UPDATE // New Member w/TRT protocol from Defy. Please compare, critique and advise!

[readyforchange]

My pre-trt Estradiol was 19, so definitely on the low end (perhaps even dangerously so).

I was prescribed a similar initial protocol to yours, just with 2x weekly instead of m/w/f. Similarly, I was concerned about "blanket" inclusion of an AI, so I didn't take it the first week and injected HCG and Test.

Within one week, I gained 5+ pounds (likely from water retention), felt moody/PMS-like, had increased anxiety and a different kind of fatigue than what I had pre-trt, so I knew, E2 must be going high.

I'm young(ish-- 31, lean, workout and eat really healthy, but my E2 going high has been a constant battle (and as mentioned above, pre-trt there was no indication this would be an issue, considering a level of 19).

Bottom line: everyone is different and there's really no way to know how you'll react. It's not as simple as "I have a low pre-trt E2, so I won't need an AI", as much as we all wish it were.

In my opinion, the danger of crashing E2 is significant enough -- and more challenging to recover from -- than letting it go too high and then adding in an AI to bring it back down that I would start without it. You'll likely know very quickly whether or not you can get by without it. And if you can't, adding it in isn't too difficult.

With that said, I'd also caution against getting too gung-ho with deciding what to follow and not follow from your doctor at Defy, because of many end up in a situation where they're kinda-sorta following their advice while kinda-sorta tweaking things on their own and that's a recipe for disaster at some point.

Yes, it's a pill. I see it's the lowest dose but I also see it's very powerful and so I'm wary.

I have anxiety every so often. I'd say mild as I can think through it and be logical about things. I've had ED issues, lack of motivation and the other things I listed in the initial post. How would I know I need to take the Anastrozole if I start without it? Would I be waiting for sensitive nipples or something like that?

 

[ratbag]

You didn't add the ranges to your labs. For example SHBG is very different from Quest than it is for Labcorp and if we can't make that distinction then we have no idea and are really unable to comment on your protocol. Always post your ranges with your lab results

 

[Santana]

You didn't add the ranges to your labs. For example SHBG is very different from Quest than it is for Labcorp and if we can't make that distinction then we have no idea and are really unable to comment on your protocol. Always post your ranges with your lab results

Noted. Thanks for that. Labs were done with LabCorp. Here are my numbers with ranges, I'll update on original post:

Testosterone, Serum ..... (264 - 916 ng/dL) ........ 197
Testosterone, Free ......... (8.7 - 25.1 pg/nL) ....... 6.4
DHEA .......................... (102.6 - 416.3 ug/dL) ... 235
TSH ............................ (0.450 - 4.500 uIU/mL) . 1.25
LH .............................. (1.7 - 8.6 mIU/mL) ....... 5.2
IGF-1 .......................... (88 - 246 ng/mL) ......... 216
Estradiol, Sensitive ........ (8 - 35 pg/mL) ............ 21.9
SBGH .......................... (16.5 - 55.9 nmol/L) ..... 23.7

 

[CoastWatcher]

I'm in agreement with the comments regarding anastrozole. However, what was the tone of the discussion when you spoke with Defy about your anxieties during your consultation?

 

[Santana]

I'm in agreement with the comments regarding anastrozole. However, what was the tone of the discussion when you spoke with Defy about your anxieties during your consultation?

DHEA was highlighted as a strong possibility for mild anxieties (specifically my tendency to overworry) and trouble falling asleep. My DHEA came in at 235. Maybe this number, while not very low, might contribute to these symptoms when in conjunction with the Low T but not by itself? I did not think to ask this question. I was happy to hear him describe symptoms caused (or exacerbated) by lowish DHEA because they mirrored my own - such as losing erection strength when changing positions.

This was all new to me, I never thought to care about DHEA or knew it could be related to anything affecting me outside of Low T. My level is in the middle of the normal range but the doctor said that around 400 would show positive changes, this would be at the top end of the normal range. I was suggested to take 25mg nightly.

 

[WrenchHead80]

DHEA was highlighted as a strong possibility for mild anxieties (specifically my tendency to overworry) and trouble falling asleep. My DHEA came in at 235. Maybe this number, while not very low, might contribute to these symptoms when in conjunction with the Low T but not by itself? I did not think to ask this question. I was happy to hear him describe symptoms caused (or exacerbated) by lowish DHEA because they mirrored my own - such as losing erection strength when changing positions.

