Tool to Assess your TT dose response --Percentile Curves

readalot

Member
Continuing the dose response thread over here. This would be a great place to crowdsource data.



I will post up the requirements for sharing user data. A chart with FT vs dose would be better but unfortunately that's not how the history of analytical chemistry with serum testosterone shook out.

Previously I compared published pharmacokinetic studies against user data taken via LCMS/MS. Really should be no surprises what the typical dose response is to a given test dose once you understand the impact of dosing frequency.


1689002418388.png


Enjoy and we will see how this shakes out. I am sure you guys will be a great resource to balance out the left side of the chart with all the TRT/TOT points.
 
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Linear version of graph....
You can use regression equations from Bi 2018 study to get low, mean, high estimates for TT level vs weekly equivalent dose.

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Here’s the mean TT level (ng/dl) for 70. mg/week of Test Cypionate (see equations on chart below):

2.5 percentile response = 360
50 percentile response = 630
97.5 percentile response = 1200

Don't forget to use this table to convert your blood work result (trough) on given dosing protocol to mean:


Table: conversion between peak/trough/mean for first order absorption/elimination PK model assuming 4.5 day elimination half life and 8 hr absorption half life
image
 
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Ok got access over there. My original post...

Summary:
Tools to estimate your individual dose response for injectable testosterone ester in comparison to a normal distribution (95 percentile confidence estimate) of adult males (Ref). Plot below shows a summary of data from (1) clinical trials gathered from the literature + (2) crowdsourced data gathered here and elsewhere. I’ll add to the dose response chart as time allows. More background info on charts below can be found here and here in particular.

Key considerations:

  • If you are testing at TT levels above 1500 ng/dl expected, get an LC/MS-MS assay (always a good choice actually)
  • Make sure you gear is dosed correctly (third party testing)
  • Use graph and table below to confirm you are even in the vicinity of expected range
  • Make sure you test at least 4 weeks after you have made a protocol change
Plot shows mean TT level (ng/dl) vs weekly equivalent dose of test ester (mg/week). Test at trough and use table to convert to mean based on your protocol (E7D, E3.5D, etc).

Table: conversion between peak/trough/mean for first order absorption/elimination PK model assuming 4.5 day elimination half life and 8 hr absorption half life
image


image


Fig. Mean TT level vs weekly equivalent dose (mg/week). Note green shaded area is 5 percentile to ~99 percentile+ physiologic reference range (300-1200 ng/dl)

Example:
Dude is taking 200 mg/week of TC (Q3.5D protocol). He measures at trough and tests at 1000 ng/dl. Using table above for Q3.5D protocol, mean/trough = 1.2. Therefore mean TT = 1.2*1000 = 1200 ng/dl. Plot the point on the curve and you see he’s less than 50%tile on his dose response (~25-30% eyeballing). From the figure at 200 mg/week dose, 2.5 percentile response ~800 ng/dl mean, 50 percentile is ~1500 ng/dl mean, and 97.5 percentile is 2300 ng/dl mean.
 
“Members only”

Effort.
I got access to my old first post and put it in here. Got flagged for mod approval for some reason. I hope I find out soon cause this is a huge PITA combined with the 30 min time limit on editing posts. Unsure what your effort comment means.

Perhaps MGMT (@Millard) can extend me some edit rights once folks see the effort and time required to make these analyses and publication quality posts.
 
Rules/requests for submitting your data...

Minimum of 4-5 weeks with the protocol

State protocol (weekly amount of test ester and frequency)

LC/MS-MS results only for TT levels above 1500 ng/dl

Please state assay/lab used

SHBG and fT will be considered and I may make a fT plot at some point (please state the type of fT assay or calculated).

Please disclose any other AAS used concurrently (especially 17AA) which may skew TT response via SHBG in the gutter. Same for hCG.
 
Wow my posts all seem to need moderator approval LOL. I must be missing something. Another issue with the 30 min post edit limit is there is no opportunity for cross referencing posts and information. Post is essentially dead after 30 min and can't be modified.

Feel free to bump me to whatever the member status needs to be to quit getting flagged for all this stuff. Maybe my posts are breaking the system and the software thinks I am an AI spammer or ChatGPT mutant strain?
:(
 
The problem with this is that it feels like it's negating the need for blood tests, although you do mention their need. Yes almost everyone doesn't need 300 test as trt and in truth it should be about half for most. The need for a blood test to accurately gauge the individual's personal response should still be paramount vs a rough estimate of accrued data.
 
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L
Getting banned from multiple forums, like you've said, will do that. At least you're transparent
Lmao, it is actually heroic. Not a bad thing. I got a banned from TNation first time for arguing with the former admin about the word "safe". Second time was for linking to ExcelMale for stuff I had posted there plus I seem to have pissed off a very sensitive member coach for giving out horrible precedent about when to start TRT. Plus the Admins started deleting my posts which I don't appreciate.

On ExcelMale I asked Nelson to ban me since my comments on FDA were problematic for his site and he didn't seem to like my kind of humor.

Good to know now if this site isn't a good fit. I will move along then.
 
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The problem with this is that it feels like it's negating the need for blood tests, although you do mention their need. Yes almost everyone doesn't need 300 test as trt and in truth it should be about half for most. The need for a blood test to accurately gauge the individual's personal response should still be paramount vs a rough estimate of accrued data.
How's that and where did I say you can use above in place of blood work?

There would be multiple benefits with being familiar with above data. Love to understand how you "feel" this analysis negates the need for blood work. Quite the opposite but thanks for your comments.

