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TRT recommendations

drewfuss said:
I've been on 200mg for 4 weeks and it's been a noticeable difference over the 190.
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Dialed in TRT protocol is a good thing. Looking forward to seeing your bloodwork.
 
UGH, forgot to post this last week.

We didn't do blood work. I may go to private labs and order some after payday next week. Are there any discount codes or anyplace else to order bloodwork? And what would you recommend to get?
 
Female hormone panel. $65 and google for discount code.
 
These are my blood test results. E2 is 73.9. He's got me starting Adex start 1mg 3 days after my weekly injection, only one day per week.
 
drewfuss said:
Any thoughts on that dosage and frequency?
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Didn't mean to "thank" your post....

As far as your E2, it is high and taking 1mg prob won't hurt for the first few weeks. The hard part is the fact the E2 is so individualized. I pin 50 mgs of test every 3.5 days. I take .25 mgs of arimidex on the injection days. That keeps my E2 at 21. How often are you having to go for bloodwork?
 
Your SHBG is low and that's why your T levels are so low and E2 is spiking. I was up to 300mg weekly just to stay in range. IMHO you should use EOD injections of 60mg to start and split the Arimidex into .25mg EOD dosing as well until you get it down. Because of the low SHBG you will clear E2 faster also. I could swing from 60's to undetectable in one week with overdoing the AI dosing. You could find yourself needing much lower T dosing once you start high frequency dosing.
 
bad rad said:
Your SHBG is low and that's why your T levels are so low and E2 is spiking. I was up to 300mg weekly just to stay in range. IMHO you should use EOD injections of 60mg to start and split the Arimidex into .25mg EOD dosing as well until you get it down. Because of the low SHBG you will clear E2 faster also. I could swing from 60's to undetectable in one week with overdoing the AI dosing. You could find yourself needing much lower T dosing once you start high frequency dosing.
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His SHBG isn't low. It's nearly mid range. Also, doesn't high SHBG cause Free T to drop and not low SHBG?
 
drewfuss said:
Any other recommendations on the adex dosing?
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Take .5 mgs a week instead of 1 mg, then cut back to .25 mgs a week. If you still feel like you E2 is high then bump up the dose slightly. High and low sides for E2 are similar. Ask your dr for more frequent labs. You should be going every 2-3 months for labs until your protocol is dialed in. Have you asked about self injecting? You may need to start looking for another dr.
 
He'll do labs more often, if there's a reason for it, like in this case. I go to Low T Center, who doesn't offer self injection. I've already considered looking for an Endo so I can self inject, but I don't know where to start looking.
 
sammpedd88 said:
His SHBG isn't low. It's nearly mid range. Also, doesn't high SHBG cause Free T to drop and not low SHBG?
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Serum protein isn't the same as SHBG. My serum protein is normal and his SHBG is 9 which is lower than my low SHBG. When someone with lower SHBG or high bioavailable Test injects a large dose once weekly our numbers sky rocket before dropping like a lead balloon due to the faster metabolizing of the hormone. It also causes our E2 conversion to spike rapidly before also dropping quickly due to hormone turnover rates.

His best bet is small, frequent injections like I use.
 
drewfuss said:
Any other recommendations on the adex dosing?
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Start slow. When I was on 200mg/weekly with single injections .5mg dropped my E2 to high 30's and 1mg dropped E2 to 16. It's easier to adjust when you take smaller doses more frequently. I use .25mg EOD to E4D when required.
 
bad rad said:
Serum protein isn't the same as SHBG. My serum protein is normal and his SHBG is 9 which is lower than my low SHBG. When someone with lower SHBG or high bioavailable Test injects a large dose once weekly our numbers sky rocket before dropping like a lead balloon due to the faster metabolizing of the hormone. It also causes our E2 conversion to spike rapidly before also dropping quickly due to hormone turnover rates.

His best bet is small, frequent injections like I use.
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Thanks for the info, you taught me something regarding SHBG.

Also, I totally agree with smaller more frequent injections. I've been pinning like that for about 4 years now.
 
I thought I read that 1mg adex drops your E2 by 70% after 1 dose. Wouldn't that put me around the mid 20s? Then the subsequent dose being 1 week later drop it too much?
 
drewfuss said:
I thought I read that 1mg adex drops your E2 by 70% after 1 dose. Wouldn't that put me around the mid 20s? Then the subsequent dose being 1 week later drop it too much?
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The standard "rules" don't apply when dealing with low SHBG levels. You really don't want to overdo the AI.
 
Gotcha. Thanks for all the info and help. I've always questioned everything doctors have told me. I've wanted to help myself make a better informed choice, rather than take their word as the final say.
 
