Male TRT - blood test - Bangkok

[FriendlyFarang]

59 minutes ago, Hummin said:

I read about trt dosage pr week up to 500 ml (former bodybuilders) and all the way down to 75mg,

TRT stands for testosterone replacement therapy, it's supposed to replace what is supposed to be there naturally

That means a dosage of around 10mg per day, significantly more than that is not TRT.

[Hummin]

16 minutes ago, FriendlyFarang said:

TRT stands for testosterone replacement therapy, it's supposed to replace what is supposed to be there naturally

That means a dosage of around 10mg per day, significantly more than that is not TRT.

This is an simple but good article. I guess most understood 500mg is far beyond the high level for a normal person?

 

When you say 19mg or day, is that a rule no matter treatment and ester used? 

 

https://www.google.com/amp/s/www.swintegrativemedicine.com/blog/testosterone-replacement-therapy-dosing-and-dosage-considerations%3fhs_amp=true

[FriendlyFarang]

54 minutes ago, Hummin said:

This is an simple but good article. I guess most understood 500mg is far beyond the high level for a normal person?

500mg (per week) is a bodybuilder cycle dosage which most of them might use for 2 or 3 months and then go off again due to the side effects of such a high dose.

 

54 minutes ago, Hummin said:

When you say 19mg or day, is that a rule no matter treatment and ester used? 

We are talking about TRT here, so the purpose of the treatment is to restore a natural testosterone level.

I was referring to Testosterone Enanthate, which contains about 70% active testosterone and 30% is the ester weight. So by injecting 10mg Test E (I'm of course talking about the average here, so maybe 70mg per week or whatever in reality) you get 7mg of actual Testosterone, which is the amount of testosterone that a healthy body produces on average.

You can also just have a look at the information that comes with a box of Test E, they recommend one amp (250mg) every 3 weeks, which is 11.x mg per day. So somewhere around there is "TRT".

Some people might of course require a bit more, but calling a dose of more than 20mg per day TRT is quite a farce.

 

I don't have a problem with anybody doing this, it's their personal choice. But I don't like when people who are on this kind of "all year round mini cycle" then tell others "If you are on TRT you need an AI". Somebody who is on actual TRT dosage doesn't need an AI because his E2 levels will be normal (of course there might be a few exceptions, but spoken for 99% of persons on TRT)

 

 

Edited May 2, 2022 by FriendlyFarang

[FriendlyFarang]

1 hour ago, MarkyM3 said:

HCG...still haven't ruled out having kids even though I'm now 51 so that's my primary motivation there. But I did read it has other potential benefits though, as well. But if you are feeling good on your TRT protocol and kids aren't a factor then I agree no reason to use it. 

I didn't put too much research in this because it's not really relevant for me, but you might want to put some research into it or discuss it with your doctor, depending on how soon you plan to have children:

Afaik you can supplement HCG later on if you ever decide to have kids.

I assume you actually medically need the TRT and coming off is not an option: If you have been on TRT (without HCG) for a while and your testis quit their job, you can start injecting HCG (while staying on TRT) and it takes about 6-12 months until your testis start to produce semen again.

Edited May 2, 2022 by FriendlyFarang

[Hummin]

18 minutes ago, FriendlyFarang said:

500mg is a bodybuilder cycle dosage which most of them might use for 2 or 3 months and then go off again due to the side effects of such a high dose.

 

We are talking about TRT here, so the purpose of the treatment is to restore a natural testosterone level.

I was referring to Testosterone Enanthate, which contains about 70% active testosterone and 30% is the ester weight. So by injecting 10mg Test E (I'm of course talking about the average here, so maybe 70mg per week or whatever in reality) you get 7mg of actual Testosterone, which is the amount of testosterone that a healthy body produces on average.

You can also just have a look at the information that comes with a box of Test E, they recommend one amp (250mg) every 3 weeks, which is 11.x mg per day. So somewhere around there is "TRT".

Some people might of course require a bit more, but calling a dose of more than 20mg per day TRT is quite a farce.

 

I don't have a problem with anybody doing this, it's their personal choice. But I don't like when people who are on this kind of "all year round mini cycle" then tell others "If you are on TRT you need an AI". Somebody who is on actual TRT dosage doesn't need an AI because his E2 levels will be normal (of course there might be a few exceptions, but spoken for 99% of persons on TRT)

 

 

You are correct, and I just stated what some people do.

