Not to chantge the subject, I too take CYP 10mg/0.5ml per week. I inject it in my leg, I see some guys are injecting 400mg a week some say 800mg’s. Am I reading this right? My whole bottle is 200mg’s. Are some of you guys taking 2-4 bottles a week. I had started working out to use it to my advantage. But I havent seen much muscle gain, is it because Iam just not using enough?
[quote]country3450 wrote:
Not to chantge the subject, I too take CYP 10mg/0.5ml per week. I inject it in my leg, I see some guys are injecting 400mg a week some say 800mg’s. Am I reading this right? My whole bottle is 200mg’s. Are some of you guys taking 2-4 bottles a week. I had started working out to use it to my advantage. But I havent seen much muscle gain, is it because Iam just not using enough? [/quote]
The dosage on the bottle should say 1ml is 200mg
If you are injecting.05 or 1/2ml then you are getting 100mg dose of Testosterone.
400mg would be 2 ml.
Are you having low T issues? If so check you E levels, mine were way off. Its as important as the T replacement.
Thanks for the info, I was reading it wrong I had thought the whole bottle was 200mg’s, See my parents should have bought me that Chem Kit in the 70’s.I quess I should have asked my wife she’s a RN. But she doesnt want me to take it anyway, Iam not taking it for the sexual part, I dont need it for that 13 seconds a month anyway. I took a blood test at my doctors and it was around 400, I just didnt have the go go juice, I had before. I quess thats part of getting older. Well thanks for clearing the 200mg bottle problem I had. Iam not stupid,just really dumb. LOL. My last check up my T was around a thousand, with the shots. I’ll check out my E levels. Thanks again.
Hello!
My name is Chewman and I’m a HRT addict!
I’ve been more of a lurking member of T-Nation but here is my story.
About a year ago a friend of mine needed to get her DEXA Scan certification. She needed to do so many men to get this and asked me if I minded spending 20 minutes on her table. I did and found that I was Osteopenic.
2 Weeks later I was sitting in front of my family MD and he was ordering a Vampires wet dream of blood work. This came back with everything looking great except my Testosterone was 260. E2 was 37.
My MD joked that we should blame this on his friend, a General Surgon, who performed my Vasectomy.
No joking aside, I started to look at this. All the medical lit says that men stay in the normal range of Testosterone post Vas. Talking with a Urologist he stated that 2 years post Vas the testicles stop producing sperm. WTF!!!
If they stop producing dont they decrease production of Test being that sperm production and Test production are tied together? I suggest getting your Test measured before you get a Vas. That way if your levels drop you too can join our TRT/HRT club!
I love my Vas. I have 5 kids. I dont want any more. Even knowing my past I would still do it again today. The only side effect I noticed before the test issue was that my boys grew by about 30% and were super sensative. My Wife liked the large swinging mass when we were intimate. I found I had to pay attention to how I sat. If the boys landed first it was painful. I couldnt just drop down on a box or a bench without pain. Try doing box squats and catch your boys. Better have spotters close!
I saw my Doc and saw a Urologist he said nothing was wrong, just wear a jock or sports supporting underwear or you will develope a hernia from them tugging at the inquinal cannals.
It was about 2 years after my Vas that I started to gain weight. Wonder why? I would diet, lift, walk, and bike without a change in my weight except that it kept going up. A little more than a year and a half ago I was walking around at 6’6" and 305 lbs. Sorry I dont know my body fat % but I’m betting on gargantuan. I have the typical E2 build and problems. I know about this now.
My Doc put me on Androgel 5mg QD and gave me a lab slip and an appointment for 2 months later. At first I loved the 5mg QD. Women werent just another animal walking the planet but something I wanted to bang and thinking about banging them had my soldier at attention. This begain about 2 weeks into it and lasted about 2 weeks and was gone.
I got my labs drawn at 6 weeks out. This Lab resulted in my Testosterone dropping to 220. Inhibitation of natural production. Saw the Doc again and the result : Androgel 10 mg QD.
