First 5 months on TRT

[Dan T]

I’ve been on TRT for 5 months now and am very happy with the results so far but I need some guidance as my GP is not as knowledgeable as most on this site.

Background: 48 yo 6’4” 250 recently dropped from 295 prior to TRT. High blood pressure prior to weight loss good BP now.

Reasons for TRT: low energy/libido occasional ED

Initial total T 310
Initial dose/dosage 200 mg test cipionate every 2 weeks intramuscular injection for 12 weeks.

Felt good for the first week after injection then nothing for the second. ED went away for that week and libido was good. Sides were oily skin some acne and a small amount of gynecomastia.

At my next Dr. appointment he had me test just before next dose (trough) and total T was at 278. He increased my dose to 200 mg test cipionate every week. My hematocrit was at 59 but he didn’t tell me the number only said it was a little high.

After doing a lot of reading on this site I didn’t want to make that big of a jump so I started injecting 150 mg weekly for 6 weeks and really liked the results. It didn’t seem to increase my sides and my libido improved but ED persisted occasionally.

I also started eating a grapefruit a day to help with my hematocrit with the increased dose.

A week and a half before my appointment I switched to 100 mg test cipionate every 3.5 days (trip to Vegas with the wife) to see how it affected me and all signs of ED went away and my wife and I both really liked the results and hoped my hematocrit levels wouldn’t be too high so we could keep that dose.

Got tested when I got back two days after a shot (peak) and my total T was 1436, and despite the increased dose my hematocrit dropped to 55 (still not good) so I think the grapefruit is helping.

I didn’t tell my Dr. I was taking 150 mg weekly or 100 mg every 3.5 days instead of the prescribed 200 mg weekly.

His recommendations were to try 200 mg every 8 days/9 days/10 days and watch symptoms and get checked in 3 months but check trough T levels instead of peak and hematocrit.

Some of my concerns:

The only tests my Dr. is concerned with are trough total T and hematocrit.

Dr. Didn’t mention donating blood to help with hematocrit numbers.

No mention of testing shbg or estrogen levels.

We live in a small town with no known hormone specialists.

I don’t have any complaints about my experience with TRT I’m just looking for advice on how to proceed with the breadth of experience and expertise that resides here.

Sorry about the novel I’m just looking forward to hearing any advise you might have to offer.

 

[Systemlord]

Initial dose/dosage 200 mg test cipionate every 2 weeks intramuscular injection for 12 weeks.

This is a horrible protocol and sadly they are quite common and are outdated. Most of the success stories on TRT are not through a sick care doctor (insurance based care) because they are mostly clueless on how to prescribe it.

Most of those that find success on TRT inject 100-150mg once, twice, three times a week, EOD and even daily to keep a steady hormone level throughout the week. There are also formulations of oral T capsules (Jatenzo) taken twice daily that may be an option if your insurance will cover it.

Also reaching a steady state on Jatenzo will only take 7 days, injections typically take 4-6 weeks to reach a steady state and when the full benefits start to become realized.

It didn’t seem to increase my sides and my libido improved but ED persisted occasionally.

This is likely happening because your injection frequency is inappropriate, the difference between peak and trough is great enough that you actually end up with hypogonadal levels in the second week and your hormones are in and out of an optimal range for your body to respond all of the time.

Too much or too little testosterone can produce symptoms.

 

[Systemlord]

His recommendations were to try 200 mg every 8 days/9 days/10 days and watch symptoms and get checked in 3 months but check trough T levels instead of peak and hematocrit.

This is not a good plan; it will likely lead to high hematocrit and a host of other unpleasant symptoms and may force you to have to stop TRT for awhile.

 

[madman]

I’ve been on TRT for 5 months now and am very happy with the results so far but I need some guidance as my GP is not as knowledgeable as most on this site.

Background: 48 yo 6’4” 250 recently dropped from 295 prior to TRT. High blood pressure prior to weight loss good BP now.