 

Myself have used mostly 250mg  17 - 21 days Enenthate.

 

Andriol 2 capsules 40mg every day (original not Thai version)

 

Testo gel 50 mg a day also work good for me.

 

Or 125mg a week Enenthate. Best results 8-9 days, but minor differences. I have this as favorite when not travelling or working offshore 

 

Best feeling and also good lab results, is Subcutaneous injections 3ml every 5 day of Enenthate. And when I know I will stay same place for awhile I use that method.

 

But as pointed out, we are not doctors and can only refer to what we believe, read, learn and what Dr says.

 

The science also change a little bit as more clinical researches being done on TRT.

 

Edit note TRT for 6 years now.

Edited May 2, 2022 by Hummin

[MarkyM3]

On 5/2/2022 at 5:23 PM, Hummin said:

Great if you share your experience.

Hi again..

 

Had my blood test yesterday at Maximum....gel applied at 9am and blood draw done 3.30pm to try get something towards midpoint between peak and trough.

 

My T and E2 figures are pretty crazy...

 

T - 1551 ng/dL

E2 - 97 pg/ML

 

Others pretty normal:

 

SHBG - 19.8 nmol/L

Albumin - 4.56 g/dL

Prolactin - 16.83 ng/mL

TSH - 0.99

Free T4 - 1.03 ng/dL

 

I last had a Nebido injection in early Nov 2021 after being on it for approximately 2 years so it should be out of my system by now. I am currently using 6 pumps of Tostran gel daily, applied in the morning, each delivering 10mg of T. That is the recommended daily dose (starting dose being 4 pumps, maximum 8 pumps allowable).

 

I used Tostran for a time when I first started TRT before going onto Nebido and never saw T figures anything like this, in fact I ended up on 7 pumps iirc. So somewhat at a loss to explain these figures. I haven't had any gel in that area for a week at least (I use thighs and shoulders nearly all the time) so that should not be a factor. I keep the gel in a room at around 26c and give it a shake each morning before applying so don't see it has mutated lol - in fact, I asked the distributor a few years ago if Tostran had any issues with heat in the tropics and they said no.  

 

So, going to cut back to 4 pumps for now and go back to Maximum for a test at the end of the month and see if anything has changed. Been taking Tadalafil 5mg daily for last week (and did so thru mid March to mid April) which is supposed to usefully suppress E2 as a side effect (discussed in my previous posts, my primary purpose is for ED at least partially linked to my Epilim use). Yet I'm still way up on E2, clearly due to the excess T aromatisation in my system.

 

Not used Anastrozole for 2.5 weeks.

 

My blood pressure was 122/74, so pretty normal. 

 

Edited May 7, 2022 by MarkyM3

[Hummin]

7 minutes ago, MarkyM3 said:

Hi again..

 

Had my blood test yesterday at Maximum....gel applied at 9am and blood draw done 3.30pm to try get something towards midpoint between peak and trough.

 

My T and E2 figures are pretty crazy...

 

T - 1551 ng/dL

E2 - 97 pg/ML

 

Others pretty normal:

 

SHBG - 19.8 nmol/L

Albumin - 4.56 g/dL

Prolactin - 16.83 ng/mL

TSH - 0.99

Free T4 - 1.03 ng/dL

 

I last had a Nebido injection in Nov 2021 after being on it for approximately 2 years so it should be out of my system by now. I am currently using 6 pumps of Tostran gel daily, applied in the morning, each delivering 10mg of T. That is the recommended daily dose (starting dose being 4 pumps, maximum 8 pumps allowable).

 

I used Tostran for a time when I first started TRT before going onto Nebido and never saw T figures anything like this. So somewhat at a loss to explain these figures. I haven't had any gel in that area for a week at least (I use thighs and shoulders nearly all the time) so that should not be a factor. I keep the gel in a room at around 26c and give it a shake each morning before applying so don't see it has gone awry - in fact, I asked the distributor a few years ago if Tostran had any issues with heat and they said no.  

