Hi folks, starting TRT tommorrow

[klepp0906]

hey guys, figured id say hi or whatnot.

Im 35 and just had a blood test done for low T (i had all the symptoms for years and was convinced that was the problem, and it was).

They got me at ~300 and asked me to come in for another to confirm. The second test had me under 200.

ive literally felt dumb as rocks (and im a smart guy) with memory and concentration issues. Ive been perpetually fatigued, and I sleep like utter garbage. Libido is nonexistent.

Meanwhile, i eat better than anyone i know, im in the gym 5 days a week, and ive carried at max 12%bf for the last year or so.

Spinning my wheels evidently.

Very eager and enthusiastic to start. Just a little concerned. My GP wanted to get me rolling and told me to take 200mg of cyp 1x a week. I'm already going to split it into 2x a week, but wondering if thats inordinately high? He didnt prescribe any hcg or AI and said that I should wait about 6 weeks and then make an appointment with an endo he referrred me to (whos female, hoping that doesnt effect her outlook on testosterone)

Anything I should be aware of or keep an eye on? Or change for that matter? Going to do IM for now. Quad quad, butt, butt, and rotate those 4.

awesome site!

 

[MarkM]

200 mg per week, even splitting it to two 100 mg injections, is huge to start off with. Do you know what any of your pre-TRT labs are. It’s hard to discuss and give adequate advice without knowing your labs. Can you post labs for deeper conversation?

 

[Systemlord]

Shbg will be key to determining injection frequencies. That's a Whopper of a starting dose and unless you are a hyper T metabolizer or hyper excreter, it's going to cause problems I assure you.

I couldn't handle a 100 mg a week split up however many ways I choose.

 

[Vettester Chris]

"Anything I should be aware of or keep an eye on? Or change for that matter? Going to do IM for now. Quad quad, butt, butt, and rotate those 4. "

Keep an eye on balancing the other variables upstream & downstream, start slow & grow into your protocol, and support it with a healthy lifestyle (diet, sleep, balance, stability). Ruthe n labs at six weeks, know your PSA going in and include in future labs .. Lastly, the more time you spend on a Site like ours, the more knowledge you will attain ... Knowledge is power! TRT is only piece of equation, get familiar with all variables to ensure your success.

 

[klepp0906]

hi again. thank you very much for the replies. Here I am stuck up at 340 am due to the awesome sleep I get

As my GP, he only ran the minimum a far as "extras" were concerned.

Here is what I have for "other chemistry" on lab results. Everything else is like the basic stuff.

Should i get with the endocrinologist sooner? Or will I be okay for 6 weeks? Should I modify the dose or just go with the 200? Also I hear a lot about testing in a "trough" to see where my lowest point is after I stabilize? When would that be if your shooting IM every 3.5 days? Is an AI going to be something I should get on my own?

Definitely appreciate the time and advice. Huge comittment here and with 2 new little girls, longevity is paramount so i want to do this right

 

[HealthMan]

hi again. thank you very much for the replies. Here I am stuck up at 340 am due to the awesome sleep I get

As my GP, he only ran the minimum a far as "extras" were concerned.

Here is what I have for "other chemistry" on lab results. Everything else is like the basic stuff.

View attachment 5705

Should i get with the endocrinologist sooner? Or will I be okay for 6 weeks? Should I modify the dose or just go with the 200? Also I hear a lot about testing in a "trough" to see where my lowest point is after I stabilize? When would that be if your shooting IM every 3.5 days? Is an AI going to be something I should get on my own?

Definitely appreciate the time and advice. Huge comittment here and with 2 new little girls, longevity is paramount so i want to do this right

2x a week and maybe 1x a week you should be fine given your SHBG. I agree 200mg it is a high start dosage. Discuss with your doctor to start with a lower dosage and go from there (anywhere from 100-140mg a week. I always prefer to start low so if it was me starting TRT today I would start with 100mg a week) I doubt he would be against it (if you were asking for a higher dosage maybe but a lower one?). An AI is only needed if you end up with high estradiol with symptoms (something you will only know after weeks into your protocol). HCG a lot of people use. Some don’t. A lot of debate if it is really needed or not but overall consensus is that it is a smart addition to a TRT protocol for a few reasons (a lot of information about this in this forum). Looks like fertility is not a concern right?
Best of luck

 

[klepp0906]

Hi Healthman, and thank you.

