Dialing in dosing: "Bottom-up" vs. "Top-down"?

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krm

Member
Hi guys, so after a few REALLY miserable days I got my blood drawn today for the doctors 6-week follow up.
He is absolutely inexperienced and put me on a really shitty protocol (discussed in other threads) of 125mg/E2W.

I've managed to convince him via email to at least agree to weekly injections, but he said "until we got the results stick with the prescribed dose".

Well, as it's my body and I know how I feel I'm sure as heck NOT going to stick with 60mg/week (I'm a top-top-top-of the range SHBG guy), so I'll adapt the protocol myself;

due to the fact that where I live (Switzerland) only 250mg ampoules are available (no rubber-top vials), him prescribing me 60mg/week basically means I'm getting 4x 250mg ampoules to draw 60 and throw 190 away.

Which means - for my "self-administered protocol", I'm basically free to choose anything between 0 and 250mg / week, as that's what I get with my prescription.

Given that I'm (literally) tired after MONTHS of getting to the point of getting a TRT prescription and now 6 weeks of a shitty protocol where I started feeling worse than before, I'm really tempted to "re-start" at the high end of this amount - e.g. 200mg / week - and get my own labs through an independent provider in a few weeks.

I was nor wondering about the pros and cons of "starting bottom up" (e.g. starting with 100mg/week and working up to a feel-good level) vs. "starting high" and reducing if I see any negative side effects (high E2 or whatever)?

Oh a sidenote, my E2 was BELOW what the lab could even measure before I got started with TRT, so I'm not too worried about E2, quite frankly...

Thanks! :)
 
Defy Medical TRT clinic doctor
Are you taking an AI? Your E should not be that low....that could be part of you feeling bad. Not to mention the crappy protocol.
 
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Hi, nope, never did... my levels were at the very bottom of the range the first time I ever tested them before starting TRT (actually, because I felt so shitty I thought I might have HIGH E for whatever reason) - then, when the doc did a LHRH stimulation test to see how my testicles are working E levels were tested again and came in "below detection range". That, plus the fact that my T levels were also below lab range, made the doc to start TRT....
 
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