 

So, going to cut back to 4 pumps for now and go back for a test at the end of the month and see if anything has changed. Been taking Tadalafil 5mg daily for last week (and did thru mid March - mid April) which is supposed to usefully suppress E2 as a side effect (discussed in my previous posts).

 

Not used Anastrozole for 2.5 weeks.

 

My blood pressure was 122/74, so pretty normal. 

 

That was a rapid peak t, and I would consider to check in the morning instead before putting any gel on.

 

Seems E follow T proportional ? What did the Dr say about that? 

 

One reason for me to not use gel when living with my gf, is because I do not want to transfer any active gel to her. Except from that, I feel good on the the 50mg sackers daily. Especially very good solid morning glory every day as proof 23 hours since I put any gel on, and also mood throughout the day.

 

 

Edited May 7, 2022 by Hummin

[MarkyM3]

15 minutes ago, Hummin said:

That was a rapid peak t, and I would consider to check in the morning instead before putting any gel on.

 

Seems E follow T proportional ? What did the Dr say about that? 

 

One reason for me to not use gel when living with my gf, is because I do not want to transfer any active gel to her. Except from that, I feel good on the the 50mg sackers daily. Especially very good solid morning glory every day as proof 23 hours since I put any gel on, and also mood throughout the day.

 

 

The draw was done 6.5 hours after putting gel on so not sure that's correct. Readings are supposed to decline throughout the day on gel, mimicking the natural T cycle.

 

Did some research and endos with patients on gel recommend blood draw 6-8 hours after gel application to get somewhere midpoint between peak and trough. Which is what I did.

 

I could get a test done before applying gel but that's going to be an absolute trough figure. Strikes me my figures are way too high at 3.30pm if I'm logging those numbers. I'm near double the upper limit for T and over double for E2.

 

Didn't speak with doc as I'm not on their program. Back to UK on 30 June so no point me joining. If I move to BKK fulltime I'll probably do so. 

 

Btw - agree on the gel and worry about transferring to gf. Same issues for me. I also found it caused some skin irritation for a while though that's abated now. 

Edited May 7, 2022 by MarkyM3

[eezergood]

On 5/7/2022 at 11:44 PM, MarkyM3 said:

The draw was done 6.5 hours after putting gel on so not sure that's correct. Readings are supposed to decline throughout the day on gel, mimicking the natural T cycle.

 

Did some research and endos with patients on gel recommend blood draw 6-8 hours after gel application to get somewhere midpoint between peak and trough. Which is what I did.

 

I could get a test done before applying gel but that's going to be an absolute trough figure. Strikes me my figures are way too high at 3.30pm if I'm logging those numbers. I'm near double the upper limit for T and over double for E2.

 

Didn't speak with doc as I'm not on their program. Back to UK on 30 June so no point me joining. If I move to BKK fulltime I'll probably do so. 

 

Btw - agree on the gel and worry about transferring to gf. Same issues for me. I also found it caused some skin irritation for a while though that's abated now. 

Sorry so late to the party - Gels, you are probably sweating a whole lot more here so losses are going to be high.

 

You can get all of your previous meds over the counter here, so..........

 

Also as you mentioned that T level is VERY high, where did you apply the gel and where was the blood take from? potential contaminated shot?

 

 

[MarkyM3]

12 hours ago, eezergood said:

Sorry so late to the party - Gels, you are probably sweating a whole lot more here so losses are going to be high.

 

You can get all of your previous meds over the counter here, so..........

 

Also as you mentioned that T level is VERY high, where did you apply the gel and where was the blood take from? potential contaminated shot?

 

 

It's Tostran topical gel (called Fortesta in the US). I'm on TRT in the UK and that's my current prescription medication (I brought it with me when I flew over to BKK at beginning of Feb). 

 

Have been taking the standard dosage of 6 pumps a day. I had applied it to the thighs as directed (4 pumps). I also had 1 pump on each shoulder. And yeah, I was pretty shocked by that reading tbh. And the E2 as well, though both excess T and E2 seem to follow the same trajectory. The blood draw was done from my right arm and that wasn't contaminated to best of my knowledge and I hadn't used it for gel for at least a week previous. I'm now going to stick to thighs only. 

 

Did more checking on Tostran/Fortesta (US equivalent) and the manufacturer recommends taking blood draws 2 hours after applying gel. Mine was done 6.5 hours later but the figures should be slighly lower if anything yet still got that high reading...

