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  1. #1

    New here

    56 years old, total T tanked from 650 to 200 over last 3 years if labs are to be believed. Just completed first 10 weeks of 2x week .5cc IM test cyp (200mg/ml) injections and .5mg 1x per week Anastrazole. Can't say I have anything to rave about so far. Labs tomorrow, we'll see.

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    Super Moderator Nelson Vergel's Avatar
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    Have you tried testosterone without anastrozole? How about adding HCG to it?

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    Welcome to Excelmale, we hope you'll be an active member. Any further background you'd like to share?
    I am not a physician. Comments offered here are for discussion purposes only. Please consult your doctor before initiating, changing, or stopping any therapy.

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    Quote Originally Posted by Nelson Vergel View Post
    Have you tried testosterone without anastrozole? How about adding HCG to it?
    I have not, Doc put me on anastrozole right at start, now not sure why as Estradiol was not initially tested, though it is one of my labs ordered for tomorrow.

    I plan on asking about HCG.

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    Thanks CoastWatcher! I have been somewhat of an exercise fanatic most of my life, focus on bodybuilding early on and then also mixed things up with cycling and swimming, kind of a mixed bag. At one time I was at 245 lbs. with sub 10% bodyfat in my early 20's (I'm 6'2"). When I was more into the aerobic stuff, weight was down to 220. I am now at 245 but way over 10% . Gains in the weight room have really fallen off. My brother who is 12 years younger has been on TRT for several years, he really built up the response to therapy so I might have been expecting too much. I have lost a few pounds and have improved libido, but not the rush he spoke of. Even Doc seemed to build this up, said I was a perfect candidate in that I had maintained exercise over the years and should really respond.

  7. #6
    Quote Originally Posted by StuD View Post
    Thanks CoastWatcher! I have been somewhat of an exercise fanatic most of my life, focus on bodybuilding early on and then also mixed things up with cycling and swimming, kind of a mixed bag. At one time I was at 245 lbs. with sub 10% bodyfat in my early 20's (I'm 6'2"). When I was more into the aerobic stuff, weight was down to 220. I am now at 245 but way over 10% . Gains in the weight room have really fallen off. My brother who is 12 years younger has been on TRT for several years, he really built up the response to therapy so I might have been expecting too much. I have lost a few pounds and have improved libido, but not the rush he spoke of. Even Doc seemed to build this up, said I was a perfect candidate in that I had maintained exercise over the years and should really respond.
    Your protocol, and the failure to perform essential testing, raises a number of red flags (as many here will tell you), but given that you're testing...that will tell the tale. What tests are on the list?
    I am not a physician. Comments offered here are for discussion purposes only. Please consult your doctor before initiating, changing, or stopping any therapy.

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    Super Moderator Vettester Chris's Avatar
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    Welcome to EM! It definitely takes time, so be patient, and keep in mind that balance throughout the body and endocrine system should be the goal. Glad you joined!
    Please, no PM's posting lab results ... Let's Keep them on the Open Forum for Everyone to Comment. Feel free to PM me a link to your thread if you would like me to comment. Thanks!!


    I am not a Doctor, I only play one on T.V. Please consult your physician, or a trained-licensed physician before proceeding with any comments or suggestions posted on this or any forum.


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    Really? I thought the protocol was pretty reasonable, but was surprised at the absence of estradiol in initial testing. It is included in the 10 week labs to be taken tomorrow, along with CMP, CBD, and of course total and free T.

  10. #9
    Quote Originally Posted by StuD View Post
    Really? I thought the protocol was pretty reasonable, but was surprised at the absence of estradiol in initial testing. It is included in the 10 week labs to be taken tomorrow, along with CMP, CBD, and of course total and free T.
    It's fairly well established that adding anastrozole in the absence of confirmed, elevated e2 levels (relying only on the sensitive/LC/MS, MS lab test) is tempting fate. In fact, even elevated lab values - if there are no symptoms associated with high estradiol - don't necessarily merit intervention. It's fairly easy to lower estradiol but it can be a nightmare to raise it should it be crashed.

    Where does your SHBG sit?
    I am not a physician. Comments offered here are for discussion purposes only. Please consult your doctor before initiating, changing, or stopping any therapy.

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    Moderator Vince's Avatar
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    Quote Originally Posted by StuD View Post
    I have not, Doc put me on anastrozole right at start, now not sure why as Estradiol was not initially tested, though it is one of my labs ordered for tomorrow.

    I plan on asking about HCG.
    When I started trt, I've only used testosterone and HCG. I did Labs at 12 weeks and never needed an AI.
    I am not a medical practitioner. Any suggestions I provide are not medical recommendations and are just my opinions. Please consult with your physician on any matters concerning your health.

