LOW TESTOSTERONE???

[5hout]

Saying everyone should get X mg of T a week no matter what makes as much sense as saying everyone should add 2.5kg to the bar every week. That seemed dangerous to me, so I declined.

Agree. Also, the amounts talked about by TRT consultants/advocates aren't "minimum necessary to maintain age appropriate virility", but instead seem a lot closer to "maximum amount that can colorably be considered 'medical'". Heck, one of the popular authors in this space advocates titrating up to side effects, then backing off.

[mgil]

Yeah, most of the “male vitality” clinics wanna park your levels at the upper end of “normal”. Like 1,000 ng/dL or whatever the unit is.

[Hardartery]

The clinics are a problem, for a number of reasons. Not least of which is the fact that they do cookie cutter protocols and almost always want to prescribe aromatase inhibitors as part of it. If you need an AI, your dose is almost certainly too high. The testosterone shoots high initially and slowly drops until the next shot, so shot frequency makes a huge difference in some people and shouldn't be a thing that you have to go in to a clinic for - it should happen at home on a schedule that is best for the individual. You aren't following a circadian rhythm anymore with it like a natty, so you aren't at peak at 9 AM and near the botom around 3PM. It' also important to know that the actual number of your serum level is irrelevant without the lab range becasue that range is not standardised, every lab is different. So when someone talks about being below or above a given number, like 250 or 300, if they don' discuss range they are being disingenous and intentionally misleading you about something with their argument. The lab range could even be something like 150-800, which makes a result of 300 extremely different than if the lab has a range of 300-1100. Clinics are just there to fleece you, and most endos don't know a lot about the subject either because it's mostly new information that they didn't study in school and haven't needed to know. Your GP or NP is going to know even less, and people get some screwed up protocol because of that. Ronnie Coleman ran all pharmacy/prescription stuff during his career, you could do the same thing today throuugh a clinic quite easily. They will do it all telemedicine and mail you the stuff and never actually see you in person if you want. Which means they don't even know if the bloodwork you send them is actually yours and they don't monitor things like your blood pressure. They are right up there with the pain management clinics that used to be everywhere and gave rise to the opioid problem, IMO.

[KyleSchuant]

The other aspect for me was, never get into something unless you know your way out. I asked, "Suppose I get side effects, or because of family history or something get some cancer or heart disease, what's the way out? What's the treatment protocol for going off?" And then they got evasive. Basically then it's off to an endocrinologist, and in Australia you might be waiting months for them. So what do you do in the meantime, just go cold turkey, and fall into depression or something? I don't know, and they couldn't - or wouldn't - answer me.

It annoys me, because like any drug, this stuff can change lives. It really should be more available to help people like cancer patients, people recovering from joint surgery, and so on. And on occasion helping people ageing, like HRT does for menopausal women. But because of our neurosis about PEDs and sports, it's just not part of modern medicine, leaving the space to be occupied by cowboys who don't really care about people's health.

[Hardartery]

The other aspect for me was, never get into something unless you know your way out. I asked, "Suppose I get side effects, or because of family history or something get some cancer or heart disease, what's the way out? What's the treatment protocol for going off?" And then they got evasive. Basically then it's off to an endocrinologist, and in Australia you might be waiting months for them. So what do you do in the meantime, just go cold turkey, and fall into depression or something? I don't know, and they couldn't - or wouldn't - answer me.

It annoys me, because like any drug, this stuff can change lives. It really should be more available to help people like cancer patients, people recovering from joint surgery, and so on. And on occasion helping people ageing, like HRT does for menopausal women. But because of our neurosis about PEDs and sports, it's just not part of modern medicine, leaving the space to be occupied by cowboys who don't really care about people's health.

I can explain all of the options, actually, if someone wants to know. It's not that big of a deal to stop, other than needing a little patience, and being prepared to be probaby exactly as you were before starting treatment. The truth of it is though, I would not start if I didn't have access to what I needed and a legit doctor or endo. I don't trust any of those shady-ass clinics, and no one NEEDS to run top of the range. I can tell you from experience that it makes about zero difference for me to be running mid-range or justover top of the range except the chance of a few other health markers may play up (Like RBC count, which freaks out some docs). It is nuanced and individual, and from what I understand a nightmare in Australia. Research is disproving the whole cancer concern lately, and showing that low test is actually more dangerous for your health than a lot of things, including any possible sides from TRT., mostly because low test means low estrogen in men (All of your estrogen is aromatized from testosterone locally in tissues) and estrogen is super important for cardiovascular health and bone density. Menopausal women get osteoporosis in large part because their estrogen levels tank.

[SeeMac]

Bumping this because I feel like I can contribute.

I am 26 (about to be 27), and have been on TRT for a little over 2 years now. I didn't get sold by "tiktok" or anything, but rather I actually needed it.

I had some bloodwork done a few times between the ages of 18 and 20, and for curiosity sake I asked for testosterone to be included (was going through a bit of a biohacking phase at this time). Always tested between 25 - 30 nmol/L (700 - 900 ng/dl) with comparably high-ish free testosterone. Then I had testicular torsion twice within a few months at 20, and then at 21 I had a testicular inguinal hernia.

Throughout the pandemic, I started to feel generally shitty. Started with fatigue, then started to get more aches and pains, and my sex drive took a nose dive. I assumed it was the lack of socialization and such, but eventually I saw my Dr and got some tests done. Nothing was "abnormal", but my total testosterone was 14 nmol/L (400ish ng/dl). My Dr sent me for another round of bloodwork including a full sex hormone workup (basically testosterone + gonadotropins, which are the signalling hormones produced by your pituitary to signal your testicles to make testosterone). I believe total test here was 13 or 14 nmol/L.

