***Long post incoming.***
I'm interested in who may have had any genetic testing done and if it ultimately led to discovering the "optimal" protocol, whatever that may be.
I'm not a fan of the term, but it probably best describes things at this point.
TRT prescribed by my PCP for two years now, never truly felt perfectly dialed in despite messing around with quite a few different protocols. My doc has prescribed the cookie cutter 200mg per week, administered once or twice weekly, with an AI, on paper. Off the record conversations have been a little different - only use an AI if E2 symptoms arise. I actually have never tried this as I've stayed with a bit more frequent dosing to keep things slightly flatter.
A few things I have tried:
- 40mg test cyp every other day, .25mg adex every 4th day. Total test at 48 hour trough was 1062, E2 was at 17. Didn't feel too bad here in all honesty.
- 50mg test cyp every other day, 20mg equipoise every other day (I know, not TRT / HRT but I didn't feel like spending money on primo and had access cheap). Total test at 48 hour trough was 1368, E2 was 21. Again, didn't feel too bad here in all honesty and actual performance in what I train for was improved.
- 20mg test cyp every day, no AI. Total test at 24 hour trough was 1116, E2 was at 41. I felt ok - not bad, but I noticed the increased E2, and not sure that I noticed it in a good way.
- 20mg test prop every day, no AI. Total test at 24 hour trough was 790, E2 was at 56. Eh, ok at best. I do like the little more peak and trough from prop but I definitely felt the E2 getting up there.
All things considered, anecdotally, I seem to feel best with E2 controlled on the lower end of things whereas some people seem to like it to run pretty high. I do like the peak and trough from prop but I think 100% prop is a bit too extreme and a bit of a blend, either 2:1 or 1:1 cyp to prop, would be better.
Now on to some interesting information. I've had some genetic testing done recently (my wife is starting to go down this rabbit hole with both us and our kids more out of curiosity than anything) and there were some interesting findings:
- Very fast COMT activity. I can say I have seen this more anecdotally throughout my entire life with respect to being more of a "gamer". Always underperformed in practice in athletics and overperformed on game day. The more I have on my plate with life, family, professionally, the better I do. The more intense the situation, the more I seem to be a bit calm and clear.
- Predisposed to high CYP19A1 activity. Essentially, should be an above average aromatizer. I am reasonably lean (maintain visible abs and visible veins in lower abs year round in my 40's now), so any aromatization is not necessarily a body fat driven thing for me.
- Predisposed to high CYP1B1 activity. Essentially, should have increased 4-OHE levels compared to the norm or average. I don't know much about this at this point but am doing some reading.
As much as I don't put 100% stock in AI, I have used various models to interpret the testing, interpret blood work, and essentially help draft what might be an optimal way to approach HRT in the long term. The general consensus has been pretty consistent across all - drop test down a bit further to 15mg per day, preferably a longer ester (peaks and troughs might not be great for very fast COMT individuals), no AI, and let it ride.
Full transparency - part of me questions whether or not I actually should, as I just have this gut feeling that I would not be getting as much out of TRT / HRT as I should long term. This is a mental block on my side, and I do believe it is partially influenced by hearing some more public folks in the field (Dr. Keith Nichols, Dr. Andrew Winge, Dave Lee, etc.) talk about leveraging a pretty healthy dose of testosterone and not really worrying about E2 all that much. But I can say, at this point anyways, I seem to have felt better with E2 a bit more controlled, and I would predict that pulling test dose down would get E2 into the low 30's with no control.
Another part of me wonders if, with this potentially not being enough, I may benefit from actually dropping the testosterone dose down, but adding some nandrolone back in to make up for the milligrams. Most models seem to think people with very fast COMT activity would do better with more DHT or DHT like compounds (ie. masteron, proviron), but again, I have a bit of a mental block or pull on my side looking more into the nandrolone route because of the reported success of a lot of individuals who don't seem to tolerate testosterone as well. Another mental aspect is the fact that nandrolone is relatively frequently prescribed...it shouldn't make a difference but something makes me more comfortable knowing its not necessarily an extreme or off the wall approach.
All of that to say -
Has anyone gone through with any kind of genetic testing or have anecdotes that line up with being a very fast COMT activity individual with a bit more propensity towards aromatization and sensitivity to elevated E2? What have you found to be a good protocol where you feel the best while being healthy?
