2 months on TRT

[TRTinNY]

All...

Definitely feeling a better on my protocol which currently is 50mg every 3.5 days...No HCG or Arimidex. Erections are stronger, morning wood has partially returned, mood is improved and feel decent in the gym but not much stronger.

My bloodwork was done 48 hours after my last shot. I would expect test levels to be much higher. Please see the attachments.

Dr just upped my dose to 180mg per week of test 90mg (.45ML from a 1ML bottle) and added 250IU of HCG and also 1mg of Arimidex on Mondays and Thursdays for two weeks and then once a week going forward.

I would appreciate any input from the community.

Thanks!

 

[CoastWatcher]

All...

Definitely feeling a better on my protocol which currently is 50mg every 3.5 days...No HCG or Arimidex. Erections are stronger, morning wood has partially returned, mood is improved and feel decent in the gym but not much stronger.

My bloodwork was done 48 hours after my last shot. I would expect test levels to be much higher. Please see the attachments.

Dr just upped my dose to 180mg per week of test 90mg (.45ML from a 1ML bottle) and added 250IU of HCG and also 1mg of Arimidex on Mondays and Thursdays for two weeks and then once a week going forward.

I would appreciate any input from the community.

Thanks!

I have questions about your doctor's recent protocol adjustments. Given your low SHBG, I would expect that he'd have considered an EOD injection schedule. That's the underlying reason, I feel, you're not at a decent level. By ramping your total testosterone up, but leaving you on a schedule where you only inject twice a week, you're likely to see your free testosterone shoot up, along with your estradiol. It seems counterproductive.

The anastrozole dose is perfect - for a woman recovering from breast cancer. Two weeks at two milligrams a week will hammer your levels, even with the e2 rise that I'd expect to see given the increased T dose. Then, once you've crashed your levels, you will maintain them in the bargain basement with a dose of one milligram per week.

Not what I'd have expected.

 

[TRTinNY]

I have questions about your doctor's recent protocol adjustments. Given your low SHBG, I would expect that he'd have considered an EOD injection schedule. That's the underlying reason, I feel, you're not at a decent level. By ramping your total testosterone up, but leaving you on a schedule where you only inject twice a week, you're likely to see your free testosterone shoot up, along with your estradiol. It seems counterproductive.

The anastrozole dose is perfect - for a woman recovering from breast cancer. Two weeks at two milligrams a week will hammer your levels, even with the e2 rise that I'd expect to see given the increased T dose. Then, once you've crashed your levels, you will maintain them in the bargain basement with a dose of one milligram per week.

Not what I'd have expected.

Thank you for the quick response...

Without sounding silly...Could you be more specific about what you think I should be altering about my protocol so I can have a more pointed discussion with the doctor? I currently inject Tuesday mornings and Friday evenings.

 

[CoastWatcher]

Thank you for the quick response...

Without sounding silly...Could you be more specific about what you think I should be altering about my protocol so I can have a more pointed discussion with the doctor? I currently inject Tuesday mornings and Friday evenings.

You have very low SHBG. That contributes to the very low levels of testosterone you posted. In goes the testosterone, and out goes the testosterone. That's just the way it works with low SHBG. How to deal with it? Not by ampimg up your testosterone dose, but by increasing the number of times per week you inject (which may or may not require a dose increase). We see it again and again - low SHBG is overcome with small, frequent injections. I have the same issue and inject 16mg of testosterone enanthate every morning; my total testosterone is over 1000. This is a fundamental approach to a patient with low SHBG - which a good doctor should know.

Why are you even being prescribed anastrozole, and why did the doctor you consult possibly order the incorrect test? Was that the sensitive LC, MS/MS assay? Any other test is not to be relied on in men. The result you posted, though possibly inaccurate, wasn't elevated. What high e2 symptoms are you presenting with? Estradiol is NOT a waste product - it's an essential hormone for male health (particularly sexual health). Your dose, two milligrams a week is four times the amount a man might initiate therapy with...if he needed it at all.

 

[TRTinNY]

You have very low SHBG. That contributes to the very low levels of testosterone you posted. In goes the testosterone, and out goes the testosterone. That's just the way it works with low SHBG. How to deal with it? Not by ampimg up your testosterone dose, but by increasing the number of times per week you inject (which may or may not require a dose increase). We see it again and again - low SHBG is overcome with small, frequent injections. I have the same issue and inject 16mg of testosterone enanthate every morning; my total testosterone is over 1000. This is a fundamental approach to a patient with low SHBG - which a good doctor should know.

