Switched from TRT 1x/week to 2x/week...when to draw labs?

[Rocca1290]

Hey guys,

I have been on TRT for the past 9 months or so, specifically 100mg of testosterone cypionate injected subcutaneously, once a week. Upon doing some research and learning of the benefits of splitting the dose into two shots per week, I decided to make the switch. Therefore my current regimen consists of 50mg test cypionate Saturday morning (subQ), followed by 50 mg test cypionate (subQ) on Tuesday evening, so approximately 3.5 days apart.

Now that I have gotten to thinking about this, I'm not sure what is the proper amount of time after injecting to draw labs to get a peak and a valley reading. Since testosterone cypionate has around an 8 day half-life (peaking around the 3rd day), it makes sense while on 1x/week to draw labs about 3 days after the shot to get peak levels, and just before the next shot is due for the low-end levels....but how does this work on a twice per week regimen? Obviously the more frequent dosing will not impact the onset of action of the testosterone or affect the half life, so I suppose I can still get a "peak" reading by drawing blood around 3 days following and injection, but the thing is, that point in time is also the point just before the next injection...does this make sense? So it would seem as if the peak and the trough would occur at the same time. Can anyone offer some insight here as to how I can go about getting my labwork done to find peak and valley Testosterone and Estradiol readings so I can get my protocol fine tuned?

Also, a side question if anyone can assist. Does anyone know right off hand which lab tests are the appropriate/accurate ones to measure free and total testosterone? A Quest or LabCorp link would be fine and much appreciated. I've been thoroughly confused by the variety of different lab orders available for the same test/measurement.

Thank you so much in advance for your assistance.

[DrSauce99]

Wait... your injecting test-c subQ? That sounds like it would burn and hurt like a motherfucker. I've never heard of injecting oil subq.

I've played with 1x and 2x a week dosing and don't seem to find much difference unless your having estrogen issues it can help lower conversion.

You'd want a test of total and free testosterone, estrdiol, DHT, & SHBG. The numbers of total shouldn't change really much at all. You may have less estrogen and thus lower SHBG = more free test = better results.

[xxblazenlowxx]

I inject sub q every other day, it doesn’t burn and its common practice.

Im not as educated as other members but I believe if you injected Tuesday evening you should have your blood drawn Thursday morning.

[Rocca1290]

Thanks for the reply. As the other guy mentioned, yes I believe subQ test is becoming more commonplace. I have read up quite a bit on it and it seems the only reason it has yet to be implemented as the standard is for the simple fact that there hasn't been quite enough research for it to break into the mainstream. But all the results seem to be an improvement over IM injections, slower more steady absorption, less estrogen conversation, more stable levels (thus less peaks and side effects). I think the biggest concern is not knowing the potential long term implications of injecting an oil into fatty tissue; I suspect this is not much cause for concern. Personally I find SubQ much easier to do and keep up with. I have been injecting subQ once a week since I believe March 2019, so a little over 9 months without issue. I notice very little burn when injecting, certainly nothing that deters me whatsoever.

Essentially I am struggling with my doctor because I'm in a situation without medical insurance, and being treated by a doctor who is by no means an expert on TRT, in fact I was very shocked when she offered it to me. But it's basically been a "here's your script, you're on your own" sort of deal. I have brought up estrogen management a couple times to her and both times I have been quickly shot down, with her stating if I want estrogen management I have to go to a testosterone clinic (which I cannot afford at this time). So basically for the past 9 months on TRT I have been toying with my levels, trying to figure out if my estrogen is in balance and if I'm on a safe protocol. I was able to order some genuine anastrozole online and have been on various dosing schedules, varied from 1/2mg twice a week to 1/4mg once a week but I've just really been unable to find a sweet spot and get where I need to be. I need to figure out when to get my levels tested so I can determine my peak land trough levels, to make sure that my estrogen and testosterone are remaining within appropriate ranges at all times. At no point have any adjustments been made to my dosing by the doctor's office, nor have they mentioned anything about my labs when my estrogen levels have come back both high and low (as a result of playing with different anastrozole dosages). The only thing they are concerned with is donating blood regularly to keep HCT levels down, which I have been on top of. I have been irritable, tired, felt good, felt anxious and everything in between during the course of this treatment due to the fact that I've yet to stabilize myself.

What is the purpose of testing the DHT? And what is the significance of having SHBG tested? I mean if your free and total test are fine, then obviously SHBG is not a problem, correct?

And I understand I need to get my free and total T checked, as well as my estradiol level, but the problem is, the doctor always asks me which labs I want and upon looking on the LabCorp or Quest sites, there are multiple different options for all the different lab tests, different "versions" if you will. I am not sure which one is the appropriate and accurate test for guys on TRT. For example, see attached image. There are two different versions of a total testosterone lab test, I assume they are simply different testing methods. Which one is the appropriate one to get done?





Thank you guys for your time and patience

[Rocca1290]

I believe I am experiencing some estrogen related symptoms including some irritability and a bit of ED actually. But when someone has a high estradiol level, regardless of whether or not they are experiencing symptoms, isn't it quite a serious issue that needs to be controlled? The way I understand it, an elevated estradiol level in men (above ~32 pg/ml or so) increases the risk of cardiovascular problems including heart attack and stroke, and a low estradiol level (below 18 pg/ml) greatly increases the risk of osteoporosis (I actually have osteopenia myself, which I suspect is a result of my having low testosterone and not addressing it for many years; I'm only 29, I found out I had osteopenia when I was 24-25, I've been dealing with Testosterone issues, or I should rather say I first became aware that I had low testosterone at around 22-23 years old). Thanks for taking the time to reply man, I do appreciate it.