I had the same results with the 10mg QD that I did with the 5mg. A couple weeks into it and my wife was tired of me. After a couple weeks I was back to my old self falling asleep in my chair. Follow up lab showed Test to be 680. Doc didnt do E2. I did the 10 mg QD for about 6 months and found that my hands were losing sensation. Not numb but I couldnt feel if it was 1 page or 3 when reading. If I forgot to do the gel on a weekend, being the routine was different, I noticed on Monday that my hands were more sensative. I made an appointment to see my Doc. Hint: This is what happened to me. It might work as a good excuse to get off the gel if your Doc is apprehensive. I suspect it was the ethanol base of the Gel causing my nerves to desensatise do to the daily application. They use Ethanol to kill nerves if an amputee is having ghost sensations.
I did lose weight while on the Gel 10mg dose. I went from 305 to 270. The boys did shrink a bit but if you read the above I was relieved. My wife liked them large, but I am more comfortable.
2 weeks later and all the insurence hassles and I’m now on 200mg Test Cyp per week. You’d think the insurence company would be happy to get me off the damn Gel. Gel = $1300.00. Test Cyp $120. It’s not Rocket Science!
I stated my 200mg per week splitting it into 3 injections. I noticed after a couple weeks I started to feel better. Attitude is up, and I’ve dropped a couple pounds. I used to get DOMS and would still be sore after lifting compaired to my gym partners. This has since been alieviated to a point. I seem to be ready to lift and am hanging pretty tight with them.
3 weeks later I got my first labs. Test was 1050, but E2 was 68!!!
Following the advice from this well versed group and a couple PM’s to KSman, I got my anti E and started it. In a few weeks I see the doc, and will try to get a script to make it legit. If not thanks to this group I know what to do.
Chewman
I just started my injections today. i am on 200mg T-CYP weekly. I used a 1 1/2 inch 22 gauge needle. what are the size of needles that most of you all use? I feel this is a pretty long needle and if i can a shorter one would be less chance of poking a vein. I am 6’ 2" 220 lbs with 20% body fat mostly in gut. not much fat if any on the glutes
[quote]jakeman124 wrote:
I just started my injections today. i am on 200mg T-CYP weekly. I used a 1 1/2 inch 22 gauge needle. what are the size of needles that most of you all use? I feel this is a pretty long needle and if i can a shorter one would be less chance of poking a vein. I am 6’ 2" 220 lbs with 20% body fat mostly in gut. not much fat if any on the glutes[/quote]
That is a high dose.
You can use a #25 1" needle into the quads - vastus lateralis. You might also feel better injecting twice a week.
For those who are saving their testicles and injecting hCG 250iu SC EOD, some also inject T at the same time, using #28 .5" .5ml insulin syringes, often as .14ml.
There is no need to inject into the gluts with 1.5" needles. That was develop for in-office injections, with larger amounts injected every two weeks. This really is not appropriate for self injecting. The doctors will not tell you that.
What are you doing for estrogen control???
He orederd some tests which i had done this morning
IGF-1
Estradiol
Testosterone Total
Testosterone Free
Thyroxine Free
He said he would give me something for the estrogen when i see him in feb. he wanted to get a base line.
I ask about the thigh and he said to many things can go wrong with the thigh. i tought well hell I can not do myself in the backside. The wife has to do it.
I also thought that 200mg a week is a lot. Between me and you i am going to only do150mg weekly and see how that works.
I am thinking because I look like I train he was thinking I wanted to do a cycle. He trains also I believe. He also ask me to check into HGH which I do not want. And of coarse he will give me HCG when the levels get in check.
as far as injecting twice a week he said to stay where I am at for a month and if wanted to go twice a week i can.
Thanks KSman as always you help out.
Your doc asked to check into HGH, and you’re not intested? To quote Ricky Ricardo,
“Lucy, you some 'splaning to do”.