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    Quote Originally Posted by CoastWatcher View Post
    It's fairly well established that adding anastrozole in the absence of confirmed, elevated e2 levels (relying only on the sensitive/LC/MS, MS lab test) is tempting fate. In fact, even elevated lab values - if there are no symptoms associated with high estradiol - don't necessarily merit intervention. It's fairly easy to lower estradiol but it can be a nightmare to raise it should it be crashed.

    Where does your SHBG sit?
    OK, makes sense. SHBG was at 50 before beginning TRT.

  13. #12
    Quote Originally Posted by StuD View Post
    OK, makes sense. SHBG was at 50 before beginning TRT.
    Did that SHBG, certainly a higher value, figure into your doctor's decision about protocol design - shot frequency and the amount injected?
    I am not a physician. Comments offered here are for discussion purposes only. Please consult your doctor before initiating, changing, or stopping any therapy.

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    Quote Originally Posted by CoastWatcher View Post
    Did that SHBG, certainly a higher value, figure into your doctor's decision about protocol design - shot frequency and the amount injected?
    Doc did describe the protocol as the best approach in his experience with the lab values I presented, though he did not directly refer to the SHBG when we did consultation. I was so thrown by the low T values that I focused my questions there, as total T had dropped from 652 in the fall of 2015 to 188 for the initial testing 10 weeks ago. I did not have free T values from the 2015 test, but free T was at 2.7 in the test just this spring.

  15. #14
    Quote Originally Posted by StuD View Post
    Doc did describe the protocol as the best approach in his experience with the lab values I presented, though he did not directly refer to the SHBG when we did consultation. I was so thrown by the low T values that I focused my questions there, as total T had dropped from 652 in the fall of 2015 to 188 for the initial testing 10 weeks ago. I did not have free T values from the 2015 test, but free T was at 2.7 in the test just this spring.
    Was your brother's hypogonadism determined to be primary or secondary? Did he have a similar presentation as you? My father was diagnosed with hypogonadism shortly before his death, didn't really start treatment, so familial patterns interest me.
    I am not a physician. Comments offered here are for discussion purposes only. Please consult your doctor before initiating, changing, or stopping any therapy.

  16. #15
    Does your brother use an AI with his protocol?

  17. #16
    Quote Originally Posted by CoastWatcher View Post
    Was your brother's hypogonadism determined to be primary or secondary? Did he have a similar presentation as you? My father was diagnosed with hypogonadism shortly before his death, didn't really start treatment, so familial patterns interest me.
    Family patterns interest me as well. My dad 1 million percent has low T, but will not go get checked. And my younger brother is now having all the symptoms, but can’t get him to get checked either. Stud consider urself lucky that you have your brother to use as a loose guideline. Everyone’s different obv, but if he’s feeling great I personally would ask him what protocol is working for him and see how it compares to the protocol you’re on.

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    Quote Originally Posted by CoastWatcher View Post
    Was your brother's hypogonadism determined to be primary or secondary? Did he have a similar presentation as you? My father was diagnosed with hypogonadism shortly before his death, didn't really start treatment, so familial patterns interest me.
    Pretty sure brother's diagnosis was secondary and related to normal aging, I'm checking with him. I know he has had sort of roller coaster ride with estrogen levels but only in last couple years of 10 years total treatment.

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    Quote Originally Posted by Gman86 View Post
    Does your brother use an AI with his protocol?
    Only recently as estradiol levels were always relatively low for him. He says he doesn't like the effect of the AI (anastrozole).

  20. #19
    Quote Originally Posted by StuD View Post
    Only recently as estradiol levels were always relatively low for him. He says he doesn't like the effect of the AI (anastrozole).
    I would say most of the time when someone says they don't like the effects of an AI, they are just using too much. AI's are very strong. On just a 1/4 of a tab of anastrozole EOD, my E2 went from 71 to 9. That's only 0.94mg/ week. Slightly less than 1mg/ week. And most doctors prescribe at least 1mg per week. In regards to an AI, definitely the less the better. Always start very very conservatively.

  21. #20
    Quote Originally Posted by StuD View Post
    Pretty sure brother's diagnosis was secondary and related to normal aging, I'm checking with him. I know he has had sort of roller coaster ride with estrogen levels but only in last couple years of 10 years total treatment.
    Man I wish I had a brother or father that has been on TRT for 10 years. You can learn so much from them. I would literally be asking my brother a thousand questions about it every time I see him lol. All the mistakes he has made, how he felt throughout the 10 years, all the protocol changes he has made over the years and any advice he would have for someone just starting out, or any advice he would give himself when he first started if he could go back in time. That's just a few of the questions I would ask! Definitely take advantage of the fact that you have someone so close to you that has been through it, especially considering he has a lot of the same genetics/ DNA as you.

