies everything?

They did not give me the details of the testerone and I did not ask. I will be sure to find out the next time I call them.

My lowest total test was 540 and highest was 670 in my trt bloodwork over about a 2 year span on 200 mg per week. People are different plain and simple. If it were me I'd up the dose from 160 to 200. If it doesn't raise it some then then something strange is going on for sure.

Quote:

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Originally Posted by shaunjohn242002

My lowest total test was 540 and highest was 670 in my trt bloodwork over about a 2 year span on 200 mg per week. People are different plain and simple. If it were me I'd up the dose from 160 to 200. If it doesn't raise it some then then something strange is going on for sure.

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Yes, we are all different and values *(normal ranges) between labs are all different too. Not sure how important it is in this case, but as folks who follow my saga may remember, when I started TRT, my problem is not low T, but rather low Free T because I had very high SHBG. To that end, I have employed very low dose Stanozolol (Winstrol) to bring it down to normal with great success. From what I've read in the literature (very limited), been told by a world famous TRT specialist in private conversations, and have noticed in my own labs (posted in prior threads), as SHBG goes down and the injected dose of T remains the same, Total T will go down substantially and Free T will increase.

However, changes in Total and Free T cannot be entirely accounted for by a simple shift from bound to free T. Total T goes down much more than would be anticipated if it were a simple shift in the bound state. We know that one of the functions if SHBG is to serve as a buffer by protecting the T from metabolism in the liver. Recall that unbound (free T) has a half life of only a few hours, I theorize that when the shift to unbound T occurs as a result of SHBG suppression (or in the case of low SHBG for those with this problem), it gets metabolized and excreted at a higher rate and causes Total T to decrease even though the amount of T administered remains unchanged. For me this is good, because even though my Total T goes down from the 1000 to 1200 ng/dL to the 800 ng/dL range, my free T goes up from mid-range (10-13 pg/mL range) to upper-range (20-27 pg/mL). Exact numbers depend on the exact dose of both T an Stanozolol, and the lab running the test, but the trends are clear (at least to me).

Food for thought!

Your free test looks good to me, those are the numbers you want to concentrate on. Do not know whether you can get it in the USA but Proviron will trigger free testosterone levels while preventing estrogen levels from rising.

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Originally Posted by Cre

Your free test looks good to me, those are the numbers you want to concentrate on. Do not know whether you can get it in the USA but Proviron will trigger free testosterone levels while preventing estrogen levels from rising.

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Unfortunately, Stanozolol (Winstrol) is no longer commercially available in the USA. The manufactures withdrew it for marketing not safety reasons. I had to go off the grid to obtain it from overseas suppliers. As far as I know there are just three choices for alternative meds to lower SHBG in the USA if you can manage a script, Proviron (which I have not researched), Danazol (Danocrine) which I have not tried but others have posted success at about 20 mg/day, and Anavar (Oxandrolone).

I have just finished a 6 week trial of Anavar at 30 mg per day. I'm back on my standard Stanozolol protocol now. I shoul have lab results to post from the Anavar trial in a few days. I ran across it as an effective SHBG suppressant in another forum and did some deeper research. I found this large and well designed randomized and placebo controlled study with HIV patients that's worth a read: https://www.ncbi.nlm.nih.gov/pubmed/16540931. The full paper is available for free in PubMed. I was most impressed that Anavar (contrary to common belief) does not seem it cause polycythemia, but is suppressive to the HPTA (well known), and was mildly hepatoxic in a dose-response fashion (goes against common Bro Science). In fact, hepatic toxicity was the major limitation for subject withdrawal from the study. I think that it should be pointed out though that there are very sick patients taking multiple drugs, so their livers may have already been stressed. I am very interested in seeing my liver enzymes after 6 weeks at 30 mg/day.

In a nutshell, here is what they observed in the study:

• Increasing doses from 20 to 80 mg daily had increasing suppressive effect on SHBG (% Decrease over placebo)
○ Placebo: +1.0% (NS)
○ 20mg: -58.9% (p=0.0001)
○ 40mg: -63.4% (p=0.0001)
○ 80mg: -79.2% (p=0.001)
• Increasing doses from 20 to 80mg had increasing suppressive effect on HPTA (LH data given as example, but also shown with FSH and Total Testosterone)
○ LH Placebo: +26.4% (NS)
○ 20mg: -26.5% (p=0.0029)
○ 40mg: -34.0% (p=0.0020)
○ 80mg: -54.1% (p=0.001)
• Interestingly, increasing doses from 20 to 80mg had no effect on Hemoglobin production.
• Increasing doses from 20 to 80 mg had increasingly detrimental effects on liver enzymes and cholesterol. At 20 mg, the changes seemed to be more manageable.
• Take home message. Keep doses under 40mg. Do not use for extended periods without a break (advice in forums seems to be around 8 week cycles).
• Take home message is that it may not be a good idea to continue Stanozolol (Winstrol) while taking Oxandrolone (Anavar) due to synergistic effect on lowering SHBG.
• Need to determine optimum dosing of Stanozolol (Winstrol) and testosterone while on a Oxandrolone (Anavar) anabolic cycle. More than likely need to discontinue Stanoxolol completely as I did for my trial.