Just did my first injection. Felt pretty awful lol. Got nauseous and started to feel like fainting. Told my wife to come in and I pulled the needle out and told her id have to re-do it. She asked me why... I looked down and I had already injected it all lol.

So yea.

As for fertility, definitely not a concern. 2 and through as they say. The 1st was great. the 2nd turned it into a madhouse around here. This is coming from a man who wanted 0 to begin with

Is HCG used purely for fertility and aesthetic reasons? (so testes dont shrink?) Irrespective of answer, it wouldnt increase testosterone even further would it? (just in case i decide or dr decides i need it down the road). I believe i recall reading that it can raise test used by itself? (i could be remembering incorrectly however, my memory has been laughingly bad for a long while now).

I did do a tad under a 1/2ml of a 200mg/ml vial. Partially intentionally i guess, partially working out the air. I'll probably "stay under the line" as opposed to even or over to at least skew on the side of conservatism until my first bloods.

I should wait at least 4 weeks is the general consensus? Also, 2 pins for every injection right? Basically use 1 to draw, swap needle to inject? (its what I did this time, just trying to figure out long term math on how often ill need to buy syringes among other things)

I apologize for all the questions - ive done a fair amount of research over the years but its been on and off and now everything began happening so fast that I have to really cram on whats current and best for my specific situation.

Thanks for your time!

 

[Deleted member 16042]

Your story is all too common.

I'll bet your doc has you using a harpoon sized needle as well.

When will the ignorant T mills and endos stop this kind of nonsense?

Hi Healthman, and thank you.


Is HCG used purely for fertility and aesthetic reasons? (so testes dont shrink?) Irrespective of answer, it wouldnt increase testosterone even further would it? (just in case i decide or dr decides i need it down the road). I believe i recall reading that it can raise test used by itself? (i could be remembering incorrectly however, my memory has been laughingly bad for a long while now).

I should wait at least 4 weeks is the general consensus? Also, 2 pins for every injection right? Basically use 1 to draw, swap needle to inject? (its what I did this time, just trying to figure out long term math on how often ill need to buy syringes among other things)

Your story is the same as around 1/2 dozen new members per week here, and all signs are that your doctor is ignorant in multiple regards. You need to become fully educated to act as your own advocate and find a doctor that actually understands modern standards of TRT, not dated obsolete guidelines which commonly do men harm.

I am glad they have not prescribed you anastrozole from the get go as part of your cookie cutter bombastic protocol.

-100mg is a much more generally accepted initial dose, and with your SHBG at 55 is probably a good starting point. However, 100mg/week may end up being too high a dose which can cause elevated Hematocrit and estradiol. My own SHBG os 48 and I had to reduce dose 4 times from 150/week in order to reduce HCT. The reductions have been Hellish as hormone levels drop each time. In retrospect it would have been better for me to start around 80mg/week which would have boosted my Total and free T far above my hypogonadal baseline and incrementally bumped up from there if needed.

-The testicular issues are not entirely cosmetic. For some of us, me included, testicles shrink and retract like before puberty. This becomes more than uncomfortable especially when testicles retract during sex/orgasm. HCG helps to restore some testicular size and relax the scrotum so the guys hang instead of get sucked into the pelvis. HCG also helps" backfill the pathways" meaning stimulating production of pregnenelone and DHEA which are precursors to Testosterone and are also beneficial hormones in their own right. mono HCG treatment can be useful to secondary hypogonal patients who's testicles will still produce testosterone when stimulated. Most hypogonadal men are rpimary which means the testicles don't do their job. For them, HCG may help a little, but basically the testicles can't respond with T production.