My Dr's wife is a psychiatrist, and he agreed that he didn't think I was depressed based on my symptoms. He remembered my previous testicle "issues", and asked if I had ever had any bloodwork done prior. I had, and dug up the results for him. He suggested we try testosterone, despite me not being a typical candidate. Started on 100mg / week (I split this into injections every other day, which he is fine with). Turns out that wasn't enough, so we bumped it to 150 / week. This was too much, so dropped it to 125 / week. This seems to be the sweet spot, and I've been on this dose for probably 18 months or so. My total test stays around 25 nmol / L (700 ish ng / dl), and my free testosterone is right at the upper end of the reference range (TRT will drop SHBG, so free test / total test ratio will go up).

Turns out, despite being around 400 ng/dl, I had low testosterone. On paper it was not low, but repeated tests show that my levels were 1/2 of what they were prior to testicular injuries a few years prior. Everyone has a different androgen receptor density, and thus their "normal" will be different. I was lucky that I had measurements from "before" (i.e. when I didn't feel shitty) and "after", and could make deductions from there.

Luckily I have a compassionate and fairly liberal family Dr, as I've heard some people go through hell trying to get testosterone prescribed in Canada.

A sidenote: TRT is generally never going to be over 150 / week. Rarely should it be over 125 / week. Testosterone cypionate (the most prescribed injectable) is about 70% testosterone by weight, so 100 mg of testosterone cypionate contains about 70 mg of testosterone. Men produce 3 - 10 mg of testosterone per day (21 - 70 mg per week). Thus, 100 mg of cypionate is the upper end of natural production. When you have a steady supply of testosterone as you get when on TRT, your body will metabolize it slightly quicker, and thus an exposure slightly greater than the average natural production is necessary. Hence the 100 mg / week starting dose. Also, the half life of cypionate is about 5-6 days, not 10-14 like the pamphlets say. You should inject at a minimum of 1x per week, but ideally 2 - 3x per week. Lower peaks and higher troughs will lower the side effect burden.

TRT should not result in high hematocrit, high estrogen, or really any side effect. It is a bioidentical hormone. If you have side effects, you likely need to lower your dose, or increase injection frequency. If you inject 1x per week, get bloodwork on the trough and have normal levels, you are likely through the roof the other 6 days. No shit you have side effects.

[Hardartery]

Bumping this because I feel like I can contribute.

I am 26 (about to be 27), and have been on TRT for a little over 2 years now. I didn't get sold by "tiktok" or anything, but rather I actually needed it.

I had some bloodwork done a few times between the ages of 18 and 20, and for curiosity sake I asked for testosterone to be included (was going through a bit of a biohacking phase at this time). Always tested between 25 - 30 nmol/L (700 - 900 ng/dl) with comparably high-ish free testosterone. Then I had testicular torsion twice within a few months at 20, and then at 21 I had a testicular inguinal hernia.

Throughout the pandemic, I started to feel generally shitty. Started with fatigue, then started to get more aches and pains, and my sex drive took a nose dive. I assumed it was the lack of socialization and such, but eventually I saw my Dr and got some tests done. Nothing was "abnormal", but my total testosterone was 14 nmol/L (400ish ng/dl). My Dr sent me for another round of bloodwork including a full sex hormone workup (basically testosterone + gonadotropins, which are the signalling hormones produced by your pituitary to signal your testicles to make testosterone). I believe total test here was 13 or 14 nmol/L.

My Dr's wife is a psychiatrist, and he agreed that he didn't think I was depressed based on my symptoms. He remembered my previous testicle "issues", and asked if I had ever had any bloodwork done prior. I had, and dug up the results for him. He suggested we try testosterone, despite me not being a typical candidate. Started on 100mg / week (I split this into injections every other day, which he is fine with). Turns out that wasn't enough, so we bumped it to 150 / week. This was too much, so dropped it to 125 / week. This seems to be the sweet spot, and I've been on this dose for probably 18 months or so. My total test stays around 25 nmol / L (700 ish ng / dl), and my free testosterone is right at the upper end of the reference range (TRT will drop SHBG, so free test / total test ratio will go up).

Turns out, despite being around 400 ng/dl, I had low testosterone. On paper it was not low, but repeated tests show that my levels were 1/2 of what they were prior to testicular injuries a few years prior. Everyone has a different androgen receptor density, and thus their "normal" will be different. I was lucky that I had measurements from "before" (i.e. when I didn't feel shitty) and "after", and could make deductions from there.

Luckily I have a compassionate and fairly liberal family Dr, as I've heard some people go through hell trying to get testosterone prescribed in Canada.

A sidenote: TRT is generally never going to be over 150 / week. Rarely should it be over 125 / week. Testosterone cypionate (the most prescribed injectable) is about 70% testosterone by weight, so 100 mg of testosterone cypionate contains about 70 mg of testosterone. Men produce 3 - 10 mg of testosterone per day (21 - 70 mg per week). Thus, 100 mg of cypionate is the upper end of natural production. When you have a steady supply of testosterone as you get when on TRT, your body will metabolize it slightly quicker, and thus an exposure slightly greater than the average natural production is necessary. Hence the 100 mg / week starting dose. Also, the half life of cypionate is about 5-6 days, not 10-14 like the pamphlets say. You should inject at a minimum of 1x per week, but ideally 2 - 3x per week. Lower peaks and higher troughs will lower the side effect burden.