This was all new to me, I never thought to care about DHEA or knew it could be related to anything affecting me outside of Low T. My level is in the middle of the normal range but the doctor said that around 400 would show positive changes, this would be at the top end of the normal range. I was suggested to take 25mg nightly.

Hi, Just wanted to add not to stress about the anxiety. I used to suffer bad panic attacks and between that and no energy, they were the reasons I started TRT. After finding this place and changing my protocol to yours (their very similar) my anxiety went away the first time in my life. We also share the same DHEA, pre T numbers ect and were almost the same age. Only difference looks to be your thyroid is in a lot better shape then mine. So your lucky you don't have to worry about that. Also be glad your using Defy to start. I started at two bad places before I found Defy. Best of luck to you and again don't stress over the anxiety being a problem.

BTW-> Thanks for mentioning the DHEA thing. I'm surprised they never offered that to me since I mentioned I suffer the same thing as you and my DHEA number is exactly like yours too. Need to look into DHEA for myself. Just happened to be reading a article from Dr. Crisler about it today.

 

[Kirk001]

Why "based on my SHBG"? I know the pre-TRT level helps determine but I don't understand why.

Lower SHBG like yours usually means more frequent injections at smaller doses. Higher SHBG, less frequent injections at higher doses.

 

[Santana]

Hi, Just wanted to add not to stress about the anxiety. I used to suffer bad panic attacks and between that and no energy, they were the reasons I started TRT. After finding this place and changing my protocol to yours (their very similar) my anxiety went away the first time in my life. We also share the same DHEA, pre T numbers ect and were almost the same age. Only difference looks to be your thyroid is in a lot better shape then mine. So your lucky you don't have to worry about that. Also be glad your using Defy to start. I started at two bad places before I found Defy. Best of luck to you and again don't stress over the anxiety being a problem.

BTW-> Thanks for mentioning the DHEA thing. I'm surprised they never offered that to me since I mentioned I suffer the same thing as you and my DHEA number is exactly like yours too. Need to look into DHEA for myself. Just happened to be reading a article from Dr. Crisler about it today.

Thank you for your input! Never got panic attacks but definite anxiety at times. I think I'll hold off on adding the DHEA until I see my first labs after starting the protocol. Wouldn't DHEA move one way or another due to the other changes going on? Plus it would give me a sense of how DHEA itself would make me feel and not confuse it's effects with the other drugs.

 

[Santana]

My pre-trt Estradiol was 19, so definitely on the low end (perhaps even dangerously so).

I was prescribed a similar initial protocol to yours, just with 2x weekly instead of m/w/f. Similarly, I was concerned about "blanket" inclusion of an AI, so I didn't take it the first week and injected HCG and Test.

Within one week, I gained 5+ pounds (likely from water retention), felt moody/PMS-like, had increased anxiety and a different kind of fatigue than what I had pre-trt, so I knew, E2 must be going high.

I'm young(ish-- 31, lean, workout and eat really healthy, but my E2 going high has been a constant battle (and as mentioned above, pre-trt there was no indication this would be an issue, considering a level of 19).

Bottom line: everyone is different and there's really no way to know how you'll react. It's not as simple as "I have a low pre-trt E2, so I won't need an AI", as much as we all wish it were.

In my opinion, the danger of crashing E2 is significant enough -- and more challenging to recover from -- than letting it go too high and then adding in an AI to bring it back down that I would start without it. You'll likely know very quickly whether or not you can get by without it. And if you can't, adding it in isn't too difficult.

With that said, I'd also caution against getting too gung-ho with deciding what to follow and not follow from your doctor at Defy, because of many end up in a situation where they're kinda-sorta following their advice while kinda-sorta tweaking things on their own and that's a recipe for disaster at some point.

Love to find people with similar profiles pre-TRT. Thank you. I called Defy today and was told that I can keep it aside to use in case I feel I need it. I was inclined to go this route, anyway, but wanted to see what Defy would say. Did you end up using it regularly or "as needed"?

