Questioning lab results, please advise

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Trying to find my optimal TRT/cruise dose of Testosterone that allows healthy strength/sex drive and doesn't require E control (sensitive to sides, and want to see which dose I don't need AI). At 200mg test enanthate per week, I get some gyno symptoms and a bit of acne with so-so sex drive. So, I titrated down.

First Check:

I was using 160mg/w enanthate and 20mg/d tamoxifen to reduce gyno tissue in the nips from said 200mg trial. I wanted to see where this much T would put my levels. Results:

Estradiol - 50pg/ml
Free T - 328.8 pg/mL
Total T - 953 ng/dl

I wanted to kick the Estradiol down a few more points so I could reach ~30, so next I tried 115mg test per week (80mg every 5 days). At this point, I had been off of the tamoxifen for a month and on the 115mg for a month. I thought this would be enough time for accurate measurements but wtf?

Estradiol - 70
Free T - 278.3
Total - 846

The T is perfect, but how did the E go up 20 points after having lowered the T by over 40mg/w? I didn't think tamoxifen affected circulating E levels, and I thought one month would allow enough time for the old dose's aromatization and half-lives to finish clearing up so that this current dose is reflected accurately enough for reference. Which one of those assumptions are incorrect?

On that dose, my sex drive wasn't ideal either, and I lost a few more pounds than I would have liked...so I had started 140mg/w (100 e5d) right after getting the blood drawn. That, I would have thought, will bring my E down below 50 as it was with 160/w, while keeping the T on the high end of normal. But with these results, should I be worrying about the E going above 70 as it was with 115/w, instead of below 50?
 

DocDePanda187123

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It's usually easier ti testing up than it is down so I'd start again if you have the patience but start on the low end. Also, if you believe yourself to be gyno prone or sensitive to estorgen, I'd recommend getting an LC/MS estradiol panel not the basic Roche ECLIA one. Sometimes you'll see it listed as sensitive or ultra sensitive estradiol.
 

DF

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As Doc said the sensitive test is more accurate. The only other option would be to pin 2x/week & check the E2. Looks to me though that you will not be able to avoid taking an AI.
 
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Thanks for the input, I'll see about getting the sensitive text next time. But do you guys know if tamoxifen affects circulating E levels? I'm still puzzled about how the same lab test taken during the same time of the day/day of the week relative to injection frequency came up with higher E despite having dropped the dose of T.
 

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Thanks for the input, I'll see about getting the sensitive text next time. But do you guys know if tamoxifen affects circulating E levels? I'm still puzzled about how the same lab test taken during the same time of the day/day of the week relative to injection frequency came up with higher E despite having dropped the dose of T.

No, it doesn't. It just blocks the receptors.
 

DocDePanda187123

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Thanks for the input, I'll see about getting the sensitive text next time. But do you guys know if tamoxifen affects circulating E levels? I'm still puzzled about how the same lab test taken during the same time of the day/day of the week relative to injection frequency came up with higher E despite having dropped the dose of T.

Study was done on women but....

http://www.ncbi.nlm.nih.gov/m/pubmed/9168075/

Estradiol levels can vary independently of test levels. Your body fat, aromatization rate, et etc can affect this. Could just be a ome test thing and if you were to retest it could be different.
 

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This is just a theory, but it might be possible to have higher e in your second bw as residual e from your previous dose. I am curious to know how quickly e rises with higher test. I ould imagine it isn't imediate therfore it it's drop wouldn't be inline with the drop in test. As someone said above maybe working up is a better Guage. Good luck and keep us posted
 
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Study was done on women but....

http://www.ncbi.nlm.nih.gov/m/pubmed/9168075/

Estradiol levels can vary independently of test levels. Your body fat, aromatization rate, et etc can affect this. Could just be a ome test thing and if you were to retest it could be different.

Indeed. But I had less body fat during these last bloods when the E came up higher. I also recall drinking less alcohol throughout the month, which should have also kept it from being skewed. One of these labs must have gotten messed up for such an aberration to come up or something.

I'm going to have my GP order that follow-up estrogen lab real soon. What is the name of that sensitive test I should get? This doc probably won't know because she's not an endo/uro (would take a bit too long seeing one right now). So, is it "LC/MS estradiol panel"? Or do I use some other terms on the script that the lab is familiar with?

How many days after inject was bloods done?

I inject every 5 days. The bloods are done on the 5th day, before the injection.
 

DocDePanda187123

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Indeed. But I had less body fat during these last bloods when the E came up higher. I also recall drinking less alcohol throughout the month, which should have also kept it from being skewed. One of these labs must have gotten messed up for such an aberration to come up or something.

I'm going to have my GP order that follow-up estrogen lab real soon. What is the name of that sensitive test I should get? This doc probably won't know because she's not an endo/uro (would take a bit too long seeing one right now). So, is it "LC/MS estradiol panel"? Or do I use some other terms on the script that the lab is familiar with?



I inject every 5 days. The bloods are done on the 5th day, before the injection.

If those are your TT levels 5days post injection they are high. Those would be trough readings and a trough of 800 is probably a peak of 1000 or more. You could drop your dosage significantly and more than likely avoid an AI all while lowering your E2.

Did different labs run the two different tests? If so that's a possibility for the difference. If it was the same lab there's not a high possibility of them making a mistake. It's just a normal fluctuation IMO.
 

DocDePanda187123

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And you'd want an E2 test with and LC/MS or LC/MS/MS assay which is typically called sensitive or ultra sensitive estradiol.
 