I HAVE to ask, why not? Most doctors are so gun shy now about HGH, and this guy is on the ball?
I WISH my doc would write me a script for the stuff regardless of what it costs.
200mg/week is a nice dosage for most of us, I have a close friend who also is built like a train, and his doc has him at 75mg/week. That just sucks. You may be one of the guys using a small dosage, who gets great numbers, or you may not.
With this one exception, (your dosage)I always agree with KSman. Forgive me KSman, I realize he needs an AI too, but my take on this is (unless jakeman has a secret plan) go for the maximum dose , and wait for the b/w to come out. That way, if you’re too high, the doc cuts you back. If you have a secret plan and hope at 150/week to come in low an hope the doctor will give you 250 instead, well that’s another story…
Me personally, I feel best north of 1000 TT levels. Way north, to be honest, but since my doctor only allows me 200mg/week of T-Cyp, I do all I can to keep it unbound and free.
I hope this wasn’t a rant, if so I apologize.
KNB
[quote]KNB wrote:
Your doc asked to check into HGH, and you’re not intested? To quote Ricky Ricardo,
“Lucy, you some 'splaning to do”.
I HAVE to ask, why not? Most doctors are so gun shy now about HGH, and this guy is on the ball?
I WISH my doc would write me a script for the stuff regardless of what it costs.
200mg/week is a nice dosage for most of us, I have a close friend who also is built like a train, and his doc has him at 75mg/week. That just sucks. You may be one of the guys using a small dosage, who gets great numbers, or you may not.
With this one exception, (your dosage)I always agree with KSman. Forgive me KSman, I realize he needs an AI too, but my take on this is (unless jakeman has a secret plan) go for the maximum dose , and wait for the b/w to come out. That way, if you’re too high, the doc cuts you back. If you have a secret plan and hope at 150/week to come in low an hope the doctor will give you 250 instead, well that’s another story…
Me personally, I feel best north of 1000 TT levels. Way north, to be honest, but since my doctor only allows me 200mg/week of T-Cyp, I do all I can to keep it unbound and free.
I hope this wasn’t a rant, if so I apologize.
KNB[/quote]
I have no secret plan lol. I am new to this so still learning. The HGH kind of scares me it has some sides to it and I am on the verge of type 2 Diabetes now. So before I make the decission to do HGH I am going to need alot more knowledge than I have now. The good thing is I have until Feb 14th to decide. We are both pretty sure with my circumstances my insurance will pay or 1 of them will.
I am sure I will like the dosage of T-CYP, hell I do already. But I do not want to build up a resistence to it. I am only 50. I could probably just ask for 250mg /week and get it easy. I didn’t have to say anything for what I have now.
He is a young doctor and a D.O. He is really into the TRT/HRT thing and is proud to be the only dodtor in my area that does HRT. He wants my levels at 600 to 800. But I am like you the closer I get to 1000 the better I should feel. I have felt so bad for so long that I am looking foward to feeling like a person, no a man.
Jakeman,
Thanks for the honesty. “Building a resistance to it”…, I understand your thinking, but it doesn’t work that way with HRT that I have EVER heard, of course I’m just some shmoe that’s coming up on his two year mark of HRT and has a quality of life like I don’t ever remember.(GREAT now)
As far as the TypeII, I’m really sorry to hear that. I don’t know enough about diabetes and HRT to be intelligent, but the concept of HGH and slowing down the aging process,(maybe even the Type II), I believe is a great idea. HGH at really low doses has benefits I have read, I believe a lot of those using it, go for the maximum dosage, and therefore have the greatest potential for side effects.
I can (almost)guarantee when you get your dosage dialed in, and your E2 under control, life will be great due to the fact you have a great young doctor. We use the phrase “welcome to hell” for the guys with unresponsive doctors, that are mostly too uninformed to be really helpful for HRT, and those particular men have to do “what they have to do” to regain a quality of life they so drastically desire.
