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Testosterone Replacement, Low T, HCG, & Beyond
Testosterone Basics & Questions
Short vs long esters
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<blockquote data-quote="madman" data-source="post: 199791" data-attributes="member: 13851"><p><strong>If every protocol is needed to be given 2-3 months to asses after the initial 8 weeks, what would be the reason when <u>I started TRT with sustanon in November 2019 I got very quick huge improvements in the means of 2-4 weeks</u>, and in the first 3 months everything was great, UNTIL I stopped absorbing sub-q and my levels fell significantly in a matter of weeks on the same dose without a protocol change?</strong></p><p></p><p>Every protocol should be given 8 weeks after the stabilization period (4-6 weeks).</p><p></p><p>Again there is a lot going on during the weeks leading up until blood levels have stabilized as hormones will be in FLUX and the body is trying to ADJUST to the increasing T levels.</p><p></p><p>First time hopping on trt using the 4 blends esterified T (Sustanon) and you experienced quick/huge improvements within the first 2-4 weeks.</p><p></p><p>Hard to say for sure but you just went from being hypogonadal (pre-trt) to driving up your T levels with the use of exogenous testosterone.....ask anyone that starts trt for the first time especially on the higher dosed protocols many can feel euphoric during the transition period (first 4 weeks) leading up until blood levels have stabilized.</p><p></p><p>Keep in mind many can be going from <300 ng/dL well above 1000 ng/dL 4-6 weeks in.</p><p></p><p>Huge surge in T/dopamine.</p><p></p><p></p><p><strong>and <u>in the first 3 months everything was great, UNTIL I stopped absorbing sub-q and my levels fell significantly in a matter of weeks on the same dose without a protocol change</u>? I think this was the first pitfall.</strong></p><p></p><p>Seems odd that in the first 3 months (12 weeks) everything was great using the same protocol (ester/sub-q injections) then all of a sudden your body supposedly stopped absorbing the T.</p><p></p><p>If such was the case with absorption strictly sub-q it would have more than likely happened much sooner.....not 12 weeks in.</p><p></p><p></p><p><strong>I know you are proponent of sub-q injections, but when my stomach was full of nodules everywhere my levels fell with 40 percent and the way I felt transferred from from God-like to like pre-TRT.</strong></p><p></p><p>If such is truly the case then it is plain and simple.....stick with strictly IM</p><p></p><p>Do what you feel is best for you!</p><p></p><p></p><p><strong>I then tried <u>sub-q enanthate(8 weeks) and shallow IM UGL cyionate protocol(8 weeks) achieving levels of 800-1000 when for the corresponding dose of 160mg per week I was expecting at least 1300</u>. Also I felt way worse on enan and cyp compared to the sustanon on the fallen levels.</strong></p><p><strong>When my levels on sustanon fell I just started to feel pretty much like before TRT, <u>but on the long single esters I felt UNKNOWN apathy and sluggishness and the further I was getting into their protocols the worse I f</u></strong><u><strong>el</strong></u><strong><u>t</u>, to the point in the last week of the sub-q enanthate protocol I was falling asleep at work and almost got kicked out of my job. </strong></p><p></p><p></p><p>Again you only gave each protocol 8 weeks and trough TT was in the high end which would have your trough FT level on the high end with an SHBG 30 nmol/L.</p><p></p><p>You were definitely hitting healthy T levels but even then I would need to see full labs and top it off that I am not too fond of UGL gear!</p><p></p><p>If you truly felt horrible using such esters (IM or sub-q) when compared to Sustanon then go back to using Sus.</p><p></p><p>Hope you understand that the main ester used in Sustanon is decanoate (100 mg to boot) which is longer acting than cypionate/enanthate!</p><p></p><p></p><p><strong>After that <u>I tried scrotal cream, held on that only 3-4 weeks</u> because I got from it terrible unheard of before anxiety and panic attacks, I've never had panic attacks in my life.</strong></p><p></p><p>3-4 weeks then you bailed.....let alone no labs to post!</p><p></p><p></p><p><strong>Then somebody suggested to me to try sustanon IM and at that point my test levels climbed quickly and the way I felt abruptly improved. I quickly got improvements, in a matter of 3-4 weeks even less and started to feel really great, not like the first 2-3 months of TRT, but lets say 80 percent of that.