Week 3 on TRT and Already Time to Tweak the Protocol

Pharma / TRT Testosterone Replacement
1

Here’s my current protocol, as prescribed by my doc at a men’s clinic.

210mg Test Cyp. 1 x week IM
1MG Anastrazole 1 x week
500IU HCG 2 x week

Within 2 days of my first shot I noticed a difference. Morning woods have been consistent every day, I wake up feeling rested, mental clarity has improved, energy level much better, mood better. The only thing I haven’t noticed an improvement in is libido, but otherwise, I noticed a big difference. I’m hungry all the time, and despite having a very clean diet, my scale weight it going up. However, I don’t look like I’ve gained weight and my clothes fit about the same.

I inject T on Mondays. HCG is injected Mondays and Thursdays.

Now here’s the problem - I feel like garbage on Mondays and Tuesdays. Mental focus and clarity sucks on these days. Basic math, problem solving is difficult on these days. I also wake up feel worst, and I’m in a worse mood overall.

I track daily so while it’s only been twice now that I’ve experienced this crash, I believe it is due to the once a week injections.

I called my clinic and they said something like, “things will even out - stay the course”. But they also told me that if I wanted to supply my own needles that twice a week is OK with them.

My does of T Cyp. (210/week) is high, from what I’ve been reading, but I don’t want to alter it for now without my doc’s permission. I also don’t want to alter the HCG routine just yet, but may look at that in the future.

But what I am going to do is to split my 210mg/week into 2 doses using 29g .5" 1/2CC insulin syringes. I plan on Monday and Thursday, to follow my HCG injection schedule, and will switch from IM to sub q.

Also - I will split my anastrazole pill in half and take .5MG on Monday and Thursdays.

It seems ridiculous to already tweak, but I know how I feel and it’s like going backwards - maybe even worse. I wanted to do exactly what my doctor said, but I also feel like educating myself and deciding for myself is what’s best for me.

So I’m only changing three things:

  • Test cyp. Injection frequency - changing to twice weekly
  • Test cyp. Injection type - changing from IM to sub q
  • Splitting anastrazole does in two - changing from 1x week to twice a week

Does anyone have any feedback on my plan?

2

Looks like a step in the right direction. Get follow up labs done in a month to see where you’re at.

3

Can you believe my doc wants to wait 13 weeks??? I’ll do my own at 8 weeks, I think.

4

Looks like a good change.
But T dose easily excessive.

Some would need 2mg anastrozole per week to manage 200mg T per week.
So you are probably suffering from surges of E2.

Refer to:

Please read the stickies found here: About the T Replacement Category - #2 by KSman

  • advice for new guys
  • things that damage your hormones
  • protocol for injections
  • finding a TRT doc

You need to know your stuff and not be passive with the docs and clinics as they often fail.

5

KSman - thanks for the input! That’s a great point about needing more anastrazole to manage that level of T.

I was trying not to modify the doctor’s dosage, but from everything I’ve read, it is excessive, and that you recommend starting at 100MG per week. If I modify his dose I guess I’m either going to have to tell him or choose not to tell him…

Thanks again. I will think about it, for sure!

6

Many have great results on 100mg/week. If years later you need to kick it up because of age, you still have some head room left. We have seen some guys never get things right on 200mg/week. Now we have more and more T-clinics blinding starting guys on 200mg/week. But that is what many are now seeking…

Hematocrit needs to be watched. Some guys get in trouble on 100mg/week and 200mg/week would then be dangerous.

If one’s thyroid function or adrenals are not in good shape, the increased/restored metabolic demands from TRT can run out of gas against those other issues. 200mg/week would then crash harder.

Any labs to post?

1 Like
7

you’re probably crashing on Mondays – and it takes a day or so after that injection to ramp up your levels again - so the 2x/week pin should help even things out. The fact that you were taking 200 mg per week – which is a very high dose by the way – may have exacerbated the crash as you come down hard after seven days. As noted above – try a lower dose two times a week and you should be good to go.

8

Why the hell would the doc prescribe such a high dose? Ugh. I guess I am going to have to cut his dose in half see how it goes.