I second Bad Rad's advice on overdoing an AI. Low E2 really sucks. That's why you should be getting more frequent labs among other reasons.
 
sammpedd88 said:
I second Bad Rad's advice on overdoing an AI. Low E2 really sucks. That's why you should be getting more frequent labs among other reasons.
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Third this. Low estradiol feels horrible.
 
So I took 1 mg last Friday and another 1 mg on Monday. I must say, it seems to have curbed my moodiness and morning wood is back. I'm going to take .5mg tomorrow, 24 hrs after my injection today, then .5mg on Monday, pending how I'm feeling, and adjust from there.
 
drewfuss said:
So I took 1 mg last Friday and another 1 mg on Monday. I must say, it seems to have curbed my moodiness and morning wood is back. I'm going to take .5mg tomorrow, 24 hrs after my injection today, then .5mg on Monday, pending how I'm feeling, and adjust from there.
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Sounds like you're bringing your E2 down. Now the trick is to find your sweet spot and stay in it. If you start feeling like you did with high E2, you may be getting low. On your next injection, you may want to go with .25 mgs
 
Always try starting at o.5mg every Monday and Thursday first. This is what we call low complexity dose and move up from there accordingly. Let me know of any questions and I am sure we can get you dialed in

Dr B
 
Well, yesterday we drew blood for E2, TT, SHBG, and cFT. Will have the results next Thursday. I've been feeling under the weather this week and lifting has suffered a little, but not horribly. I hope E2 didn't crash. No real signs that it did, but the test results will tell that.
 
trtdoc said:
Always try starting at o.5mg every Monday and Thursday first. This is what we call low complexity dose and move up from there accordingly. Let me know of any questions and I am sure we can get you dialed in

Dr B
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No offense Doc but I wouldn't take 0.5 mgs of arimidex twice a week. Why don't you recommend .25 mgs instead?
 
So labs came back.

TT 199
cFT 4.3
E2 5.9

Everything dropped, which explains my tiredness and weak erections. Joints are popping when lifting, but strength is still there's they upped my dose to 260, drop the adex, and retest in 3 weeks.
 
Roller coaster protocol. What is your exact protocol now? Your posts are a little confusing.
 
As of today, I am on 260mg test cyp once per week. Nothing else is being taken. They are gonna retest in 3 weeks.
 
drewfuss said:
As of today, I am on 260mg test cyp once per week. Nothing else is being taken. They are gonna retest in 3 weeks.
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That's not a good protocol and you are going to continue to have estradiol issues. I suggest this:

200 mg testosterone cypionate split into 100 mg injections every 3.5 days.

Add 0.25 mg Anastrozole the day after injection.

Here is a good read:

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Also,
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I would need to find a new DR to do self injections. Low T Center doesn't offer this, only once weekly office injections. I'm already looking into endos in my area, unless there is one that can do everything by mail that's recommended here. I'm in Ohio.
 
drewfuss said:
I would need to find a new DR to do self injections. Low T Center doesn't offer this, only once weekly office injections. I'm already looking into endos in my area, unless there is one that can do everything by mail that's recommended here. I'm in Ohio.
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I'm in Ohio as well. The best provider I've found is Entourage Hormones out of Arizona. Telemedicine is used. I'm running a log of their services here on AM. $114 per month that includes syringes, HCG, Anastrozole and Testosterone cypionate. Everything except for bloodwork is covered.
 
Here you go.
First AM Patient

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Running 0.5mg of adex bi weekly is the standard. This is evidence based protocol. I have treated thousands and never dropped estrogen conversion with this dose. That being said I would not dose at that if synthetic T is not given per required of at least 150mg weekly

Your current protocol is horrible and will lead you down the wrong path. Time to change providers my friend

Dr. B
 
trtdoc said:
Running 0.5mg of adex bi weekly is the standard. This is evidence based protocol. I have treated thousands and never dropped estrogen conversion with this dose. That being said I would not dose at that if synthetic T is not given per required of at least 150mg weekly

Your current protocol is horrible and will lead you down the wrong path. Time to change providers my friend

Dr. B
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Your saying .5 mg dosed at twice a week tues.sat split etc ?
 
Yes, that is sufficient. I prefer Monday and Friday with the same dosing for injections if ok pinning twice a week.

Have to factor in the half life of the medications.

Dr. B
 
Your total T will drop status post 3 days without adex. Its a similar to a bell curve. You will peak 24/48 hours then drop. Adex does not bind any testosterone it can actually boost testosterone levels

Dr. B
 
I tested at 531 7 days post injection. Add adex and total T drops to 199 7 days post injection. Only thing new was adding Adex for 6 weeks
 
probably invalid labs. Very hard to get exact T levels unless 3 separate draws at 3 separate times or via urine test. Adex will not drop total T
 
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