</strong></p><p><strong>And now <u>2-3 months ago I decided to try to ease my life and reduce a life-long sequence of deep IM injections, which was the whole point of transferring to enanthate</u>.</strong></p><p></p><p>Again if you feel best on Sustanon then why waste your time with enanthate/cypionate.</p><p></p><p>The easier fix is to inject shallow IM using a fixed LDS insulin syringe 27-29G x 1/2" (12.7MM) needle length.</p><p></p><p>Pain/scar tissue will be minimal.....problem solved!</p><p></p><p></p><p><u><strong>But I experience the same type of sluggishness I got before on the long single esters, this time is not as bad because I guess Im doing IM</strong></u><strong>.</strong></p><p></p><p>At least it is not as bad and you are 8 weeks in strictly IM but I would put money on it that regardless of the ester (enanthate) your trough TT/FT levels are too high on your current protocol and can easily cause one to feel horrible.</p><p></p><p>If anything I would be dropping your overall weekly dose from 140 mg/week (70mg every 3.5 days) to 100-120 mg/week (50-60 mg every 3.5 days).</p><p></p><p>Regardless you would still need to wait 4-6 weeks for blood levels to stabilize and give the protocol another 2 months to truly gauge how you feel overall.</p><p></p><p>Like I stated already numerous times you have never given your protocols a fighting chance.</p><p></p><p></p><p><strong>We both agree my test levels are too high, but isnt it expected this to lead to something like agressivness, anxiety, feeling tense, hyped, sleeps issues and so on? But instead <u>I feel apathy and sluggishness, zero motivation to do anything</u>, to talk to people and so on... Provided this heads that way, do you believe that after 2-3 months of investment of time which would be a terrible tornment for me something magical will happen and at some point I will start feeling completely different? </strong></p><p></p><p>Depends on the individual and higher levels can also lead to burnout in some.</p><p></p><p>T has a tonic effect on the CNS and can make one feel amped up.</p><p></p><p>Also has an impact on dopamine and may have a negative impact when running high levels let alone a steady state.</p><p></p><p>You are running very high trough TT/FT levels and estradiol will be high.</p><p></p><p>Many can struggle with issues when it comes to where estradiol levels sit.</p><p></p><p></p><p><strong>Also can you give me some reference for the 2-3 months period like a content from a TRT physicians somewhere online? I mean I've watched most of the content TRT doctors put online, I've watched doctors with contradictory to each other opinions about things like estrogen, HCG and so on but all of them claim to asses a protocol on 6-8 weeks and I've never seen someone mentioning a need to wait another 2-3 months if the patient feels crappy. If there is such reference I will thoroughly examine it. I do not mean to put disrespect to you, just if I'm gonna make a strong investment in something I look for at least 2 credible opinions.</strong></p><p></p><p>Never going to be able to assess the true effectiveness of a protocol in 6-8 weeks as again during the weeks leading up until blood levels stabilize (4-6 weeks) hormones are in FLUX as in T levels let alone estradiol are rising and the body is trying to ADJUST.</p><p></p><p>Snapshot of BLOODWORK at 6 weeks.....sure!</p><p></p><p>Need to know where trough TT/FT/e2 levels let alone other blood markers sit as I stated earlier we want to make sure T levels are not too low or high as this will have a negative impact on achieving the desired long-term beneficial effects of having healthy testosterone levels.</p><p></p><p>Even then once blood levels have stabilized it will take another 8 weeks for the body to fully ADAPT to the new levels.</p><p></p><p>Patience is key!</p><p></p><p></p><p><strong>but all of them claim to <u>asses a protocol on 6-8 weeks and I've never seen someone mentioning a need to wait another 2-3 months if the patient feels crappy</u>.</strong></p><p></p><p>If <u>T levels are too low or too high</u> and one feels shitty 6-8 weeks in then the sensible move would be to tweak the protocol (dose T, AI?)