 

[Santana]

I think your protocol looks okay based on your SHBG but I personally don't like the anastrozole built into your solution right off the bat. Your Estradiol Sensitive is sitting at just under 22 on pre-TRT labs and I wouldn't want to see it go lower. A small amount of anastrozole can make a big difference in lowering your estradiol further. But, I am not a doctor, just a simple layman.

This was a big worry for me. I called Defy and was told I can use as needed. I will go this route and be very careful with it.

 

[readyforchange]

I used it consistently for most of the past year. At a Test Cyp dose of 70mg and HCG of 500 IU's (2x weekly), I needed .25 anastrozole twice per week (same day as injections) to get E2 in high 20s. With .125 anastrzole twice per week, I was up in the 50's for estradiol and felt it (another example of pre-trt labs not meaning a whole lot in terms of where things like E will go).

My biggest drawback from going the "as needed" route is that, at least for me, it hasn't always been easy to tell by feel. I've suspected high E multiple times and had labs confirm it... but there have also been a time or two I coulda swore I had low E because it felt different and it came back high (like 50's-60's high), so it's not always so simple to tell.

Love to find people with similar profiles pre-TRT. Thank you. I called Defy today and was told that I can keep it aside to use in case I feel I need it. I was inclined to go this route, anyway, but wanted to see what Defy would say. Did you end up using it regularly or "as needed"?

 

[WrenchHead80]

Thank you for your input! Never got panic attacks but definite anxiety at times. I think I'll hold off on adding the DHEA until I see my first labs after starting the protocol. Wouldn't DHEA move one way or another due to the other changes going on? Plus it would give me a sense of how DHEA itself would make me feel and not confuse it's effects with the other drugs.

Mine never moved, but everyone is different. It has been said many times here when you start a few things at the same time you wont be able to tell whats helping or hurting, so I can see waiting till you've been on Test / HCG for at least six weeks and see how you feel then. By that time you'll have labs to confirm where your DHEA is at too. I'd discuss it with Defy and see what they or others here think. I do think it is a good idea to start Test and HCG at the same time though.

 

[Santana]

I want to thank everyone for their input, suggestions and for sharing your experiences! I took my first shots yesterday. Did T Cyp and HCG subcutaneous into the stomach fat. Was nervous because I do not have much fat anywhere, lost a tiny bit of "man oil" but seems to have been done right.

Last night, roughly 12 hours post injection, my libido showed up. While I would still get erections every morning pre-TRT, it would be difficult at night and desire was never really there morning or night. So not only an erection when lounging in bed with the wife but libido was there in a way I haven't felt in years.

Didn't think I would feel anything or notice any changes until at least a few more days?

As mentioned before, and from the advice of members here and Defy's agreement, I skipped the Anastrozole.

 

[callebs]

Definitely keep us posted. I received a similar protocol from Defy but haven't started yet. I'm especially interested to see if it helps with your brain fog, anxiety and fatigue, as those are the issues plaguing me the worst right now.

 

[Santana]

How common is trouble sleeping after staying TRT?

I've had trouble sleeping since my early 20s. A year ago I started vaping cannabis - biggest quality of life adjustment I have ever made. I could fall asleep and sleep deeply consistently for the first time in my life.

Today is day 4 since I started TRT. I did my second injections yesterday morning. I had not slept well for two nights prior to last night but it was my fault for staying up late. Yesterday I was exhausted. So tired I could barely finish dinner. Strangely, it took me long to fall asleep and it was not deep sleep at all. This is after the cannabis that would knock me out, especially on a night like that.

Anybody else experience trouble sleeping after starting TRT?

 

[Systemlord]

How common is trouble sleeping after staying TRT?

I've had trouble sleeping since my early 20s. A year ago I started vaping cannabis - biggest quality of life adjustment I have ever made. I could fall asleep and sleep deeply consistently for the first time in my life.

Today is day 4 since I started TRT. I did my second injections yesterday morning. I had not slept well for two nights prior to last night but it was my fault for staying up late. Yesterday I was exhausted. So tired I could barely finish dinner. Strangely, it took me long to fall asleep and it was not deep sleep at all. This is after the cannabis that would knock me out, especially on a night like that.

Anybody else experience trouble sleeping after starting TRT?

