Dialing in dosing: "Bottom-up" vs. "Top-down"?

krm

Member
Hi guys, so after a few REALLY miserable days I got my blood drawn today for the doctors 6-week follow up.
He is absolutely inexperienced and put me on a really shitty protocol (discussed in other threads) of 125mg/E2W.

I've managed to convince him via email to at least agree to weekly injections, but he said "until we got the results stick with the prescribed dose".

Well, as it's my body and I know how I feel I'm sure as heck NOT going to stick with 60mg/week (I'm a top-top-top-of the range SHBG guy), so I'll adapt the protocol myself;

due to the fact that where I live (Switzerland) only 250mg ampoules are available (no rubber-top vials), him prescribing me 60mg/week basically means I'm getting 4x 250mg ampoules to draw 60 and throw 190 away.

Which means - for my "self-administered protocol", I'm basically free to choose anything between 0 and 250mg / week, as that's what I get with my prescription.

Given that I'm (literally) tired after MONTHS of getting to the point of getting a TRT prescription and now 6 weeks of a shitty protocol where I started feeling worse than before, I'm really tempted to "re-start" at the high end of this amount - e.g. 200mg / week - and get my own labs through an independent provider in a few weeks.

I was nor wondering about the pros and cons of "starting bottom up" (e.g. starting with 100mg/week and working up to a feel-good level) vs. "starting high" and reducing if I see any negative side effects (high E2 or whatever)?

Oh a sidenote, my E2 was BELOW what the lab could even measure before I got started with TRT, so I'm not too worried about E2, quite frankly...

Thanks! :)
 
Hi, nope, never did... my levels were at the very bottom of the range the first time I ever tested them before starting TRT (actually, because I felt so shitty I thought I might have HIGH E for whatever reason) - then, when the doc did a LHRH stimulation test to see how my testicles are working E levels were tested again and came in "below detection range". That, plus the fact that my T levels were also below lab range, made the doc to start TRT....
 

hCG Mixing Calculator

HCG Mixing Protocol Calculator

TRT Hormone Predictor Widget

TRT Hormone Predictor

Predict estradiol, DHT, and free testosterone levels based on total testosterone

⚠️ Medical Disclaimer

This tool provides predictions based on statistical models and should NOT replace professional medical advice. Always consult with your healthcare provider before making any changes to your TRT protocol.

ℹ️ Input Parameters

Normal range: 300-1000 ng/dL

Predicted Hormone Levels

Enter your total testosterone value to see predictions

Results will appear here after calculation

Understanding Your Hormones

Estradiol (E2)

A form of estrogen produced from testosterone. Important for bone health, mood, and libido. Too high can cause side effects; too low can affect well-being.

DHT

Dihydrotestosterone is a potent androgen derived from testosterone. Affects hair growth, prostate health, and masculinization effects.

Free Testosterone

The biologically active form of testosterone not bound to proteins. Directly available for cellular uptake and biological effects.

Scientific Reference

Lakshman KM, Kaplan B, Travison TG, Basaria S, Knapp PE, Singh AB, LaValley MP, Mazer NA, Bhasin S. The effects of injected testosterone dose and age on the conversion of testosterone to estradiol and dihydrotestosterone in young and older men. J Clin Endocrinol Metab. 2010 Aug;95(8):3955-64.

DOI: 10.1210/jc.2010-0102 | PMID: 20534765 | PMCID: PMC2913038

Beyond Testosterone Podcast

Online statistics

Members online
3
Guests online
372
Total visitors
375

Latest posts

Back
Top