I have a another friend on HRT on this site, that with 100mg/week he’s at the 800 mark. I would like to be him; 200mg/week and get 1500+? Hello, Superman… Or something close. There are lots of documented cases of men your age and older that are on HRT, proactive about their health, and refuse to not “age gracefully” by instead keep their youthful outlook and lifestyle foremost. Good luck my new friend, if I may be of any help, ever, just ask.
[quote]jakeman124 wrote:
I just started my injections today. i am on 200mg T-CYP weekly. I used a 1 1/2 inch 22 gauge needle. what are the size of needles that most of you all use? I feel this is a pretty long needle and if i can a shorter one would be less chance of poking a vein. I am 6’ 2" 220 lbs with 20% body fat mostly in gut. not much fat if any on the glutes[/quote]
As the title of this thread is TRT Injection Support, I would like to broach the topic of Subcutaneous Testosterone Injections. Does anyone else do subcutaneous testosterone injections?
At the instruction of my physician, I do .5ml SubQ injections of 100mg testosterone cypionate (200mg/ml) 1X/week into the abdomen using a 27 gauge, 1/2" needle. SubQ injections are quite easy and I have never had any problems or discomfort. It takes about a minute to load and 10 - 15 seconds to inject. The slow injection is quite comfortable.
It is my understanding SubQ testosterone Cypionate (enanthate) injections are safer, have less chance of abscess, are easier to administer and are far more comfortable than IM injections.
Based on other research/reading I am now exploring the option of injecting testosterone every three days (Days 1, 4, 7, 10 etc.). This would result in a simple three day cycle of (Day 1): 50 mg Testosterone Cypionate, (Day 2): .25mg Arimidex and (Day 3): 250IU HCG.
It is a rare doctor who is aware of the results of the Canadian study that eval’d T SC. Others are doing this [few] at anabolicminds.com. Not really an option that gets discussed here. It will be interesting who tries this out.
I tried it out to eval, but find IM injections more comfortable. The test cyp was irritating to me at first, but that did seen to be going away. I inject in the vastus lateralis with #28x.5". Really a matter of personal choice in many cases.
I think that the really important message is for guys who are major overweight where IM injections is not really going to happen properly in many cases. They can start with SC or not worry if their IM injection is not fully IM.
I don’t think that there is any infection risk either way. Some will argue that the muscles are more vascular and the immune system has a better ability to deal with the bacterial that are ALWAYS dragged in from the skin.
250iu hCG SC EOD is a good research supported dose. With the EOD requirement, I inject .14ml/28mg test cyp at the same time and take anastrozole EOD as well. Given the half life of anastrozole, that is a good choice as well.
You have an excellent program going. Did your doc intro T+AI+hCG all at once or one at a time.
I wish I had been properly introduced to HRT. It has been a long road, and I have found a doc who is very experienced as well as cutting-edge. Original diagnosis was by my GP and Urologist who together put me on Androgel. About a year later I asked for HCG to restore “shrinkage”. Still, my results were mixed.
After continued research and a switch to Test Cyp injections and a new doctor, I finally added AI (Arimidex) to the regimen. I believe T+AI+HCG is usually a pretty good solution. However, I feel the best approach is to start with T and obtain desired levels (do labs), add an AI if estradiol is above optimal (do labs), and then finally add HCG (and do more labs). Any combination/order of the Magic 3 should be considered, based on the facts and circumstances.
KSMan, I chuckled at the exactness of your dosage: 28mg. I would just round up to 30mg.
[quote]luv2lift_temp wrote:
I wish I had been properly introduced to HRT. It has been a long road, and I have found a doc who is very experienced as well as cutting-edge. Original diagnosis was by my GP and Urologist who together put me on Androgel. About a year later I asked for HCG to restore “shrinkage”. Still, my results were mixed.
