TRT: Protocol for Injections

Pharma TRT
41

[quote]KSman wrote:

Some guys bodies eat T, don’t know where it goes, but the liver is probably doing a job too well.

[/quote]

This is low SHBG.

Without SHBG for T to attach to, it is quickly cleared from the body.

Pharmaceutical drugs, of all kinds, and a significant percentage of them, increase SHBG to some extent. Some just a fraction of an amount, some can really boost it up.

This is a big problem with the birth control pill that many women take. Ramps up SHBG.

I have seen some literature that many pain killers, NSAID’s, and such increase SHBG, probably to a much smaller percentage.

I do not know the main characteristics of why this is so. I would speculate that it has something to do with the liver, in that anything that taxes the liver, such as many pharmaceutical drugs do (and remember, most do at a safe and reasonable amount) can raise SHBG.

SHBG is produced mainly in the liver. How this can potentially react when other drugs is up for much speculation, and I don’t think anyone can answer that with any specificity.

It is like how many drugs are also pro estrogenic. We have theories and ideas and concrete reasons why many do, but others we do not.

Many older men with liver disease often always have high SHBG.

Associations of Sex-Hormone-Binding Globulin (SHBG) with Non-SHBG-Bound Levels of Testosterone and Estradiol in Independently Living Men
Willem de Ronde, Yvonne T. van der Schouw, Majon Muller, Diederick E. Grobbee, Louis J. G. Gooren, Huibert A. P. Pols and Frank H. de Jong

The body is always looking for homeostasis, and to protect itself at all costs. It will send a message to the liver to stop producing SHBG when it is poisoned by excessive T.

Your body has nothing for the T to attach itself too, it will just simply dump dump dump and by mid afternoon, you will have no T.

I think many men on TRT end up with lower SHBG because they take to much T.

Why? Because they think that T will solve all their energy and QOL problems, and that once they start TRT everything will be gravy.

When they don;t get the energy and overall experience from 100mg or equivalent of T in a gel a week, they increase dose looking for more energy.

There is no SHBG in the world that cannot be stopped by a huge overload of testosterone.

The problem is what to do once it goes down low.

So we need to be careful when administering T

The increasing SHBG we see as gents get older is the bodies way of trying desperately to hold onto what shrinking amounts of T it has every year.

I.E., T bound by SHBG is more usable than previously thought.

SHBG goes up as a result of the bodies decreasing ability to make T every year.

SHBG goes up because your T level goes down every year past the age of 25 or so.

Raising SHBG is the bodies desperate, and fruitless way, of preserving T.

2 Likes
42

[quote]Wise Guy wrote:

This is low SHBG.

Without SHBG for T to attach to, it is quickly cleared from the body.

…

Associations of Sex-Hormone-Binding Globulin (SHBG) with Non-SHBG-Bound Levels of Testosterone and Estradiol in Independently Living Men
Willem de Ronde, Yvonne T. van der Schouw, Majon Muller, Diederick E. Grobbee, Louis J. G. Gooren, Huibert A. P. Pols and Frank H. de Jong

The body is always looking for homeostasis, and to protect itself at all costs. It will send a message to the liver to stop producing SHBG when it is poisoned by excessive T.

…

Why? Because they think that T will solve all their energy and QOL problems, and that once they start TRT everything will be gravy.

…

There is no SHBG in the world that cannot be stopped by a huge overload of testosterone.

…

SHBG goes up because your T level goes down every year past the age of 25 or so.

Raising SHBG is the bodies desperate, and fruitless way, of preserving T.

[/quote]

Interesting. SHBG also binds estrogen. Albumin also binds testosterone.

Affinities and concentration gradients really complicate things.

What is your opinion on herbs that bind to SHBG supposedly freeing up T? Does that just hasten the excretion of free T as well?

Thanks for the citation too, I will read it.

43

This has a lot of useful information, thanks.

I’m just hoping I can get a doctor to prescribe this protocol and not give me some lame excuses.

44

[quote]bigdawg011 wrote:

What is your opinion on herbs that bind to SHBG supposedly freeing up T? Does that just hasten the excretion of free T as well?