Reasons for TRT: low energy/libido occasional ED

Initial total T 310
Initial dose/dosage 200 mg test cipionate every 2 weeks intramuscular injection for 12 weeks.

Felt good for the first week after injection then nothing for the second. ED went away for that week and libido was good. Sides were oily skin some acne and a small amount of gynecomastia.

At my next Dr. appointment he had me test just before next dose (trough) and total T was at 278. He increased my dose to 200 mg test cipionate every week. My hematocrit was at 59 but he didn’t tell me the number only said it was a little high.

After doing a lot of reading on this site I didn’t want to make that big of a jump so I started injecting 150 mg weekly for 6 weeks and really liked the results. It didn’t seem to increase my sides and my libido improved but ED persisted occasionally.

I also started eating a grapefruit a day to help with my hematocrit with the increased dose.

A week and a half before my appointment I switched to 100 mg test cipionate every 3.5 days (trip to Vegas with the wife) to see how it affected me and all signs of ED went away and my wife and I both really liked the results and hoped my hematocrit levels wouldn’t be too high so we could keep that dose.

Got tested when I got back two days after a shot (peak) and my total T was 1436, and despite the increased dose my hematocrit dropped to 55 (still not good) so I think the grapefruit is helping.

I didn’t tell my Dr. I was taking 150 mg weekly or 100 mg every 3.5 days instead of the prescribed 200 mg weekly.

His recommendations were to try 200 mg every 8 days/9 days/10 days and watch symptoms and get checked in 3 months but check trough T levels instead of peak and hematocrit.

Some of my concerns:

The only tests my Dr. is concerned with are trough total T and hematocrit.

Dr. Didn’t mention donating blood to help with hematocrit numbers.

No mention of testing shbg or estrogen levels.

We live in a small town with no known hormone specialists.

I don’t have any complaints about my experience with TRT I’m just looking for advice on how to proceed with the breadth of experience and expertise that resides here.

Sorry about the novel I’m just looking forward to hearing any advise you might have to offer.

Initial total T 310
Initial dose/dosage 200 mg test cipionate every 2 weeks intramuscular injection for 12 weeks.

Felt good for the first week after injection then nothing for the second. ED went away for that week and libido was good. Sides were oily skin some acne and a small amount of gynecomastia.

At my next Dr. appointment he had me test just before next dose (trough) and total T was at 278. He increased my dose to 200 mg test cipionate every week. My hematocrit was at 59 but he didn’t tell me the number only said it was a little high.

You need to find a new doctor.....he is out to lunch!

You should have had a full set of labs done pre-trt including TT, FT, estradiol, SHBG, prolactin, DHT, DHEA-S, full thyroid panel, cortisol (4-point saliva), lipids, CMP, and CBC which includes important blood markers such as RBCs/hemoglobin/hematocrit.

Let alone after one starts a sensible trt protocol once blood levels have stabilized (4-6 weeks using TC/TE) blood work needs to be done to see where said protocol (dose of T/injection frequency) has your trough TT, FT, estradiol and important blood markers such as RBCs/hemoglobin/hematocrit.

He took you on a rollercoaster ride (low-t) and put you on a piss poor protocol (200 mg T every 2 weeks) which would have your TT, FT levels sky-high post-injection/during the first few days only to be followed by much lower levels to the point of being back to hypogonadal before your next injection (14 days later).

Top it off that to make matters worse he did a complete 360 and instead of starting you off on a sensible trt protocol 100 mg T/week whether once weekly or better yet split into twice-weekly injections (50 mg T every 3.5 days) he jacked your dose up to 200 mg T/week which most men would never need as such dose can easily have one's trough FT level too high.

Even then your hematocrit of 59% is absurdly high and needs to be addressed.

Definitely need to lower your dose/get on a sensible protocol and get your FT down

Regarding those struggling with high hematocrit here is my reply from another thread:

When using exogenous T RBCs/hemoglobin/hematocrit will increase within the 1st month and can take up to 9-12 months to reach peak levels.