After continued research and a switch to Test Cyp injections and a new doctor, I finally added AI (Arimidex) to the regimen. I believe T+AI+HCG is usually a pretty good solution. However, I feel the best approach is to start with T and obtain desired levels (do labs), add an AI if estradiol is above optimal (do labs), and then finally add HCG (and do more labs). Any combination/order of the Magic 3 should be considered, based on the facts and circumstances.
KSMan, I chuckled at the exactness of your dosage: 28mg. I would just round up to 30mg.[/quote]
All three items interact. Settle one and add another and things change.
Start all three at once. Then with the first 3 month lab reviews, all can be adjusted as needed. There is no reason for shrinking testicles. Lay down hCG as part of the new baseline. Start AI immediately and the first med review can be refinement instead of a discussion of libido that came and went, mood changes and low energy.
hCG will increase TT and FT for most and probably E2. This increase in E2 with hCG is well known. AI may need to be increased.
Optimal E2 is so low that I don’t think that anyone on TRT could be near that. Debate is good, it brings out different aspects to be considered.
I worked with a guy through labs and being able to make is case with his doc for T+AI+hCG all at once. His numbers at the first med review were what most would consider perfect.
And of note: One’s dose of arimidex may need to be increased over time. 1mg/wk can work well at first. After 6 - 12 months more may be required.
My main reason for suggesting T+AI+hCG all at once is to avoid suffering. Estrogen poisoning can be a very big problem. Shrinking testicules should not be a cost of feeling well.
“I chuckled at the exactness of your dosage: 28mg. I would just round up to 30mg.”… I am an engineer!
Just my two cents… I did AI alone for about a year and since I was already in the habit of taking it first thing in the morning before my morning cardio, I’ve kept that habit. I don’t eat until about 45 mins after I take the anastrozole. Not that I’ve ever read that it matters. I do my injections after work the same day (approx 12 hrs later) and I load the T and hCG in the same syringe.
As for starting with an AI right off the bat, I think the logic is clear. First off, there is a good chance that your low T is going to be accompanied by high E before you even get started. Also, since T levels and E levels are tied together by aromatase, the only way that raising T wouldn’t also raise E is if the exogenous T somehow inhibited aromatase production. Since all the available data suggests that simply doesn’t happen, I don’t see any logical or medical reason to delay using an AI.
I also don’t understand the “wait and see” approach to hCG. What is the possible downside to starting hCG immediately? The point is to get your program dialed in as quickly as possible and delaying the start of hCG does nothing except delay that process. If you get your dosage of T dialed in without hCG and then you add the hCG and it affects your T levels (as it could very well do) then all you’ve done is go back to square one. It doesn’t make any logical sense to me. You need the important testicular functions that hCG preserves (it isn’t just cosmetic) and so it needs to be started at the same time as the testosterone. Delaying hCG seems to me to be an emotional position and not a medical position.
Getting your testosterone and estradiol in the optimum ranges as quickly as possible is the goal of TRT and is actually the more conservative approach.
Taking “one step at a time” may be good advice in some situations, but that doesn’t make it right in all situations and I think in this situation, it is actually wrong. The point of TRT is to have optimum levels of both testosterone and estradiol and any approach that delays getting those levels in the optimum ranges should be avoided.
None of these biochemicals work in isolation; they are part of a system. It’s the balance of the entire system that we want and the only way to achieve that is to have all the parts of the system in place together.
KSman and happydog,
I believe we are all on the same page - T+AI+HCG all at once. Let me clarify:
I should have made it clearer that I was responding to KSman’s question re: my personal situation: was it all at once or in steps? Unfortunately, it was in steps. I now have the benefit of hindsight.
At the time, we did not know what exactly was wrong, and they looked at a host of possible causes, including, but not limited to, diabetes and cancer. I was referred to specialists in Urology and Endocrinology (UCLA).
