HELP - Doubts about TRT

[Mastodont]

How about this, before the invention of frequent injections, guys have been injecting 200-250mg in one shot every two weeks, sure this kind of protocol has a period of supraphysiological levels, where the receptors get saturated, but to compensate the latter part of the cycle gives the system a rest. Since peaks occur naturally in certain life events, i argue that a short lived peak on the supraphysiological side is not as harmful as keeping levels above range constantly. I think we should have more data on the harm caused due to milligrams not matching natural production on those protocols that used to be the norm. Sure, injecting 250mg enanthate puts you high, but the milligrams dont really matter since you are burning through a lot in the first few days, the more frequently you choose to inject the more the milligrams matter. I know so many guys who inject every two weeks, they have no issues, no high hematocrit, and since they dont feel the fluctuation they don't see the need to inject more frequently. Not saying this is the way to go, for some it probably is, if it's due to not flooding the system as much or has to do with T/E ratio.

 

[Cataceous]

SAT-037 Effect of Weight on Serum Testosterone with Subcutaneous Testosterone Enanthate in Men with Testosterone Deficiency

BACKGROUND: In men, obesity is often associated with low testosterone (T) levels, but information is limited as to how body weight affects the pharmacokinetic profile or dosing of testosterone therapy (TTh) in men with T deficiency. Historically, men ...

www.ncbi.nlm.nih.gov

From that page:

“Conclusion: Our results show an inverse relationship between body weight and T exposure. Men with higher mean body weights required higher doses of SC TE to achieve physiologic T levels compared with men with lower mean body weights. The available doses provide effective options to reach target exposures. These findings highlight the impact of weight and dose selection on SC TE exposure.”
...

I thought you might cite this one. Nope, try again. Higher weight correlates with lower SHBG, which drives down total testosterone. You need a study that shows the underlying metabolism is enhanced, or at least one that looks at free testosterone.

...For your second statement, we also all process food with the same basic biology. However there are vast differences between people when it comes to food metabolism.
...

Testosterone = 1 particular molecule metabolized in very limited ways
Food = thousands of different molecules metabolized in a large variety of ways

...For your third statement, I asked which formula because the link you posted earlier did not show how much testosterone a healthy young person produces each day. It showed four different formulas that are used to calculate levels, and there were substantial differences in the outcomes between the formulas. Likewise the study you posted above simply compares DHT conversion in white men in PA to Chinese men living in China. It does nothing to show how much testosterone a healthy young person creates each day.

You are mixing up references to free testosterone and references to testosterone production. Different things, although testosterone production is what drives free testosterone.

You didn't look very hard at the study involving Chinese men, as there is a graph showing measured testosterone production rates of around 4-8 mg/day.

 

[Phil Goodman]

I thought you might cite this one. Nope, try again. Higher weight correlates with lower SHBG, which drives down total testosterone. You need a study that shows the underlying metabolism is enhanced, or at least one that looks at free testosterone.


Testosterone = 1 particular molecule metabolized in very limited ways
Food = thousands of different molecules metabolized in a large variety of ways


You are mixing up references to free testosterone and references to testosterone production. Different things, although testosterone production is what drives free testosterone.

You didn't look very hard at the study involving Chinese men, as there is a graph showing measured testosterone production rates of around 4-8 mg/day.

Did they measure SHBG levels of the participants in that study, or are you just assuming that is what caused the variation? Did they measure SHBG levels in this study:

Testosterone 2% Gel Can Normalize Testosterone Concentrations in Men with Low Testosterone Regardless of Body Mass Index

Little is known about the effect of body mass index (BMI) on the efficacy and safety of testosterone therapy in hypogonadal men. A prior noncomparativ…

www.sciencedirect.com

Which stated this:

“In this study, daily application of testosterone 2% gel was effective at returning serum testosterone to physiologic levels in men with low testosterone and high BMI, although required dose was affected by BMI. ”




Also, people of the same weight can have different SHBG levels correct? So that would affect the amount of testosterone it would take to reach the same free t levels. Also, young men tend to have lower SHBG levels….so a young person with low SHBG producing 8 mg of test/day would end up with higher free t than an old man taking in 8 mg/test per day.




But, I’ll step away from this part of the discussion now as I don’t want to derail OP’s thread anymore than it already is since he is looking for legit guidance going forward.

 

[Cataceous]

Did they measure SHBG levels of the participants in that study, or are you just assuming that is what caused the variation? Did they measure SHBG levels in this study:
...

The problem is they did not measure SHBG or free testosterone. When there are variations in SHBG, which is particularly true of the obese, then total testosterone becomes a less valid measure of testosterone sufficiency. Free testosterone should be used instead.