 

Anyways, I've cut back from 6 pumps to the recommended minimum starter dose of 4 pumps, as per UK manufacturer instructions, and I will get another T and E2 test done in 2 weeks at 2 hours after application. Manufacturer instructions say if the T figure is between 500 and 1250ng/dL then no dosage adjustment needed. Lower than 500 and I go up by one dose. If it's still too high then that will be interesting...

 

Will need to see what the E2 says as well. I've stopped taking Ansastrozole now, as discussed previously. I'm taking 5mg Cialis daily, for ED but also supposed to have beneficial effects on E2 aromatisation....

 

Btw, I shave my otherwise hairy thighs and shoulders every few days to ensure gel is absorbed properly. 

Edited May 9, 2022 by MarkyM3

[The Hammer2021]

Any major private hospital

[MarkyM3]

2 hours ago, MarkyM3 said:

It's Tostran topical gel (called Fortesta in the US). I'm on TRT in the UK and that's my current prescription medication (I brought it with me when I flew over to BKK at beginning of Feb). 

 

Have been taking the standard dosage of 6 pumps a day. I had applied it to the thighs as directed (4 pumps). I also had 1 pump on each shoulder. And yeah, I was pretty shocked by that reading tbh. And the E2 as well, though both excess T and E2 seem to follow the same trajectory. The blood draw was done from my right arm and that wasn't contaminated to best of my knowledge and I hadn't used it for gel for at least a week previous. I'm now going to stick to thighs only. 

 

Did more checking on Tostran/Fortesta (US equivalent) and the manufacturer recommends taking blood draws 2 hours after applying gel. Mine was done 6.5 hours later but the figures should be slighly lower if anything yet still got that high reading...

 

Anyways, I've cut back from 6 pumps to the recommended minimum starter dose of 4 pumps, as per UK manufacturer instructions, and I will get another T and E2 test done in 2 weeks at 2 hours after application. Manufacturer instructions say if the T figure is between 500 and 1250ng/dL then no dosage adjustment needed. Lower than 500 and I go up by one dose. If it's still too high then that will be interesting...

 

Will need to see what the E2 says as well. I've stopped taking Ansastrozole now, as discussed previously. I'm taking 5mg Cialis daily, for ED but also supposed to have beneficial effects on E2 aromatisation....

 

Btw, I shave my otherwise hairy thighs and shoulders every few days to ensure gel is absorbed properly. 

Just to add....I mentioned previously I had my last Nebido (injectable slow-release testosterone) injection in early Nov 2021.

 

Having re-read the manufacturer info, it says the half-life of this is 90 days. I tested for T levels of around 700-750 at the end of January, nearly 3 months after the last Nebido injection and without using anything else. I would usually have had another Nebido injection in the next week or two but didn't and switched to gels.

 

I didn't use gel much at all for the first month or two thereafter because I was conscious of the influence of Nebido in my system but didn't appreciate the amount would only be halving every 3 months thereafter (on basis half life is 90 days). Therefore, it would appear there is still quite a bit of Nebido in my system, even now, which would explain high T readings with using standard Tostran dose as well.

 

It looks like I will need to wait several more months for Nebido to fully disappear from my system and hence tailor the Tostran dose in the meantime. 

 

Back from 60 to 40mg Tostran gel now and will test T and E2 in a couple of weeks to see if I'm back in range. Thinking that when the Nebido fully disappears, I will finally end up back at standard 60mg dose or thereabouts or look at alernative treatments.

Edited May 9, 2022 by MarkyM3

[eezergood]

9 hours ago, MarkyM3 said:

Just to add....I mentioned previously I had my last Nebido (injectable slow-release testosterone) injection in early Nov 2021.

 

Having re-read the manufacturer info, it says the half-life of this is 90 days. I tested for T levels of around 700-750 at the end of January, nearly 3 months after the last Nebido injection and without using anything else. I would usually have had another Nebido injection in the next week or two but didn't and switched to gels.

 

I didn't use gel much at all for the first month or two thereafter because I was conscious of the influence of Nebido in my system but didn't appreciate the amount would only be halving every 3 months thereafter (on basis half life is 90 days). Therefore, it would appear there is still quite a bit of Nebido in my system, even now, which would explain high T readings with using standard Tostran dose as well.