-Your new steady state will be at/around 6 weeks out, not 4 weeks. Some guys need even longer to really reach steady state after dosage changes. Testing at 6-8 weeks is the generally accepted norm. And have labs drawn at trough, the day of injection right before you inject.

-2 pins, NO. Get yourself some 1/2" insulin syringes with fixed needles, 29g if T is in grapeseed oil, 27g if cottonseed. These have essentially zero dead space. Your luer tip syringes have dead space and you lose T as waste which never is expelled from the syringe. There is no reason to harpoon yourself with large needles!

 

[klepp0906]

i did go with a box of 25g at least. Some were saying thats the smallest thats feasable. I did hear you can go smaller for SubQ but it was a pain to fill or some such.

I did ask about hcg and AI as i mentioned, but am wondering if theyre always necessary? I mean the less foreign stuff your taking the better id imagine yea?

When I use this syringes up I will look into something smaller if it can be made to work safely for IM. Not sure what kind of oil theyre in, ill have to take a look sunday evening when i do the next injection.

Do you recommend I do a smaller dose next time or should I just keep with what im doing? Which I imagine will be ~180g a week.

I scheduled the endo appointment for the 26th (its a female doc, does this tend to be a problem? Not sure how much bias is in the industry based on gender when it comes to testosterone). It was all they had unless I wanted to wait till december. It does fall on my injection morning, however they said they dont do blood work in their office so Id have to go elsewhere which I could put off a week until the following wednesday I gather.

Dont recommend scooping up an AI online JIC? Or should I be okay for ~5 weeks?

Man now you guys got me nervous about the dosing. Like any guy, I want high test - and feeling how ive felt for so long.. i crave it. But not at the expense of something else.

I really do appreciate the time

 

[MarkM]

I would drop the dose down to 100 mg to 120 mg. I think 180 mg to 200 mg is just way to high. You can also increase at a later date and it is easier to increase than to decrease the dosages. One injection per week is probably fine with your high SHBG.

You can go smaller than a 25 gauge for injections. I'd at least move to a 27 gauge 1/2" which should work fine with all oils and for IM. I use a 28 gauge 1/2" for IM.

Whenever possible it is a good idea to start off initially with Testosterone monotherapy. That is all many men use. You could always order some AI to have handy but be hesitant to use it unless absolutely necessary. They are very potent and what may seem like a small dose can be very damaging quickly.

High testosterone numbers aren't always a good fit for everyone. Don't fixate on a number, fixate on how you feel. Your Free Testosterone is much more important than your Total Testosterone. Even though it is a small fraction of your Total Testosterone, it is the piece that does all the work. We need our Free T to be 2% - 3% of our Total T.

Good luck and keep us posted on your progress.

 

[Deleted member 16042]

Generally speaking, shooting for high T also provokes high estradiol and Hematocrit. It was Hell for me personally having to deal with these and the dosage reductions in order to manage them.

Dr Crisler recommends SubQ. It works fine for many, me included. For some it can cause lumps under the skin. The only way to know is to try. I use 5/16" 30g with T cyp in grapeseed oil. (BTW, I am low body fat like you and never had a problem with SubQ. It seems guys with more fat have more of the troublesome bumps.)

Personally, I'd forego the thrift and just buy a box of 100 1/2" insulin syringes, especially with your reaction to injection. The smaller the needle, the less freakout. They are around $12-$15/100

 

[Deleted member 16042]

We need our Free T to be 2% - 3% of our Total T.

This always has me scratching my head. How do guys with SHBG say 70 or 15 fit into this theoretical model? Or are they just completely hosed?

 

[MarkM]

This always has me scratching my head. How do guys with SHBG say 70 or 15 fit into this theoretical model? Or are they just completely hosed?

