protocol suggestion

utex89

New Member
Hello all, was hoping to get suggestions. For the past few years I have been taking 100mg every 3.5 days along with .25-.5 mg of anastrozole with each injection.
Lab results from bloodwork at trough, right before next injection:
Total MS Testosterone 888 ng/dL (250-1100)
Dialysis free Testosterone 270.7 pg/mL (35-155)
Estrodial ultrasenstivie 30 pg/mL (<=29)

I decided to try 40 mg EOD (~140mg weekly) for two reasons. I'd been having some issues for the past few months with ED, even with usage of cialis. Lowered libido as well. Additionally, I wanted to see if by lowering dosage and switching to more frequent injections if I could eliminate the need for an AI.

4 weeks after the protocol change I took additional labs using the same tests:
Total MS 589 ng/dL (250-1100)
Dialysis free 180.9 (35-155)
Estrodial ultrasensitive 80 pg/mL (<=29)

I felt a slight improvement maybe the first week or two of the change but now it seems the ED is a bit worse than before. My estrodial seems very high even with EOD frequency and lowered dosage. Am I one of those people that just needs an AI? Historically my SHBG has come in around 10-11 nmol/L (10-50). Looking for thoughts on where I should go from here.
 

madman

Member
Hello all, was hoping to get suggestions. For the past few years I have been taking 100mg every 3.5 days along with .25-.5 mg of anastrozole with each injection.
Lab results from bloodwork at trough, right before next injection:
Total MS Testosterone 888 ng/dL (250-1100)
Dialysis free Testosterone 270.7 pg/mL (35-155)
Estrodial ultrasenstivie 30 pg/mL (<=29)

I decided to try 40 mg EOD (~140mg weekly) for two reasons. I'd been having some issues for the past few months with ED, even with usage of cialis. Lowered libido as well. Additionally, I wanted to see if by lowering dosage and switching to more frequent injections if I could eliminate the need for an AI.

4 weeks after the protocol change I took additional labs using the same tests:
Total MS 589 ng/dL (250-1100)
Dialysis free 180.9 (35-155)
Estrodial ultrasensitive 80 pg/mL (<=29)

I felt a slight improvement maybe the first week or two of the change but now it seems the ED is a bit worse than before. My estrodial seems very high even with EOD frequency and lowered dosage. Am I one of those people that just needs an AI? Historically my SHBG has come in around 10-11 nmol/L (10-50). Looking for thoughts on where I should go from here.


You need to keep in mind that on your original protocol although the weekly dose of 200 mg T (100 mg every 3.5 days) is very high and you were only hitting a trough TT 880 ng/dL that your FT is high due to you having low SHBG (10-11 nmol/L) which would drive up your e2/free e2let alone hemoglobin/hematocrit.

Regardless of where your trough TT/FT levels sit on the second protocol (40 mg EOD) you need to understand that you had only been on such protocol for 4 weeks which can be very misleading as hormones will be in FLUX during the weeks leading up until blood levels stabilize (4-6 weeks) and it is common for many to experience ups/downs during this transition.

Even then once blood levels stabilize (4-6 weeks) it can take the body 2-3 months to adapt to those new levels and this is the time when one should gauge how they truly feel overall on such protocol.

Too many fall into the trap of gauging how they feel during the transition when hormones are still in FLUX.

Anytime a protocol is tweaked (increase/decrease dose T) hormones will be in FLUX during the weeks leading up until blood levels stabilize and experiencing bumps along the way is to be expected.

You need to give it more time to truly gauge how you feel overall as your body will need time to adjust to the new T levels.

If anything when you decide to tweak the protocol again (dose T/injection frequency) you would most likely do better switching to daily injections using low doses of T seeing as your SHBG is low and not only will you be clipping the peak--->trough but more importantly blood levels will be more stable throughout the week.

Although TT is important to know FT is what truly matters as it is the active unbound fraction of testosterone responsible for the positive effects.

Much respect to you for using an accurate assay to test your FT as it is critical to know where your FT level truly sits on such protocol (dose T/injection frequency).
 

utex89

New Member
Thanks Madman. I'll try and sit with it a bit more and assess how a feel in a few weeks. I was just worried that it would even be possible to feel good with an estrogen level that high, i.e. am I spinning my wheels right now? Is it possible that the estrogen comes down with a bit more time?

I've been reading all the anti AI posts on several sites and it freaked me out a bit. I always felt better taking them than not, as it pertains to libido and erectile function, the last few months aside.

