My journey

[Tdizzle]

Hello everyone, I wanted to start my own thread to try and get some help and advice from you guys. Just a little background , I am a 37 year old male and cancer survivor. I had testicular cancer in my early 20’s and have been living with low t symptoms for a long time. I never could find a doctor to take my symptoms serious since my levels fell within “normal” range.

So I took the recommendation of another member here and started working with a Urologist to address my Low t symptoms. I had blood work done on September 5 and the results were I have low t. Here are the results

So i was put on test cypionate, 40mg every 3.5 days. I felt very good for the first two weeks, increase in energy, libido , just overall felt very good. 3rd week my libido went away completely and I could not get an erection at all. I also noticed a tightening in my scrotum and smaller testicle size which I’m not happy about. Taking Cialis seemed to help with the erections so i took some until my follow up visit.

Over the next 3 weeks I had some ups and downs , mainly down. Noticed a decrease in energy and also started feeling unmotivated and depressed b I followed up with the doctor last week and he took labs. Here are the results i got today. I was shocked how low my T levels still are.

 

[Tdizzle]

So I spoke with the doctor and he made a comment that maybe we shouldn’t continue therapy ? Not sure that’s a option for me at This point. I thought for sure when I saw my T was still in the low 300’s he would increase the dose ?

So we went away with him wanting to start me on HCG injections and do new labs in 6 weeks. I was feeling very good about treatment in the beginning but I’m not feeling very hopeful right now.

 

[Tdizzle]

From all the reading I’ve been doing , I’m under the impression my SHBG being on the low end is causing me to not sustain good T levels. I saw some guys with similar numbers are doing daily or every other day injections.

 

[Vince]

I think your dose of testosterone is too low or better yet go to daily. My opinion is inject 16 mg of testosterone daily, that seems to work the best for most members that inject daily. Once your levels stabilize, I would start adding in HCG. If you use cottonseed oil I would use a 27g half inch syringe, if you using grape seed or sesame seed oil I would use of 29g 1/2" easy touch syringe. Makes for a nice shallow IM injection.

 

[Vince]

Best Injection site, no aspiration needed, avoids all nerves

 

[Tdizzle]

@Vince dont you have low SHBG as well ? I’m going to ask my doctor to raise my dose and go to daily injections, see what he says. If he refuses , do you think I should seek a second opinion ?

 

[Vince]

No I don't have low shbg but I do inject daily. Here's my protocol and labs.

My protocol is 16 mg of testosterone cypionate daily, 500 iu of HCG twice a week, 25 mg of DHEA, 10mg of pregnenolonea and no AI.

Testosterone serum 1117 ng/dL range 264 - 916
Free T 30.3 pg/mL range 6.6 - 18.1
DHEA - Sulfate 347.3 range 48.9 - 344.2
Estradiol, Sensitive 29.5 range 8.0 - 35.0
SHBG 48.8 range 19.3 - 76.4
HCT 47.9 range 37.5 - 51.0

 

[Gman86]

Just hang in there. You definitely need therapy. Don't give up. You could of felt great at the beginning because you had your own testosterone production going on, as well as the 80mg/ week from the injections. Then once your natural production stopped, your testosterone level might of dropped too low on the 80mg.

So Vince might be right, your dose might be too low. Also, you're right as well. With that low of a SHBG, you do burn through your testosterone very quickly. So it peaks and declines at a rapid rate. So you would benefit from daily or EOD injections.

Lastly, with your SHBG being so low, you cannot handle much estradiol. So another reason why the benefits could have ceased could be that your estrogen went up a little past what your body prefers.

So overall, you probably just need to switch to ED or EOD injections and find a testosterone dose where your free T is in a healthy range. Don't worry about you total T number. To reach a good free T, you're not going to need a high total T. You're lucky in this regard. So you probably don't need a high dose of testosterone to get your free T to a healthy level. And just monitor E2, as well as free E2 if possible. If an ai is needed, just start with an extremely small dose and titrate up slowly. But only implement an ai once you get your free T dialed in. That's if you even need one at all, of course. Once your numbers are all within range, and you switch to ED or EOD injections, I don't see why you wouldn't feel great. If fertility is important to you, I would include HCG in your TRT protocol from the beginning, or if testicular atrophy is a concern. Otherwise, I would leave it out at the beginning and see how you feel once your numbers all look good on testosterone alone.

 

[Tdizzle]

Thanks man I appreciate it. I guess what is frustrating me is I obviously need more T but instead of raising my dose, the doctor is starting me on HCG and retesting me in 6 weeks. I’m feeling pretty crappy right now and after feeling a bit of relief for a few weeks, it’s really hard to feel like this again and not be upset knowing I need a change in my dose.

