Amendment to the Trt protocol. Daily protocol, EOD, doses? Consequences and parameters to follow.

gerardo

Member
Hello everyone. I have recently been part of this forum and I thank you in advance as I am finding it interesting. I have seen a lot of other topics and found it important to post this topic.
I'm 51 years old, I'm a little bit fat. 01 year ago I started trt protocol with Nebido. 01 injection + 1 with 45 days + 1 with 120 days and maintenance with one application every 3 months. With this protocol some things improved, but I had problems with hematocrit, testicular atrophy, decreased sperm and some symptoms of prostatic hyperplasia. The E2 oscillated upwards and the breasts started to become sensitive and at the end of the second month, it returned to the middle. TT and FT were at good levels with a decline in the third month. SHBG has decreased. And progesterone is always too low (<10).

With the help of this forum (thanks Madman and everyone) I decided to change the protocol instead of applying the 90-day Nebido again. I started with 20Mg of testosterone cypionate / every two days subq. Today I have started 10 days (5 applications of 20Mg). As I previously had problems with hematocrit, high E2, decreased SHBG, testicular atrophy and decreased sperm, I decided to do some blood tests to follow up. Blood was collected 14 hours after the last subq injection. I know that the timing is not ideal, but if we know in advance what is happening along with the symptoms, could we not reduce some side effects and find the lowest dose with the benefits of exogenous testosterone? So I bring you, who are more experienced, some doubts for discussion because, unfortunately, doctors don't care. After the 5 sub injections of 20Mg what happened. E2 has increased to the limit. The hematocrit is fine. Progesterone remains very low. TT and FT increased at the upper limit. I feel good, but a little anxious (E2?), Sensitive breasts. The SHBG keeps it low (12). Since E2 is increasing until the TT and FT levels stabilize, what do you think? Do I decrease the dose by 20Mg or 15Mg or 12 Mg every two days? Do I change to 8Mg, 10 Mg daily? Even if the E2 effect was changed to 10 Mg per day and the others would not tend to remain unbalanced? How to make Progesterone replacement? About DHEA I suspended for now because it also increases my E2 as well as HCG. For now only with testosterone cypionate.

Exams done today:

Hematocrit: 44 (40 - 55). I was in 53 and I had two phlebotomies.
E2: 35 pg / ml (11 - 42). It was 17.5. In me the E2 needs is between 20-30.
FSH: 0.23. Before Trt it was 2.70. I don't need fertility, but I need a lot of sperm and the testicles are not so small.
LH: 0.09. Before, it was 2.06.
Progesterone: <10
Ferritin: 42
FT: 32.7 ng / dL (1.67 - 18.3). I know that the actual levels may be different. Here we do not have the equilibrium dialysis method.
TT: 959.04 ng / dL (142 - 923)
SHBG: 12.7 nmol / L. Before Trt it was 21.8.

Thank you to everyone who can participate with your experiences.
 

madman

Member
Hello everyone. I have recently been part of this forum and I thank you in advance as I am finding it interesting. I have seen a lot of other topics and found it important to post this topic.
I'm 51 years old, I'm a little bit fat. 01 year ago I started trt protocol with Nebido. 01 injection + 1 with 45 days + 1 with 120 days and maintenance with one application every 3 months. With this protocol some things improved, but I had problems with hematocrit, testicular atrophy, decreased sperm and some symptoms of prostatic hyperplasia. The E2 oscillated upwards and the breasts started to become sensitive and at the end of the second month, it returned to the middle. TT and FT were at good levels with a decline in the third month. SHBG has decreased. And progesterone is always too low (<10).

With the help of this forum (thanks Madman and everyone) I decided to change the protocol instead of applying the 90-day Nebido again. I started with 20Mg of testosterone cypionate / every two days subq. Today I have started 10 days (5 applications of 20Mg). As I previously had problems with hematocrit, high E2, decreased SHBG, testicular atrophy and decreased sperm, I decided to do some blood tests to follow up. Blood was collected 14 hours after the last subq injection. I know that the timing is not ideal, but if we know in advance what is happening along with the symptoms, could we not reduce some side effects and find the lowest dose with the benefits of exogenous testosterone? So I bring you, who are more experienced, some doubts for discussion because, unfortunately, doctors don't care. After the 5 sub injections of 20Mg what happened. E2 has increased to the limit. The hematocrit is fine. Progesterone remains very low. TT and FT increased at the upper limit. I feel good, but a little anxious (E2?), Sensitive breasts. The SHBG keeps it low (12). Since E2 is increasing until the TT and FT levels stabilize, what do you think? Do I decrease the dose by 20Mg or 15Mg or 12 Mg every two days? Do I change to 8Mg, 10 Mg daily? Even if the E2 effect was changed to 10 Mg per day and the others would not tend to remain unbalanced? How to make Progesterone replacement? About DHEA I suspended for now because it also increases my E2 as well as HCG. For now only with testosterone cypionate.