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    Quote Originally Posted by Gman86 View Post
    I would say most of the time when someone says they don't like the effects of an AI, they are just using too much. AI's are very strong. On just a 1/4 of a tab of anastrozole EOD, my E2 went from 71 to 9.
    That seems to be the case, just told me that his crashed pretty quickly upon use of an AI.

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    Quote Originally Posted by Gman86 View Post
    Man I wish I had a brother or father that has been on TRT for 10 years. You can learn so much from them. I would literally be asking my brother a thousand questions about it every time I see him lol. All the mistakes he has made, how he felt throughout the 10 years, all the protocol changes he has made over the years and any advice he would have for someone just starting out, or any advice he would give himself when he first started if he could go back in time. That's just a few of the questions I would ask!
    I have pretty much asked all that, interestingly he has been on much the same protocol for the entire 10 years. SubQ in glute, one injection per week until recently and going to 2x week really just an experiment as he never really felt "lows" between injections and T levels came up quickly and have always been pretty stable. Felt immediate effects when he started and until recent mood swings/estrogen fluctuations, very few issues or reasons to do anything different.

  24. #23
    Quote Originally Posted by StuD View Post
    I have pretty much asked all that, interestingly he has been on much the same protocol for the entire 10 years. SubQ in glute, one injection per week until recently and going to 2x week really just an experiment as he never really felt "lows" between injections and T levels came up quickly and have always been pretty stable. Felt immediate effects when he started and until recent mood swings/estrogen fluctuations, very few issues or reasons to do anything different.
    Man what a lucky dude! Having a protocol work great from the start, and then work great for 8-9 years. Jealous lol. But in regards to you, guess you just have to see what your labs look like. You should be able to figure out pretty easily what to do based off of your labs. I mean to get E2 where you need it on the first shot would be like throwing one dart and just happening to hit the bullseye. It’s just extremely rare. So adjusting your E2 after your labs by either lowering AI, increasing AI, dropping it completely, or lowering testosterone dosage and keeping AI the same will absolutely make you feel better. Maybe not perfect, but better. Also you’re on a very high dose of testosterone. On 200mg/ week my total would be 2000+. So you might need to lower your dose to get where you need to be. When I was on 108mg/ week of test, and 1000iu/ week of HCG, my total T was 1855 and E2 71. So you just never know what your numbers are gonna be until you get blood work done. Everyone responds differently.

  25. #24
    Actually, just to clarify, are you on 50mg 2x/ week (100mg total/ week), or 100mg 2x/ week for a total of 200mg?

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    Quote Originally Posted by Gman86 View Post
    Actually, just to clarify, are you on 50mg 2x/ week (100mg total/ week), or 100mg 2x/ week for a total of 200mg?
    Total of 200mg per week from two .5cc injections (compounded test cypionate at 200mg/ml concentration).
    While I'm here a couple of other questions. Is compounded test widely considered as valid, I mean it's not from my local walgreens or CVS, can you count on the dosage, purity, etc.? What about temperatures during shipping? Since mine is coming from out of state a summer shipment could be exposed to high temperatures, is degradation possible?

  27. #26
    Quote Originally Posted by StuD View Post
    Total of 200mg per week from two .5cc injections (compounded test cypionate at 200mg/ml concentration).
    While I'm here a couple of other questions. Is compounded test widely considered as valid, I mean it's not from my local walgreens or CVS, can you count on the dosage, purity, etc.? What about temperatures during shipping? Since mine is coming from out of state a summer shipment could be exposed to high temperatures, is degradation possible?
    Thanks for clarifying. And very good questions. All questions I had at one time. I personally get my testosterone from Empower pharmacy, which is a compounding pharmacy in Texas, where obviously it gets very hot. I've never had any issues with it, and it definitely doesn't suffer from any potency loss that I can tell. On 108mg test/ week, and 1000iu's of HCG/ week, my total T came back at 1855. So I know 100% that Empower's compounded testosterone cypionate works as good as it's supposed to. So that answers your question about purity/ potency. Also they use grape-seed oil for the carrier oil, which makes it very easy to draw up in an insulin syringe and inject.

    As far as the temperature during shipping, it doesn't seem like it effects it negatively at all. I'm paranoid about that stuff though. When they were shipping my HCG, it was still in powder and unreconsituted, so they said it would be fine to ship without an ice pack. But I drove myself crazy worrying about whether the heat would effect it or not since it was coming from Texas and going to be in the back of a box truck, so I decided to just pay the extra money and have it shipped with an ice pack. Figured the little extra money to ship would be worth it just to put my mind at ease. As far as testosterone, I think you don't have to worry really. But I would like to hear other guy's opinion's on this. I'm pretty sure you're supposed to store testosterone in a dry, cool and dark place. So does that mean excessive heat could potentially effect it negatively?

