50YO male - Been on TRT since October 2018 when I got tested twice and testosterone was under 150 with depressive lethargic symptoms. I inject 0.2 ML or 40 mgs of testosterone cypionate twice a week and have a trough total testosterone level of 600. Very stable and feel great.
Here are the top 12 things / tips I’ve learned over the years from this site and other research to dial in my protocol.
1) Draw up testosterone with an 18 gauge needle and inject with a 25 gauge needle
2) I use a small sticky ice pack called “pain cake” on my injection site for 10 min before injection and have almost no pain or sting when injecting. When traveling, I just fill a plastic bag with ice from the ice machine in the hotel.
3) I inject in the upper outer quadrant of my thighs and alternate legs - right on Monday night and left on Friday morning. Minimal scar tissue to date but am watching. Many say the upper central glute is best but I find that hard to reach / do
4) I sometimes get water retention within 24 hours of injection so I use a little extra caffeine or other diuretic and exercise a little longer to clear the excess water. Watch heart rate tho.
5) An optimal testosterone to estradiol ratio is around 14 to 1. The calculation is total testosterone divided by estradiol and it’s that number to 1. Always trust how you feel over the ratio, but it’s a good guide. If you are near 14-1 and feel bad, your free test and/or other micro measurements may be off and should be looked at
6) Body fat, otherwise known as Adipose tissue, converts excess testosterone to Estrogen via aromatase. The more fat you have the more apt you will be to convert. Aromatase Inhibitors (AI) are extremely effective at lowering estradiol, but can be very difficult to dial in. Many have crashed their estradiol and felt horrible. Use these carefully if at all. Losing fat can help reduce estrodiol.
7) low dose (2.5-5.0 mg) daily tadalafil (generic cialis) can help with ED issues. Studies show it can also lower estradiol some as well as blood pressure. If you take BP meds or Flomax for prostate, need to be careful as it may dramatically lower BP. Results vary by person
8) Everyone’s biology is different so everyone feels good / bad at different levels of Testosterone, Free Test, Estradiol etc. you have to experiment in a controlled way to find what works for you. There’s no absolute right answer
9) Watch hemoglobin / hematocrit very closely. Red blood cells can spike causing thicker blood. Donating blood every 8 weeks can lower hematocrit levels by 200-300 basis points, meaning if your hematocrit is at 52% (51% is the upper limit), donating blood will get you down to 49-50% and so on
10) testosterone increase sebum production otherwise known as skin oil. I tend to have oily skin as is so Acne has become an issue. if your skin tends to be dryer, this may be a good thing. If you get acne, It really helps to clean up your diet. I also use salicylic acid pads on acne spots and rub in benzoyl peroxide cream immediately after that. Seems to work well.
11) increases in a byproduct of testosterone called DHT can cause you to lose hair from your head and it can grow more on your body. I’ve used a compounded topical spray of finasteride/minoxidil from HIMS on my head to block DHT. Topical is better than pill bc you don’t want to block DHT throughout your body as that defeats the purpose of TRT. I wish Instarted the spray when so started TRT. I have some hair loss but the spray has stopped it now and I have some regrowth. 4 sprays a day, very easy to use
12) Shrinkage. I have shrinkage and most guys do bc TRT stops production of testosterone by the testicles and you need that natural made T to keep testicle size. It really doesn’t bother me at all and my wife could care less. For me TRT has been great birth control as my sperm count is near zero on 2 tests. This is not guaranteed birth control, so take other steps as needed, but dramatically reduces chances
Lastly, my TRT has been managed by my primary care physician, urologist and endocrinologist. They are 3 of the best in their respective specialties in my area and they are NOT current with their TRT knowledge. None would prescribe anything other than Testosterone and they had limited very knowledge of all the above things I listed, if any at all.
So I highly recommend you go to a men’s clinic that specializes in TRT, like Defy. No, I don’t work for them and this is not a paid advertisement. I did a consult with Defy at one point on Clomid and the guy I met with was himself on TRT and was extremely knowledgeable. Decided against Clomid.