My hematocrit was already to within a few points of the upper limit - probably because of snoring. I donated blood the first week and plan on doing so every two months.

As for thyroid function, I’m checked my temperature today and it’s low. 96.3 upon waking, 96.6 3 hours later, and 96.8 6 hours after waking and also 9 hours after waking (3:30pm). I’ll be doing this for the next few days as well.

So my new, tweaked protocol is going to be:

  • Test cyp 105MG per week split even in two doses, Mon and Thursdays injected sub q
  • 1MG per week of anastrazole split into two doses - taken on injection days
  • 500IU HCG twice per week - same days as T

My labs pre-medication were:
Total T: 414
Free T: 4.7
LH: 2.4
Estradiol: 17.5

Today is Wednesday and I’m super tired…think I got a good night of sleep but man do I feel tired.

Off to do more reading! Thanks, guys!

9

200 mg/week T would be a problem with your hematocrit.

Low body temperatures:
Have you been using iodized salt to support thyroid hormone production?
Are outer eyebrows sparse?

Labs:
TSH
fT3
fT4 [please not T3, T4]
AM cortisol at 8AM

Fatigue can be thyroid and/or cortisol[adrenal]

Waiting on more info about you, see the first sticky.

10

Thanks for the response. I ordered new labs last night - did them this morning before seeing your post, but I did get all of those except for cortisol. I also got free and total T, along with sensitive E2 and a CBC.

Tired again today. Also reminded myself that I have been having mild headaches almost every day, which is rare for me - I never get headaches.

As for the iodized salt, not yet. I just ordered some that will be here tomorrow, and I will continue to take my temp a few times a day at the same time to get some consistent data.

Blood pressure today midday was slightly elevated.

I took .25MG of anastrazole last night before going to bed to see if it would make me feel any better today. It may have worked a little. Lab work will tell.

Again, thanks for the response!

11

Why were you not using iodized salt?

Symptom: Are outer eyebrows sparse?

12

Just read about iodized salt and the thyroid yesterday.

Eyebrows - haven’t looked at them for a long time but they seem thinner than they used to be.

13

Quick update.

Rough past week, but hopefully things will be looking up with new protocol.

Today was medication day, so I just administered my first modified dosage, consisting of:

  • .5mg anastrazole
  • 52.5mg Test Cyp
  • 500 IU HCG

Notes:

  • HCG still stings like a bitch, despite numerous injection sites
  • New 29 gauge needles for sub c test was painless. Drawing the T took a while but thankfully my test is 210mg/ml so I only have to draw .25ml :smile:
  • using the pill cutter on the anastrazole seems imprecise, but it’ll probably do the trick

I expect lab work soon, which will be interesting to correlate how I felt last week on original 210mg/week dosage.

Thyroid/Body Temp

  • I have been monitoring my temperature for the past 6 days and every day my waking temp has been below 97.3 degrees. Only one day my temp has gotten anywhere close to 98.6 at 3pm. Iodoral arrives tomorrow.
14

Update:

The past 8 days have been much better. And it has only been 8 days (3 times administering meds) since I modified my dose from 210mg to 105mg and split my dose of anastrazole. I feel tired, foggy, and unmotivated today, but maybe that’s just because I didn’t sleep that well last night.

Lab work from 12/22 finally came in. I got this lab work done 3 days after my 210mg dose of T and 1mg anastrazole the preceding Monday and .25mg anastrazole Wed evening. I felt like shit and suspected that my E2 might be off the charts. It WAS off the charts, but at the other end of the spectrum…

Results:

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Notes from the results:

  • Total and Free T were off the charts high
  • E2, at 8.4 was almost out of range on the low end
  • Hematocrit well within ref. range
  • Have to read about interpreting my thyroid tests. i.e. TSH, fT4 and fT3

I am really glad I listened to you guys regarding the 210mg per week dose. Obviously that was just “off-the-charts” stupid. So thank you @KSman and others.

Surprised that my E2 was so low after 210mg of T, and 1.25mg of anastrazole.