Does anyone think HCG is going to make much difference in my case ? I was under the impression that any external testosterone will shut down natural production and if HCG did increase T Levels, it won’t be by much

Just hang in there. You definitely need therapy. Don't give up. You could of felt great at the beginning because you had your own testosterone production going on, as well as the 80mg/ week from the injections. Then once your natural production stopped, your testosterone level might of dropped too low on the 80mg.

So Vince might be right, your dose might be too low. Also, you're right as well. With that low of a SHBG, you do burn through your testosterone very quickly. So it peaks and declines at a rapid rate. So you would benefit from daily or EOD injections.

Lastly, with your SHBG being so low, you cannot handle much estradiol. So another reason why the benefits could have ceased could be that your estrogen went up a little past what your body prefers.

So overall, you probably just need to switch to ED or EOD injections and find a testosterone dose where your free T is in a healthy range. Don't worry about you total T number. To reach a good free T, you're not going to need a high total T. You're lucky in this regard. So you probably don't need a high dose of testosterone to get your free T to a healthy level. And just monitor E2, as well as free E2 if possible. If an ai is needed, just start with an extremely small dose and titrate up slowly. But only implement an ai once you get your free T dialed in. That's if you even need one at all, of course. Once your numbers are all within range, and you switch to ED or EOD injections, I don't see why you wouldn't feel great. If fertility is important to you, I would include HCG in your TRT protocol from the beginning, or if testicular atrophy is a concern. Otherwise, I would leave it out at the beginning and see how you feel once your numbers all look good on testosterone alone.

 

[Gman86]

Honestly a dose increase might not even be necessary. With a total T of 295, your free T was the same as my free T when my total was 700. I’m a very high SHBG guy. So 80mg might be enough for you to boost your free T up enough. Only blood work will tell, but your ideal protocol might end up only being around 80-100mg per week.

It’s always good to start low and go slow. The more frequent injections, the less T you need too. Not by much, but by some. A lot of guys report having to drop their total T per week by 10-15mg when switching to and everyday protocol. Just some things to keep in mind.

For reference, while I was on 105mg/ week of T, and 1000iu/ week of HCG, my trough total T came back at 1855. While injecting EOD for both T and HCG. So you never know how you’re going to respond to a certain T dose. Starting low and going slow, while getting blood work as frequently as you can at the beginning, is the way to go.

Is your doctor adding the HCG to your testosterone protocol, or is he taking you off of T and putting you on HCG only? And HCG is a tricky one when it comes to bringing your testosterone level up on its own. It’s extremely hit or miss depending on the person, and in my experience, depending on the brand of HCG. So again, the only way to find out if the HCG you use will raise your testosterone levels, and how much, is through bloodwork. I’ve personally done HCG mono where 2,000iu/ week brought my total T to 1200 at trough while injecting EOD. I’ve used other brands where 2,000iu’s brought my total T to around 600, and another brand that had my total T at around 300. All on the same dose of 2,000iu/ week. So, in my experience, HCG is EXTREMELY hit or miss in regards to how much endogenous testosterone production you’re going to get.

 

[Gman86]

And I feel you on the frustrating part, trust me. Once you get a taste of what it’s like to feel good, nobody understands the torture it is to feel crappy day in and day out. The importance of patience is the biggest thing I’ve learned while on TRT. But being patient is WAY easier said than done when you have to deal with all of life’s responsibilities everyday while not feeling like yourself. It’s worth it though in the end.

 

[Tdizzle]

@Gman86 the HCG is being added on top of the 80mg weekly of test cypionate. Not sure how much HCG yet, I’m still waiting to hear from the pharmacy. The labs that i posted , 9/5 was prior to treatment and 10/24 was actually taken 12 hrs after an injection. I can only imagine how low I’m dropping at my trough ....

 

[Vince]

Thanks man I appreciate it. I guess what is frustrating me is I obviously need more T but instead of raising my dose, the doctor is starting me on HCG and retesting me in 6 weeks. I’m feeling pretty crappy right now and after feeling a bit of relief for a few weeks, it’s really hard to feel like this again and not be upset knowing I need a change in my dose.

Does anyone think HCG is going to make much difference in my case ? I was under the impression that any external testosterone will shut down natural production and if HCG did increase T Levels, it won’t be by much

The Use of HCG to Prevent / Reverse Testicular Shrinkage and Preserve Fertility

 

[Gman86]

Oh wow, that was 12 hours after an injection? Ya your numbers are obv still pretty low. The thing is that testosterone cypionate takes at least 24-36 hours to peak, as far as I know. Not sure if that differs with guys that have very low SHBG levels. I know they burn through and excrete it very quickly, so I guess I would assume they would have a shorter peak time after their testosterone cypionate/ enanthate injection.