</p><p></p><p></p><p><strong>On the other hand provided every time I've started sustanon I GOT QUICK IMPROVEMENTS do you think there might be some action of it that stimulates my endocrine or nervous system to make me feel good, action that is not present from the slow steady release of the single long esters? We know sustanon is very different with all of its downsides like being very difficult to dial in.</strong></p><p></p><p>If you truly felt better using Sustanon then stick with what you feel is best.</p><p></p><p>Even then I would try lowering your overall weekly T-dose then get labs done in 6 weeks and if T levels are healthy give it at least another 2 months before claiming your protocol using enanthate is a failure.</p><p></p><p></p><p><strong>Do you also think switching to enanthate with different oil may lead to improvement?</strong></p><p></p><p>Doubtful.</p><p></p><p></p><p><strong>I see some people on this forum combining propionate with cypionate, do you think their cases may have some correlation to mine?</strong></p><p></p><p>Hard to say and the only way you would know is to give it a go.</p><p></p><p></p><p></p><p></p><p></p><p></p><p></p><p></p><p></p><p></p><p></p><p>Look over some references in the most recent paper.</p><p></p><p>Ask Nelson who Mohit Khera and Abraham Morgentaler are!</p><p></p><p></p><p><strong>26.What is a reasonable timeline to begin to observe improvements in the signs and symptoms of testosterone deficiency?</strong></p><p><strong></strong></p><p><strong><em>*Following the initiation of testosterone therapy, serum concentrations of testosterone are known to correct earlier than the symptomatic, structural, and metabolic signs associated with TD.76,77 </em></strong></p><p><strong><em></em></strong></p><p><strong><em>*As such, patients should be counseled that symptom response will not be immediate. Expectations for treatment response should be established with each patient. Patients can anticipate improvements in many of the common symptoms of TD (libido, energy levels, sexual function) after 3 months of treatment or longer. Metabolic and structural (body composition, muscle mass, bone density) changes may take upwards of 6-months. 77 </em></strong>In addition, patients should be counseled that diet and exercise in combination with testosterone therapy are recommended for body composition changes.</p><p></p><p><strong><em>*Appreciating this pattern of response to testosterone therapy is fundamental when determining the impact of treatment and the appropriate timing of follow-up evaluations while on therapy. </em></strong></p><p><strong><em></em></strong></p><p><strong><em>*For example, if patients undergo a symptom review and measurement of testosterone levels too early (< 3 months), it may lead both physicians and patients to conclude that the treatment has not been impactful (i.e. normal levels of testosterone without symptomatic/structural/metabolic benefit). However, if the same assessment was scheduled 3-6 months after the initiation of therapy, the clinical response tends to be more reflective of normalized levels of serum testosterone.</em></strong></p></blockquote><p></p>
[QUOTE="madman, post: 199791, member: 13851"] [B]If every protocol is needed to be given 2-3 months to asses after the initial 8 weeks, what would be the reason when [U]I started TRT with sustanon in November 2019 I got very quick huge improvements in the means of 2-4 weeks[/U], and in the first 3 months everything was great, UNTIL I stopped absorbing sub-q and my levels fell significantly in a matter of weeks on the same dose without a protocol change?[/B] Every protocol should be given 8 weeks after the stabilization period (4-6 weeks). Again there is a lot going on during the weeks leading up until blood levels have stabilized as hormones will be in FLUX and the body is trying to ADJUST to the increasing T levels. First time hopping on trt using the 4 blends esterified T (Sustanon) and you experienced quick/huge improvements within the first 2-4 weeks. Hard to say for sure but you just went from being hypogonadal (pre-trt) to driving up your T levels with the use of exogenous testosterone.....ask anyone that starts trt for the first time especially on the higher dosed protocols many can feel euphoric during the transition period (first 4 weeks) leading up until blood levels have stabilized. Keep in mind many can be going from <300 ng/dL well above 1000 ng/dL 4-6 weeks in. Huge surge in T/dopamine. [B]and [U]in the first 3 months everything was great, UNTIL I stopped absorbing sub-q and my levels fell significantly in a matter of weeks on the same dose without a protocol change[/U]? I think this was the first pitfall.