question from a user
My original TT was under 600, free t was very low. I had a lot of low T symptoms including sex drive, libido, energy, mood, etc.. Before TRT my estrogen was over 70 and prolactin was on the higher end of 11.9 top was 15.2 on blood levels. I started with a low dose of 120mg a week of TRT and bloods came back around 850 for TT. I increased to 140mg week and bloods TT came back 1164. Even at these doses I saw improvement but not how I normally felt my entire life. I’ve always had a huge sex drive all the time and energy levels. I increased to 180mg week and bloods came back over 1500 at that point I felt normal again and great. I was injecting twice a week. I take an AI to keep the estrogen down. My bloods show everything normal even hemocrat is 44%. Since I inject twice a week I take my blood work before next injection 3.5 days from last injection. I also take 250 of hcg now which was not part of the previous testing and I have not had bloods yet drawn to see where they affects everything. My question is what are the long term effects at the levels I’m at above 1500 going to cause for health concerns? Or is the problem that my injection is so frequent it’s not a cause for concern being so close to last injection? If you have any recommendations as well I’m all ears.
AlphaMD's Answer
The only long term side effects of supraphysiologic testosterone levels that have been identified are increased risk of high blood pressure and low HDL levels. But even then, that doesn't mean that these are definitely going to occur in someone with high T levels.
The higher your T level is, the more likely your body will convert the excess into estradiol and/or DHT, and high E2 or DHT come with their own concerns, but high T in and of itself is not a risk factor for anything. Studies confirm that previous concerns that there was a correlation between high T and prostate cancer and heart disease were unfounded.
If you only get symptom relief with a T level of 1500, then that may well be the right level for you — something the provider overseeing your care can confirm.
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