IMO, the real disease should be called “DDKS Syndrome.” This stands for “Doctors Don’t Know Sh_t”. (You can fill in the blank). Even the “best”, most highly regarded physicians are remarkably uninformed. Most docs are stressed with busy practices and do not devote a lot of time to the wide variety of information out there. Etc., etc.
I have been to the “best” and found the entire healthcare system to be full of shortcomings. I pity the masses out there who do not understand they may be receiving improper care, wrong medications, dosage errors, etc.
Better stop before I get high blood pressure!
Thanks for your remarks, gentlemen.
I am just starting TRT and my Doctor has started me on 200mg T-CYP a week and next visit he said he would give me a AI. then in 3 months when my levels are in check he will give me HCG. I got part of my labs back and my TT was 847 and Estradiol was 52.9. My wife said my nipples are geting puffy and I am noticing a little discomfort in them and they are sensitive. I called him today and hopefully he will get back with me. I do know when I see him Feb 14 I will let him know I do not want to play this game and to just get me on everything now. I think he wants to help but just doesn’t know enough about it. But he is the only 1 we have here.
I have learned so much about this in the past 3 months, and its a shame the media only reports on the negitive stuff and not on the positive. Until that is changed a lot of men are goig to suffer like I did for almost 4 years.
OK i am done
[quote]jakeman124 wrote:
I am just starting TRT and my Doctor has started me on 200mg T-CYP a week and next visit he said he would give me a AI. then in 3 months when my levels are in check he will give me HCG. I got part of my labs back and my TT was 847 and Estradiol was 52.9. My wife said my nipples are geting puffy and I am noticing a little discomfort in them and they are sensitive. I called him today and hopefully he will get back with me. I do know when I see him Feb 14 I will let him know I do not want to play this game and to just get me on everything now. I think he wants to help but just doesn’t know enough about it. But he is the only 1 we have here.
I have learned so much about this in the past 3 months, and its a shame the media only reports on the negitive stuff and not on the positive. Until that is changed a lot of men are goig to suffer like I did for almost 4 years.
OK i am done [/quote]
No, you’re not. (respectfully) Stand up for your manliness, and the satisfaction of your woman. Today. I don’t know what kind of insurance you have, but adex is $9.00/mg at the pharmacy. It’s $0.97/mg research.
Your E2 is on the rise, due to the 200mg/week (so was mine) and if the doc will prescribe adex you’ll only have have a couple more weeks of hell. If he doesn’t do what you need to do to not grow man boobs that won’t go away.
With all that said, I suggest using the half-life calculator:
www.roidcalc.com/
And you will see it takes weeks (6 or7) for your T levels to be predictable, so things will be in a state of change for a while, but hang in there, at least the one doctor you can access isn’t completely worthless for HRT.
PM if you want.
[quote]jakeman124 wrote:
I am just starting TRT and my Doctor has started me on 200mg T-CYP a week and next visit he said he would give me a AI. then in 3 months when my levels are in check he will give me HCG. I got part of my labs back and my TT was 847 and Estradiol was 52.9. My wife said my nipples are geting puffy and I am noticing a little discomfort in them and they are sensitive. I called him today and hopefully he will get back with me. I do know when I see him Feb 14 I will let him know I do not want to play this game and to just get me on everything now. I think he wants to help but just doesn’t know enough about it. But he is the only 1 we have here.
I have learned so much about this in the past 3 months, and its a shame the media only reports on the negitive stuff and not on the positive. Until that is changed a lot of men are goig to suffer like I did for almost 4 years.
OK i am done [/quote]
Your doctor does not appear unreasonable and has provided you with a plan - that is a LOT better medicine than I received in the beginning. The “Step Approach” is very common practice - even by the “famous” docs. See Crisler’s TRT.doc at All Things Male.com for a discussion of his approach.