[/B] Seems odd that in the first 3 months (12 weeks) everything was great using the same protocol (ester/sub-q injections) then all of a sudden your body supposedly stopped absorbing the T. If such was the case with absorption strictly sub-q it would have more than likely happened much sooner.....not 12 weeks in. [B]I know you are proponent of sub-q injections, but when my stomach was full of nodules everywhere my levels fell with 40 percent and the way I felt transferred from from God-like to like pre-TRT.[/B] If such is truly the case then it is plain and simple.....stick with strictly IM Do what you feel is best for you! [B]I then tried [U]sub-q enanthate(8 weeks) and shallow IM UGL cyionate protocol(8 weeks) achieving levels of 800-1000 when for the corresponding dose of 160mg per week I was expecting at least 1300[/U]. Also I felt way worse on enan and cyp compared to the sustanon on the fallen levels. When my levels on sustanon fell I just started to feel pretty much like before TRT, [U]but on the long single esters I felt UNKNOWN apathy and sluggishness and the further I was getting into their protocols the worse I f[/U][/B][U][B]el[/B][/U][B][U]t[/U], to the point in the last week of the sub-q enanthate protocol I was falling asleep at work and almost got kicked out of my job. [/B] Again you only gave each protocol 8 weeks and trough TT was in the high end which would have your trough FT level on the high end with an SHBG 30 nmol/L. You were definitely hitting healthy T levels but even then I would need to see full labs and top it off that I am not too fond of UGL gear! If you truly felt horrible using such esters (IM or sub-q) when compared to Sustanon then go back to using Sus. Hope you understand that the main ester used in Sustanon is decanoate (100 mg to boot) which is longer acting than cypionate/enanthate! [B]After that [U]I tried scrotal cream, held on that only 3-4 weeks[/U] because I got from it terrible unheard of before anxiety and panic attacks, I've never had panic attacks in my life.[/B] 3-4 weeks then you bailed.....let alone no labs to post! [B]Then somebody suggested to me to try sustanon IM and at that point my test levels climbed quickly and the way I felt abruptly improved. I quickly got improvements, in a matter of 3-4 weeks even less and started to feel really great, not like the first 2-3 months of TRT, but lets say 80 percent of that. And now [U]2-3 months ago I decided to try to ease my life and reduce a life-long sequence of deep IM injections, which was the whole point of transferring to enanthate[/U].[/B] Again if you feel best on Sustanon then why waste your time with enanthate/cypionate. The easier fix is to inject shallow IM using a fixed LDS insulin syringe 27-29G x 1/2" (12.7MM) needle length. Pain/scar tissue will be minimal.....problem solved! [U][B]But I experience the same type of sluggishness I got before on the long single esters, this time is not as bad because I guess Im doing IM[/B][/U][B].[/B] At least it is not as bad and you are 8 weeks in strictly IM but I would put money on it that regardless of the ester (enanthate) your trough TT/FT levels are too high on your current protocol and can easily cause one to feel horrible. If anything I would be dropping your overall weekly dose from 140 mg/week (70mg every 3.5 days) to 100-120 mg/week (50-60 mg every 3.5 days). Regardless you would still need to wait 4-6 weeks for blood levels to stabilize and give the protocol another 2 months to truly gauge how you feel overall. Like I stated already numerous times you have never given your protocols a fighting chance. [B]We both agree my test levels are too high, but isnt it expected this to lead to something like agressivness, anxiety, feeling tense, hyped, sleeps issues and so on? But instead [U]I feel apathy and sluggishness, zero motivation to do anything[/U], to talk to people and so on... Provided this heads that way, do you believe that after 2-3 months of investment of time which would be a terrible tornment for me something magical will happen and at some point I will start feeling completely different? [/B] Depends on the individual and higher levels can also lead to burnout in some. T has a tonic effect on the CNS and can make one feel amped up. Also has an impact on dopamine and may have a negative impact when running high levels let alone a steady state. You are running very high trough TT/FT levels and estradiol will be