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    Quote Originally Posted by Gman86 View Post
    Thanks for clarifying. And very good questions. All questions I had at one time. I personally get my testosterone from Empower pharmacy, which is a compounding pharmacy in Texas, where obviously it gets very hot. I've never had any issues with it, and it definitely doesn't suffer from any potency loss that I can tell. On 108mg test/ week, and 1000iu's of HCG/ week, my total T came back at 1855. So I know 100% that Empower's compounded testosterone cypionate works as good as it's supposed to. So that answers your question about purity/ potency. Also they use grape-seed oil for the carrier oil, which makes it very easy to draw up in an insulin syringe and inject.

    As far as the temperature during shipping, it doesn't seem like it effects it negatively at all. I'm paranoid about that stuff though. When they were shipping my HCG, it was still in powder and unreconsituted, so they said it would be fine to ship without an ice pack. But I drove myself crazy worrying about whether the heat would effect it or not since it was coming from Texas and going to be in the back of a box truck, so I decided to just pay the extra money and have it shipped with an ice pack. Figured the little extra money to ship would be worth it just to put my mind at ease. As far as testosterone, I think you don't have to worry really. But I would like to hear other guy's opinion's on this. I'm pretty sure you're supposed to store testosterone in a dry, cool and dark place. So does that mean excessive heat would not be good for it?
    Thanks for the info, my pharmacy is in Florida, so I had similar concerns. It is also compounded in grape-seed oil. I just noticed yesterday that the vial specifies storage at basically room temperature, If I remember correctly 85F max. Seems like there would be a reason for that but maybe a few days at higher temperatures during transport is not an issue?

  29. #28
    Quote Originally Posted by StuD View Post
    Thanks for the info, my pharmacy is in Florida, so I had similar concerns. It is also compounded in grape-seed oil. I just noticed yesterday that the vial specifies storage at basically room temperature, If I remember correctly 85F max. Seems like there would be a reason for that but maybe a few days at higher temperatures during transport is not an issue?
    I use Defy Medical for my HRT, and looked on their website and this is what they had to say about the risks of the testosterone being too cold. So you definitely don't want to ship it with an ice pack. So that leaves one option, just regular shipping. Which is fine by me. I like when I don't have options. Much easier on my brain lol. I drive myself crazy sometimes when I have too many options to choose from.

    Please Be Advised

    Regarding your Testosterone Cypionate suspended in oil for injection;
    Storage at low temperatures may result in the separation or “crystallization” of the testosterone within the solution. Injecting testosterone which has been separated may result in pain and swelling at the site of injection which may persist until the testosterone is completely absorbed from the site. If you reside in a state with seasonal low temperatures and we shipped your testosterone through mail; please be aware that separation may have occurred, although it may not be visible to you.
    To re-dissolve the testosterone: Place the vial into hot water for at least 5 minutes prior to injection and INJECT SLOWLY. You may boil water at a low temperature or use hot water directly from the faucet. Be careful not to touch the glass vial until it has cooled off after being placed in the hot water. This only needs to be done if the vial has been stored and/or exposed to low temperatures for a period of time, not prior to every injection if the vial is properly stored at room temperature.
    DO NOT REFRIGERATE store Testosterone Cypionate at room temperature

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    Quote Originally Posted by Gman86 View Post
    I use Defy Medical for my HRT, and looked on their website and this is what they had to say about the risks of the testosterone being too cold. So you definitely don't want to ship it with an ice pack. So that leaves one option, just regular shipping. Which is fine by me. I like when I don't have options. Much easier on my brain lol. I drive myself crazy sometimes when I have too many options to choose from.

    Please Be Advised

    Regarding your Testosterone Cypionate suspended in oil for injection;
    Storage at low temperatures may result in the separation or “crystallization” of the testosterone within the solution. Injecting testosterone which has been separated may result in pain and swelling at the site of injection which may persist until the testosterone is completely absorbed from the site. If you reside in a state with seasonal low temperatures and we shipped your testosterone through mail; please be aware that separation may have occurred, although it may not be visible to you.
    To re-dissolve the testosterone: Place the vial into hot water for at least 5 minutes prior to injection and INJECT SLOWLY. You may boil water at a low temperature or use hot water directly from the faucet. Be careful not to touch the glass vial until it has cooled off after being placed in the hot water. This only needs to be done if the vial has been stored and/or exposed to low temperatures for a period of time, not prior to every injection if the vial is properly stored at room temperature.
    DO NOT REFRIGERATE store Testosterone Cypionate at room temperature
    Thanks, that's similar information that I just received from my clinic.

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