Exams done today:

Hematocrit: 44 (40 - 55). I was in 53 and I had two phlebotomies.
E2: 35 pg / ml (11 - 42). It was 17.5. In me the E2 needs is between 20-30.
FSH: 0.23. Before Trt it was 2.70. I don't need fertility, but I need a lot of sperm and the testicles are not so small.
LH: 0.09. Before, it was 2.06.

Progesterone: <10
Ferritin: 42
FT: 32.7 ng / dL (1.67 - 18.3). I know that the actual levels may be different. Here we do not have the equilibrium dialysis method.
TT: 959.04 ng / dL (142 - 923)
SHBG: 12.7 nmol / L. Before Trt it was 21.8.

Thank you to everyone who can participate with your experiences.

I'm 51 years old, I'm a little bit fat. 01 year ago I started trt protocol with Nebido. 01 injection + 1 with 45 days + 1 with 120 days and maintenance with one application every 3 months. With this protocol some things improved, but I had problems with hematocrit, testicular atrophy, decreased sperm and some symptoms of prostatic hyperplasia. The E2 oscillated upwards and the breasts started to become sensitive and at the end of the second month, it returned to the middle. TT and FT were at good levels with a decline in the third month. SHBG has decreased. And progesterone is always too low (<10).

As you should very well know by now that these side-effects are expected and common when using exogenous testosterone although hematocrit may be better controlled for some when using the very long-acting testosterone undecanoate (Nebido).

Use of hCG along with trt will not only prevent/minimize testicular atrophy but also maintain fertility.

Injectable T has been shown to have a greater impact on increasing HCT compared to transdermal T.

3–18% with transdermal administration and up to 44% with injection.

In most cases when using injectable T high supra-physiological peaks post-injection and overall T levels (running too high TT/FT level) will have a big impact on increasing HCT.

Manipulating injection frequency by injecting more frequently using lower doses of T resulting in minimizing the peak--->trough and maintaining more stable levels may lessen the impact on HCT but it is not a given.

As again running very high TT/FT levels will have a stronger impact on driving up HCT.

T formulation, the dose of T, genetics (polymorphism of the AR), age all play a role in the impact a trt protocol will have on blood markers (RBCs/hemoglobin/hematocrit).

Other factors such as sleep apnea, smoking can have a negative impact on hematocrit.


I started with 20Mg of testosterone cypionate / every two days subq. Today I have started 10 days (5 applications of 20Mg). As I previously had problems with hematocrit, high E2, decreased SHBG, testicular atrophy and decreased sperm, I decided to do some blood tests to follow up. Blood was collected 14 hours after the last subq injection. I know that the timing is not ideal, but if we know in advance what is happening along with the symptoms, could we not reduce some side effects and find the lowest dose with the benefits of exogenous testosterone?

You are still not understanding how this works!

You just switched over from Nebido to TC 20 mg EOD which you have only been on for 10 days.

Having blood work done this soon is pointless as again when starting trt or tweaking a protocol (dose T/injection frequency) hormones will be in flux during the weeks leading up until blood levels stabilize (4-6 weeks).

You need to wait until your blood levels stabilize then have blood work done at the true trough.

Where your TT/FT/e2 levels sit as of now is misleading!


After the 5 sub injections of 20Mg what happened. E2 has increased to the limit. The hematocrit is fine. Progesterone remains very low. TT and FT increased at the upper limit. I feel good, but a little anxious (E2?), Sensitive breasts. The SHBG keeps it low (12). Since E2 is increasing until the TT and FT levels stabilize, what do you think? Do I decrease the dose by 20Mg or 15Mg or 12 Mg every two days? Do I change to 8Mg, 10 Mg daily? Even if the E2 effect was changed to 10 Mg per day and the others would not tend to remain unbalanced?

You need to stick to the protocol (dose T/injection frequency) as again it will take 4-6 weeks for blood levels to stabilize than blood work is done at the true trough to see where your TT/FT/e2 levels sit on such protocol.....end of story!

Your SHBG is very low and injecting lower doses of T more frequently as in daily or EOD would be sensible let alone you will not need a very high TT to achieve a healthy FT level.

You may always have issues with higher e2 depending on where your FT level sits.


Exams done today:

Hematocrit: 44 (40 - 55). I was in 53 and I had two phlebotomies.
E2: 35 pg / ml (11 - 42). It was 17.5. In me the E2 needs is between 20-30.
FSH: 0.23. Before Trt it was 2.70. I don't need fertility, but I need a lot of sperm and the testicles are not so small.
LH: 0.09. Before, it was 2.06.
Progesterone: <10
Ferritin: 42
FT: 32.7 ng / dL (1.67 - 18.3). I know that the actual levels may be different. Here we do not have the equilibrium dialysis method.
TT: 959.04 ng / dL (142 - 923)
SHBG: 12.7 nmol / L. Before Trt it was 21.8.


Again no need to test LH/FSH.