T formulation, the dose of T, genetics (polymorphism of the AR), age all play a role in the impact a trt protocol will have on blood markers (RBCs/hemoglobin/hematocrit).

Other factors such as sleep apnea, smoking can have a negative impact on hematocrit.

Injectable T has been shown to have a greater impact on increasing HCT compared to transdermal T.

3–18% with transdermal administration and up to 44% with injection.

In most cases when using injectable T high supra-physiological peaks post-injection and overall T levels (running too high TT/FT level) will have a big impact on increasing HCT.

Manipulating injection frequency by injecting more frequently using lower doses of T resulting in minimizing the peak--->trough and maintaining more stable levels may lessen the impact on HCT but it is not a given.

As again running very high TT/FT levels will have a stronger impact on driving up HCT.

Although injectables have been shown to have a greater impact on HCT you can see even when using a transdermal formulation that maintains stable serum concentrations that the impact it has on HCT is DEPENDANT ON THE DOSE AND SERUM LEVEL OF T.

Using higher doses of transdermal T and achieving higher TT/FT levels will have a great impact on HCT levels.

How high an FT level you are running is critical.

It is a given that most men on trt struggling with elevated RBCs/hemoglobin/hematocrit are running too high an FT level.

Sure some men are more sensitive than others as they may still struggle with elevated blood markers when running lower T levels but it is far from common and many may already have an underlying health issue contributing to such.

If you are struggling with such blood markers then in most cases finding the lowest FT level you can run while still maintaining the beneficial effects may very well be the solution.

Easier said than done as many men on trt tend to do better running higher-end FT levels within reason.

Mind you some are lucky and never have an issue or levels tend to stabilize over time.

Others will continue to struggle until the cows come home.

Unfortunately too many are caught up in running absurdly high trough FT levels due to the herd mentality spewed on the bro forums and gootube!




After doing a lot of reading on this site I didn’t want to make that big of a jump so I started injecting 150 mg weekly for 6 weeks and really liked the results. It didn’t seem to increase my sides and my libido improved but ED persisted occasionally.

I also started eating a grapefruit a day to help with my hematocrit with the increased dose.

A week and a half before my appointment I switched to 100 mg test cipionate every 3.5 days (trip to Vegas with the wife) to see how it affected me and all signs of ED went away and my wife and I both really liked the results and hoped my hematocrit levels wouldn’t be too high so we could keep that dose.

Smart move lowering your dose but even then you would have been better off splitting your dose into twice-weekly injections (75 mg T every 3.5 days).

Doubtful eating the grapefruit is going to have a significant impact on driving down your hematocrit.

Unfortunately, you made the mistake of only giving the protocol 6 weeks let alone upping your dose again weeks later to a whopping 200mg T/week split into twice-weekly injections (100 mg T every 3.5 days) which would easily have most men's trough FT levels absurdly high.

You need to be consistent and stay on the same protocol (dose T/injection frequency) as it will take 4-6 weeks for blood levels to stabilize when using TC/TE.

Keep in mind that your hormones will be in FLUX during the weeks leading up until blood levels have stabilized and it is common for many to experience ups/downs during the transition as the body is trying to adjust.

Even then once blood levels have stabilized it will take time for the body to adapt to the new set-point and this is the critical time period when one should gauge how they truly feel overall regarding relief/improvement of low-t symptoms.

Every protocol should be given 12 weeks to claim whether it was truly a success or failure.

The only time the dose of T should be increased at the 6-week mark is if your trough FT level is too low (highly doubtful).



Got tested when I got back two days after a shot (peak) and my total T was 1436, and despite the increased dose my hematocrit dropped to 55 (still not good) so I think the grapefruit is helping.

I didn’t tell my Dr. I was taking 150 mg weekly or 100 mg every 3.5 days instead of the prescribed 200 mg weekly.

You are not even going to know where your testosterone level truly sat (1436 ng/dL) as you were previously on 150 mg T/week for 6 weeks and instead of getting bloodwork done as your levels would have been stabilized you went and increased your dose 200 mg T/week split (100mg T every 3.5 days) but highly doubtful you stayed on that dose for 6 weeks to see where your trough level truly sat.