Using klepp0906's SHBG of 55 in this case, he is probably going to have to target the low end of that range, closer to 2%. In order to do that his Total T is going to have to be somewhat supra-physiological, probably 1250 to 1300. Most of that is going to be bound to SHBG as you know but that would get his Free T to maybe 2% and in the upper part of the Free T range. Will that increase his E2, sure it will but it will bind to SHBG too so what we have to worry about in that case is the amount of Free E2.

High SHBG individuals are similar to low SHBG individuals in that because they are at the extreme ends of the equations and it makes it more difficult for them to get dialed in and find a sweet spot. I think it is more difficult for low SHBG individuals to find their spot.

 

[Systemlord]

Felt pretty awful lol. Got nauseous and started to feel like fainting.

That's a physiological response to sticking yourself with a syringe, I experience something similar. I like to use 27-29 gauge insulin syringes, less muscle damage over the decades. You may need to locate a 1ml 27-29 gauge syringe in order to be able to load enough T-Cyp.

 

[Deleted member 16042]

Using klepp0906's SHBG of 55 in this case, he is probably going to have to target the low end of that range, closer to 2%. In order to do that his Total T is going to have to be somewhat supra-physiological, probably 1250 to 1300. Most of that is going to be bound to SHBG as you know but that would get his Free T to maybe 2% and in the upper part of the Free T range. Will that increase his E2, sure it will but it will bind to SHBG too so what we have to worry about in that case is the amount of Free E2.

High SHBG individuals are similar to low SHBG individuals in that because they are at the extreme ends of the equations and it makes it more difficult for them to get dialed in and find a sweet spot. I think it is more difficult for low SHBG individuals to find their spot.

Thx, my point is that there are those who fall either at the extreme high or low or outside of this % range. For them, the ratio isn't really helpful other than to say, sorry your outside of norms and you're screwed. Perhaps there is a different more useful paradigm for these people, like "target your free t level".

 

[Systemlord]

Thx, my point is that there are those who fall either at the extreme high or low or outside of this % range. For them, the ratio isn't really helpful other than to say, sorry your outside of norms and you're screwed. Perhaps there is a different more useful paradigm for these people, like "target your free t level".

I couldn't agree with you more blackhawk, I used to go by this free testosterone percentages until I saw my own at 2.86%, it may appear like an excellent result until you learn that while my free testosterone was midrange (TT 376), I was heavily symptomatic.

It's apparent that I need free testosterone at the top of the ranges or higher to feel normal.

 

[MarkM]

Thx, my point is that there are those who fall either at the extreme high or low or outside of this % range. For them, the ratio isn't really helpful other than to say, sorry your outside of norms and you're screwed. Perhaps there is a different more useful paradigm for these people, like "target your free t level".

Okay, I can agree with that. Before I started TRT my Total T was 64 and my Free T was 2 which gave me a Free T percentage of 3.1%. So while over the top of the so called generally accepted range of 2% to 3%, it meant diddlysquat.

 

[Deleted member 16042]

my Total T was 64 and my Free T was 2

YIKES!

 

[MarkM]

YIKES!

I began wondering why I started squatting verse using the urinal when going to the bathroom. A light finally went off. I don't squat any more.

 

[klepp0906]

even more confused now. so many opinions. I wonder if i should stay the course so they know where to adjust from. if my shbg(sp) does point to needing higher levels of testosterone perhaps thats best?


I will move down/try some 27 gauge when i exhaust these 25s. since this is for life and im only going to rotate 4 spots, i might as well limit as best i can. Might even look into SubQ down the road, but I wanna get this dialed in for the long haul first.

I just cant wait to feel better. I feel super weak in the gym, like bordering on injury if i try to lift heavy. I have 0 interest in sex. I dont even bother trying to concentrate anymore, and id be lucky to get 6 hours a sleep a night total in 3 sessions of 2 hours ><

its been rough. I can still remember what it felt like to feel like a man though, hoping that all comes back

Ill do some more poking around the site and keep you guys posted as i move forward. I appreciate all the input bigtime!