Either way, you should start testing your level at trough, the morning you would usually do your injection. And I would just stay on the 80mg of test/ week, add whatever dose of HCG they put you on, and inject both ED or EOD

 

[Tdizzle]

The Use of HCG to Prevent / Reverse Testicular Shrinkage and Preserve Fertility

Thanks for the link Vince, I remember watching that before but now I’ve watched that about 3 times again.
Am I correct in assuming that the addition of HCG to my protocol could boost my T levels ? That’s what I got from it and hope that’s the case. I’m really feeling crappy lately

 

[Vince]

Thanks for the link Vince, I remember watching that before but now I’ve watched that about 3 times again.
Am I correct in assuming that the addition of HCG to my protocol could boost my T levels ? That’s what I got from it and hope that’s the case. I’m really feeling crappy lately

It can really be a pain to get dialed in, but once you were there you're so happy that you put in the work.

 

[Tdizzle]

It can really be a pain to get dialed in, but once you were there you're so happy that you put in the work.

I hear other guys talk about it being rough before getting dialed in. I keep trying to remind myself of that. The past few weeks I am feeling even worse than before I started.

It’s been putting a major strain on my personal life. I’ve been arguing with my wife a lot and I feel like I’m having constant panic attacks. Also very tired and not sleeping well

My doctor added HCG 500IU every other day, I’m hoping to get started this week, just waiting on the pharmacy to get it together for me.

 

[madman]

If anything seeing as your SHBG is so low you will need to inject daily or EOD to achieve more stable testosterone levels.

On 80 mg/week (40 mg every 3.5 days) your TT is still sub-par although testing was done at the wrong time as testing 12 hrs post injection is pointless and labs should be done at trough just before your next injection to truly see where your TT, FT and e2 (sensitive assay) sit.

Peak testosterone levels are usually 24-48 hrs post injection and I would say closer to 24 hrs.

Although TT is good to know there is no point in dwelling over it as FT is what truly matters since it is the unbound active fraction of testosterone responsible for the positive effects.

Seeing as your SHBG is low you will not need to run a high TT in order to achieve a healthy FT.

Most men do well having their FT 2-3% of TT.

Whether your FT needs to be mid or high in the physiological range?.....by gauging how you feel along the way and only when you start experiencing relief/improvement of low t symtoms along with blood work will you know what levels you feel best at!

Since your doctor is only prescribing you 80 mg/week (injecting 40 mg every 3.5 days) and you are still feeling shitty due to your protocol (dose/injection frequency) it would seem more sensible to inject 12 mg daily (84 mg/week) as the miniscule 4 mg weekly will should not make a difference in your prescription running out too soon as you were prescribed 80 mg.

Sure 12 mg daily may still turn out being too low of a dose but your testosterone levels will definitely be more stable and depending on how you feel overall during this protocol change once levels have stabilized and in 6 weeks when blood work is done you will know if the dose needs to be increased slightly.

SHBG will dictate ones dose/injection frequency and is critical to the effectiveness of a trt protocol!

 

[Tdizzle]

I definitely thought the timing was off for testing. I was in the office because I was having some other issues so he decided to test while I was there.

I’m going to talk to him about daily injections when I see him in a week or so. I think I want it do it regardless as I willnsgsy within the prescribed dose but still want to be on the same page with my doctor.

I also need a prescription for more syringes to switch to daily injections. Is there anywhere to get syringes without a script ?

If anything seeing as your SHBG is so low you will need to inject daily or EOD to achieve more stable testosterone levels.

On 80 mg/week (40 mg every 3.5 days) your TT is still sub-par although testing was done at the wrong time as testing 12 hrs post injection is pointless and labs should be done at trough just before your next injection to truly see where your TT, FT and e2 (sensitive assay) sit.

Peak testosterone levels are usually 24-48 hrs post injection and I would say closer to 24 hrs.

Although TT is good to know there is no point in dwelling over it as FT is what truly matters since it is the unbound active fraction of testosterone responsible for the positive effects.

Seeing as your SHBG is low you will not need to run a high TT in order to achieve a healthy FT.

Most men do well having their FT 2-3% of TT.

Whether your FT needs to be mid or high in the physiological range?.....by gauging how you feel along the way and only when you start experiencing relief/improvement of low t symtoms along with blood work will you know what levels you feel best at!

Since your doctor is only prescribing you 80 mg/week (injecting 40 mg every 3.5 days) and you are still feeling shitty due to your protocol (dose/injection frequency) it would seem more sensible to inject 12 mg daily (84 mg/week) as the miniscule 4 mg weekly will should not make a difference in your prescription running out too soon as you were prescribed 80 mg.

Sure 12 mg daily may still turn out being too low of a dose but your testosterone levels will definitely be more stable and depending on how you feel overall during this protocol change once levels have stabilized and in 6 weeks when blood work is done you will know if the dose needs to be increased slightly.

 

[Gman86]

Yes, there are many places to get syringes without prescriptions. These are where I personally get mine

SureComfort U-100 Insulin Syringes 29G 1cc 1/2 inch 100/bx Shop Diabetic Supplies Online | ADW Diabetes

EasyTouch Insulin Syringe 27 Gauge, 1cc, 1/2" - 100ct
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