Thanks for the citation too, I will read it.[/quote]

They work well if you can find a legitimate company with quality herbs.

Maca works well in this arena.

But just like Tribulus or any herb that affects the HTPA, eventually the body will adjust.

You must constantly cycle to maintain effectiveness and fool the body.

45

I expect that drugs increase SHBG by reduction of E clearance resulting from the P450 pathways getting loaded up by the drugs. We cannot separate the effects of increasing E and SHBG in studies if older men.

Albumin bound T is weakly bound and is the major component of bio-available T. I have not seen anything suggesting that SHBG bound T can release useful amounts of T. If published, hard to see in the sea of other stuff on the WWW.

In my case I have had to increase T dose to increase FT. FT was 36 3 years ago, then has been falling. My dose of T increase to 125 and now 175 in an attempt to get back to near FT=36. With my increasing T, if that is driving SHBG low, then FT should be increasing. Have not done labs yet on the 175mg T dose to see what the effect has been.

Overall, if higher doses of T are pushing down SHBG, then should we not expect to see higher FT? Perhaps one would need bio-T results to better understand what is happening. All such discussions would seem to be pointless if E2 and E2 control is not included.

If higher T doses lower SHBG, that would imply that one could lower TT by injecting more T. That does not work for me.

1 Like
46

[quote]bigdawg011 wrote:
Wise Guy wrote:

Associations of Sex-Hormone-Binding Globulin (SHBG) with Non-SHBG-Bound Levels of Testosterone and Estradiol in Independently Living Men
Willem de Ronde, Yvonne T. van der Schouw, Majon Muller, Diederick E. Grobbee, Louis J. G. Gooren, Huibert A. P. Pols and Frank H. de Jong

[/quote]

This does not discuss responses to TRT or increases in T dose. If such a study was done and AI doses were changed with increasing T to keep E2 optimal and unchanged, that would produce interesting data.

1 Like
47

[quote]KSman wrote:
I expect that drugs increase SHBG by reduction of E clearance resulting from the P450 pathways getting loaded up by the drugs. We cannot separate the effects of increasing E and SHBG in studies if older men.[/quote]

One of them, among other issues.

[quote]KSman wrote:
Albumin bound T is weakly bound and is the major component of bio-available T. I have not seen anything suggesting that SHBG bound T can release useful amounts of T. If published, hard to see in the sea of other stuff on the WWW.[/quote]

You won’t see any literature on it because it is not known by many except the few cutting edge Dr’s who specialize in HRT.

SHBG bounds up T, we know that. But it also prevents T from being quickly metabolized by the liver and excreted from the body.

Many men who have very low SHBG levels often have the same mirror symptoms of those with low T, even when they have high T levels and dialed in E levels.

[quote]KSman wrote:
In my case I have had to increase T dose to increase FT. FT was 36 3 years ago, then has been falling. My dose of T increase to 125 and now 175 in an attempt to get back to near FT=36. With my increasing T, if that is driving SHBG low, then FT should be increasing. Have not done labs yet on the 175mg T dose to see what the effect has been.[/quote]

First off you need to stop relying on inaccurate methods to measure steroids androgens. The FT serum assay is one of them, especially from Labcorp. It is known to be invalid and highly inaccurate.

And Just because increasing T = driving SHBG down = does not also equal increasing FT. You can easily increase TT and see no increase in FT, especially if SHBG is low (this will result in little circulating FT) or E is high.

You also continue to rely on an inaccurate estradiol assay as well (the one Labcorp uses through LEF)

[quote]KSman wrote:
Overall, if higher doses of T are pushing down SHBG, then should we not expect to see higher FT? Perhaps one would need bio-T results to better understand what is happening. All such discussions would seem to be pointless if E2 and E2 control is not included.

If higher T doses lower SHBG, that would imply that one could lower TT by injecting more T. That does not work for me.[/quote]

Yes, a BioT result would be a much better method of analyzing the situation.

Remember, TT score can be driven up with increasing injections of T.

However, we do not want this. With SHBG low, the T has nothing to attach itself to.

Without this, it will be quickly metabolized by the liver and cleared from the body.