TRT should not result in high hematocrit, high estrogen, or really any side effect. It is a bioidentical hormone. If you have side effects, you likely need to lower your dose, or increase injection frequency. If you inject 1x per week, get bloodwork on the trough and have normal levels, you are likely through the roof the other 6 days. No shit you have side effects.

You failed to include lab ranges with your numbers, which matters. Test levels are not a universally standardized test like TSH or RBC, it is lab dependent and the the range is required to give meaning to the results. 400 ng/dl is middle of the range in some labs, while bottom of the range in others. And "Bioidentical" doesn't actually mean anything, all synthetic drugs designed for replacement are purportedly bioidentical, that does no actually mean that they function like the real thing. Case in point, real testosterone does not have a half life of 4.5 days and effective life of 7-8 days, so it isn't really the same thing and individual biochemistry plays a huge role in functionality. 125mg/week puts my level at 486 on a range of 300-900. I bloat with cypionate, I bloat less with enanthate, I do not bloat at all with Sustanon. Different sources seem to say different things about half-life, but generally cypionate is considered to have a shorter half life than enanthate but the same effective life and because of that they are considered interchangeable. I can tell you from experience, they hit different and enanthate is "Better". There is a fairly renowned doctor and clinic in Burlington, it isn't particularly difficult to get treatment in Canada - it's difficult most places. I don't current;y get treatment in Canada, but I am Canadian and have no serious concern that I could get what I need if I moved back there.

Things like elevated E2 are not abnormal during initial treatment and go away, and high hematocrit depends on the person. There are guuys walking around on massive doses for athleticv use with normal hematocrit, and other guys on 100mg a week that are pushing the envelope. Mine tends to be at the high end, same at 200mg/week (Starting dose) as it is at 125mg/week. Sometimes it is what it is. Injection frequency made no perceptible difference for me either, it maybe lowered my E2 slightly. Other guys are suffering if they aren't at least EOD and some guys need every day. Then you have guys like Dorian Yates that gets one shot every 2 weeks and is fine and dandy. It isn't as cut and dried as you make it out to be.

[SeeMac]

Bumping this because I feel like I can contribute.

I am 26 (about to be 27), and have been on TRT for a little over 2 years now. I didn't get sold by "tiktok" or anything, but rather I actually needed it.

I had some bloodwork done a few times between the ages of 18 and 20, and for curiosity sake I asked for testosterone to be included (was going through a bit of a biohacking phase at this time). Always tested between 25 - 30 nmol/L (700 - 900 ng/dl) with comparably high-ish free testosterone. Then I had testicular torsion twice within a few months at 20, and then at 21 I had a testicular inguinal hernia.

Throughout the pandemic, I started to feel generally shitty. Started with fatigue, then started to get more aches and pains, and my sex drive took a nose dive. I assumed it was the lack of socialization and such, but eventually I saw my Dr and got some tests done. Nothing was "abnormal", but my total testosterone was 14 nmol/L (400ish ng/dl). My Dr sent me for another round of bloodwork including a full sex hormone workup (basically testosterone + gonadotropins, which are the signalling hormones produced by your pituitary to signal your testicles to make testosterone). I believe total test here was 13 or 14 nmol/L.

My Dr's wife is a psychiatrist, and he agreed that he didn't think I was depressed based on my symptoms. He remembered my previous testicle "issues", and asked if I had ever had any bloodwork done prior. I had, and dug up the results for him. He suggested we try testosterone, despite me not being a typical candidate. Started on 100mg / week (I split this into injections every other day, which he is fine with). Turns out that wasn't enough, so we bumped it to 150 / week. This was too much, so dropped it to 125 / week. This seems to be the sweet spot, and I've been on this dose for probably 18 months or so. My total test stays around 25 nmol / L (700 ish ng / dl), and my free testosterone is right at the upper end of the reference range (TRT will drop SHBG, so free test / total test ratio will go up).

Turns out, despite being around 400 ng/dl, I had low testosterone. On paper it was not low, but repeated tests show that my levels were 1/2 of what they were prior to testicular injuries a few years prior. Everyone has a different androgen receptor density, and thus their "normal" will be different. I was lucky that I had measurements from "before" (i.e. when I didn't feel shitty) and "after", and could make deductions from there.

Luckily I have a compassionate and fairly liberal family Dr, as I've heard some people go through hell trying to get testosterone prescribed in Canada.

A sidenote: TRT is generally never going to be over 150 / week. Rarely should it be over 125 / week. Testosterone cypionate (the most prescribed injectable) is about 70% testosterone by weight, so 100 mg of testosterone cypionate contains about 70 mg of testosterone. Men produce 3 - 10 mg of testosterone per day (21 - 70 mg per week). Thus, 100 mg of cypionate is the upper end of natural production. When you have a steady supply of testosterone as you get when on TRT, your body will metabolize it slightly quicker, and thus an exposure slightly greater than the average natural production is necessary. Hence the 100 mg / week starting dose. Also, the half life of cypionate is about 5-6 days, not 10-14 like the pamphlets say. You should inject at a minimum of 1x per week, but ideally 2 - 3x per week. Lower peaks and higher troughs will lower the side effect burden.

TRT should not result in high hematocrit, high estrogen, or really any side effect. It is a bioidentical hormone. If you have side effects, you likely need to lower your dose, or increase injection frequency. If you inject 1x per week, get bloodwork on the trough and have normal levels, you are likely through the roof the other 6 days. No shit you have side effects.