 

It looks like I will need to wait several more months for Nebido to fully disappear from my system and hence tailor the Tostran dose in the meantime. 

 

Back from 60 to 40mg Tostran gel now and will test T and E2 in a couple of weeks to see if I'm back in range. Thinking that when the Nebido fully disappears, I will finally end up back at standard 60mg dose or thereabouts or look at alernative treatments.

The nebido injections seem to be problematic with their release - yes the half life is 90 days, but this is calculated on ONLY the very first injection and no subsequent injections and on a very limited number of test subjects. So you may well have accumulated nebido still in your system. I would look to a faster acting ester, unless injections are an issue for you? as under normal circumstances a AI would or should not be needed for TRT/HRT. Again some people are HIGHLY sensitive. 

[MarkyM3]

1 hour ago, eezergood said:

The nebido injections seem to be problematic with their release - yes the half life is 90 days, but this is calculated on ONLY the very first injection and no subsequent injections and on a very limited number of test subjects. So you may well have accumulated nebido still in your system. I would look to a faster acting ester, unless injections are an issue for you? as under normal circumstances a AI would or should not be needed for TRT/HRT. Again some people are HIGHLY sensitive. 

Bear in mind I have been on Nebido for 2+ years previously and steady state apparently isn't reached for some time due to the cumulative effect of injections and their half lives. That is what I was told. I was injected every 90 days roughly which coincides with the stated half life of a jab (stated as 90 days +/- 40 days depending on the individual's endocrine system). The principle seems roughly similar to doing daily 5mg Cialis/Tadalafil, which has a half life of around 18 hours and you end up with a steady state of 8mg per day on it after 5 days. 

 

Anyway, whatever the case, looks like I am still carrying accumulated Nebido as I can't see how I could have logged 1550 ng/dL on Tostran 6 pumps. I'll see how what it looks like back to minimum dose of 4 pumps when I go back for a test in a couple of weeks. 

 

Decided I don't want to go back to Nebido, although it's convenient. Will consider injections but they need to fit in with travel between London and BKK. If you read my earlier comments, due to me using an anti-epilepsy medicine which apparently decimates the LH which tells your balls to make T and sperm then it has been suggested on a forum I should ask about HCG monontherapy. Plus I want to retain fertility as I might still want kids. However....now age 51 so declining T may well be a factor regardless.

 

Regards AI, been using Anastrozole for a long time but I'm very sensitive to it. Come around to view to try and avoid it if possible. Not used any for 3 weeks now. 

Cheers for input!

 

[eezergood]

1 hour ago, MarkyM3 said:

Bear in mind I have been on Nebido for 2+ years previously and steady state apparently isn't reached for some time due to the cumulative effect of injections and their half lives. That is what I was told. I was injected every 90 days roughly which coincides with the stated half life of a jab (stated as 90 days +/- 40 days depending on the individual's endocrine system). The principle seems roughly similar to doing daily 5mg Cialis/Tadalafil, which has a half life of around 18 hours and you end up with a steady state of 8mg per day on it after 5 days. 

 

Anyway, whatever the case, looks like I am still carrying accumulated Nebido as I can't see how I could have logged 1550 ng/dL on Tostran 6 pumps. I'll see how what it looks like back to minimum dose of 4 pumps when I go back for a test in a couple of weeks. 

 

Decided I don't want to go back to Nebido, although it's convenient. Will consider injections but they need to fit in with travel between London and BKK. If you read my earlier comments, due to me using an anti-epilepsy medicine which apparently decimates the LH which tells your balls to make T and sperm then it has been suggested on a forum I should ask about HCG monontherapy. Plus I want to retain fertility as I might still want kids. However....now age 51 so declining T may well be a factor regardless.

 

Regards AI, been using Anastrozole for a long time but I'm very sensitive to it. Come around to view to try and avoid it if possible. Not used any for 3 weeks now. 

Cheers for input!

 

My father has the same issues with his epilepsy medication & the huge strain this has out on his liver essentially leading him to non alcoholic fatty liver like symptoms. 

 

Hope you can get things sorted, remember test is readily available here so the travelling thing is less of an issue