Why are you even being prescribed anastrozole, and why did the doctor you consult possibly order the incorrect test? Was that the sensitive LC, MS/MS assay? Any other test is not to be relied on in men. The result you posted, though possibly inaccurate, wasn't elevated. What high e2 symptoms are you presenting with? Estradiol is NOT a waste product - it's an essential hormone for male health (particularly sexual health). Your dose, two milligrams a week is four times the amount a man might initiate therapy with...if he needed it at all.

He prescribed bc my nipples started getting a bit sensitive and i got flushed and overheated a few times randomly. Also, at first my erections were a bit better and they regressed a little bit. The E2 test was ultra sensitive.

Do you suggest i increase the frequency and up the dose? What do i do with my HCG dosing that i just started as well? Should i do every day? Every other day?

 

[CoastWatcher]

He prescribed bc my nipples started getting a bit sensitive and i got flushed and overheated a few times randomly. Also, at first my erections were a bit better and they regressed a little bit. The E2 test was ultra sensitive.

Do you suggest i increase the frequency and up the dose? What do i do with my HCG dosing that i just started as well? Should i do every day? Every other day?

I would go to an every other day injection schedule. Forty milligrams of testosterone every other day is a reasonable starting dose on that sort of protocol and see how you respond, subjectively and with lab values, in four to six weeks. It's always easier if you "start low and go slow."

Nothing could persuade me to take two milligrams of anastrozole every week. I'd take no more than a quarter or half a milligram of AI (which means you'd need a compounding pharmacy to prepare your prescription)...if I even took that. Sensitive nipples are a routine part of TRT. Over three years in, I still have occasional bouts of itchy, sore nipples.

Thats a modest HCG dose. Did he explain why he chose it?

 

[TRTinNY]

When you say modest what do you mean by that and no he didn't.

 

[Vince Carter]

There's so much wrong here...CW has covered things brilliantly:

SHBG is going to dictate that you need EOD injections to get your numbers up.

You can't load dose Anastrozole like this 1mg twice per week and then 1mg once per week it doesn't work that way...and as stated, those are WHOPPER doses that are irresponsibly prescribed.

What I'd do...40mg EOD, 250iu HCG...NO Anastrozole. As noted as well, some itchy nips are totally normal especially early on as you are.

 

[Vince Carter]

..and then ultimately you've not really stated a real problem at two months in, your comments are largely positive,yet your Dr is totally starting you over with something completely different, taking you back to zero, as it were.

 

[CSI007]

I can't believe your Dr is going to change your protocol so radically even after you are making some progress. Regarding the AI, I need some and I am even reluctant to take it. As others have said, the dose he is proposing is an insane amount and any progress you made will quickly turn into a disaster. I suffered from low E2 for quite a while and it sucks. You don't want to go there. Regarding your nipples. Mine did the same thing when I started out. It's normal. Your body is adjusting to your new T levels. I couldn't put a shirt on without it bothering them. That is all passed now and they are back to normal.

Smooth out your peaks an valleys by increasing the frequency of your dose of T and I am willing to bet you will feel even better. I know I did and I didn't even get a significant increase in my total T lab tests as a result but just by having more in my system at any given time made me feel better.

 

[JMP]

Much has been said here and I agree with almost all of it. I think with the level of total test that you have after 2 months, you definitely need a dose increase. I don't think splitting the 100mg into 3-4 shots a week is going to bring you to 7-800+ Now, almost doubling it I think is not wise at all either. So why not split the difference with 140mg/wk split m/w/f or EOD. Increasing frequency to manage the low SHBG effects and raising your levels with the higher dose. Now that AI dose seems crazy to me and I would never take it. Your Estradiol sensitive is 32 which seem totally fine. Even if it goes to the low 40's with your dose change it would still be fine and not need an AI unless symptoms warranted. I would think sensitive nipples at this juncture should not be cause for alarm yet. Good luck getting dialed in, but what ever you do don't take that large dose of AI.

 

[JMP]

Also as far as HCG, common dosing seems to be 750-1000iu/wk. So 500 2x per week or 250 or 300 3x per week something like that.

 

[JMP]

Last thing just for a reference, I am 7 weeks in to TRT, started at 150mg/wk split m/w/f (shbg=22), HCG-300iu 3x/wk, no AI. I haven't gotten labs yet (due in a few weeks or so) but it is going very well so far. Moderate increase in muscle and strength (I lift weights 3x/wk). More motivation, morning and overnight erections most nights, more libido, calmer attitude. If I have any E sides it would be a small bit of water retention that I notice in my face but haven't gained more than a pound or two in body weight in 7 weeks. Maybe I am in the honeymoon period but I would think that you are not that far off of a good protocol.