Not sure if you had donated previously when you were on Nebido but your ferritin may be low (post reference range)?
 

gerardo

Member
I'm 51 years old, I'm a little bit fat. 01 year ago I started trt protocol with Nebido. 01 injection + 1 with 45 days + 1 with 120 days and maintenance with one application every 3 months. With this protocol some things improved, but I had problems with hematocrit, testicular atrophy, decreased sperm and some symptoms of prostatic hyperplasia. The E2 oscillated upwards and the breasts started to become sensitive and at the end of the second month, it returned to the middle. TT and FT were at good levels with a decline in the third month. SHBG has decreased. And progesterone is always too low (<10).

As you should very well know by now that these side-effects are expected and common when using exogenous testosterone although hematocrit may be better controlled for some when using the very long-acting testosterone undecanoate (Nebido).

Use of hCG along with trt will not only prevent/minimize testicular atrophy but also maintain fertility.

Injectable T has been shown to have a greater impact on increasing HCT compared to transdermal T.

3–18% with transdermal administration and up to 44% with injection.

In most cases when using injectable T high supra-physiological peaks post-injection and overall T levels (running too high TT/FT level) will have a big impact on increasing HCT.

Manipulating injection frequency by injecting more frequently using lower doses of T resulting in minimizing the peak--->trough and maintaining more stable levels may lessen the impact on HCT but it is not a given.

As again running very high TT/FT levels will have a stronger impact on driving up HCT.

T formulation, the dose of T, genetics (polymorphism of the AR), age all play a role in the impact a trt protocol will have on blood markers (RBCs/hemoglobin/hematocrit).

Other factors such as sleep apnea, smoking can have a negative impact on hematocrit.


I started with 20Mg of testosterone cypionate / every two days subq. Today I have started 10 days (5 applications of 20Mg). As I previously had problems with hematocrit, high E2, decreased SHBG, testicular atrophy and decreased sperm, I decided to do some blood tests to follow up. Blood was collected 14 hours after the last subq injection. I know that the timing is not ideal, but if we know in advance what is happening along with the symptoms, could we not reduce some side effects and find the lowest dose with the benefits of exogenous testosterone?

You are still not understanding how this works!

You just switched over from Nebido to TC 20 mg EOD which you have only been on for 10 days.

Having blood work done this soon is pointless as again when starting trt or tweaking a protocol (dose T/injection frequency) hormones will be in flux during the weeks leading up until blood levels stabilize (4-6 weeks).

You need to wait until your blood levels stabilize then have blood work done at the true trough.

Where your TT/FT/e2 levels sit as of now is misleading!


After the 5 sub injections of 20Mg what happened. E2 has increased to the limit. The hematocrit is fine. Progesterone remains very low. TT and FT increased at the upper limit. I feel good, but a little anxious (E2?), Sensitive breasts. The SHBG keeps it low (12). Since E2 is increasing until the TT and FT levels stabilize, what do you think? Do I decrease the dose by 20Mg or 15Mg or 12 Mg every two days? Do I change to 8Mg, 10 Mg daily? Even if the E2 effect was changed to 10 Mg per day and the others would not tend to remain unbalanced?

You need to stick to the protocol (dose T/injection frequency) as again it will take 4-6 weeks for blood levels to stabilize than blood work is done at the true trough to see where your TT/FT/e2 levels sit on such protocol.....end of story!

Your SHBG is very low and injecting lower doses of T more frequently as in daily or EOD would be sensible let alone you will not need a very high TT to achieve a healthy FT level.

You may always have issues with higher e2 depending on where your FT level sits.


Exams done today:

Hematocrit: 44 (40 - 55). I was in 53 and I had two phlebotomies.
E2: 35 pg / ml (11 - 42). It was 17.5. In me the E2 needs is between 20-30.
FSH: 0.23. Before Trt it was 2.70. I don't need fertility, but I need a lot of sperm and the testicles are not so small.
LH: 0.09. Before, it was 2.06.
Progesterone: <10
Ferritin: 42
FT: 32.7 ng / dL (1.67 - 18.3). I know that the actual levels may be different. Here we do not have the equilibrium dialysis method.
TT: 959.04 ng / dL (142 - 923)
SHBG: 12.7 nmol / L. Before Trt it was 21.8.


Again no need to test LH/FSH.

Not sure if you had donated previously when you were on Nebido but your ferritin may be low (post reference range)?
Yes. Ferritin went down after I made two blood donations.
I understood what you said. What I mean is that even if the exams are done before 4 .. 6 weeks and in view of my reported history and aiming at decreasing the oscillation if decreasing the dosage and applying daily would not be interesting. If with 5 applications of 20Mg on alternate days, my TT and FT increased and if I changed to 8Mg daily what could be expected? I think the maximum peak increase would decrease and the minimum peak more stable. And Hcg I am watching to see the most appropriate time to start, because I believe that the dose of cypionate should decrease a little. Here we have the sublingual Hcg (I know it is controversial) which is from a very reliable pharmacy. I did a small test a month ago with 125 ui sublingual daily and the E2 and Testo increased and I had to stop. I also have injectable HCG. Thanks.
 
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