...
Also, people of the same weight can have different SHBG levels correct? So that would affect the amount of testosterone it would take to reach the same free t levels. Also, young men tend to have lower SHBG levels….so a young person with low SHBG producing 8 mg of test/day would end up with higher free t than an old man taking in 8 mg/test per day.
...

People of the same weight can have different SHBG levels, but the rest is not correct. The level of SHBG does not affect free testosterone. The myth may stem in part from the belief that the dose of testosterone directly drives total testosterone. If total testosterone were fixed then changes in SHBG would alter free testosterone. But this is not the case. The dose rate or production rate of testosterone directly drives free testosterone. Total testosterone just follows along, and is also a function of SHBG.

The results for young vs old men are actually the opposite. Metabolism slows in older men, so they have higher levels of free testosterone at the same dose. Non-obese older men also tend to have higher SHBG, which further inflates total testosterone.

 

[Cataceous]

In what form do you take them, why those dosages and why not cypionate?

How do you use enclomiphene at what dosage and frequency, and what is your reasoning using it with gonadorelin and why not HCG then.

Haha as you can see, you are a very interesting case for me because I thought of enclomiphene as an alternative to HCG.

I premix testosterone enanthate and testosterone propionate, and inject a fixed amount daily. The doses were arrived at over time, with the aim of having good subjective results and numbers that are mid-range for healthy young men. I did start TRT with cypionate alone. I was having some injection site reactions, which is how I ended up switching to enanthate.

I take 15 mg of enclomiphene daily. The rationale for using it with gonadorelin is explained here. While using hCG with TRT was better than not using it, I still felt that the results were subpar, even with all kinds of experimentation (dosing, AIs, cabergoline). At the time I was mainly blaming the problems on the long half-life of hCG relative to endogenous LH. In hindsight, I think some of the issues were a result of suppressed GnRH.

 

[BSS91]

I have enclomiphene and I honestly prefer to use it over hcg, so i will try hcg and if it doesn`t work with me, I will use enclo twice per week. Apparently it can do the job, less impactful than hcg, but it still does for many.

 

[NoVa Biker]

I am happy with TRT. I am 81 yo and 10 years into TRT. I keep my test level near the upper end of my lab’s range, 1100. No adverse effects noted. Good muscular development. The worst thing is that I hate the injections, once every five days.

Your case is different. You are much younger and worried about fertility and a lifetime of injections. But if your problems are as severe as you describe, I would recommend TRT. I think fertility can be managed.

 

[Charliebizz]

I think a lot of the “negative” talk about trt comes from unrealistic expectations. And people that do start and experience the “honeymoon” phase and constantly chase that leading to side effects. If you understand trt is used just to make you feel “normal” life will be good.

And as far as the “20+ hormones” shut down talk. Who’s to say any of them are functioning correctly any way. Don’t you think if they were we wouldn’t have low t and all the shitty symptoms to begin with ?

 

[BSS91]

I think a lot of the “negative” talk about trt comes from unrealistic expectations. And people that do start and experience the “honeymoon” phase and constantly chase that leading to side effects. If you understand trt is used just to make you feel “normal” life will be good.

And as far as the “20+ hormones” shut down talk. Who’s to say any of them are functioning correctly any way. Don’t you think if they were we wouldn’t have low t and all the shitty symptoms to begin with ?

I am thinking more in the lines of what someone else said : ``everything has a trade off, the question is are the trade offs of having test levels in range better than the trade offs of staying low t?''

Anyway, I have revised the protocol I have in mind and I think it will be 30 mg of test 3 times per week and 100 iu Hcg three times per week, test and hcg injected at same time MWF.

 

[Systemlord]

I am thinking more in the lines of what someone else said : ``everything has a trade off, the question is are the trade offs of having test levels in range better than the trade offs of staying low t?''

The only way you’re ever going know is to get your feet wet!

 

[BSS91]

The only way you’re ever going know is to get your feet wet!

Yes that is what I will do. I am really excited to start actually and hope that everything will be okay. I love to workout but can`t do that like before because I have little injuries in many joints and I hope that with this therapy I could get back on it and be smart about it.

I am sure that working out could trigger positive experiences in TRT, not only mentally with enhanced endorphin, dopamine and sertononin releases, but also physiologically like even help with e2 management, blood pressure, etc.

 

[madman]

I am thinking more in the lines of what someone else said : ``everything has a trade off, the question is are the trade offs of having test levels in range better than the trade offs of staying low t?''

Anyway, I have revised the protocol I have in mind and I think it will be 30 mg of test 3 times per week and 100 iu Hcg three times per week, test and hcg injected at same time MWF.

If maintaining fertility is your goal I would be upping the dose of hCG!

Even then as I stated in an earlier reply from another thread anyone starting testosterone therapy that is planning on having children needs to get a baseline SA done.

Any doctor in the know would recommend this.

This is critical.