The true peak would be 8-12 hrs post-injection.

True trough when injecting twice-weekly (every 3.5 days) would be 84 hrs post-injection.

Even then you tested 2 days post-injection and your TT 1436 ng/dL is absurdly high let alone your FT would be sky-high even if you have highish/high SHBG!

You are clearly over-medicated and need to get out of that more T is better mentality.




His recommendations were to try 200 mg every 8 days/9 days/10 days and watch symptoms and get checked in 3 months but check trough T levels instead of peak and hematocrit.

Some of my concerns:

The only tests my Dr. is concerned with are trough total T and hematocrit.

Dr. Didn’t mention donating blood to help with hematocrit numbers.

No mention of testing shbg or estrogen levels.

No comment.

 

[madman]

I’ve been on TRT for 5 months now and am very happy with the results so far but I need some guidance as my GP is not as knowledgeable as most on this site.

Background: 48 yo 6’4” 250 recently dropped from 295 prior to TRT. High blood pressure prior to weight loss good BP now.

Reasons for TRT: low energy/libido occasional ED

Initial total T 310
Initial dose/dosage 200 mg test cipionate every 2 weeks intramuscular injection for 12 weeks.

Felt good for the first week after injection then nothing for the second. ED went away for that week and libido was good. Sides were oily skin some acne and a small amount of gynecomastia.

At my next Dr. appointment he had me test just before next dose (trough) and total T was at 278. He increased my dose to 200 mg test cipionate every week. My hematocrit was at 59 but he didn’t tell me the number only said it was a little high.

After doing a lot of reading on this site I didn’t want to make that big of a jump so I started injecting 150 mg weekly for 6 weeks and really liked the results. It didn’t seem to increase my sides and my libido improved but ED persisted occasionally.

I also started eating a grapefruit a day to help with my hematocrit with the increased dose.

A week and a half before my appointment I switched to 100 mg test cipionate every 3.5 days (trip to Vegas with the wife) to see how it affected me and all signs of ED went away and my wife and I both really liked the results and hoped my hematocrit levels wouldn’t be too high so we could keep that dose.

Got tested when I got back two days after a shot (peak) and my total T was 1436, and despite the increased dose my hematocrit dropped to 55 (still not good) so I think the grapefruit is helping.

I didn’t tell my Dr. I was taking 150 mg weekly or 100 mg every 3.5 days instead of the prescribed 200 mg weekly.

His recommendations were to try 200 mg every 8 days/9 days/10 days and watch symptoms and get checked in 3 months but check trough T levels instead of peak and hematocrit.

Some of my concerns:

The only tests my Dr. is concerned with are trough total T and hematocrit.

Dr. Didn’t mention donating blood to help with hematocrit numbers.

No mention of testing shbg or estrogen levels.

We live in a small town with no known hormone specialists.

I don’t have any complaints about my experience with TRT I’m just looking for advice on how to proceed with the breadth of experience and expertise that resides here.

Sorry about the novel I’m just looking forward to hearing any advise you might have to offer.

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.

Excess FT levels can result in acne/oily skin (genetically prone), accelerated balding (genetically prone), drive down HDL, increased RBCs/hemoglobin/hematocrit (common), overstimulation of the CNS (common), bloating/water retention due to androgens effects on the retention of electrolytes (common).

Some of the side effects are driven by testosterone metabolites estradiol/DHT.

Too many get caught up on running absurdly high trough FT levels let alone many have no clue where their FT level truly sits as they are using/relying upon piss poor known to be inaccurate assays!

 

[Dan T]

This is not a good plan; it will likely lead to high hematocrit and a host of other unpleasant symptoms and may force you to have to stop TRT for awhile.

I am currently injecting 100 mg every 3.5 days, and was planning on giving it 6-12 weeks to see how it stabilizes an see what it does to my hematocrit. But maybe I should back it down to 75 and give that more time.

