Hello all, new here.
I just recently went to a hormone replacement/anti-aging type clinic in my area. Based off word of mouth and google reviews it seemed like a pretty reputable place so I went in to get my T levels checked as I suspected they may be low.
Sure enough my Total T came back at 215 ng/dl and my Free T was 4.95 ng/dl. I am 37 years old and in relatively good shape btw. I believe that the low T is due to at least two factors. One, I took some prohormones in 2012 and 2013 (Androlean and Androhard from Primordial Performance). Two, I am borderline hypothyroid and that is probably genetic as my dad is also hypothyroid (I take a small dose of levothyroxide for this and have for the past year).
The doctor prescribed 200mg of Testosterone Cyp, to be injected once a week. Along with 0.5 mg of Anastrozole twice a week and a sublingual HCG tablet of 1000iu, also twice a week. It’s my understanding that the Rx grade sublingual HCG tablet works, though is less effective than an injection, hence the larger dose. Anyone who would like to chime in on that, I would love to hear your thoughts, especially those who have tried both the injection and oral.
After getting home and doing some additional research I found that 200mg of the Test once a week to start off with is a little high. Especially for me personally, as I have been known to be hypersensitive to prescription drugs. The smallest doses seem to have an effect on me.
Based off the research I have been doing it seems like starting with 50mg, twice a week is a much better plan. Then work my way up from there if needed. Thoughts?
However my real question is, if I do adjust the test dose then what should I do about the dosage of the Anastrozole and HCG? The problem is that both are tablets. The Anastrozole is not split in the middle for convenient breaking and the HCG is a dissolvable tablet so breaking the pills in half isn’t really an option. Any dosage adjustments would just have to be take more or less frequently. Also it should be mentioned that this clinic send you a 5 months supply of the Anastrozole and HCG, which I have already received, so getting a different dosage isn’t really an option for now.
So what do you guys think? Is the following dosing and protocol okay to start off with or should it be adjusted?
Test Cyp - 50mg injected twice a week
Anastrozole - 0.5mg taken orally twice a week
HCG Sublingual - 1000iu taken orally twice a week
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If these are the only labs you have then you aren’t receiving adequate care, your SHBG will dictate injection frequency. So if you don’t have SHBG measured there’s no way I can tell you if this protocol is going to work out well for you.
It wouldn’t work well for me because my SHBG is low, so my response to TRT would be mediocre.
Never heard of oral HCG before.
My anastrozole is 0.050 and you can get compounded doses through compounding pharmacies if you work with well connected doctors. Your doctor doesn’t seem well connected.
It sounds like you are already ahead of the curve with your thoughts on Cyp dosage. If it were me, I would go the 50mg twice a week, spit the HCG dose in half (500iu twice per week), and put the Anastrozole on a high shelf and leave it alone.
You shouldn’t need the AI at 100mg per week unless you are getting high E2 sides.
X2 @systemlord on the SHBG needed to determine an accurate profile on frequency.
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I did get more labs done. The results of the entire endocrine evaluation portion of the labs are as follows:
FSH - 3.0 mIU/ml
LH - 5.0 mIU/ml
E2 - 23.6 pg/mL
DHEA-SULFATE - 185.2 ug/dl
DIHYDROTESTOSTERONE - 13.8 ng/dL
TESTOSTERONE TOTAL - 215 ng/dl
SHBG - 21 nmol/L
TESTOSTERONE FREE - 4.95 ng/dl
IGF-1 - 166.0 ng/mL
As far as getting different doses, I’m sure my doctor could have ordered any dose that I needed, however I am going to a clinic that orders several months worth of the prescriptions to be shipped to your house. I have 5 months worth of the HCG and Anastrozole already in my possession in the doses that I mentioned above.
Your SHBG is very close to my own, twice weekly injections didn’t provide good results because I was excreting a lot of my testosterone into my urine since SHBG is low. If I was to measure the testosterone level in my urine vs my blood, urine testosterone concentration would be way higher.
The lower the SHBG, the more frequent you must injection your testosterone.
Can you explain on SHBG affects your injection frequency? My understanding is that SHBG inhibits Testosterone by binding to it. So that would make me believe I don’t need as much TRT since my SHBG levels are on the lower end. Is this accurate, and how does it affect frequency of injections?
SHBG buffers testosterone, it prevents your body from clearing it out too quickly. There are some guys who hyper metabolize and or hyper excrete testosterone and these men will need large dosages.
Dosing isn’t necessarily dependent on SHBG.
Interesting. So you recommend starting at 100mg once a week? What are your thoughts on the AI and HCG in relation to that dose? The reason I ask is because the doc prescribed me the AI and HCG at those doses when it was planned for me to take 200mg a week. So I didn’t know if I should adjust based on the lower dose of Test.
I’m recommending injection either 30mg M/W/F or 20-25mg EOD. You want to keep levels sufficiently elevated with the least amount of fluctuations, fluctuations hinder getting the maximum benefits of TRT.
Do not take the AI unless symptoms of high E2 and labs indicate high E2. Large infrequent doses of testosterone will no doubt cause you to over-produce estrogen requiring an even large dose AI.
Your doctor a little behind, sounds like doctor is just getting feet wet in TRT. Smaller more frequent doses will lesson the need for an AI, which you doctor hasn’t learn just yet.
I see. I think I’ll try the smaller dose 3x a week then. Thanks for taking the time, I appreciate the advice.
You may need to go through some trial and error to hit on the right approach. My SHBG hovers around 24-26, I take 200mg per week, last blood tests came back 900 TT and 202 FT.
I’ve used hCG, but it was injections only. I know some who have used sublingual and your understanding is accurate, big difference when they switched to injections.
I think twice a week dosing is fine, though you may be fine with once. I do think you’ll end up needing a higher dose, but nothing wrong with starting lower and moving up. Guys that start higher and end up with higher levels usually do not want to decrease the dose, and for all we know they may have felt just as good with the lower dose.
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