I'm interested in who may have had any genetic testing done and if it ultimately led to discovering the "optimal" protocol, whatever that may be.
I'm not a fan of the term, but it probably best describes things at this point.
TRT prescribed by my PCP for two years now, never truly felt perfectly dialed in despite messing around with quite a few different protocols. My doc has prescribed the cookie cutter 200mg per week, administered once or twice weekly, with an AI, on paper. Off the record conversations have been a little different - only use an AI if E2 symptoms arise. I actually have never tried this as I've stayed with a bit more frequent dosing to keep things slightly flatter.
A few things I have tried:
- 40mg test cyp every other day, .25mg adex every 4th day. Total test at 48 hour trough was 1062, E2 was at 17. Didn't feel too bad here in all honesty.
- 50mg test cyp every other day, 20mg equipoise every other day (I know, not TRT / HRT but I didn't feel like spending money on primo and had access cheap). Total test at 48 hour trough was 1368, E2 was 21. Again, didn't feel too bad here in all honesty and actual performance in what I train for was improved.
- 20mg test cyp every day, no AI. Total test at 24 hour trough was 1116, E2 was at 41. I felt ok - not bad, but I noticed the increased E2, and not sure that I noticed it in a good way.
- 20mg test prop every day, no AI. Total test at 24 hour trough was 790, E2 was at 56. Eh, ok at best. I do like the little more peak and trough from prop but I definitely felt the E2 getting up there.
All things considered, anecdotally, I seem to feel best with E2 controlled on the lower end of things whereas some people seem to like it to run pretty high. I do like the peak and trough from prop but I think 100% prop is a bit too extreme and a bit of a blend, either 2:1 or 1:1 cyp to prop, would be better.
Now on to some interesting information. I've had some genetic testing done recently (my wife is starting to go down this rabbit hole with both us and our kids more out of curiosity than anything) and there were some interesting findings:
- Very fast COMT activity. I can say I have seen this more anecdotally throughout my entire life with respect to being more of a "gamer". Always underperformed in practice in athletics and overperformed on game day. The more I have on my plate with life, family, professionally, the better I do. The more intense the situation, the more I seem to be a bit calm and clear.
- Predisposed to high CYP19A1 activity. Essentially, should be an above average aromatizer. I am reasonably lean (maintain visible abs and visible veins in lower abs year round in my 40's now), so any aromatization is not necessarily a body fat driven thing for me.
- Predisposed to high CYP1B1 activity. Essentially, should have increased 4-OHE levels compared to the norm or average. I don't know much about this at this point but am doing some reading.
As much as I don't put 100% stock in AI, I have used various models to interpret the testing, interpret blood work, and essentially help draft what might be an optimal way to approach HRT in the long term. The general consensus has been pretty consistent across all - drop test down a bit further to 15mg per day, preferably a longer ester (peaks and troughs might not be great for very fast COMT individuals), no AI, and let it ride.
Full transparency - part of me questions whether or not I actually should, as I just have this gut feeling that I would not be getting as much out of TRT / HRT as I should long term. This is a mental block on my side, and I do believe it is partially influenced by hearing some more public folks in the field (Dr. Keith Nichols, Dr. Andrew Winge, Dave Lee, etc.) talk about leveraging a pretty healthy dose of testosterone and not really worrying about E2 all that much. But I can say, at this point anyways, I seem to have felt better with E2 a bit more controlled, and I would predict that pulling test dose down would get E2 into the low 30's with no control.
Another part of me wonders if, with this potentially not being enough, I may benefit from actually dropping the testosterone dose down, but adding some nandrolone back in to make up for the milligrams. Most models seem to think people with very fast COMT activity would do better with more DHT or DHT like compounds (ie. masteron, proviron), but again, I have a bit of a mental block or pull on my side looking more into the nandrolone route because of the reported success of a lot of individuals who don't seem to tolerate testosterone as well. Another mental aspect is the fact that nandrolone is relatively frequently prescribed...it shouldn't make a difference but something makes me more comfortable knowing its not necessarily an extreme or off the wall approach.
All of that to say -
Has anyone gone through with any kind of genetic testing or have anecdotes that line up with being a very fast COMT activity individual with a bit more propensity towards aromatization and sensitivity to elevated E2? What have you found to be a good protocol where you feel the best while being healthy?
