Test Results: (3) Months on Test Cyp (IM) + HCG (SubQ)

[inco9nito99]

Hi all,

First time posting - quick background: I was diagnosed with Low T roughly about a year ago (making me 33yrs old at the time). I exhibited all of the typical symptoms - lethargy, trouble sleeping, ED symptoms, gain in BF, loss of confidence, depression, etc. Did a blood test and my results came back with my Testosterone at a mere 326 nG/DL.

At first, the doctor I was seeing only dealt with pellet therapy; needless to say after the first 'round' of inserting (11 x 200mg pellets) I decided that it wasn't right for me as there was no way to regulate the amount of exogenous testosterone that entered my bloodstream, plus it's super inconvenient during the healing process. After suggesting injections, my doctor refused so I went with another doctor.

With the new doctor, I was prescribed 11,000IU/10mL of HCG/water mix, 200mg/mL Test Cypionate, and 1mg Anastrozole. My regimen is as follows:

Monday - 1mg AI.
Tuesday - n/a
Wednesday - n/a
Thursday - n/a
Friday - 0.5mL HCG subcutaneously.
Saturday - 0.5mL HCG subcutaneously.
Sunday - 1mL Test Cyp in my glute.

After (3) months of following this protocol my test results are in as follows, and am looking for opinions/advice. Keep in mind that I had injected Test on a Sunday and the following Thursday I'd gone in for a blood test. This lab was ordered for me by my doctor, and I was provided a requisition number to get my blood drawn.






_____

Questions:
-After some research here, I'm debating whether I should administer (2) 0.5mL SubQ Test shots via my insulin syringes (holds 0.5mL at capacity) as opposed to (1) 1mL IM shot in efforts to reduce scar tissue in the long term, and help 'normalize' hormones throughout the week.

Can someone help me formulate a sustainable schedule that incorporates 1mL test and 1mL HCG per week?

Monday -
Tuesday -
Wednesday -
Thursday -
Friday -
Saturday -
Sunday -


Thanks fellas, look forward to learning more on this forum as time permits!


Best,

 

[Deleted member 16042]

I think your dosage info is a bit whacked.

for example, 11,000iu of HCG is typically mixed into 11ml of fluid. Dosing .5 ml of that solution would be abpout right at a 500iu dose, but both doses a day apart?

And your T dosage comments

"200mg/mL Test Cypionate"

"whether I should administer (2) 50cc SubQ Test shots"

which would be 10,000mg per dose


"as opposed to (1) 1mL IM shot "

which would be 200mg in a single dose.


So have you been prescribed 200mg once a week?

Also, your dosage frequency essentially should be based on your SHBG which is not shown in your labs.

Your estradiol is kind of low, but you didn't get the correct E2 test. So it's a shot in the dark without the right numbers, but you might be taking too much anastrazole.

It appears your dosing protocol is based on very outdated strategies and without some pertinent labwork, namely SHBG and the correct sensitive estradiol test..

 

[inco9nito99]

I think your dosage info is a bit whacked.

for example, 11,000iu of HCG is typically mixed into 11ml of fluid. Dosing .5 ml of that solution would be abpout right at a 500iu dose, but both doses a day apart?

And your T dosage comments

"200mg/mL Test Cypionate"

"whether I should administer (2) 50cc SubQ Test shots"

which would be 10,000mg per dose


"as opposed to (1) 1mL IM shot "

which would be 200mg in a single dose.


So have you been prescribed 200mg once a week?

Also, your dosage frequency essentially should be based on your SHBG which is not shown in your labs.

Your estradiol is kind of low, but you didn't get the correct E2 test. So it's a shot in the dark without the right numbers, but you might be taking too much anastrazole.

It appears your dosing protocol is based on very outdated strategies and without some pertinent labwork, namely SHBG and the correct sensitive estradiol test..

Edited for accuracy, thank you!

 

[Deleted member 16042]

BTW, your TSH above 2.0 indicates further followup for your thyroid would be advised. While the typical endo would consider it "in range" and tell you your thyroid's fine, that's not the prevailing wisdom of modern well informed hormone management.

 

[inco9nito99]

@Blackhawk thank you for that piece of advice. I'll make sure to bring it up with my Endo.

As per the remaining results and the idea of splitting my once a week to twice a week...thoughts?

 

[Deleted member 16042]

@Blackhawk thank you for that piece of advice. I'll make sure to bring it up with my Endo.

As per the remaining results and the idea of splitting my once a week to twice a week...thoughts?

Splitting to 2 or 3x/week can even out peaks and troughs, and going to 2x/week probably won't cause any extra problems, but the main reason for more frequent injections even as often as daily is low SHBG. You gotta have this number to base dosing frequency. Otherwise you are shooting with a blindfold on.