 

[Dan T]

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.

I wonder if I should try to convince my Dr. to add more of these tests or do a mail in blood work up. I’m just afraid my Dr. wouldn’t know what to do with the results if I had him order more tests.

 

[madman]

I am currently injecting 100 mg every 3.5 days, and was planning on giving it 6-12 weeks to see how it stabilizes an see what it does to my hematocrit. But maybe I should back it down to 75 and give that more time.

You do not understand how this works.

200mg T/week let alone split 100 mg twice weekly is a whopping dose and will easily have your trough FT level absurdly high let alone a big impact on driving up your RBCs/hemoglobin/hematocrit.

Even then most men can achieve a healthy let alone high end and in some cases, absurdly high trough FT injecting 100-150 T/week especially when split into more frequent injections (twice weekly, M/W/F, EOD) let alone daily.

Even men with high/highish SHBG.

You need to get on a sensible protocol (dose of T/injection frequency) stick with it and have blood work done 4-6 weeks in once blood levels have stabilized to see where your trough TT, FT, estradiol let alone RBCs/hemoglobin/hematocrit sit.

You need to know where your SHBG sits as it will have a significant impact on TT/FT level achieved let alone can dictate what injection frequency may suit you best.

Forget getting caught up on TT you should be more concerned with where your trough FT truly sits.

FT should be tested using the most accurate assays such as the gold standard Equilibrium Dialysis or Ultrafiltration (next best).

Your doctor is clueless and you are flying blind here.

 

[madman]

I wonder if I should try to convince my Dr. to add more of these tests or do a mail in blood work up. I’m just afraid my Dr. wouldn’t know what to do with the results if I had him order more tests.

You can use Nelson's discounted labs!

These are the most accurate assays for TT, FT, and estradiol.

Total and Free Testosterone Test Panel plus Hematocrit

Lowest Cost Hematocrit, Total and Free Testosterone Test Panel for Men on TRT

www.discountedlabs.com

ESTRADIOL , Sensitive (LC/MS/MS)

The most accurate and sensitive estradiol blood test for men based on liquid chromatography, mass spectrometry ( LC/MS )

www.discountedlabs.com

 

[Systemlord]

I am currently injecting 100 mg every 3.5 days, and was planning on giving it 6-12 weeks

That's way too much, infact worse than what your doctor suggested. Most guys only need closer to 100mg weekly, so 50mg twice weekly is more reasonable.

Your trough levels will be higher on twice weekly protocol even if injecting the same amount on a weekly regime.

 

[madman]

I am currently injecting 100 mg every 3.5 days, and was planning on giving it 6-12 weeks to see how it stabilizes an see what it does to my hematocrit. But maybe I should back it down to 75 and give that more time.

Sounds like you have been brainwashed by those bros on the numerous romper room forums littered on the net, some of the misinformed spewing s**t on gootube, or one of those run of the mill/dime a dozen T-clinics pushing that more T is better mentality MUMBO JUMBO!

 

[Dan T]

When I started this my biggest issue was the ED. My wife’s libido had far exceeded my ability to take care of it.

The first protocol that worked for me to alleviate ED and match my wife’s libido was this current protocol. This isn’t bro science that brought me to that dose, it’s what alleviated the symptoms I was experiencing.

I have concerns about what it will do to my long term health that’s why I’m here asking questions. Unless you consider this site to be a bro romper room I haven’t been brainwashed I just have a Dr. with little experience in this field.

I’ve seen several “that’s a bad protocol” but I’ve yet to see any “if it were me in your shoes I would try this:” suggestions.