For the Bros what is the obvious benefit to my herculean efforts? If your blood work on 500 mg/week ain't coming back within the confidence limits you probably need to have a talk with your pharmacy or source.
 
How's that and where did I say you can use above in place of blood work?

There would be multiple benefits with being familiar with above data. Love to understand how you "feel" this analysis negates the need for blood work. Quite the opposite but thanks for your comments.
Eh I'm just sideways on stuff like this. Probably from being around many young users and knowing in how they read things. They'll see a fancy graph and take it as gold.
 
Yes almost everyone doesn't need 300 test as trt and in truth it should be about half for most.
50 to 100 mg/week for most (true TRT)
100 to 200 mg/week gets into that wonderful gray zone between TRT and "TOT". Yeah I got another thread for that where I tried to help poor Danny Bossa.

300 mg/week for TRT? Laughable.
 
Eh I'm just sideways on stuff like this. Probably from being around many young users and knowing in how they read things. They'll see a fancy graph and take it as gold.
Oh it is gold but they should damn sure get proper bloodwork. LCMS/MS for TT plus ED for FT. Cheap as hell now. I try to steer all youngsters away from abuse if I can.

You can't assess your dose response if you don't have the data for comparison LOL.

And I have noticed the trend. The harder I work to put data like this out the more sh*t I catch. It is similar to giving someone a new car and they bitch that the color ain't right. Oh well, humans haha.
 
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TT dose/response is useless. If absolute fT is low, and hypogonadal symptoms persist, take more T.

Since what changes with age in particular is FAI due to SHBG (probably because of E2 increasing), what we really want to know is fT distribution by age at endogenous T concentrations.
 
ExcelMale: making well-intentioned people dumber by teaching them to play whack-a-mole with arbitrary bloodwork values, and exploiting that idiocy by marketing unnecessary laboratory bloodwork and medical services for cold hard cash.
 
TT dose/response is useless. If absolute fT is low, and hypogonadal symptoms persist, take more T.

Since what changes with age in particular is FAI due to SHBG (probably because of E2 increasing), what we really want to know is fT distribution by age at endogenous T concentrations.
And as you know getting that FT dose response chart (I did mention it above) is hard to come by since we still don't have harmonized FT measurement methods. Care to point me to the extensive literature we can mine for accurate confidence intervals much less asking for user data. Nope, the fact is we just recently harmonized TT and the historical precedent of

FT = f(TT, SHBG)

Is still firmly entrenched even though it is backwards.

Try getting everyone to understand FT measurement by ED or even why cFTV still is the best calculator we have. I still can't get most to understand why their direct FT test is about a factor of 7 off from what would be expected if FT/TT is typically 2 to 3%.

I appreciate your comments though.

In summary, TT dose response useless? Hardly. But to your point it is clouded by SHBG variation. What we would like (yes no good deed goes unpunished-- i get it) instead is FT dose response which would then not have the SHBG baggage built in and would depend on true PK parameters...clearance and distribution volume. These later two clearly change with age and affect how men process exogenous T. Now if we can get guys to understand this instead of using terms like hyperexcretets and such we will be in business.

The correct paradigm (in contrast to above) is

TT = f(FT, SHBG)

Let me know if you want to talk shop on FT situation fron a clinical perspective. That is fun. Happy to get your feedback but I give it a C. Calling TT dose response useless is a stretch.
If anything it nice sets up the procedure to do what you what you suggest with age adjusted FT intervals. And besides the Bros can see if there gear is bunk. Handy tool.
 
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ExcelMale: making well-intentioned people dumber by teaching them to play whack-a-mole with arbitrary bloodwork values, and exploiting that idiocy by marketing unnecessary laboratory bloodwork and medical services for cold hard cash.
DiscountedLabs offers some great prices on bloodwork you can order yourself. Very effective IF you know what you are doing. But think of it from Nelson's perspective, he has to make a living. But that is why I had to go. When my comments interfere with his business I became a liability so I excused myself.

Glad you chimed in. Looking forward to more interaction with you.
 
And as you know getting that FT dose response chart (I did mention it above) is hard to come by since we still don't have harmonized FT measurement methods. Care to point me to the extensive literature we can mine for accurate confidence intervals much less asking for user data. Nope, the fact is we just recently harmonized TT and the historical precedent of

FT = f(TT, SHBG)

Is still firmly entrenched even though it is backwards.

Try getting everyone to understand FT measurement by ED or even why cFTV still is the best calculator we have. I still can't get most to understand why their direct FT test is about a factor of 7 off from what would be expected if FT/TT is typically 2 to 3%.

I appreciate your comments though.

In summary, TT dose response useless? Hardly. But to your point it is clouded by SHBG variation. What we would like (yes no good deed goes unpunished-- i get it) instead is FT dose response which would then not have the SHBG baggage built in and would depend on true PK parameters...clearance and distribution volume. These later two clearly change with age and affect how men process exogenous T. Now if we can get guys to understand this instead of using terms like hyperexcretets and such we will be in business.

The correct paradigm (in contrast to above) is

TT = f(FT, SHBG)

Let me know if you want to talk shop on FT situation fron a clinical perspective. That is fun. Happy to get your feedback but I give it a C. Calling TT dose response useless is a stretch.
If anything it nice sets up the procedure to do what you what you suggest with age adjusted FT intervals. And besides the Bros can see if there gear is bunk. Handy tool.
30 min time edit limit kicked in LOL. This 30 min edit stuff is BS when dealing with topics and data you won't even get in the academic literature.
 
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