Injecting subQ vs IM is pretty much personal preference. Some guys get lumps in fatty tissue with SubQ, some get pain from IM. I am the latter and do SubQ with a 30g 5/16" needle. I have no trouble with lumps from SubQ injection and my T levels on subQ are just fine.

And as mentioned, the typical endo will deny any problem with TSH at 3.8. You probably won't get any love on that point with your endo.

Based on your treatment protocol and lack of pertinent labs, it sounds to me like your endo is of the typical sort who really doesn't know how to manage TRT and Thyroid up to modern standards.

 

[CoastWatcher]

The appropriate time to test is just prior to an injection. You want to capture testosterone, total and free, at trough to see how well your body is sustaining your protocol over the week. That means very few conclusions can be drawn from what is presented.

 

[inco9nito99]

The appropriate time to test is just prior to an injection. You want to capture testosterone, total and free, at trough to see how well your body is sustaining your protocol over the week. That means very few conclusions can be drawn from what is presented.

To this, I was told by my doctor to visit LabCorp 4-5 days after an injection. I had injected 1mL on Sunday and gone in on a Thursday morning.

 

[inco9nito99]

And as mentioned, the typical endo will deny any problem with TSH at 3.8. You probably won't get any love on that point with your endo.

Based on your treatment protocol and lack of pertinent labs, it sounds to me like your endo is of the typical sort who really doesn't know how to manage TRT and Thyroid up to modern standards.

I spoke to my doctor (who's local) and he said my numbers look great and to stick with (1) IM weekly with the current protocol/regimen of TRT/HCG. He said the other labs aren't really needed (Estradiol [Sensitive] and this SHBG test ). This is my first time experimenting with this doctor, but may have to look elsewhere from what I'm hearing.

I keep hearing about Defy Medical, (doesn't look like they have a Chicago branch) and/or Dr. Daniel S. Berger (who's in Chicago, but I've not researched).

 

[CoastWatcher]

To this, I was told by my doctor to visit LabCorp 4-5 days after an injection. I had injected 1mL on Sunday and gone in on a Thursday morning.

There are idiots, and then there are endocrine idiots. Testing as you were instructed to does nothing other than confirm that your body reflects the fact that exogenous testosterone entered your system...at some point. will it be at a therapeutic level when it's time for your next shot? Can't tell you - you don't know your SHBG and the next injection is two to five days away. Is estradiol going to be an issue? Not sure - "E follows T," and it won't have peaked until your testosterone is at trough.

Sadly, you're not the first member of EM to discover they are being poorly served by their doctor.

 

[CoastWatcher]

I spoke to my doctor (who's local) and he said my numbers look great and to stick with (1) IM weekly with the current protocol/regimen of TRT/HCG. He said the other labs aren't really needed (Estradiol [Sensitive] and this SHBG test ). This is my first time experimenting with this doctor, but may have to look elsewhere from what I'm hearing.

I keep hearing about Defy Medical, (doesn't look like they have a Chicago branch) and/or Dr. Daniel S. Berger (who's in Chicago, but I've not researched).

Defy is a national tele-health practice that treats many of our members. Call them and ask whatever you want - they won't dodge. Dr. Berger is a friend of Nelson's.

 

[CoastWatcher]

This study shows that SHBG isn't simply a nice-to-have.

https://www.excelmale.com/forum/sho...rum-Levels-and-Urges-Testing-for-TRT-Patients

 

[Deleted member 16042]

I don't disagree that there indeed are idiots in all walks of life, but (maybe I am wrong) seems to me that endocrinological idiocy is in large part just ignorance. They don't know any better, because they were never taught or they are still stuck in old methodology.

Anyway, inco9nito99, if you study this forum intently, you will no doubt know more about TRT than your endo in short order.

 

[CoastWatcher]

I don't disagree that there indeed are idiots in all walks of life, but (maybe I am wrong) seems to me that endocrinological idiocy is in large part just ignorance. They don't know any better, because they were never taught or they are still stuck in old methodology.

Anyway, inco9nito99, if you study this forum intently, you will no doubt know more about TRT than your endo in short order.

When two endocrinologists, one holding an endowed chair at a local medical school, both tell me that the study confirming a protocol calling for injections is "not relevant," that is idiocy. When the management of estradiol test is not even addressed in their most recently revised practice guidelines, that goes beyond an old methodology and qualifies as idiocy. As a body, and far too often as individuals, they lead men looking for hypogonadism relief down a trail ending in frustration.

Are there capable endocrinologists? Certainly. But not in the numbers that there should be. It is maddening to realize how so many men have been thwarted in their search for health by the group of doctors who, on paper, should be the most qualified to bring them help.