You failed to include lab ranges with your numbers, which matters. Test levels are not a universally standardized test like TSH or RBC, it is lab dependent and the the range is required to give meaning to the results. 400 ng/dl is middle of the range in some labs, while bottom of the range in others. And "Bioidentical" doesn't actually mean anything, all synthetic drugs designed for replacement are purportedly bioidentical, that does no actually mean that they function like the real thing. Case in point, real testosterone does not have a half life of 4.5 days and effective life of 7-8 days, so it isn't really the same thing and individual biochemistry plays a huge role in functionality. 125mg/week puts my level at 486 on a range of 300-900. I bloat with cypionate, I bloat less with enanthate, I do not bloat at all with Sustanon. Different sources seem to say different things about half-life, but generally cypionate is considered to have a shorter half life than enanthate but the same effective life and because of that they are considered interchangeable. I can tell you from experience, they hit different and enanthate is "Better". There is a fairly renowned doctor and clinic in Burlington, it isn't particularly difficult to get treatment in Canada - it's difficult most places. I don't current;y get treatment in Canada, but I am Canadian and have no serious concern that I could get what I need if I moved back there.

Things like elevated E2 are not abnormal during initial treatment and go away, and high hematocrit depends on the person. There are guuys walking around on massive doses for athleticv use with normal hematocrit, and other guys on 100mg a week that are pushing the envelope. Mine tends to be at the high end, same at 200mg/week (Starting dose) as it is at 125mg/week. Sometimes it is what it is. Injection frequency made no perceptible difference for me either, it maybe lowered my E2 slightly. Other guys are suffering if they aren't at least EOD and some guys need every day. Then you have guys like Dorian Yates that gets one shot every 2 weeks and is fine and dandy. It isn't as cut and dried as you make it out to be.

The labs used standardized testing equipment The reference ranges are only specific to their lab's population studies, not the testing procedure or equipment. I've seen ECLIA machines cite reference ranges using less than 100 people to create their ranges. As I'm sure you know, a reference range is simply the container for mean +- 2 sigma of whoever they studied.

I said the bioidentical piece to illustrate that replacing a naturally produced hormone should not come with side effects. If it does, the dosing protocol is incorrect. Not sure why you are getting your panties in a bunch here.

Again, yes side effect protocol is individual. If you are taking therapeutic doses, you should not have polycythaemia. You should also not have elevated E2, unless you are obese. If you have either of those things, your dosing protocol is incorrect.

Cypionate absolutely does not have a shorter half life than enanthate. Estarase degrades esters at a rate proportional to the number of carbon atoms. Cypionic acid has 8, enanthic acid has 7.

[Hardartery]

The labs used standardized testing equipment The reference ranges are only specific to their lab's population studies, not the testing procedure or equipment. I've seen ECLIA machines cite reference ranges using less than 100 people to create their ranges. As I'm sure you know, a reference range is simply the container for mean +- 2 sigma of whoever they studied.

I said the bioidentical piece to illustrate that replacing a naturally produced hormone should not come with side effects. If it does, the dosing protocol is incorrect. Not sure why you are getting your panties in a bunch here.

Again, yes side effect protocol is individual. If you are taking therapeutic doses, you should not have polycythaemia. You should also not have elevated E2, unless you are obese. If you have either of those things, your dosing protocol is incorrect.

Cypionate absolutely does not have a shorter half life than enanthate. Estarase degrades esters at a rate proportional to the number of carbon atoms. Cypionic acid has 8, enanthic acid has 7.

Reference ranges are a result largely of the algorithm used to calculate the number, and that algorithm can vary not just by machine but also by location. There is a standard algorithm proffered that works across all currently available machine but no one is particularly motivated to adopt it. The labs with the really low range numbers (I don't remember exactly, but I believe it is 200-700) are using that algorithm and everyone bitches about it. Soi, you can compare your numbers to each other if all processing was done at the same lab, but the number does not compare to my lab results unless we include ranges. This is not the case with standardised testing like TSH, and the notion that the individual machine establishes the range based on who it has tested is a ridiculous statement. The range is set in the software when the machine is set up, before it has run any live tests.

Cypionate half life versus Enanthate half life. It used to actually refence them both on Wikipedia but the Cypionate entry no longer seems to actually include that, it lists the number for enanathate and calls it comparable. I had references from a chemist on my other laptop, not sure if I have them anymore, they were posted on T-Nation a while back. They are in fact not the same according to the literature that was referenced, which I found surprising. And you can say whatever you want about what "Should" and "Should not" happen, that's spitting into the wind. You shouldn't get gyno from normal levels during puberty as a male and yet there are men that do. People are not uniform, that's why you can't just design a drug and use it, you have to actually test is to see what happens in the real world. You give 100 men the same drug at the same dose and you will NEVER get 100 exactly the same reactions, no matter what reason you may have to believe that can't happen. My problem is that you are speaking in absolutes, which is always problematic. The fact is, "Bio-identical" means nothing in real life, it is no more than a marketing label. If it was really particularly identical it wouldn't have an ester and you'd need a pump to inject it based on constant feedback, like the body produces hormones does naturally. There are a lot more factors than how fat you are or are not.

Technically, enanthate and cypionate are considered the same and should do exactly the same thing. They don't because they aren't. Keep the "Shoulds" for faiyrtale stories with the kids, and having actually used both I can tell you that firstand from experience and if you knew who to ask you would find that that is not an n=1 thing.

[SeeMac]

The labs used standardized testing equipment The reference ranges are only specific to their lab's population studies, not the testing procedure or equipment. I've seen ECLIA machines cite reference ranges using less than 100 people to create their ranges. As I'm sure you know, a reference range is simply the container for mean +- 2 sigma of whoever they studied.