200mg/week is generally considered a high starting dosage. 1st labs are often done around Day 4 after 5th (weekly) injection. Everyone reacts differently, and 847 is not overly high for 200mg. I don’t think your nipples are going to blow up (yet!) with 53 E2, which I believe is the top of the “normal” range. You may get some puffiness and itchiness, but that generally should subside later with the AI and probably not permanent. I went through it for months and months, and am fine. Also keep in mind the AI will reach stable blood levels in a week, but other benefits can take a month to feel.
In the short term this is not a huge problem - long term poses serious concerns in many areas, e.g. cancer, etc. You can always take an assertive approach with your doc and get the AI NOW, if you are really worried. In the meantime, consider 50 - 100mg Zinc/ED, plus DIM 25mgDIM/100mg blend 3X/ED to help mitigate the symptoms. These should help, but not nearly as effective as Arimidex. Some also recommend Indole-3-Carbinol, but I do not see the point as it just converts to DIM.
They way I see it, everything needs to be adjusted periodically anyway, so why not just start everything together and fine-tune dosages, accordingly?
Best of luck…have patience. You are on the right path and have a lot of support here.
[quote]KSman wrote:
Many issues here.
Injections every two weeks will leave you crashing and as SHBG and E2 increases, many will feel worse than before TRT [as the T levels drop, with the now increase E2 levels, you will feel worse]. You have been prescribed 100mg/wk, you are in control and can inject with whatever feels best to you. You can load and inject with 1.5" #23 in the gluts and 1.0" #25 in the vastus lateralis. For every other day injections (EOD) you can use 1/2" #29 .5ml [50 unit] insulin syringes.
The 200mg every two weeks is something that comes out of a practice where the patient goes to the doctors office every two weeks. For self injections that is totally inappropriate.
More frequent injections of lesser amounts that add up to 100mg/wk will lower T spikes, and that will reduce E2, reduced E2 leads to less SHBG which leads to more free T. SHBG bound T does not do the work, only free T (FT) or weakly bound T.
You need to control E levels. You cannot expect to get significant changes to %BF and fat distribution patterns if your E2 is elevated. The range of 0-53, but that ‘normal’ lab statistic also includes men that have serious untreated hormone problems. Normal lab range does not in this case imply proper body functioning or health. Many doctors do not understand this. They will let a guy with E2=50 suffer, as they just do not understand the issues at all.
E2 blocks the action of T at T receptors and many parts of your body want to develop female characteristics or a lack of male characteristics. Elevated E2 can block your libido. In some cases, E2 in the 35-40 range can kill libido, create brain fog, lack of energy and all of the symptoms of low T, WHILE your total T (TT) is high [even at 1000pg/ml] and FT is good or above normal range. You need to be testing for E2 and should have E2 results from your pre TRT lab work as well. You need to get your E2 down into the lower 20’s for TRT to work best. It is thought that E2=17-20 provides optimal libido.
Elevated E2 levels can also block the sensitivity of your penis. It is possible for the penis to be numb with high T levels if E2 is elevated.
Libido can be the first thing to respond and can change quickly. You should use libido to act as your barometer of what works and what does not. Other changes do not have anything that you can sense and can be slow and progressive… difficult to use as a guide to wellness. If E2 is blocking libido, starting with Arimidex at 1mg/week can create a huge boost in libido in 7-10 days.
Elevated E2 is perhaps the biggest cause of prostate enlargement. Keeping E2 low is protective. In most cases, higher DHT levels are not a concern if E2 is low. But cancers can respond to T and DHT. You need to check PSA once or twice a year. And have a PSA number from before starting TRT. PSA should be checked at the first TRT lab work at 2 or 3 months.
Arimidex [aromatase inhibitor] interferes with T–>E aromatization. 1mg/wk is a typical starting dose. Originally developed to treat female E sensitive cancers [breast]. Some docs do not understand its use and will not prescribe or will read about its use for female cancers and will prescribe 1mg/day which will take E2 too low in some cases and otherwise is a waste of an expensive drug.
When E2 is reduced, libido will pick up. Other changes in thinking and attitude will be mostly in place in two months, and will be completed by 3 months.