You only just started TRT, if you thought you were going to see immediate results think again. Normally it takes 6 weeks to reach a stable state and longer for gene expression to occur. TRT is a marathon, not a sprint.

 

[Santana]

You only just started TRT, if you thought you were going to see immediate results think again. Normally it takes 6 weeks to reach a stable state and longer for gene expression to occur. TRT is a marathon, not a sprint.

Thank you for your input, I understand this but was wondering if this was a common issue when starting TRT. I guess a lot of things can change or be unusual until a new normal is achieved.

 

[WrenchHead80]

How common is trouble sleeping after staying TRT?

I've had trouble sleeping since my early 20s. A year ago I started vaping cannabis - biggest quality of life adjustment I have ever made. I could fall asleep and sleep deeply consistently for the first time in my life.

Today is day 4 since I started TRT. I did my second injections yesterday morning. I had not slept well for two nights prior to last night but it was my fault for staying up late. Yesterday I was exhausted. So tired I could barely finish dinner. Strangely, it took me long to fall asleep and it was not deep sleep at all. This is after the cannabis that would knock me out, especially on a night like that.

Anybody else experience trouble sleeping after starting TRT?

Here's my theory based on you saying vaping cannabis has helped you so much with your sleep and you saying now only a few days into starting T you can't sleep. Being only two shots in since you started, little is actually happening yet, so that tells me its in your head. You have a over active mind, its normal. A lot of people I know who have problems sleeping have them because they can't shut down their minds to sleep. Your on constant repeat thinking whatever it is you think about and you cant sleep. You smoke weed that repeat loop shuts off. Like they say weed effects short term memory. You probably started sleeping fine cause you stopped dwelling on or repeating whatever it is your thinking about when you should be relaxing and falling asleep.

Now you started taking something you have never taken before and your probably over analyzing everything since this is all new to you. I know when I started, for the first week I was waiting for something to happen lol, what I don't know lol. Try to relax and stay positive. People read some negative effects others have and they start worrying if they will have them. I know I did. Your starting off with a great clinic to work with and a good protocol. Plus you found a great forum early on to help. I had a nightmare of a start going from to little to too much doses with both places being clueless with what they were doing and even I didn't have a horrible mental or physical problem. Didn't feel good at times but it was bearable. So you wont even have to deal with any of that. I'm sure you'll do fine. Also you do have low numbers to start with so your body will be going threw changes as it fixes itself which takes time as others mentioned.

BTW-> You said your doing M W F shots. Are you doing them the same time everyday? Cause you should do them Mon morning, Wed afternoon and Fr evening if you want them evenly spaced out. If you did them the same time every time you will have more of a gap over the weekend. Not the end of the world though.

 

[sh1973]

For what it's worth, I've been on TRT several years and had levels from one end of the spectrum to the other. With that said, if my total t is over 1000ng, I can barely sleep even with Ambien. I have much higher shbg than you, so its not really comparing apples to apples. There are many men that state the same regarding high t levels. You are on a hefty dose for starting out and not really sure I'd be taking the AI without symptoms, because these can lead to bad side effects, been there done that.

 

[WrenchHead80]

For what it's worth, I've been on TRT several years and had levels from one end of the spectrum to the other. With that said, if my total t is over 1000ng, I can barely sleep even with Ambien. I have much higher shbg than you, so its not really comparing apples to apples. There are many men that state the same regarding high t levels. You are on a hefty dose for starting out and not really sure I'd be taking the AI without symptoms, because these can lead to bad side effects, been there done that.

I don't think I would call 150mg a week spaced out in three shots a "huge" dose. Their has been many people that started with protocols of 200mg a week in one shot from doctors that didn't know any better. You can include me. Most including me, lowered their dose on the recommendation of members here explaining why staying on such a dose long term isn't a great idea. These people never felt horrible though, they lowered it to be on the safe side.

From all my reading here it doesn't sound like any members first protocol was the one they ended up sticking with. Its trial and error or just trying different things to see how they work for you. You do have to give sufficient time though for each protocol before switching things though. So ride it out on your current protocol and see how you feel and what your numbers look like. I look at your current protocol as your high side protocol. If you end up not liking it you can try a lower dose per week or go to daily shots.