Hope this post helps you, all the best in your journey!!
Here are the top 12 things / tips I’ve learned over the years from this site and other research to dial in my protocol.
1) Draw up testosterone with an 18 gauge needle and inject with a 25 gauge needle
2) I use a small sticky ice pack called “pain cake” on my injection site for 10 min before injection and have almost no pain or sting when injecting. When traveling, I just fill a plastic bag with ice from the ice machine in the hotel.
3) I inject in the upper outer quadrant of my thighs and alternate legs - right on Monday night and left on Friday morning. Minimal scar tissue to date but am watching. Many say the upper central glute is best but I find that hard to reach / do
4) I sometimes get water retention within 24 hours of injection so I use a little extra caffeine or other diuretic and exercise a little longer to clear the excess water. Watch heart rate tho.
5) An optimal testosterone to estradiol ratio is around 14 to 1. The calculation is total testosterone divided by estradiol and it’s that number to 1. Always trust how you feel over the ratio, but it’s a good guide. If you are near 14-1 and feel bad, your free test and/or other micro measurements may be off and should be looked at
6) Body fat, otherwise known as Adipose tissue, converts excess testosterone to Estrogen via aromatase. The more fat you have the more apt you will be to convert. Aromatase Inhibitors (AI) are extremely effective at lowering estradiol, but can be very difficult to dial in. Many have crashed their estradiol and felt horrible. Use these carefully if at all. Losing fat can help reduce estrodiol.
7) low dose (2.5-5.0 mg) daily tadalafil (generic cialis) can help with ED issues. Studies show it can also lower estradiol some as well as blood pressure. If you take BP meds or Flomax for prostate, need to be careful as it may dramatically lower BP. Results vary by person
8) Everyone’s biology is different so everyone feels good / bad at different levels of Testosterone, Free Test, Estradiol etc. you have to experiment in a controlled way to find what works for you. There’s no absolute right answer
9) Watch hemoglobin / hematocrit very closely. Red blood cells can spike causing thicker blood. Donating blood every 8 weeks can lower hematocrit levels by 200-300 basis points, meaning if your hematocrit is at 52% (51% is the upper limit), donating blood will get you down to 49-50% and so on
10) testosterone increase sebum production otherwise known as skin oil. I tend to have oily skin as is so Acne has become an issue. if your skin tends to be dryer, this may be a good thing. If you get acne, It really helps to clean up your diet. I also use salicylic acid pads on acne spots and rub in benzoyl peroxide cream immediately after that. Seems to work well.
11) increases in a byproduct of testosterone called DHT can cause you to lose hair from your head and it can grow more on your body. I’ve used a compounded topical spray of finasteride/minoxidil from HIMS on my head to block DHT. Topical is better than pill bc you don’t want to block DHT throughout your body as that defeats the purpose of TRT. I wish Instarted the spray when so started TRT. I have some hair loss but the spray has stopped it now and I have some regrowth. 4 sprays a day, very easy to use
12) Shrinkage. I have shrinkage and most guys do bc TRT stops production of testosterone by the testicles and you need that natural made T to keep testicle size. It really doesn’t bother me at all and my wife could care less. For me TRT has been great birth control as my sperm count is near zero on 2 tests. This is not guaranteed birth control, so take other steps as needed, but dramatically reduces chances
Lastly, my TRT has been managed by my primary care physician, urologist and endocrinologist. They are 3 of the best in their respective specialties in my area and they are NOT current with their TRT knowledge. None would prescribe anything other than Testosterone and they had limited very knowledge of all the above things I listed, if any at all.
So I highly recommend you go to a men’s clinic that specializes in TRT, like Defy. No, I don’t work for them and this is not a paid advertisement. I did a consult with Defy at one point on Clomid and the guy I met with was himself on TRT and was extremely knowledgeable. Decided against Clomid.
Hope this post helps you, all the best in your journey!!
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