When starting TRT without AI or HCG, things can feel great at first, but E2 and SHBG levels are increasing and FT is reduced. The down time before your next injection can become longer and longer until you are down all the time an feel nothing from your injections at all. Part of this are changes in the brain caused by E2. Those changes take time and your though patterns slowly adjust in a negative way. Libido, initially very strong, goes away. Some of the increase in libido in the beginning is not from the absolute level of T, but from the transient increase. That cannot be sustained and the long term effects often do not feel as good as when you started TRT.
If your doc is not testing for E2 or DHT, you have someone who really does not understand the issues and success factors.
TRT will shut down your HPTA and LH production will stop. You testes will shutdown and shrink in time. The scrotum will pull up tight like a little boy’s. The testes produce things other than T that are important. Much of the pregnenolone in the body is produced there. Injecting 250iu HCG SC EOD will keep the testes working near baseline. That will work if the testes are not damaged and are LH/HCG responsive. Pregnenolone is critical for for the nervous system and brain and is the starting point for neural steroids. Many note a improvement in mood with HCG. If you doc does not understand the HCG connection, you have a problem! There is also an issue of sexual self image and how ones mate sees you, a strong quality of life (QOL)issue.
You need TRT+HCG+AI, that is simply best practice. All are critical and not doing all of these will often lead to marginal results. Without AI, TRT often simply will not work. I strongly believe that HCG and AI should be started with TRT and not be added one at a time as symptoms develop. Younger men should not let their testes atrophy. Some older men will not care and some will have testes that will not respond to LH or HCG. If the testes are allowed to atrophy, in the long term, irreversible tissue changes will occur and the state cannot be reversed at a later date.
The big success factors in TRT seem to be gaining knowledge and finding the right doctor or educating your current doctor if [his/her] ego will allow that.
One can also have thyroid level problems and if TRT does not seem to be working right, low energy and mood, thyroid levels can be checked, TSH, FT3, FT4. If the thyroid levels are good, then one should consider depression as a factor. Some men get into a depressed state that does not have a factor of profound sadness or gloom, but a lack of energy, initiative, passiveness, apathy etc. That situation presents some difficulty in recognition.
TRT can greatly decrease total cholesterol while leaving HDL unchanged. In some cases statin drugs can be avoided, discontinued or reduced. Statin drugs can kill libido as well.
The odd thing is that so many men who have signs of hypogonadism do not seem to care and if you talk to an older friend about TRT/HRT they think that you are crazy or a drug addict or steroid junkie.
Your weight suggests a possible case of metabolic disorder aka syndrome X. That is a prediabetic state associated with low T, elevated E and fat patterns that create an apple shape in the long run. You need to have your fasting serum glucose levels checked and this should be part of your basic CBC panels. This prediabetic state is characterized by insulin resistance. That can be partly driven by dietary factors that reduce cell wall permeability. The reduces many aspects of cellular functioning. Improving that condition by diet and supplements can improve many aspects of health/aging. Adding TRT/HRT to a bad situation will alone not fix everything.
Fat gain and low energy are also signs of possible hypothyroidism. It is not a surprise when an overweight guy with a need for TRT also has thyroid issues. One needs to be open minded to this possibility if TRT does not seem to work mentally or lead to fat loss and reapportionment when E2 levels are optimal.
Get copies of and retain all lab results. You need to have these for yourself. Do not simply leave these in your doctors hands. Understand whats there and demand that some things be added to lab work if needed. You cannot be passive about this.
There are a lot of things that need to stated about diet and supplements. These things can be found elsewhere and everything that has been discussed in this thread has been stated many times before. Use the search functions of this website and spend a few weeks or months educating yourself. You need to do some things on your own. Facts can be consolidated in this thread, but this thread will become history as they all do.[/quote]
Above is the post from KSman that motivated me to join this forum. He is responding to the first post on this thread. I am quoting it here again just in case others might have missed it.