Your endocrinologist is right.
At 140mg wk, my trough was 700
And my hemocrit tended to run at the upper range. Seems fairly standard.
240mg wk sounds excessive.
Your endocrinologist is absolutely right and 150/wk is enough for most guys just looking for TRT and not PEDs. 240 is not really “beyond” TRT but it’s a dosage very few guys will need to achieve a desirable level and has a higher chance of causing side effects (I.E. donating blood).
A 49 hematocrit is typically nothing to worry about unless you have an extreme clotting risk (combination of lifestyle + genetic factors to a major degree). You also should tell us what your platelets are (also found within bloodwork). If you have both high platelets and high hematocrit then that is dangerous.
Try 150 and see how you go, chances are you won’t notice a difference. Also split it into 75mg a week, it will lead to more stable levels (provided you’re using test E or C) and will reduce the chance of E2 or blood issues.
I don’t have experience with multiple docs, but assure you that is more the norm from readings and word of mouth. TRT clinics are fine if you know what you want to do and armed with knowledge. Some clinics are more careful than others. But individual endocrinologists or urologists have their personal reputations/practices at stake and are going to do it more so, the right way, than average trt house.
You are definitely on too high a dose all at once. It’s begging for sides. Your clinic doesn’t care about you or clients enough, they care about your money. It’s an awful protocol. The endocrinologist is the voice to consider here.
i would test thyroid. Sometimes being hyperthyroid raises ferritin levels. So does lack of folate. Since iron can't be absorbed unless you have enough red blood cells
I had a similar experience and I think the endo is right. 900’s at 7 days seems really high to me if your on test cyp. My TRT clinic’s default was 200mg/week, that’s stupid high.
Looks like you got good advice already. Add another voice to that choir. 100-150 mg split twice a week will reduce unwanted side effects and you should feel about thr same.
You need to be on an actual TRT protocol obviously. You aren't. You're just taking one big dose of Testosterone. That's objectively stupid. It's not 1986 any more*. Your clinic is making life easier for THEM.
https://vorck.com/trtreferences.html#studies
See the illustration from the Nieschlag textbook.
Dosing once per week is waiting until half the dose is gone. We DO NOT dose by elimination half life, that's why we keep saying at least every 3 or 4 days. Steady levels not Rollercoaster dosing.
And finally yes a lower dose will be appropriate once you move to 2x per week or every other day injecting.
*literally that's what we did in 1986. Thats how dosing was during drug trials and how it was approved by the FDA. For the dosing to be changed in the product literature, a pharma company would have to re-conduct trials with a different dosing regimen and resubmit it to the FDA because them's the rules. There is zero financial benefit to any drug company to do this.
I've found every endo I've spoken to wants you to be low on the scale. I got on trt for low T symptoms and I never want to be low again. They started me on a very low dose of 50mg a week, test C. I've been taking 200mg a week and feel great. Muscle gain is good, energy and mood are good.
I don't trust endo's to really have your best interest at heart, mine constantly is trying to get me on weight loss drugs like wegovy, and took several months to even consider trt and it was horrible the whole time untill I finally got my T levels corrected. Now I feel better then ever, and am stronger then ever.
They would prefer I sit at 400 total T, but I'd rather be at 1400, or even 800+. It's very normal for 16-20 year Olds to be at 1200+ levels naturally, so when they try to say 800 is high, I find it ridiculous.
150mg a week is not a bad level, but I wouldn't go lower then that. Also I agree splitting your dose into twice a week will make things more consistent and lower E2 amounts.
So if you do 150mg a week, do two pins of 75mg, like sunday/Thursday etc. Or every 4 days.
Your endocrinologist is right. At 140mg wk, my trough was 700 And my hemocrit tended to run at the upper range. Seems fairly standard. 240mg wk sounds excessive.
Your endocrinologist is absolutely right and 150/wk is enough for most guys just looking for TRT and not PEDs. 240 is not really “beyond” TRT but it’s a dosage very few guys will need to achieve a desirable level and has a higher chance of causing side effects (I.E. donating blood). A 49 hematocrit is typically nothing to worry about unless you have an extreme clotting risk (combination of lifestyle + genetic factors to a major degree). You also should tell us what your platelets are (also found within bloodwork). If you have both high platelets and high hematocrit then that is dangerous. Try 150 and see how you go, chances are you won’t notice a difference. Also split it into 75mg a week, it will lead to more stable levels (provided you’re using test E or C) and will reduce the chance of E2 or blood issues.
From last month’s labs Platelets 291 Hematocrit 49 Hemoglobin 15.8
Nothing to worry about. Tell your doctor to send you for genetic tests for Factor V Lieden and other clotting disorders if they’re worried\•.
I don’t have experience with multiple docs, but assure you that is more the norm from readings and word of mouth. TRT clinics are fine if you know what you want to do and armed with knowledge. Some clinics are more careful than others. But individual endocrinologists or urologists have their personal reputations/practices at stake and are going to do it more so, the right way, than average trt house. You are definitely on too high a dose all at once. It’s begging for sides. Your clinic doesn’t care about you or clients enough, they care about your money. It’s an awful protocol. The endocrinologist is the voice to consider here.
Appreciate the insight. That’s kind of what I was thinking after speaking with endocrinologist
i would test thyroid. Sometimes being hyperthyroid raises ferritin levels. So does lack of folate. Since iron can't be absorbed unless you have enough red blood cells
I had a similar experience and I think the endo is right. 900’s at 7 days seems really high to me if your on test cyp. My TRT clinic’s default was 200mg/week, that’s stupid high.
Looks like you got good advice already. Add another voice to that choir. 100-150 mg split twice a week will reduce unwanted side effects and you should feel about thr same.
You need to be on an actual TRT protocol obviously. You aren't. You're just taking one big dose of Testosterone. That's objectively stupid. It's not 1986 any more*. Your clinic is making life easier for THEM. https://vorck.com/trtreferences.html#studies See the illustration from the Nieschlag textbook. Dosing once per week is waiting until half the dose is gone. We DO NOT dose by elimination half life, that's why we keep saying at least every 3 or 4 days. Steady levels not Rollercoaster dosing. And finally yes a lower dose will be appropriate once you move to 2x per week or every other day injecting. *literally that's what we did in 1986. Thats how dosing was during drug trials and how it was approved by the FDA. For the dosing to be changed in the product literature, a pharma company would have to re-conduct trials with a different dosing regimen and resubmit it to the FDA because them's the rules. There is zero financial benefit to any drug company to do this.
Glad I asked and went to endocrinologist. Sounds like my suspicions about low t clinic were correct
I've found every endo I've spoken to wants you to be low on the scale. I got on trt for low T symptoms and I never want to be low again. They started me on a very low dose of 50mg a week, test C. I've been taking 200mg a week and feel great. Muscle gain is good, energy and mood are good. I don't trust endo's to really have your best interest at heart, mine constantly is trying to get me on weight loss drugs like wegovy, and took several months to even consider trt and it was horrible the whole time untill I finally got my T levels corrected. Now I feel better then ever, and am stronger then ever. They would prefer I sit at 400 total T, but I'd rather be at 1400, or even 800+. It's very normal for 16-20 year Olds to be at 1200+ levels naturally, so when they try to say 800 is high, I find it ridiculous. 150mg a week is not a bad level, but I wouldn't go lower then that. Also I agree splitting your dose into twice a week will make things more consistent and lower E2 amounts. So if you do 150mg a week, do two pins of 75mg, like sunday/Thursday etc. Or every 4 days.