[GearHeaded]

I believe I am experiencing some estrogen related symptoms including some irritability and a bit of ED actually. But when someone has a high estradiol level, regardless of whether or not they are experiencing symptoms, isn't it quite a serious issue that needs to be controlled? The way I understand it, an elevated estradiol level in men (above ~32 pg/ml or so) increases the risk of cardiovascular problems including heart attack and stroke,

this is a half truth.. having higher levels of Estrogen WHEN androgens levels are low can point to health risk factors.
but having higher levels of estrogen, when Androgen levels are also in the higher range are not indicative of health risks.

so if your taking exogenous test and keeping your levels in the high range, having slightly elevated Estrogen is not an issue..
the issue is when estrogen levels are high and androgen levels are low (which is often the situation in older unhealthy obese men with heart disease and poor lifestyle choices.. its not the elevated estrogen in this case that is the direct cause, its actually only a side symptom of their choices and condition)

[Youthful55guy]

Regarding time of the lab draw, your question points to one of the drawbacks of 2X per week dosing. It is important to keep the time interval between injection and as constant as possible so that you can compare one lab to another over months and years. This is one reason I advocate every 3 day dosing (E3D) instead of 2X per week. The interval between injections is always constant, so it doesn't matter which injection you choose for the lab draw. They are all the same. It makes scheduling around work and life for the lab draws much easier.

Since you are doing the AM/PM split on the injections, it probably doesn't matter which one you choose as long as the time to draw is relatively constant. I would say pick a time interval and stick with it.

Since you are using normal dose ranges for your TRT (as opposed to pharmacological/bodybuilding doses), you can probably use the LabCorp Total and Free T Regular (140103) lab where Free T is measured by direct analog/radioimmunoassay (RIA) and Total T is measured by electrochemiluminescence immunoassay (ECLIA).

If you expect your T to be very low (<150 ng/dL) or very high (>1500 ng/dL), then the recommended lab is the one that uses the more expensive LC/MS method. It has no upper or lower level of measurement sensitivity.

[rocko1290]

Regarding time of the lab draw, your question points to one of the drawbacks of 2X per week dosing. It is important to keep the time interval between injection and as constant as possible so that you can compare one lab to another over months and years. This is one reason I advocate every 3 day dosing (E3D) instead of 2X per week. The interval between injections is always constant, so it doesn't matter which injection you choose for the lab draw. They are all the same. It makes scheduling around work and life for the lab draws much easier.

Since you are doing the AM/PM split on the injections, it probably doesn't matter which one you choose as long as the time to draw is relatively constant. I would say pick a time interval and stick with it.

Since you are using normal dose ranges for your TRT (as opposed to pharmacological/bodybuilding doses), you can probably use the LabCorp Total and Free T Regular (140103) lab where Free T is measured by direct analog/radioimmunoassay (RIA) and Total T is measured by electrochemiluminescence immunoassay (ECLIA).

If you expect your T to be very low (<150 ng/dL) or very high (>1500 ng/dL), then the recommended lab is the one that uses the more expensive LC/MS method. It has no upper or lower level of measurement sensitivity.

The only problem with that LabCorp test is I've found it measures the free T with pg/ml instead of ng/dl which is not commonly used so it's difficult to discern if it's within range of what your numbers ought to be. I also found that when I tried to convert pg/ml to ng/dl online, the numbers made no sense. Any advice on that?

[Fetch]

Just to input about the subcutaneous injections - there was a study several years back that actually found the method to be effective - more than IM in some cases. Test levels were more stable over time in the original study I read. A quick Google Scholar points to a bunch of new studies in recent years (many for transgender folks) that also point out the effectiveness of the method. I've thrown all sorts of stuff into the fatty tissue. When on cycle, I actually prefer to inject Tren that way. Anecdotally, I almost never get Tren cough.

[Youthful55guy]

The only problem with that LabCorp test is I've found it measures the free T with pg/ml instead of ng/dl which is not commonly used so it's difficult to discern if it's within range of what your numbers ought to be. I also found that when I tried to convert pg/ml to ng/dl online, the numbers made no sense. Any advice on that?

Yes, it is true that LabCorp reports Free T in pg/mL, but converting the number to ng/dl is unnecessary. What's more important, is where the result they give you is within the 'normal' range. In fact, you should never attempt to compare results across labs, test methods and lab ranges differ from lab to lab so the more important factor is to compare the result within the lab's normal range.

The one caveat with Free T is that most labs (or at least LabCorp and one other I occasionally use) report Free T with age-adjusted normal ranges. The older you get, the lower the normal range. This is because Total T production normally decreases with age and SHBG increases with age. I'm 62, but do I want the hormones of their 60+ geriatric range? Hell no! I want the Free T of a 30-40 year old. In fact, my goal with TRT is to maintain Free T in the upper 75th percentile for a 30-40 year old healthy male, which using LabCorp ranges is about 21 to 22 pg/mL. (as opposed to 6.6-18.1 for my age group).