Questions

  1. I ordered this lab work on Wed evening because I was feeling bad. I suspected it was due to high E2, so on Wed evening I took .25mg of anastrazole. Blood drawn Thursday morning. How much that would have knocked down my E2?
  2. Do I need 1mg/week of anastrazole or is this too much?
  3. Should I get more labs done this week?
  4. Should I stay the course and let things settle down or modify anastrazole dosage?
  5. Any feedback on thyroid labs is appreciated

I really don’t mind getting more labs and I’m wary of altering anything else - want to make sure I give things a solid chance and not change too much.

In other news, have been supplementing with 50mg of iodoral for the past 4 days. Waking temps about the same.

15

Tired again today…tired all day yesterday. Joints don’t hurt but I notice them - popping, cracking.

On second thoughts, and after a lot more reading, I think I should skip my AI dose tomorrow.

E2 being reduced to 8.4 after a big dose of T and an undersized dose of AI (in relation to the T dose) combined with how I’ve been feeling the past 2 days most likely means that my E2 is too low and that I am most likely an over-responder.

Any ideas, guys?

16

Based on advice @KSman gave in another thread, and assuming I’m an over-responder, I’m going to:

Stop anastrozole for 5-6 days for 4 half life washout
Resume at 1/4th the expected dose, 0.25mg a week.
Inject T twice a week and take 0.125mg at time of injections.

17

Thankfully I feel much better today. Joints still making a lot of noise, but at least I got a great night of sleep and felt better upon waking today.

Did my dose and skipped the AI. Getting blood drawn today. Need to confirm that low E2 reading from 2 weeks ago. Also see how my off-the-charts T levels have come down since switching from 210mg to 105mg per week.

18

Lab work came in today for the blood drawn on 1/5/17.

This lab work was exactly 2 weeks after I cut my T cyp. dose in half - from 210mg/week to 105mg/week. My previous labs were:

  • TOTAL T: >1500
  • FREE T: 32.8
  • E2: 8.4

Results of latest labs are:

  • TOTAL T: 787
  • FREE T: 13.2
  • E2: 7.6

I expected to see lower free and total T levels, but perhaps not this low. I will get more blood work done this Thursday (another 2 weeks) and see where we stand, but for now I don’t intend to adjust T dosage for a bit until things stabilize.

I also expected that my E2 might be the same or a bit higher, but it was slightly lower. Blood work done this Thursday will be 2 weeks with no AI. Probably be 3 or 4 weeks until I get the damn lab results. In the meantime, I expect that my E2 will rise and I will be on the lookout for high E2 symptoms. Until that point, I will not be taking any more AI.

Current dosage and protocol:
105mg Test. Cyp. divided evenly dosed 2 x per week (Mon and Thurs)
250IU HCG EOD

I did end up making the final tweak to my protocol for now, and that is doing 250IU of HCG EOD as recommended. I figure there’s nothing else to modify at this point.

In other news, I have been supplementing with Iodoral for a little over 2 weeks now. Lost my damn thermometer so can’t check body temps but will get a new one soon.

I feel like my life is slowly coming back after feeling awful with low E2. I actually worked out, did yoga, and went surfing this past weekend. This is a change because nothing got me excited when E2 was low and I had ZERO motivation for working out or doing hobbies that I love.

Now if I can only get used to waking up in the middle of the night with a god damn baseball bat between my legs getting in the way when I try and roll over. It’s like a kick stand on a bicycle.

Thoughts? Comments? Opinions?

19

Please take all of this with a grain of salt as I’m not an expert.

We have similar situations. Skipping all of my boring details, I finally found a protocol that works for me. I realized that AI really dropped me low on E and I had to learn to be very careful. Rarely take it and feel great around 30 E.

Also, I take .5 cc Hcg with another .5 cc T in the same syringe twice a week SubQ. That works out to 500 IU HCG and 100 mg TC.

This has worked much better than my other protocols and I have tried THEM ALL!

Good luck and make sure you make changes very carefully so you can track what works and what doesn’t. Take care!

20

Thanks for the reply @longjourney - When do you take AI? What do you base it on?