Finding a Dosage Sweet Spot

Hi folks. I just gave myself my first TRT shot last night after a battle to get the prescription. For a brief background, I’m 30, 6’2", 205, been suffering from low T for a few years before I realized I wasn’t just depressed. I had ED, difficulty gaining muscle, depression, poor response to stress, and fatigue. My levels were at the bottom of the range before I started treatment, never higher than 320ng/dL (scale 240-1080). SHBG and E2 were normal before starting treatment. LH and FSH also in range, so I guess I have secondary hypogonadism.

I tried Androgel first. 2 pumps/day made me feel better mood and energy-wise. I got some relief from ED symptoms and felt better in the gym than I had in years. My levels never came up particularly high and the endo I was seeing at the time suggested we try 4 pumps/day. I started having some symptoms of estrogenic side effects-- flushing around the face/neck, fat deposits around my chest (always been lean there), water retention, etc. My levels still never got very high and so the endo suggested shots. He gave me a 200mg shot of cyp on 7/12, to which I had a terrible reaction. I got major water retention, fatigue, and mood disturbance. I gained about 10lbs of water in the first 3 days and felt like absolute crap. The endo was not helpful when I called to complain about sides. They told me they weren’t related to the shot (ridiculous) and were not receptive to smaller/more frequent dosing and so I essentially fired him and went back to my regular physician, who at least is reasonable. The endo even told me that measuring E2 was not important! My physician gave me a 100mg shot, which made me feel a bit better but I still had some sides-- water retention, brain fog, and lethargy. I finally got a prescription for cyp and picked it up yesterday. Victory!

I guess what I’m wondering is this: I have always been sensitive to medicine and seem to metabolize things very quickly. I always need smaller doses of meds, and the 2 pumps of Androgel was way better than 4. Since both larger shots didn’t work for me, should I assume that 100mg/week is the right amount? Or should I try less? I did some looking on half-life calculators, and since I felt better 10 days after the 200mg shot and about 5-6 days after the 100mg shot, am I right to hypothesize that whatever is left in my blood then reflects a pretty good sweet spot for me? After looking at those calculators, it looks like about 70mg/week would get me to those levels once blood levels stabilize. I have insulin pins and am planning on a Monday/Thursday injection schedule. I just did my first shot of 35mg last night into my delt, and on a side note, insulin pins are SO the way to go-- easy and quick and infinitely better than the 1.5" needles the docs use in the office.

If I’m not thinking about my sweet spot correctly, what other considerations should I keep in mind? I don’t want to have to use an AI and would like to find the smallest weekly dose that gets me feeling good. Where have some of you found a sweet spot? What tips can you offer me?

Thanks!

100mg is pretty common. Given your reaction to the 200mg, it’s probably in the ball park.

Cutting sides (other than directly addressing them… beat the crap out of the doc who doesn’t want to measure E2… no room for that kind of thinking) will be a matter of spreading the 100mg out over the week. The overall effect on your test levels will be about the same, but it will reduce the peaking that causes the bad E2 levels and their sides.

Nothing hurt by trying it… you are still in the prescription amount (the 100mg per week being key). Might reduce sides.

But ya gotta get that E2 level registered and tracked. You can’t really tell how much of any AI you need without it.