My history with trt replacement isnt long but I feel its long enough. Started in adolescense but never did it regularly then. My doctor really didnt know what he was doing considering he was injecting me once monthly but it was understandable considering my age att.
Now I am trying to be serious about hormone optimization since I still had low T. I do not remember the exact level but it was in the 200s. In april I was on clomid and arimidex but I felt they were prone to giving me mood swings. Regardless the blood test back in May showed a spike to 900-something but I still didnt feel “vigor”. Starting either early July or late June, I am now injecting once a week of 1mL of Test Cypionate 200 mg/mL as well as 0.75 mL of HCG . However even now I am not entirely sure if there is any marked change. My current health reports also suggest that I may have something wrong with my thyroid and for a time I was pre-diabetic, I no longer am, but my insulin resistance might still be high. Various sources say I need to inject more or something because of these factors but Im not sure. I think they might be right since I still dont feel that much different despite the higher numbers. With no marked change and all these factors that might be in the way, Im starting to believe I may not be made for this or something. Im trying not to feel discouraged.
What should I do? How can I make sure its working correctly? Is this hopeless?
Lots of speculation and no labs. What do you expect from us? I don’t like your protocol, likely too much T. Your HCG is a volume listed and not a dose. What are you injecting?
If you have been on the current protocol awhile and feel decent, get labs done before changing anything. Include TT, Free T, SHBG, E2, DHT, and Prolactin. No need to test FSH/LH since you are on T. Did you have thyroid labs done already?
You need to measure SHBG, this will determine your injection frequency. You say you’re not made for TRT but I think it’s your terrible protocols your doctors are putting you on. Once weekly injections is a problem for most men, levels peak and start falling after only a few days and levels are lower by the end of the week, we call this the hormonal roller coaster.
You need a hormone specialist, not some garden variety endocrinologists. Insurance is almost completely useless for TRT, I went through several doctors and none of them knew much of anything about TRT. I went private and the level of care I’m receiving now is top notch.
Do not start taking more than 200mg weekly. If you are not feeling sides of increased test levels at that dose, at least for a few days after the shot, you have something else going on that needs to be addressed.
I would cut the dosage back a bit, and split it into two injections per week.
Your SHBG is on the lower side, and you may feel a bit better with more frequent injections.
Read the stickies for the TRT section. They are a great help.
You may not be feeling anything based upon your current estradiol level. Some men need it lower to feel the effects of TRT. SPlitting your dose into 2 injections/week will help to lower it as well.
I would start there and report back in 4-6 weeks. TRT takes a lot of time to dial in what feels best. I’m well over a year on it and still tinkering.
Unless you are hyper metabolizing testosterone or a hyper excreter, then 200mg weekly will end in failure as it’s just too much Test for the majority of men. Your somewhat low SHBG drives the above point home I would hope.
You would do much better on smaller doses EOD, this will better control hematocrit and keep estrogen at bay and provide more stable levels and you feel good as a result.
I inject 20mg EOD and feel way better than twice weekly and estrogen is lower and more manageable. I still require .0625 anastrozole EOD together with my injections to keep estrogen from being too high.
We need recent labs, not labs from in May. The only way you’re ever going to feel normal again is if you seek the care of an expert hormone doctor. You’re supposed to do labs 6 weeks after changing your TRT protocol.
You can’t do this on your own and you can’t keep going to a doctor that doesn’t have any clue. I thought I could do this on my own, I was wrong.
You don’t take anastrozole once weekly, it’s half life is 2 days so by the end of the week it’s cleared out of your system. Twice weekly at a minimum.
You really need to stop perpetuating this myth. @physioLojik has dispelled this multiple times. I’m personally on 250/week and feel great. I’ve been on over 1000/week for extended periods with no ill effect. He has also shown that high E2 in the presence of high Test is good, its high E2 in the presence of low Test that is bad and creates problems.
What do you consider high estrogen? High estrogen in the presents of symptoms is a problem that needs a solution. Most guys come here who are broken and have many systems not functioning optimally that is ripe for estrogen conversion, not men who are in the prime of their life.
You take a guy who is in perfect shape and put him above ranges and most likely he will do fine.
We are not talking about all men. There’s nothing wrong with taking thing slow.
These were my lab results in July. As you can see my Estrogen is high but when coupled with my level of Test (at trough), I have no symptoms, no gyno, awesome libido and erections.
Testosterone, Total 852.4ng/dL Range 264.0 - 916
Free Testosterone (Direct) 28.9 pg/mL. Range 7.2 - 24.0
Estradiol Roche ECLIA methodology 66.9 pg/mL. Range 7.6 - 42.6
You’re stating that your estrogen is high, you don’t know that. I see you’re using the incorrect methodology for measuring E2 for men, it’s more likely that your estrogen is in range and not high at all. You can’t really pay attention to the ECLIA methodology, very little accuracy especially when scoring higher.
So your idea that high estrogen and zero symptoms in your case is invalid just like the ECLIA methodology.
Fine. My point was and is…is that you are espousing a max of about 100/week telling these new TRT users that anything over is detrimental to their health. As I said in my first post, a very qualified endo who practices what he preaches has shown that just isnt true. He also insists against AI and only uses SERMS like Nolvadex.
I never stated a max of 100mg/week, I state that it’s a good “starting point” instead of starting out at 200mg/week and then having to back down the dosage because it’s too high.
It’s clear you don’t spend much time here, rinse and repeat I see guys coming in here who were started out too high and are experiencing symptoms as a result. These guys often feel better after lowering their dosages.
You are the exception to the rule, far from the norm.
I’m allowed to have a my own opinion and shouldn’t be attacked for it, notice how I didn’t attack you or call BS on your point of view. I disagreed and explained why in a mature manor, you’re entitled to your viewpoint, so am I.
Forgive me if I don’t get on my hands and knees everytime an endo graces this forum, I appreciate their knowledge and contributions, I will agree with most things, but not on everything.
Having a difference of opinion doesn’t equal bullshit, to think so is childish.