Funnily enough, my hematocrit has never been an issue. Guess I'm lucky with that.
Last hematocrit test at the 200mg weekly does was 46.4 (38.5-50).
 

madman

Member
Thanks Madman. I'll try and sit with it a bit more and assess how a feel in a few weeks. I was just worried that it would even be possible to feel good with an estrogen level that high, i.e. am I spinning my wheels right now? Is it possible that the estrogen comes down with a bit more time?

I've been reading all the anti AI posts on several sites and it freaked me out a bit. I always felt better taking them than not, as it pertains to libido and erectile function, the last few months aside.

Funnily enough, my hematocrit has never been an issue. Guess I'm lucky with that.
Last hematocrit test at the 200mg weekly does was 46.4 (38.5-50).


Some do need to use micro-doses of an AI but it comes down to the individual and what they feel is best.

Your e2 is still very high due to the higher FT.
 

madman

Member
Thanks Madman. I'll try and sit with it a bit more and assess how a feel in a few weeks. I was just worried that it would even be possible to feel good with an estrogen level that high, i.e. am I spinning my wheels right now? Is it possible that the estrogen comes down with a bit more time?

I've been reading all the anti AI posts on several sites and it freaked me out a bit. I always felt better taking them than not, as it pertains to libido and erectile function, the last few months aside.

Funnily enough, my hematocrit has never been an issue. Guess I'm lucky with that.
Last hematocrit test at the 200mg weekly does was 46.4 (38.5-50).


Hello all, was hoping to get suggestions. For the past few years I have been taking 100mg every 3.5 days along with .25-.5 mg of anastrozole with each injection.
Lab results from bloodwork at trough, right before next injection:
Total MS Testosterone 888 ng/dL (250-1100)
Dialysis free Testosterone 270.7 pg/mL (35-155)
Estrodial ultrasenstivie 30 pg/mL (<=29)

I decided to try 40 mg EOD (~140mg weekly) for two reasons. I'd been having some issues for the past few months with ED, even with usage of cialis. Lowered libido as well. Additionally, I wanted to see if by lowering dosage and switching to more frequent injections if I could eliminate the need for an AI.


Unfortunately, you were struggling with ED/lower libido even when using an AI and that is with a high FT level.
 

captain_j

New Member
I also have the same issue with SHBG. I've been off and on with an AI, tried both Anastrozole and Exemestane. I've noticed that when I take 200 mg/week test cyp (ED or EOD), it's a lot harder for me to crash my estrogen with an AI. When I go down to 140 mg/week (ED or EOD), I have to be a lot more careful with my AI dosage. But I did the same thing as you, going down to 140 mg/week hoping to eliminate my AI. My estradiol seemed to float in the mid to upper 50s on that protocol. While I did feel "better" from the absence of an AI, that protocol still isn't optimal for me. I think having total E2 in the mid to upper 50s with low SHBG meant that my free E2 was most likely high. I'm still on 140 mg per week at the moment, and am trying to only take an AI here and there when I feel the need. I know this isn't really great because it's not consistent, but I hate the way AI's make me feel. I think ultimately the move may be to lower my dose from 140 down to 120 or maybe even 100, but my libido was never as good on 140 + no AI as it was on 200 + AI.

For my personally, I did not see a change in my total E2 between an ED and EOD protocol. I am still currently doing ED just because of the low SHBG.

Maybe you can try just taking a small dose of AI once a week?
 

madman

Member
I also have the same issue with SHBG. I've been off and on with an AI, tried both Anastrozole and Exemestane. I've noticed that when I take 200 mg/week test cyp (ED or EOD), it's a lot harder for me to crash my estrogen with an AI. When I go down to 140 mg/week (ED or EOD), I have to be a lot more careful with my AI dosage. But I did the same thing as you, going down to 140 mg/week hoping to eliminate my AI. My estradiol seemed to float in the mid to upper 50s on that protocol. While I did feel "better" from the absence of an AI, that protocol still isn't optimal for me. I think having total E2 in the mid to upper 50s with low SHBG meant that my free E2 was most likely high. I'm still on 140 mg per week at the moment, and am trying to only take an AI here and there when I feel the need. I know this isn't really great because it's not consistent, but I hate the way AI's make me feel. I think ultimately the move may be to lower my dose from 140 down to 120 or maybe even 100, but my libido was never as good on 140 + no AI as it was on 200 + AI.

For my personally, I did not see a change in my total E2 between an ED and EOD protocol. I am still currently doing ED just because of the low SHBG.

Maybe you can try just taking a small dose of AI once a week?