I said the bioidentical piece to illustrate that replacing a naturally produced hormone should not come with side effects. If it does, the dosing protocol is incorrect. Not sure why you are getting your panties in a bunch here.

Again, yes side effect protocol is individual. If you are taking therapeutic doses, you should not have polycythaemia. You should also not have elevated E2, unless you are obese. If you have either of those things, your dosing protocol is incorrect.

Cypionate absolutely does not have a shorter half life than enanthate. Estarase degrades esters at a rate proportional to the number of carbon atoms. Cypionic acid has 8, enanthic acid has 7.

Reference ranges are a result largely of the algorithm used to calculate the number, and that algorithm can vary not just by machine but also by location. There is a standard algorithm proffered that works across all currently available machine but no one is particularly motivated to adopt it. The labs with the really low range numbers (I don't remember exactly, but I believe it is 200-700) are using that algorithm and everyone bitches about it. Soi, you can compare your numbers to each other if all processing was done at the same lab, but the number does not compare to my lab results unless we include ranges. This is not the case with standardised testing like TSH, and the notion that the individual machine establishes the range based on who it has tested is a ridiculous statement. The range is set in the software when the machine is set up, before it has run any live tests.

Cypionate half life versus Enanthate half life. It used to actually refence them both on Wikipedia but the Cypionate entry no longer seems to actually include that, it lists the number for enanathate and calls it comparable. I had references from a chemist on my other laptop, not sure if I have them anymore, they were posted on T-Nation a while back. They are in fact not the same according to the literature that was referenced, which I found surprising. And you can say whatever you want about what "Should" and "Should not" happen, that's spitting into the wind. You shouldn't get gyno from normal levels during puberty as a male and yet there are men that do. People are not uniform, that's why you can't just design a drug and use it, you have to actually test is to see what happens in the real world. You give 100 men the same drug at the same dose and you will NEVER get 100 exactly the same reactions, no matter what reason you may have to believe that can't happen. My problem is that you are speaking in absolutes, which is always problematic. The fact is, "Bio-identical" means nothing in real life, it is no more than a marketing label. If it was really particularly identical it wouldn't have an ester and you'd need a pump to inject it based on constant feedback, like the body produces hormones does naturally. There are a lot more factors than how fat you are or are not.

Technically, enanthate and cypionate are considered the same and should do exactly the same thing. They don't because they aren't. Keep the "Shoulds" for faiyrtale stories with the kids, and having actually used both I can tell you that firstand from experience and if you knew who to ask you would find that that is not an n=1 thing.

The "algorithm" is just high school statistics. Calibrate the machine, sample the population, find the mean, find the standard deviation, range is mean +- 2 sigma. Different labs will report different ranges for a variety of reasons, but generally ECLIA machine ranges are lower than LC/MS. Standardized ranges like TSH are because the testing procedure is consistent across machinery. Testosterone (and other sex hormones like E2) use completely different methods depending on the equipment, hence different ranges.

I am not speaking in absolutes regarding drug response. I am speaking in absolutes in terms of chemistry. Enanthate carbon chain is shorter than cypionate. Other variables affecting the pharmacokinetics include concentration, carrier oil viscocity etc but the underlying drug's metabolism is pretty well worked out.

[Hardartery]

The labs used standardized testing equipment The reference ranges are only specific to their lab's population studies, not the testing procedure or equipment. I've seen ECLIA machines cite reference ranges using less than 100 people to create their ranges. As I'm sure you know, a reference range is simply the container for mean +- 2 sigma of whoever they studied.

I said the bioidentical piece to illustrate that replacing a naturally produced hormone should not come with side effects. If it does, the dosing protocol is incorrect. Not sure why you are getting your panties in a bunch here.

Again, yes side effect protocol is individual. If you are taking therapeutic doses, you should not have polycythaemia. You should also not have elevated E2, unless you are obese. If you have either of those things, your dosing protocol is incorrect.

Cypionate absolutely does not have a shorter half life than enanthate. Estarase degrades esters at a rate proportional to the number of carbon atoms. Cypionic acid has 8, enanthic acid has 7.

Reference ranges are a result largely of the algorithm used to calculate the number, and that algorithm can vary not just by machine but also by location. There is a standard algorithm proffered that works across all currently available machine but no one is particularly motivated to adopt it. The labs with the really low range numbers (I don't remember exactly, but I believe it is 200-700) are using that algorithm and everyone bitches about it. Soi, you can compare your numbers to each other if all processing was done at the same lab, but the number does not compare to my lab results unless we include ranges. This is not the case with standardised testing like TSH, and the notion that the individual machine establishes the range based on who it has tested is a ridiculous statement. The range is set in the software when the machine is set up, before it has run any live tests.

Cypionate half life versus Enanthate half life. It used to actually refence them both on Wikipedia but the Cypionate entry no longer seems to actually include that, it lists the number for enanathate and calls it comparable. I had references from a chemist on my other laptop, not sure if I have them anymore, they were posted on T-Nation a while back. They are in fact not the same according to the literature that was referenced, which I found surprising. And you can say whatever you want about what "Should" and "Should not" happen, that's spitting into the wind. You shouldn't get gyno from normal levels during puberty as a male and yet there are men that do. People are not uniform, that's why you can't just design a drug and use it, you have to actually test is to see what happens in the real world. You give 100 men the same drug at the same dose and you will NEVER get 100 exactly the same reactions, no matter what reason you may have to believe that can't happen. My problem is that you are speaking in absolutes, which is always problematic. The fact is, "Bio-identical" means nothing in real life, it is no more than a marketing label. If it was really particularly identical it wouldn't have an ester and you'd need a pump to inject it based on constant feedback, like the body produces hormones does naturally. There are a lot more factors than how fat you are or are not.