 

[Outcome]

Hi Dan. You should just get on board with a good telemed doctor. Explain you situation like you did above and get a program prescribed to you. Further refinement of the protocol should be expected until you find a nice sweet spot.
I’ve learned from reading here that some find a sweet spot rather quickly while others have to adjust some. I started at a T mill and while the program wasn’t terrible it was far from optimal. I was being given 200 mg Cypionate initially then tapered down to 140mg. But as I wasn’t feeling optimal began dosing upwards again and back to 200 mg! Hematocrit went to the moon. This is the point where I started digging deeper into how to correctly do trt. Thanks to this site I found answers. I was about to move to a rural area and went with a tele med dr so I could continue without the hassle of driving for a shot. So the new things that made a difference to me were donating blood, injecting 2x weekly, taking hcg and very carefully taking an Ai. A little later I added Tadalifil which is great in many ways and a fine compliment to a trt protocol. I consider my protocol a success and it’s basically the first one prescribed by my telemed doctor with only very minor tweaks. But I would’ve been open to more changes to the protocol if needed. It can be a challenge for some but a good doc and the support gained here are all you need. There are people here with incredible knowledge willing to share which is a real treasure really. So that’s what I would try. Good luck

 

[madman]

When I started this my biggest issue was the ED. My wife’s libido had far exceeded my ability to take care of it.

The first protocol that worked for me to alleviate ED and match my wife’s libido was this current protocol. This isn’t bro science that brought me to that dose, it’s what alleviated the symptoms I was experiencing.

I have concerns about what it will do to my long term health that’s why I’m here asking questions. Unless you consider this site to be a bro romper room I haven’t been brainwashed I just have a Dr. with little experience in this field.

I’ve seen several “that’s a bad protocol” but I’ve yet to see any “if it were me in your shoes I would try this:” suggestions.

I’ve been on TRT for 5 months now

Initial dose/dosage 200 mg test cipionate every 2 weeks intramuscular injection for 12 weeks.

Felt good for the first week after injection then nothing for the second. ED went away for that week and libido was good. Sides were oily skin some acne and a small amount of gynecomastia.

At my next Dr. appointment he had me test just before next dose (trough) and total T was at 278. He increased my dose to 200 mg test cipionate every week. My hematocrit was at 59 but he didn’t tell me the number only said it was a little high.

After doing a lot of reading on this site I didn’t want to make that big of a jump so I started injecting 150 mg weekly for 6 weeks and really liked the results. It didn’t seem to increase my sides and my libido improved but ED persisted occasionally.

I also started eating a grapefruit a day to help with my hematocrit with the increased dose.

A week and a half before my appointment I switched to 100 mg test cipionate every 3.5 days (trip to Vegas with the wife) to see how it affected me and all signs of ED went away and my wife and I both really liked the results and hoped my hematocrit levels wouldn’t be too high so we could keep that dose.

Got tested when I got back two days after a shot (peak) and my total T was 1436, and despite the increased dose my hematocrit dropped to 55 (still not good) so I think the grapefruit is helping.


Let's keep it real here.

You have been on trt for 5 months and the first 12 weeks were a complete waste due to your piss poor protocol of 200 mg T every 2 weeks.

This says it all.....Felt good for the first week after injection then nothing for the second. ED went away for that week and libido was good. Sides were oily skin some acne and a small amount of gynecomastia.

Here is where it gets even better.

Your doctor went and did a complete 360 and jacked up your T dose to a whopping 200 mg/week.....go figure!

This says it all.....He increased my dose to 200 mg test cipionate every week. My hematocrit was at 59 but he didn’t tell me the number only said it was a little high.

Anyone with sense in their head would have started you on 100 mg T/week once weekly or better yet split into twice-weekly injections (50 mg T every 3.5 days).

Start low and slow on a T-only protocol we say as we want to see how your body reacts to testosterone and where said dose has your trough TT, FT and estradiol let alone important blood markers such as RBCs/hemoglobin/hematocrit.

Your doctor is an idiot plain and simple and if you researched enough on your own as you stated especially on this forum then you should be well aware of all the threads/posts that echo starting low and slow on a T-only protocol let alone getting a full-set of labs done pre-trt and 6 weeks after starting or tweaking a protocol.

Lab work is critical!

This says it all.....After doing a lot of reading on this site I didn’t want to make that big of a jump so I started injecting 150 mg weekly for 6 weeks and really liked the results. It didn’t seem to increase my sides and my libido improved but ED persisted occasionally.