Thus, you have an ester which is doing its job (releasing T over an extended period). However, with nothing for the T to attach itself to, it will be quickly cleared. These are called hyper metabolizers.

Your chasing invalid assays (FT). Why?

Why do you need more T? Are you experiencing diminishing effects?

How do you know dimishing effects on QOL and energy levels as well as libido are T related? They can be neurotransmitter related, as well as GH related.

They can also be E related. You E assay is inaccurate. You need to understand this.

1 Like
48

Well this thread appears to have come to inconclusive end. Was this discussion picked up somewhere else.

49

Sorry about that last post, I did not see the date of Wiseguys post.

50

I admit this is all Greek to me. I’m surprised this is an issue for so many guys.

I’ll be 47 in a couple of months, yet do not display any obvious signs of low test. Sex drive is full-throttle, appetite is good (on workout days especially), sleep is average (the same since I was in my 20s), and I’m putting on new size lately and am heavier than I’ve ever been. I’m not as strong as in my youth, but several injuries (some chronic) keep me working with “safer” weights at this age.

Should I assume this is good? Would investigating my test levels be opening a can of worms?

51

[quote]Iron Dwarf wrote:
I admit this is all Greek to me. I’m surprised this is an issue for so many guys.

I’ll be 47 in a couple of months, yet do not display any obvious signs of low test. Sex drive is full-throttle, appetite is good (on workout days especially), sleep is average (the same since I was in my 20s), and I’m putting on new size lately and am heavier than I’ve ever been. I’m not as strong as in my youth, but several injuries (some chronic) keep me working with “safer” weights at this age.

Should I assume this is good? Would investigating my test levels be opening a can of worms? [/quote]

While its likely you can still have decent T levels at that age, it is highly, near 100% certain that your GH levels are low.

52

[quote]Wise Guy wrote:

However, we do not want this. With SHBG low, the T has nothing to attach itself to.

Without this, it will be quickly metabolized by the liver and cleared from the body.

Thus, you have an ester which is doing its job (releasing T over an extended period). However, with nothing for the T to attach itself to, it will be quickly cleared. These are called hyper metabolizers.

[/quote]

SHBG bound T [SHBG-T] is not bio-available and is junk. So much of the TT level is meaningless. With low SHBG, there will be less SHBG-T and more bio-T. If bio-T is increased and more of that T gets metabolized that way instead of as SHBT-T… who cares. In the end, metabolism rates balance input rates.

Are you saying that low SHBG [hyper metabolizes] have lower bio-T and FT? That does not make sense.

When Stanozolol is used in small oral doses, it can decrease SHBG by around 1/2. This is known to increase bio-T. While that drug might have some toxicity concerns, all the more for TRT [long term], I can’t seem to argue that that outcome is negative. Proviron is stated to have some similar effects, but stated to be its binding to SHBG to make the SHBG less bio-available, thus increasing Bio-T and FT.

For most cases, low SHBG is not a problem, often the opposite. I fear that we may be misleading many into been concerned about this.

Can we drop this… off topic for a sticky.

53

HCG injection questions.

I anticipate picking up perscription for HCG tommarow and was wondering what to expect and how long it would likely take to see or feel some results. My balls definetly appear to be retracting up in side me. Don’t think they started shrinking yet, but it sure is an obiouse sign that they are saying "well I guess you don’t need us any more). Also is there any need or benefit to increasing the intial doses above the recommended 250iu (i.e. front loading).

I started the androgel about 5 months ago with little results other than elevated E. I’ve been injecting the 100ml/w twice a week for about 6 weeks and taking the anastrozole 1mg/w (approx .25ml EOD). Have lab results comming this week. I’m guessing the E is still high based on some leg cramps. I also think I’m retaining water. My eyes feel puffy.

Thanks again for all the help so far

54

Just an up date for anyone interested

Got my lab numbers back today

Total T 994
Free T 334
Estradiol 26

These are up from 296 total T previous, Free T at 78 and E2 at 41

I just started the HCG tonight (250iu) and increased the anastrozole to .375mg EOD.

Should be interesting to see where the numbers go from here.