Technically, enanthate and cypionate are considered the same and should do exactly the same thing. They don't because they aren't. Keep the "Shoulds" for faiyrtale stories with the kids, and having actually used both I can tell you that firstand from experience and if you knew who to ask you would find that that is not an n=1 thing.

The "algorithm" is just high school statistics. Calibrate the machine, sample the population, find the mean, find the standard deviation, range is mean +- 2 sigma. Different labs will report different ranges for a variety of reasons, but generally ECLIA machine ranges are lower than LC/MS. Standardized ranges like TSH are because the testing procedure is consistent across machinery. Testosterone (and other sex hormones like E2) use completely different methods depending on the equipment, hence different ranges.

I am not speaking in absolutes regarding drug response. I am speaking in absolutes in terms of chemistry. Enanthate carbon chain is shorter than cypionate. Other variables affecting the pharmacokinetics include concentration, carrier oil viscocity etc but the underlying drug's metabolism is pretty well worked out.

The algorithm I am referring to is the math that calculates the result that you see from the test data. The are variations in how that is written, which results in variation across machines, it causes differences between one LC/MS versus another more particularly and that is the more common test. As far as underlying chemistry, even Wikipedia stated the half-life of enanthate as 7 days and cypionate as 3.5-4.5 just 2 or three years ago. Now it doesn't. The citations were there to back it up. We know very little compared to what we think we know about chemistry as weell as the other sciences and science has a habit of changing it's mind frequently, speaking in absolutes is problematic given that we will likely be told something different in the future based on learniong something we don't know now. Actual use reflects information at odds with what we think we know about the science.

As far as E2 levels, fat sores a greater concentration of aromatase enzyme than lean tissue, which should not be taken to mean that there is necessarily greater production there, and somebody with clinically low test is going to have a bunch of weird issues that resolve over time after starting therapy. SHBG SHOULD decrease, free test SHOULD rise and you SHOULD burn off excess stored enzyme and you hopefully burn off some excess stored fate through increased metabolism (Hopefully, via increased muscle mass) and increased calorie expenditure through increased NEAT. That list doesn't always happen.

[SeeMac]

The labs used standardized testing equipment The reference ranges are only specific to their lab's population studies, not the testing procedure or equipment. I've seen ECLIA machines cite reference ranges using less than 100 people to create their ranges. As I'm sure you know, a reference range is simply the container for mean +- 2 sigma of whoever they studied.

I said the bioidentical piece to illustrate that replacing a naturally produced hormone should not come with side effects. If it does, the dosing protocol is incorrect. Not sure why you are getting your panties in a bunch here.

Again, yes side effect protocol is individual. If you are taking therapeutic doses, you should not have polycythaemia. You should also not have elevated E2, unless you are obese. If you have either of those things, your dosing protocol is incorrect.

Cypionate absolutely does not have a shorter half life than enanthate. Estarase degrades esters at a rate proportional to the number of carbon atoms. Cypionic acid has 8, enanthic acid has 7.

Reference ranges are a result largely of the algorithm used to calculate the number, and that algorithm can vary not just by machine but also by location. There is a standard algorithm proffered that works across all currently available machine but no one is particularly motivated to adopt it. The labs with the really low range numbers (I don't remember exactly, but I believe it is 200-700) are using that algorithm and everyone bitches about it. Soi, you can compare your numbers to each other if all processing was done at the same lab, but the number does not compare to my lab results unless we include ranges. This is not the case with standardised testing like TSH, and the notion that the individual machine establishes the range based on who it has tested is a ridiculous statement. The range is set in the software when the machine is set up, before it has run any live tests.

Cypionate half life versus Enanthate half life. It used to actually refence them both on Wikipedia but the Cypionate entry no longer seems to actually include that, it lists the number for enanathate and calls it comparable. I had references from a chemist on my other laptop, not sure if I have them anymore, they were posted on T-Nation a while back. They are in fact not the same according to the literature that was referenced, which I found surprising. And you can say whatever you want about what "Should" and "Should not" happen, that's spitting into the wind. You shouldn't get gyno from normal levels during puberty as a male and yet there are men that do. People are not uniform, that's why you can't just design a drug and use it, you have to actually test is to see what happens in the real world. You give 100 men the same drug at the same dose and you will NEVER get 100 exactly the same reactions, no matter what reason you may have to believe that can't happen. My problem is that you are speaking in absolutes, which is always problematic. The fact is, "Bio-identical" means nothing in real life, it is no more than a marketing label. If it was really particularly identical it wouldn't have an ester and you'd need a pump to inject it based on constant feedback, like the body produces hormones does naturally. There are a lot more factors than how fat you are or are not.

Technically, enanthate and cypionate are considered the same and should do exactly the same thing. They don't because they aren't. Keep the "Shoulds" for faiyrtale stories with the kids, and having actually used both I can tell you that firstand from experience and if you knew who to ask you would find that that is not an n=1 thing.

The "algorithm" is just high school statistics. Calibrate the machine, sample the population, find the mean, find the standard deviation, range is mean +- 2 sigma. Different labs will report different ranges for a variety of reasons, but generally ECLIA machine ranges are lower than LC/MS. Standardized ranges like TSH are because the testing procedure is consistent across machinery. Testosterone (and other sex hormones like E2) use completely different methods depending on the equipment, hence different ranges.