 

[BSS91]

If maintaining fertility is your goal I would be upping the dose of hCG!

Even then as I stated in an earlier reply from another thread anyone starting testosterone therapy that is planning on having children needs to get a baseline SA done.

Any doctor in the know would recommend this.

This is critical.

Yes but considering what I read I thought maybe a starting dose could be that.

I ve seen many reports of people thinking they don’t tolerate hcg but then coming after a few weeks and saying that they actually needed less spreaded through multiple injections.

So my goal is to arrive at 750 iu per week but progressively getting there so going from 100 to 250 iu in the span of a few months.

It would also allow me to better assess how I react to test, with a tiny dosage of hcg.

I don’t feel comfortable starting on test alone because the hcg question will stay in my head.

This is my reasoning behind it. I wish there was an alternative to hcg, a viable one, not a super expensive one.

I ve see clinics advocating for enclomiphene and cases where low dose clomid and TRT keeping fsh and lh active but it seems to be a hit or miss for the most part.

For SA yes it is done, done that last week and sperm is good quality and in the process of being frozen.

 

[Systemlord]

So my goal is to arrive at 750 iu per week but progressively getting there so going from 100 to 250 iu in the span of a few months.

I wouldn't bother to torturing yourself, you're in for a real bad time! Constantly changing things is going to force your body to adapt to these changes and too many changes is going to lead to instability.

Overthinking this is going to lead to misery!

 

[BSS91]

I wouldn't bother to torturing yourself, you're in for a real bad time! Constantly changing things is going to force your body to adapt to these changes and too many changes is going to lead to instability.

Overthinking this is going to lead to misery!

But how is progressively increasing the hcg dose to let my body acclimate slowly a bad thing?

I get the overthinking part, I just don’t get the other part.

 

[Systemlord]

But how is progressively increasing the hcg dose to let my body acclimate slowly a bad thing?

I get the overthinking part, I just don’t get the other part.

I never had this mindset when starting TRT, I selected a dosage and waited for improvement, if there was none, I made a change. I didn't plan out everything so meticulously.

If you go through the Canadian healthcare system, you can forget about hCG together with TRT, not going to happen.

You're too far ahead of yourself.

 

[BSS91]

I never had this mindset when starting TRT, I selected a dosage and waited for improvement, if there was none, I made a change. I didn't plan out everything so meticulously.

If you go through the Canadian healthcare system, you can forget about hCG together with TRT, not going to happen.

You're too far ahead of yourself.

Well many telehealth clinics offer both, men’s clinics like science and humans or jack health have been offering it for quite some time now.

At this point you know how much I overthink, do you think I would prepared all of this while not knowing FOR CERTAIN that hcg is available?

For the other part of your comment, yes so my goal is to start a protocol and update it with how I feel after 6 weeks and lab numbers.

 

[madman]

I never had this mindset when starting TRT, I selected a dosage and waited for improvement, if there was none, I made a change. I didn't plan out everything so meticulously.

If you go through the Canadian healthcare system, you can forget about hCG together with TRT, not going to happen.

You're too far ahead of yourself.

WTF!

My uro let alone may others offer hCG with exogenous T.

PREGNYL hCG by MERCK CANADA

PREGNYL® (chorionic gonadotropin for injection, USP) 10,000 units/vial Human Gonadotropin Merck Canada Inc. 16750 route Transcanadienne Kirkland QC Canada H9H 4M7 The action of human chorionic gonadotropin (hCG) is virtually identical to that of pituitary LH, although hCG appears to have a...

www.excelmale.com

 

[madman]

Yes but considering what I read I thought maybe a starting dose could be that.

I ve seen many reports of people thinking they don’t tolerate hcg but then coming after a few weeks and saying that they actually needed less spreaded through multiple injections.

So my goal is to arrive at 750 iu per week but progressively getting there so going from 100 to 250 iu in the span of a few months.

It would also allow me to better assess how I react to test, with a tiny dosage of hcg.

I don’t feel comfortable starting on test alone because the hcg question will stay in my head.

This is my reasoning behind it. I wish there was an alternative to hcg, a viable one, not a super expensive one.

I ve see clinics advocating for enclomiphene and cases where low dose clomid and TRT keeping fsh and lh active but it seems to be a hit or miss for the most part.

For SA yes it is done, done that last week and sperm is good quality and in the process of being frozen.

If you feel more comfortable starting lower so be it just understand that if maintaining fertility is your goal that dose is too low!

 

[madman]

Considering all of this is theory of course.

I know practically everyone is different.

I see guys having adequate levels at 200 mg per week, others needing only 60 mg so I am talking in theory and in general.

Testosterone Therapy (TTh) - How To Treat - Abraham Morgentaler

Have every lecture! Link to some of them. Excel is littered with AM! https://vimeo.com/user19492999

www.excelmale.com