What are your thoughts about these results

[Bjjpapi]

These results are after 6 weeks of 60mg testosterone cypionate twice a week and 500 of HCG three times a week. I started out with estradiol at 37 and my doctor prescribed Anastrozole .5mg twice a week. I only took anastrozole for the first week and needed sleep throughout the day, every day that week and the following week.

HRP definitely improved my mood and Libido. I still feel “low energy/low motivation” and I’m wondering if an increase in test cyp might help (any other suggestions would be helpful as well). Aside from the initial fatigue while taking anastrozole for the first week I haven’t had any side effects except for a considerable increase in blood pressure since starting therapy (from 120/76 to 166/110).

Any advice/recommendations are appreciated

Thank you for your help

 

[Vince Carter]

I wouldnt raise the dose but would rather see the E2 come way down from the 50s though .5mg of Anastrozole is a fairly hefty dose, more common is .125 or as much as .25mg. I'd rather see you get in to the 20s with new labs and then judge it on symptoms.

 

[Systemlord]

These results are after 6 weeks of 60mg testosterone cypionate twice a week and 500 of HCG three times a week. I started out with estradiol at 37 and my doctor prescribed Anastrozole .5mg twice a week.

Your SHBG is the elephant in the room, your protocol is not optimal, low SHBG men tend to do better on ED and EOD protocols. HCG is increasing estrogen then needing an AI to compensate. Assuming HCG is for fertility and/or testicle shrinkage, you may pay a price for using HCG which can cause mood and libido problems.

Add to the fact that some men do not tolerate anastrozole well, taking away more benefits of TRT and if HCG is causing mood problems decreasing the benefits of TRT further. This is why I always recommended starting TRT in isolation.

 

[Gman86]

Ideally, I would say drop the HCG all together, raise your testosterone dose, and switch to EOD injections. Your free T is almost optimal, or possibly already optimal, but your DHT is probably too low. Raising your testosterone dose would raise both. But your E2 is already pretty high for your SHBG level, so while on the HCG, I wouldn’t raise your testosterone dose anymore, unless you don’t mind implementing an ai. But trying to avoid an ai, if possible, is usually always the smarter route. I would only use an ai if you exhausted all other options. That’s just my current opinion though on ai’s.

Another option, would be to stick to the protocol you’re on, and add in a small dose of testosterone cream applied to your testicles. That should raise T a bit, raise DHT nicely, and minimize any increase in E2.

What are you primarily using the HCG for, fertility?

 

[Vince Carter]

That is a rather high dose of HCG, good in pointing that out and the possible aromatase though I doubt that an HCG adjustment or elimination is going to resolve the E issue(s).

 

[Bjjpapi]

HCG is just what I was told to take along with Test Cyp and anastrozole. My testicle size and fertility are at the bottom of my list of priorities. If possible I’d like to keep regular sized but if it means optimizing my numbers without touching an AI I’m willing to drop the HCG. I thought HCG acted like LH and FSH in helping provide other hormones created from them downstream.

I thought high SHBG guys were better responders to more frequent smaller doses, not the other way around. I can definitely give more frequent shots a try.

Another question I have is if you guys think I need to have my LH and FSH tested...I ordered the elite male test through discounted labs and didn’t realize those weren’t tested. Is there a need to test it? I already sent the lab work to my Doc so if she wants to see it I can do it. They also pushed my second visit from late this month to 8/12 .

If I start EOD test CYP at say 25mg and drop the HCG completely do you guys think my estradiol will come down? Any Idea What might be causing the uptick in BP?

 

[Systemlord]

My testicle size and fertility are at the bottom of my list of priorities.

Not everyone will see their testicles shrink more than 20-30%, you are attempting to fix something we do not even know is broken. Yes HCG helps other downstream hormones, but what if these hormones are enough, maybe we are creating problems where none exists.

I thought high SHBG guys were better responders to more frequent smaller doses, not the other way around. I can definitely give more frequent shots a try.

There are plenty of men with high SHBG injecting frequently and doing fine, everyone is different.

Another question I have is if you guys think I need to have my LH and FSH tested.

HCG mimic LH, it doesn't replace it.

If I start EOD test CYP at say 25mg and drop the HCG completely do you guys think my estradiol will come down?

It's more than likely estrogen will decrease significantly.

Any Idea What might be causing the uptick in BP?

HCG has been known to cause BP issues, excess testosterone and estrogen cause also cause problems.

A potassium deficiency and water retention can cause BP issues.

 

[Gman86]

Low SHBG primarily benefit from more frequent injections, but more frequent injections are preferred for pretty much everybody, regardless of SHBG. But for very low SHBG guys like yourself, it’s basically mandatory to inject ED or EOD.

Testing LH and FSH is pointless while on HRT, regardless of you’re on HCG or not. They’re both going to come back at basically zero. Literally no point to test them. They only need to be tested if you are natural and not on HRT.

If I were you, I would personally keep your testosterone dose the same, and just drop HCG. Then get labs done in about a month. There’s a few reasons for keeping it the same, and only changing one variable at a time. In this case, the variable is HCG. So doing this will tell u whether HCG adds to your total T or not, whether it contributes greatly to an increase in E2, and most importantly will be able to see whether you lose any benefits. If you see a decline in any benefits, you then basically know that HCG adds some positive effects to HRT for you, and you can then add in back in at a small dose, and titrate the dose up if needed. Changing your testosterone dose, and dropping your HCG, at the same time, is problematic because if you notice some benefits, or notice some negatives, you have no clue whether it’s because of dropping the HCG or the increase in your testosterone dose. Trust me, this is easier said than done, and takes patience, but it’s the right way to do it.

 

[Gman86]

Also, don’t do 25mg EOD, your free T and DHT would be too low. If you keep your testosterone dose of 120mg/ week, it would equate to 34mg EOD.

 

[Bjjpapi]

Thank you for your help guys, I really appreciate it!!