I am not speaking in absolutes regarding drug response. I am speaking in absolutes in terms of chemistry. Enanthate carbon chain is shorter than cypionate. Other variables affecting the pharmacokinetics include concentration, carrier oil viscocity etc but the underlying drug's metabolism is pretty well worked out.

The algorithm I am referring to is the math that calculates the result that you see from the test data. The are variations in how that is written, which results in variation across machines, it causes differences between one LC/MS versus another more particularly and that is the more common test. As far as underlying chemistry, even Wikipedia stated the half-life of enanthate as 7 days and cypionate as 3.5-4.5 just 2 or three years ago. Now it doesn't. The citations were there to back it up. We know very little compared to what we think we know about chemistry as weell as the other sciences and science has a habit of changing it's mind frequently, speaking in absolutes is problematic given that we will likely be told something different in the future based on learniong something we don't know now. Actual use reflects information at odds with what we think we know about the science.

As far as E2 levels, fat sores a greater concentration of aromatase enzyme than lean tissue, which should not be taken to mean that there is necessarily greater production there, and somebody with clinically low test is going to have a bunch of weird issues that resolve over time after starting therapy. SHBG SHOULD decrease, free test SHOULD rise and you SHOULD burn off excess stored enzyme and you hopefully burn off some excess stored fate through increased metabolism (Hopefully, via increased muscle mass) and increased calorie expenditure through increased NEAT. That list doesn't always happen.

Depends on the test, but most are direct measurements that don't require calculations. Free testosterone via ECLIA uses Vermeulen's equation, but it can be directly measured using LCMS.

If that was the case, then wikipedia was wrong. The newer research is more clear, but there were some faulty measurements indicating > 10 day half lives for both at some point. Hence the common every 2 week protocol. The guy who maintains this was pretty picky about his half life calculations if you want to see it drawn out. https://www.steroidplotter.com/

Yes, obviously there are folks who have issues with high e2 without high testosterone, so it isn't fair to say that all e2 issues are a dosing problem. But 99% of the time, it will be. Gyno rate among the male population not on gear is very low, so it should be similar to guys on TRT. If it isn't, then we're fucking up somewhere.

[Hardartery]

Depends on the test, but most are direct measurements that don't require calculations. Free testosterone via ECLIA uses Vermeulen's equation, but it can be directly measured using LCMS.

If that was the case, then wikipedia was wrong. The newer research is more clear, but there were some faulty measurements indicating > 10 day half lives for both at some point. Hence the common every 2 week protocol. The guy who maintains this was pretty picky about his half life calculations if you want to see it drawn out. https://www.steroidplotter.com/

Yes, obviously there are folks who have issues with high e2 without high testosterone, so it isn't fair to say that all e2 issues are a dosing problem. But 99% of the time, it will be. Gyno rate among the male population not on gear is very low, so it should be similar to guys on TRT. If it isn't, then we're fucking up somewhere.

The guy worked in a lab and was some sort of professional chemist, so yeah he was probably pretty picky. I have seen Steroid Plotter before, it's interesting to play with. I would agree that most people are going to respond similarly, I know in my case I inflated from E2 initially but I do not have the same issue now. Cypionate in particular tends to make me a little puffy for whatever reason, and because of things like that I don't like using absolutes in talking about things. I don't believe we know anywhere near what we think that we know, which always is a bit of a worry. We are probably fucking up somewhere, but won't know it for 30 years so hopefully it doesn't present serious complications for those affected down the road.

My opinion is that most guys don't need to worry about E2 at all, they just need to be patient and let their bodies find homeostasis over time as they adjust to normal blood serum levels if they have an initial E2 issue. But people panic and run for some sort of AI and do a ton of damage to themselves, and some of these clinics in the US have the AI in the shot as an automatic thing included - tell me that that won't do some damage.

[SeeMac]

Depends on the test, but most are direct measurements that don't require calculations. Free testosterone via ECLIA uses Vermeulen's equation, but it can be directly measured using LCMS.

If that was the case, then wikipedia was wrong. The newer research is more clear, but there were some faulty measurements indicating > 10 day half lives for both at some point. Hence the common every 2 week protocol. The guy who maintains this was pretty picky about his half life calculations if you want to see it drawn out. https://www.steroidplotter.com/

Yes, obviously there are folks who have issues with high e2 without high testosterone, so it isn't fair to say that all e2 issues are a dosing problem. But 99% of the time, it will be. Gyno rate among the male population not on gear is very low, so it should be similar to guys on TRT. If it isn't, then we're fucking up somewhere.

The guy worked in a lab and was some sort of professional chemist, so yeah he was probably pretty picky. I have seen Steroid Plotter before, it's interesting to play with. I would agree that most people are going to respond similarly, I know in my case I inflated from E2 initially but I do not have the same issue now. Cypionate in particular tends to make me a little puffy for whatever reason, and because of things like that I don't like using absolutes in talking about things. I don't believe we know anywhere near what we think that we know, which always is a bit of a worry. We are probably fucking up somewhere, but won't know it for 30 years so hopefully it doesn't present serious complications for those affected down the road.

My opinion is that most guys don't need to worry about E2 at all, they just need to be patient and let their bodies find homeostasis over time as they adjust to normal blood serum levels if they have an initial E2 issue. But people panic and run for some sort of AI and do a ton of damage to themselves, and some of these clinics in the US have the AI in the shot as an automatic thing included - tell me that that won't do some damage.