200 mg/week split daily or EOD is a whopping dose of T for someone with low SHBG.

Did you ever have your FT tested using an accurate assay Equilibrium Dialysis or Ultrafiltration?

Your FT and e2/free e2 would most likely have been way too high on such a dose.

Let alone RBCs/hemoglobin/hematocrit.

It comes down to where your FT level sits.

Too high an FT will result in high e2/free e2.

Ideally one should try to find the lowest FT level they can run without having to use an aromatase inhibitor where they still reap the beneficial effects of testosterone while at the same time minimizing/avoiding any potential side-effects.

Much easier said than done especially when too many get caught up in the more T is better mentality.

Most never take the chance of trying to run lower FT levels to avoid the potential side-effects when in many cases they may very well end up feeling much better in the long run.

These are the same individuals that end up chasing their tales indefinitely!

Top it off with the hard reality that too many never give a lower dosed protocol a surviving chance.

As when one tweaks a protocol (increase/decrease dose T) not only will hormones be in FLUX during the weeks leading up until blood levels stabilize (4-6 weeks) which can be very misleading as it is the most difficult time for most especially when lowering dose as one will be sure to experience bumps along the way.

Even once blood levels stabilize it will take 2-3 months for the body to adapt to those new levels and this is the critical time period when one should gauge how they truly feel regarding relief/improvement of low-t symptoms.

This is where the majority make the grave mistake of not giving the body enough time to adapt and most will bail out way too early claiming that they feel much worse on a lower dose of T and end up jumping right back on using a higher dose.

This is where finding an effective protocol can turn out to be a real SHIT SHOW!
 
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madman

Member
I also have the same issue with SHBG. I've been off and on with an AI, tried both Anastrozole and Exemestane. I've noticed that when I take 200 mg/week test cyp (ED or EOD), it's a lot harder for me to crash my estrogen with an AI. When I go down to 140 mg/week (ED or EOD), I have to be a lot more careful with my AI dosage. But I did the same thing as you, going down to 140 mg/week hoping to eliminate my AI. My estradiol seemed to float in the mid to upper 50s on that protocol. While I did feel "better" from the absence of an AI, that protocol still isn't optimal for me. I think having total E2 in the mid to upper 50s with low SHBG meant that my free E2 was most likely high. I'm still on 140 mg per week at the moment, and am trying to only take an AI here and there when I feel the need. I know this isn't really great because it's not consistent, but I hate the way AI's make me feel. I think ultimately the move may be to lower my dose from 140 down to 120 or maybe even 100, but my libido was never as good on 140 + no AI as it was on 200 + AI.

For my personally, I did not see a change in my total E2 between an ED and EOD protocol. I am still currently doing ED just because of the low SHBG.

Maybe you can try just taking a small dose of AI once a week?


------------------------------------------------------------------------------------------------------

My protocol:
20 mg test cyp daily
2 mg exemestane daily (vodka solution microdose)
140 IU HCG EOD

Latest Labs 2020-6-5 (taken before I went back on an AI):
Estradiol Ultrasensitive -- 55 pg/mL (<29)
Testosterone, Total, MS -- 1140 ng/dL (250-1100)
Testosterone, Free -- 275.9 pg/mL (35-155)
DHT, LC/MS/MS -- 47 ng/dL. (12-65
------------------------------------------------------------------------------------------------------





Take a close look at where your FT sat on 140 mg/week T split 20 mg daily and that was having it tested using one of the most accurate FT assays Equilibrium Ultrafiltration!

It is very high, now imagine how high it would have been on your previous 200 mg/week split daily or EOD?

Absurd to say the least.

You have low SHBG and will be able to get away with injecting much lower weekly doses of T (more frequently) to achieve a healthy FT level.
 

captain_j

New Member
@madman Thanks for the replies. I can't disagree with anything you've said. Including the reluctance I have to give a much lower dose a chance. I know it's something I need to. I think my next move would be to drop down to 16 mg daily (112 mg week total) and see where I end up on that protocol. Part of my issue is that I've been lifting weights since my early 20s (I'm about to turn 39) and have always had a very hard time putting on muscle. I managed to get up to around 185 lbs by the end of my 20s, all natural of course. 5 years ago or so when I started having low T issues, I started losing almost all of my muscle. I was down to 158 lbs and I'm 6 foot tall just because my body could not hold onto muscle anymore. As soon as I got on TRT, the gains were just incredible and I have been enjoying that aspect ever since. It's something I don't want to lose entirely, but I just have to try a lower dose and see how it goes. I may still be able to keep gaining muscle even at the lower dose.
 