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If those are your TT levels 5days post injection they are high. Those would be trough readings and a trough of 800 is probably a peak of 1000 or more. You could drop your dosage significantly and more than likely avoid an AI all while lowering your E2.

Did different labs run the two different tests? If so that's a possibility for the difference. If it was the same lab there's not a high possibility of them making a mistake. It's just a normal fluctuation IMO.

I also suspected that my blood levels seem to respond very dramatically to these injections. I hear people pinning 140-250mg per week and getting readings as high as mine are with only 120/w. I'll bring it down to 100 mg/w and feel it out for a bit longer. Thanks for the reinforcement. Do you think there would be any benefit to pinning more frequently than e5d or is that fine for the sake of convenience?

One more thing... my pharmacy seems to have stopped peddling Enanthate for some reason. I will have to begin using Cypionate soon. I don't have any bloods from using Cyp. I know it's only 1 ester off, but will this bring a significant difference in the consistency of the T or E levels if I keep the mg/ml/w the same? Will this 100mg enanthate bring about a need for more cypionate or different frequency of injections to keep equal readings?
 

Cobra Strike

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also estrogen levels will vary throughout the day...20 points isn't much. I wouldnt be on a huge mission to get your e to normal levels. Its most likely not going to happen while using exogenous test...and to be honest 30 to 70 isn't a big deal unless 50 points makes a huge difference in sides. This is where docs e sensitive advice comes into play. Im never in the normal range. Always above it no matter what I do. Trying to stay within 30 points with your e is like splitting hairs. I either crash my e or I am higher than normal and higher than normal is much much better than the other end of the spectrum. Try to remember that this is the real world and not a controlled science experiment. A lot of guys like to try to follow charts and graphs but in real life that shit just don't work out.

Use the c just like the e. Even blood work wont be able to tell the difference between the two esters.
 
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also estrogen levels will vary throughout the day...20 points isn't much. I wouldnt be on a huge mission to get your e to normal levels. Its most likely not going to happen while using exogenous test...and to be honest 30 to 70 isn't a big deal unless 50 points makes a huge difference in sides. This is where docs e sensitive advice comes into play. Im never in the normal range. Always above it no matter what I do. Trying to stay within 30 points with your e is like splitting hairs. I either crash my e or I am higher than normal and higher than normal is much much better than the other end of the spectrum. Try to remember that this is the real world and not a controlled science experiment. A lot of guys like to try to follow charts and graphs but in real life that shit just don't work out.

Use the c just like the e. Even blood work wont be able to tell the difference between the two esters.

Yeah my response to side effects is ridiculous. I feel as though 30 points of E is the difference between bitch tits vs zero bloating + well-being for my system. I was on 140mg/w test e for just these past 2 weeks thinking it would be an optimal TRT dose, and the gyno flared back up again today. At 115 it didn't happen. So now I'm taking some adex for a few days and going to go down to 100-110mg/w and hope everything feels about normal after a while. It seems like splitting hairs is exactly what I need to do in order to find my homeostasis. There doesn't seem to be any other way than to account for every point. That's why I'm trying to see if it is possible to achieve a good balance for me with JUST the shots and no other hormone manipulating meds since the possibilities of doses, timing, and misc variables of multiple drugs/supps are endless. So far not much luck, but the only other time I tried the flat 100mg/w was when I was pretty depressed and didn't stay on it for long before I bumped the dose up in response. So we'll see what happens now that I'm more experienced with effects.
 

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I also suspected that my blood levels seem to respond very dramatically to these injections. I hear people pinning 140-250mg per week and getting readings as high as mine are with only 120/w. I'll bring it down to 100 mg/w and feel it out for a bit longer. Thanks for the reinforcement. Do you think there would be any benefit to pinning more frequently than e5d or is that fine for the sake of convenience?

You have to remember that you're taking nadir or trough readings if you're testing the day before you pin. When you see other people's results you have to consider if they're peaks or troughs. Any changes you make, give it a good 6wks or so before testing or making further adjustments.

Pinning E5D is fine. I pin once a week myself with enanthate. Having said that, if you do experience sides then pinning more frequently can sometimes help reduce or eliminate sides. For example, pinning 50mg twice a week vs 100mg once a week may help reduce e2 levels or the up and down feelings some get from once a week pinning. It's really trial and error to see which you prefer.

One more thing... my pharmacy seems to have stopped peddling Enanthate for some reason. I will have to begin using Cypionate soon. I don't have any bloods from using Cyp. I know it's only 1 ester off, but will this bring a significant difference in the consistency of the T or E levels if I keep the mg/ml/w the same? Will this 100mg enanthate bring about a need for more cypionate or different frequency of injections to keep equal readings?

Cyp will have slightly less hormone per unit mass bc the ester weighs slightly more. It will also have a slightly longer half life. BUT! the differences are so minor you're not going to notice anything and it's recommended to just assume they're the same.
 

Cobra Strike

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You have to remember that you're taking nadir or trough readings if you're testing the day before you pin. When you see other people's results you have to consider if they're peaks or troughs. Any changes you make, give it a good 6wks or so before testing or making further adjustments.

Pinning E5D is fine. I pin once a week myself with enanthate. Having said that, if you do experience sides then pinning more frequently can sometimes help reduce or eliminate sides. For example, pinning 50mg twice a week vs 100mg once a week may help reduce e2 levels or the up and down feelings some get from once a week pinning. It's really trial and error to see which you prefer.



Cyp will have slightly less hormone per unit mass bc the ester weighs slightly more. It will also have a slightly longer half life. BUT! the differences are so minor you're not going to notice anything and it's recommended to just assume they're the same.

I should neg rep you you frikn prick lmao
 

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