I mostly agree with that, but some doctors prescribe terrible protocols so it isn't a surprise to see e2 side effects. Enanthate should not be prescribed every 2 weeks, but it is in Canada all the time. Plus in the US, many clinics prescribe a starting dose of 200/week. That's 140 mg of actual testosterone, which is double the upper limit of natural production. So, yeah, you might get high e2 from that.

[cole]

I went in last November and measured on the low end of the normal range (mid 300's) so I got on 180mg/wk cypionate and the first month was great, then things got a little out of hand and my anxiety went through the roof, moody like a teenager, and got ED (probably from estradiol going up along with T). Immediately stopped injections, felt awesome again about a week after last dose and continued to feel great for another week or so then back to pre November feelings now. Wondering if the dose was too high and I zipped past the "sweet spot". Considering giving it another go this time with half the dose. Not sure if I want to subject myself to it again....

[GlasgowJock]

...then things got a little out of hand and my anxiety went through the roof, moody like a teenager, and got ED (probably from estradiol going up along with T)"... Considering giving it another go this time with half the dose. Not sure if I want to subject myself to it again....

Was your estradiol levels measured prior/ during/ after TRT cycle to ascertain if it was excess E2? Have you discussed/ explored an AI alongside TRT if you have such data recorded?

[cole]

...then things got a little out of hand and my anxiety went through the roof, moody like a teenager, and got ED (probably from estradiol going up along with T)"... Considering giving it another go this time with half the dose. Not sure if I want to subject myself to it again....

Was your estradiol levels measured prior/ during/ after TRT cycle to ascertain if it was excess E2? Have you discussed/ explored an AI alongside TRT if you have such data recorded?

No, I abruptly stopped the therapy and did not go back in for follow up labs. Looking back that was a mistake. My pre E2 levels were in the normal range. I am against the AI, it seems stupid to have to take something to counter something I am taking voluntarily. If anything, I would simply ask for a lower dose if my E2 were going up. I honestly think I was just given too high a dose and not enough time to adjust to it. I started at 180mg/wk. I am re-starting with 80mg/wk which is a joke I know but I would rather just titrate up very slowly until I know I am good. I have time.....

[aurelius]

I think what is missing from the discussion is abnormal physiology such as hypogonadism. To diagnose hypogonadism insurance companies require 3 tests in one week performed before 10 AM all below 150 ng/dl. The treatment protocols are for that. Consider that someone with abnormal physiology (hypogonadism):
--body has difficulty/cannot naturally reach homeostasis
--that without the body's natural ability to regulate and produce testosterone to stresses in real time that more overall artificial testosterone is required to achieve a similar effect
--TRT does not 'cure' an individual with hypogonadism. It only treats the symptoms. A person that artificially injects hormones will not operate like a normal, healthy individual.

I was diagnosed with hypogonadisum and started TRT around 33-34. My own experience in regards to performance enhancement: I had a ~1200 total before I started TRT after 4 years of lifting. My max achieved total 2-3 years later was 1345 (~10% incease). Body weight fluctuated between 185-195 through that period. I believe the strength I gained after can be attributed to strength training consistently over that time period. I don't think the increase in testosterone directly helped. Indirectly it 100% helped. Being able to sleep 6+ hours every night was a huge quality of life improvement for EVERYTHING in my life.

Clinics do offer TRT to anyone that walks in and is willing to pay for it. It is being sold as a miracle cure for any and all that will somehow turn back the clock on aging. Blame capitalism. I think that the person with normal physiology using TRT to push their numbers to high end of normal is misusing the treatment, not gaining a performance enhancing effect, and likely causing more harm.

[cole]

I think that the person with normal physiology using TRT to push their numbers to high end of normal is misusing the treatment, not gaining a performance enhancing effect, and likely causing more harm.

Probably. But if this treatment is out there, its easy and its cheap, and it makes you feel better on many levels, why not take advantage of it?
Just becasue you arent "sick" doesnt mean you cant benefit from it.

[mbasic]

I don't think the increase in testosterone directly helped. Indirectly it 100% helped. Being able to sleep 6+ hours every night was a huge quality of life improvement for EVERYTHING in my life.

another story^ that matches this one.

I think the huge conversion of T -> E2 made my joints feel invincible. I guess the story is the E2 helps increase the senvoial fluid in the joints. I had always been doing olympic lifting my whole life, and, while on my brief stint of TRT my knees and shoulders had never felt better before/after/during workouts. I could actually do JUST ONE warmup set of squats w 135 and go to 2 plates like normal human whereas before TRT: 3 sets with bar, 2-3 sets with 135, then 185 etc. Front squats, OHS, snatches, etc did not hurt my knees or shoulders anymore....

....it probably led to an overuse injury, lolz

point is, the other benefits indirectly performance aside from the anabolic effects of directly building muscle.

----------------------------------------

Also, from what I understand, test also is dopamine agonist of sorts.
IMO, this likely effects Neuro-muscular efficiency in a very positive way ...which in turn would effect any activity/performance with high NME requirements such as sprinting, hitting a baseball into the next zip code.
Read couple of articles on how dopamine is important to sprinters ...

Rip would say these non-strength-sports would use steroids because it simply makes them stronger; and said strength increases translate (mechanically) to their performance gains: McGuire home runs, various 100m sprint performances, throwing a javelin, etc. "There are no technique steroids".... I'm not sure that is so true.

I think in the case of "superfast-movement-sports", where the RFD can't happen fast enough to make a difference, the TRT/PEDs positively effect the NME and maybe 60-80% of the gains are coming from the brain-benefit, not necessarily bigger muscles. Sure better recovery, sleep, the joint-thing I mentioned above, etc.....and sure maybe a bit from some bigger stronger muscles.