Even 150 mg T/week is not low and slow!

No one on this forum other than the misinformed would recommend starting someone on 150 mg T/week.

So now 12 weeks after being on a piss-poor protocol (200mg T every 2 weeks), you decided on your own to jump into 150 mg T/week for 6 weeks and your libido improved yet you are still struggling with ED.

Remember what I stated about the honeymoon period?

So 6 weeks in on the new protocol you never had full blood work done and had absolutely no idea where your trough TT, FT, estradiol let alone SHBG sat yet a week and a half before your appointment you go and up your dose from 150 mg T/week--->to a whopping 200 mg T/week split into twice-weekly injections (100mg T every 3.5 days).....go figure.

This says it all.....A week and a half before my appointment I switched to 100 mg test cipionate every 3.5 days (trip to Vegas with the wife) to see how it affected me and all signs of ED went away and my wife and I both really liked the results and hoped my hematocrit levels wouldn’t be too high so we could keep that dose

Again remember what I stated about the honeymoon period?

Now seeing as you just upped your dose from 150 mg T/week to 200 mg T/week (100 mg every 3.5 days) you never even gave it a full 6 weeks for blood levels to stabilize yet you had blood work done which would skew your results.

You were hitting an absurdly high TT 1436 ng/dL 2 days post-injection and that is not even your true peak let alone your blood levels have not even stabilized (4-6 weeks).

You are injecting a whopping 200 mg T/week split (100mg every 3.5 days) so your true trough would be 84 hrs (3.5 days) post-injection.

This says it all.....Got tested when I got back two days after a shot (peak) and my total T was 1436, and despite the increased dose my hematocrit dropped to 55 (still not good) so I think the grapefruit is helping.

Again you do not understand how exogenous T works.

Whether starting trt or tweaking a protocol (increasing dose of T) hormones will be in FLUX during the weeks leading up until blood levels have stabilized (4-6 weeks due to half-life TC/TE) and it is common for many to experience ups/downs during the transition as the body is trying to adjust.

It is common when first starting trt or tweaking a protocol (increasing dose of T) to experience what we call the HONEYMOON PERIOD where there is an overall euphoric feeling and a strong increase in libido/erections due to the rising T-levels/increased dopamine, lighting up of the AR (androgen receptor).

Unfortunately, this is temporary and short-lived as the body will eventually adapt to the new set-point once blood levels have stabilized and the strong increase in libido/erections let alone euphoric feeling tends to wane.

As I stated previously even once blood levels have stabilized (4-6 weeks) it will take time for the body to adapt to the new set-point and this is the critical time period when one should gauge how they truly feel overall regarding relief/improvement of low-T symptoms.

Every protocol should be given 12 weeks to claim whether it was truly a success or failure.

When looking at the bigger picture the first 6 weeks mean nothing.

Patience is key!

Can you see where this is going?

Seems to be a complete mess.

 

[madman]

When I started this my biggest issue was the ED. My wife’s libido had far exceeded my ability to take care of it.

The first protocol that worked for me to alleviate ED and match my wife’s libido was this current protocol. This isn’t bro science that brought me to that dose, it’s what alleviated the symptoms I was experiencing.

I have concerns about what it will do to my long term health that’s why I’m here asking questions. Unless you consider this site to be a bro romper room I haven’t been brainwashed I just have a Dr. with little experience in this field.

I’ve seen several “that’s a bad protocol” but I’ve yet to see any “if it were me in your shoes I would try this:” suggestions.

Start low and slow on a T-only protocol.

Stay consistent with your protocol (dose/injection frequency).

Blood work is done once blood levels have stabilized (4-6 weeks TC/TE).

Testing should be done at the true trough as we want to see where said protocol (dose of T/injection frequency) has your TT, FT, estradiol, let alone other important blood markers such as RBCs/hemoglobin/hematocrit, DHT, and prolactin.