madman

Member
@madman Thanks for the replies. I can't disagree with anything you've said. Including the reluctance I have to give a much lower dose a chance. I know it's something I need to. I think my next move would be to drop down to 16 mg daily (112 mg week total) and see where I end up on that protocol. Part of my issue is that I've been lifting weights since my early 20s (I'm about to turn 39) and have always had a very hard time putting on muscle. I managed to get up to around 185 lbs by the end of my 20s, all natural of course. 5 years ago or so when I started having low T issues, I started losing almost all of my muscle. I was down to 158 lbs and I'm 6 foot tall just because my body could not hold onto muscle anymore. As soon as I got on TRT, the gains were just incredible and I have been enjoying that aspect ever since. It's something I don't want to lose entirely, but I just have to try a lower dose and see how it goes. I may still be able to keep gaining muscle even at the lower dose.


Would be a sensible move to try lowering your dose slightly than once blood levels stabilize give it some time.

Regarding gaining muscle on trt doses (100-200mg/week) although having a healthy FT level will improve body composition (muscle gain/fat loss) when following a proper diet/training protocol it will be minor in terms of pure muscular gains (actin/myosin) when compared to using steroid doses (300-600 mg/week) of testosterone.

Let alone genetics will have the final say and even then you will be lucky to gain 5-7 lbs of pure muscle tissue.

You state you had been training since your early 20s and managed to get up to 185 lb natty by your late 20s and eventually dropped down to 158 lbs 5 years ago when you started experiencing low-tissues.

Once you started trt you state that the gains were incredible but you need to keep in mind that at your peak natty after almost a decade of training under your belt you weighed 185 lb than eventually dropped down to 158 lbs (low-t) and a large percentage of your incredible gains would have been regained due to muscle memory.

Sure when you started trt you were injecting 200 mg/week split daily or EOD which would have had your FT level absurdly high as you have low SHBG and looking over your most recent labs you can see that your FT is still on the high end using a much lower weekly dose of T 140 mg/week split daily.

So most of your incredible gains were regained weight (muscle memory) plus the additional muscle you gained which would be in no way significant even from having a higher FT level using trt doses.

Most claiming to gain 15-20 lbs on trt is not putting on pure muscle tissue (actin/myosin) as a large percentage will be water weight inside (intra-cellular) the muscle cell and between the muscle/skin (extra-cellular).

As long as your FT levels are healthy and you are following a proper diet/training protocol then you will not lose any muscle.

Even than with average FT levels as long as you are following a proper diet/training protocol you will not lose muscle.

We are on trt here not using/abusing testosterone let alone packing on any significant amount of muscle.

Too many get caught up in thinking trt doses are going to pack on muscle let alone have one's libido through the roof.
 

madman

Member
@madman Thanks for the replies. I can't disagree with anything you've said. Including the reluctance I have to give a much lower dose a chance. I know it's something I need to. I think my next move would be to drop down to 16 mg daily (112 mg week total) and see where I end up on that protocol. Part of my issue is that I've been lifting weights since my early 20s (I'm about to turn 39) and have always had a very hard time putting on muscle. I managed to get up to around 185 lbs by the end of my 20s, all natural of course. 5 years ago or so when I started having low T issues, I started losing almost all of my muscle. I was down to 158 lbs and I'm 6 foot tall just because my body could not hold onto muscle anymore. As soon as I got on TRT, the gains were just incredible and I have been enjoying that aspect ever since. It's something I don't want to lose entirely, but I just have to try a lower dose and see how it goes. I may still be able to keep gaining muscle even at the lower dose.


Most will be hard-pressed when you tell them that a significant percentage of the gains can very well be water weight.

Intracellular water weight would be considered lean mass.

Extracellular water weight would be considered water retention, puffiness, bloat!

These are the gains many steroid users (testosterone/AAS) piss away when coming off cycle let alone there are many men who end up coming of trt and end up dropping a fair amount of water weight quickly.







post#3
 
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utex89

New Member
Just wanted to provide a little update. I've been trying 66mg every 3.5 days (132 mg weekly) and no AI for the last month. So far it seems to be an improvement over the EOD dosing protocol I tried in my original post. ED has more or less gone away and I have some libido again. Hopefully this trend continues.

My blood levels at this does were:
Total MS - 556 ng/dl
dialysis Free - 162.8 pg/ml

It seems like such a minor difference in blood levels, but it seems to be making a difference.

I haven't had a estrodial taken yet, but I will likely do so at some point in the future.
 

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