55

GeoBob: You could increase anastrozole to 0.25 * 26/22 = 0.30. While 0.375 might be too much, it is probably a good move to counter the E2 generation in the testes that will resume with hCG.

You will take 250iu hCG EOD? You can front load with a single 500iu dose.
Injecting SC? [no need to inject IM].

Is your T [eth?cyp] 100mg/ml or 200mg/ml? Best to report mg’s not volumes.

FT is quite good.

56

Im almost 47 and my dr just prescriped the following based on blood work:

.5 ml of test cyp (200 mg/ml) injected once week

ameridex .5 mg twice week (.5 mg to be taken on day of test shot and then .5 mg 3 days after)

HGC twice a week .25 ml two day in a row before test shot

Obviously, this is “somewhat” different than the protocol described herein (but not completely off base) and wonder if anyone has some tweaks to suggest to dr based on above. Thinking my test cyp shot should be broken up into two shots of weeks; but if i do this does then wonder about how this changes rest of it (do i only take one shot HGC before each test shot…also wonder if day before matters as protocol listed here does not seem to specify if things can taken on same days.
My results for T were:

total t: 488

free t: 72

edradiol: 58

shbg 27

have other test result but dont know if you require more.

Also dr was indicating im a candidate for HGH; but seems costly as am unsure if insurance would cover it…anyone try to cycle on and off HGH (ie: 3 or 4 days on 3 or 4 days off…or 1 month or two months on and 1 or two months off) or is it something that needs to be taken long term to have effect?

57

Thanks KSman:

Your knowledge and the time you put in here has undoubtedly help many of us more than youâ??ll ever know.

As far as your question regarding T cyp. I’m injecting 200mg/ml. That is 100mg per week on a twice a week schedule just as youâ??ve been suggesting for a starting point.

Regarding the Anastrozal, the product I purchased is so thick that dosing out by the drop seemed less accurate than the pump cap on the bottle. I shot the pump discharge into a syringe and it looks to be .125ml/squirt and the strength is 1mg/ml according to the label. Now you see how I came to the number of .375mg EOD for a new dose. I guess I should look into a new product.

If you have any idea where you can purchase a thinner liquidex product it would be helpful to post in on the board. The product I got is a blue syrup with a very sweet taste. Iâ??m not familiar with any other products since this was my first purchase.

Regarding free testosterone numbers, my doctor mentioned that it was actually slightly above the recommended levels on the lab sheet. At what level should one get concerned and what are the health concerns. I suspect my number may go up with a lower E2 and the HCG.

Iâ??ve definitely been feeling better at these levels and Iâ??d swear that the HCG dropped my nuts over night. I post before and after photos but I doubt any body really needs to see that. LOL.

Iâ??ve been using 1ml syringes with 26 gauge 5/8 inch needles for the T cyp without any issues. When I picked up the HCG I also got the smaller .5 ml syringes with the 31 gauge by 5/16 needles. Wow there is a big difference. I have not tried to use them for the T cyp yet but if you say it works I have no reason to doubt your word.

One last thing, for anyone getting a script for HCG Novarol, I suggesting asking the doctor for a 10 ml syringe to add the bacteria free water with. I had to use a 1 ml syringe and it was a bit of a pain and probable less accurate. It actually took me a bit to figure out since the product dose not come with any helpful instructions. They also provide you with 30 ml of water which is handy and Iâ??m told they donâ??t provide the mixing water. The pharmacy got me for $150 for 10000 iuâ??s.

Well thanks again and I hope others can benefit from this board the way I have.

58

If on a EOD dosing schedule with test cyp…is there any reason a person couldn’t inject SC and get the same benefit as injecting IM? It would be nice to be able to avoid muscle damage and pain by doing this, as long as the end result was the same.

59

All of the discussions here indicate SC is a steady release and probably better. Try it and see if you notice a difference. I did and I think I can feel the differnce. I actually like the bump I get from a IM. I’m positive that a 5/8 inch needle in the top of my leg is truely an IM injection but think I can feel a spike over the 24 hour period after injecting.

60

Geobob,

Do you take the HCG the same day you do your test cyp shot?