Expect to experience ups/downs during the first 6 weeks as hormones will be in flux during the weeks leading up until blood levels have stabilized (4-6 weeks TC/TE).

Almost everyone will experience what we call the honeymoon period where there is an overall euphoric feeling and a strong increase in libido/erections due to the rising T-levels/increased dopamine, lighting up of the AR (androgen receptor) when first starting trt or tweaking a protocol (increasing T dose) and this is temporary and short-lived.

Do not get caught up in chasing the honeymoon!

Blood work should be done using the most accurate assays.

Once blood levels have stabilized (4-6 weeks) it will take time for the body to adapt to the new set-point and this is the critical time period when one should gauge how they truly feel overall regarding relief/improvement of low-T symptoms.

Every protocol should be given 12 weeks to claim whether it was truly a success or failure.

The dose of T should not be increased at the 6-week mark unless trough FT levels were too low (highly doubtful in most cases).

 

[madman]

I’ve been on TRT for 5 months now and am very happy with the results so far but I need some guidance as my GP is not as knowledgeable as most on this site.

Background: 48 yo 6’4” 250 recently dropped from 295 prior to TRT. High blood pressure prior to weight loss good BP now.

Reasons for TRT: low energy/libido occasional ED

Initial total T 310
Initial dose/dosage 200 mg test cipionate every 2 weeks intramuscular injection for 12 weeks.

Felt good for the first week after injection then nothing for the second. ED went away for that week and libido was good. Sides were oily skin some acne and a small amount of gynecomastia.

At my next Dr. appointment he had me test just before next dose (trough) and total T was at 278. He increased my dose to 200 mg test cipionate every week. My hematocrit was at 59 but he didn’t tell me the number only said it was a little high.

After doing a lot of reading on this site I didn’t want to make that big of a jump so I started injecting 150 mg weekly for 6 weeks and really liked the results. It didn’t seem to increase my sides and my libido improved but ED persisted occasionally.

I also started eating a grapefruit a day to help with my hematocrit with the increased dose.

A week and a half before my appointment I switched to 100 mg test cipionate every 3.5 days (trip to Vegas with the wife) to see how it affected me and all signs of ED went away and my wife and I both really liked the results and hoped my hematocrit levels wouldn’t be too high so we could keep that dose.

Got tested when I got back two days after a shot (peak) and my total T was 1436, and despite the increased dose my hematocrit dropped to 55 (still not good) so I think the grapefruit is helping.

I didn’t tell my Dr. I was taking 150 mg weekly or 100 mg every 3.5 days instead of the prescribed 200 mg weekly.

His recommendations were to try 200 mg every 8 days/9 days/10 days and watch symptoms and get checked in 3 months but check trough T levels instead of peak and hematocrit.

Some of my concerns:

The only tests my Dr. is concerned with are trough total T and hematocrit.

Dr. Didn’t mention donating blood to help with hematocrit numbers.

No mention of testing shbg or estrogen levels.

We live in a small town with no known hormone specialists.

I don’t have any complaints about my experience with TRT I’m just looking for advice on how to proceed with the breadth of experience and expertise that resides here.

Sorry about the novel I’m just looking forward to hearing any advise you might have to offer.

*After doing a lot of reading on this site I didn’t want to make that big of a jump so I started injecting 150 mg weekly for 6 weeks and really liked the results. It didn’t seem to increase my sides and my libido improved but ED persisted occasionally

*A week and a half before my appointment I switched to 100 mg test cipionate every 3.5 days (trip to Vegas with the wife) to see how it affected me and all signs of ED went away and my wife and I both really liked the results and hoped my hematocrit levels wouldn’t be too high so we could keep that dose


Need to sit back and think on this one too.

ED usually has a multifactorial etiology.

The causes of erectile dysfunction let alone decreased libido are complex and multifactorial.

Not as simple as just having healthy hormones (testosterone/free testosterone, estradiol, dihydrotestosterone, prolactin).

Too many caught upon that higher T = raging libido/titanium erections.

Much more going on when it comes to libido/ED than just testosterone!