high. Many can struggle with issues when it comes to where estradiol levels sit. [B]Also can you give me some reference for the 2-3 months period like a content from a TRT physicians somewhere online? I mean I've watched most of the content TRT doctors put online, I've watched doctors with contradictory to each other opinions about things like estrogen, HCG and so on but all of them claim to asses a protocol on 6-8 weeks and I've never seen someone mentioning a need to wait another 2-3 months if the patient feels crappy. If there is such reference I will thoroughly examine it. I do not mean to put disrespect to you, just if I'm gonna make a strong investment in something I look for at least 2 credible opinions.[/B] Never going to be able to assess the true effectiveness of a protocol in 6-8 weeks as again during the weeks leading up until blood levels stabilize (4-6 weeks) hormones are in FLUX as in T levels let alone estradiol are rising and the body is trying to ADJUST. Snapshot of BLOODWORK at 6 weeks.....sure! Need to know where trough TT/FT/e2 levels let alone other blood markers sit as I stated earlier we want to make sure T levels are not too low or high as this will have a negative impact on achieving the desired long-term beneficial effects of having healthy testosterone levels. Even then once blood levels have stabilized it will take another 8 weeks for the body to fully ADAPT to the new levels. Patience is key! [B]but all of them claim to [U]asses a protocol on 6-8 weeks and I've never seen someone mentioning a need to wait another 2-3 months if the patient feels crappy[/U].[/B] If [U]T levels are too low or too high[/U] and one feels shitty 6-8 weeks in then the sensible move would be to tweak the protocol (dose T, AI?) [B]On the other hand provided every time I've started sustanon I GOT QUICK IMPROVEMENTS do you think there might be some action of it that stimulates my endocrine or nervous system to make me feel good, action that is not present from the slow steady release of the single long esters? We know sustanon is very different with all of its downsides like being very difficult to dial in.[/B] If you truly felt better using Sustanon then stick with what you feel is best. Even then I would try lowering your overall weekly T-dose then get labs done in 6 weeks and if T levels are healthy give it at least another 2 months before claiming your protocol using enanthate is a failure. [B]Do you also think switching to enanthate with different oil may lead to improvement?[/B] Doubtful. [B]I see some people on this forum combining propionate with cypionate, do you think their cases may have some correlation to mine?[/B] Hard to say and the only way you would know is to give it a go. Look over some references in the most recent paper. Ask Nelson who Mohit Khera and Abraham Morgentaler are! [B]26.What is a reasonable timeline to begin to observe improvements in the signs and symptoms of testosterone deficiency? [I]*Following the initiation of testosterone therapy, serum concentrations of testosterone are known to correct earlier than the symptomatic, structural, and metabolic signs associated with TD.76,77 *As such, patients should be counseled that symptom response will not be immediate. Expectations for treatment response should be established with each patient. Patients can anticipate improvements in many of the common symptoms of TD (libido, energy levels, sexual function) after 3 months of treatment or longer. Metabolic and structural (body composition, muscle mass, bone density) changes may take upwards of 6-months. 77 [/I][/B]In addition, patients should be counseled that diet and exercise in combination with testosterone therapy are recommended for body composition changes. [B][I]*Appreciating this pattern of response to testosterone therapy is fundamental when determining the impact of treatment and the appropriate timing of follow-up evaluations while on therapy. *For example, if patients undergo a symptom review and measurement of testosterone levels too early (< 3 months), it may lead both physicians and patients to conclude that the treatment has not been impactful (i.e. normal levels of testosterone without symptomatic/structural/metabolic benefit). However, if the same assessment was scheduled 3-6 months after the initiation of therapy, the clinical response tends to be more reflective of normalized levels of serum testosterone.[/I][/B] [/QUOTE]
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