Is My TRT Protocol Appropriate?

[goga]

Hello. I was prescribed 250 mg IM per week. It's 250 mg, as it is the only injection available here (Omnadren 250). I thought I felt fine the first week, but its not that good on after the second injection. The first week I felt better than before I started TRT, the second week - worse than that.
I know that one does not go to a follow up blood check at least not before the 5th injection, but is there a way to guess that the dosage is not good?
I was surprised when I was told to do it weekly (not every other week). Maybe to avoid ups and downs.

I don't know if injecting half a vial weekly is a good idea.

I have a primary hypogonadism. My T is on the lower "normal" range, my Free T is below it.

Please help.

 

[CoastWatcher]

Hello. I was prescribed 250 mg IM per week. It's 250 mg, as it is the only injection available here (Omnadren 250). I thought I felt fine the first week, but its not that good on after the second injection. The first week I felt better than before I started TRT, the second week - worse than that.
I know that one does not go to a follow up blood check at least not before the 5th injection, but is there a way to guess that the dosage is not good?
I was surprised when I was told to do it weekly (not every other week). Maybe to avoid ups and downs.

I don't know if injecting half a vial weekly is a good idea.

I have a primary hypogonadism. My T is on the lower "normal" range, my Free T is below it.

Please help.

Welcome to Excelmale. You are injecting a whopper of a dose of testosterone. Most men will find that 250mg of testosterone, in a once weekly dose, will send their estradiol soaring. That could well be what you're dealing with now. Frequent, smaller injections are *typically* far more successful.

Please post your pre-TRT lab values (particularly your SHBG level). Where do you live?

 

[Dr Justin Saya MD]

I'll back up CW with a full endorsement that 250mg in a SINGLE dosage is too much (all at once) for TRT purposes...though Omnadren is virtually identical to sustanon (4 esters) and is different than what most here are used to dealing with (cypionate, enanthate, or propionate).

 

[goga]

Thank you.
My lab tests prior to TRT were:

Total T: 11.71 nm/l (range 8.68-29.0)
LH: 15.29 mm/ml (1.7-8.6)
Prolactin: 7.16 (4.04 - 15.2)
FSH: 18.71 mm/ml (1.5-12.4)
E2: 26.77 pg/ml (11.3 -43.2)
Free T : 12.95 pg/ml (15-50).

Symptoms: ED, poor libido, Brain fogs, cognitive issues.

I was put on 250 mg T p/w. The doctor seemed to be confident about the dosage, I felt suspicious and asked if he was sure I needed it weekly.

I think if I inject half a vial, I will get the same daily T (too high) but it will last shorter. I need it to provide less daily.

T options are very limited here.

Years ago, Androgel elevated my E2 to the top of normal range, without increasing T, and slightyly increasing Free T. You can guess it did not improve my symptoms too much.

 

[goga]

I did not take SHBG but I think these results provide some clues:
Total T: 11.71 nm/l (range 8.68-29.0)
E2: 26.77 pg/ml (11.3 -43.2)
Free T : 12.95 pg/ml (15-50).

I am in my early 40's.

 

[Tommy Wall]

Hello goga, You will find in this forum good protocols. 250mg is old school and that should be injected only every second or third week. I´ll think most of the guys are on 100-140mg 1xweek or devided in 2 per week or every 3,5 days and some even more times per week. Just search and you will find the info you need here on EM.
Good Luck!

 

[goga]

Thank you Tommy.

The point is that T Cypionate or Enantant is not available here. Half a vial of IM Sustanon/Omnadren per week does not provide 125 mg p/w, it rather provides 250 mg (lasting shorter - maybe aweek, or little more).

 

[Tommy Wall]

OK but still 250mg per week is a huge dose

 

[goga]

Thanks. good to know. Amazing, why these companies are still producing it

 

[CoastWatcher]

You have no other options, in terms of what can be prescribed? You are limited to multi-ester preparations?

 

[goga]

Nebido and Androgel are available, single-ester preparations - not. (excluding Propionate)
The gel did not work for me. After a month E2 jumped up, T did not change much. Free T increased slightly.
I did not feel any improvement after Nebido. Maybe, its to strong for me.

If you think, that 100 mg Cypionate weekly is much better than 250mg multi-ester every other week, I may meet a Doc abroad (Europe preferable).

 

[Heedcase]

I currently inject 50mg Sustanon every 3 days using a slin pin, works great for me

 

[goga]

Great to know. Do you discard the capsule then? If you do, how do you keep it.
you need 6 capsules monthly, instead of 2.

 

[Heedcase]

I use a 2ml syringe with a filter needle to draw up the Sustanon from the ampule and then I back fill my slin pins.non of it gets thrown away.
My Dr stresses the importance of the filter needle to avoid injecting any microscopic glass particles from cracking open the ampule.
I used 50mg cypionate every 3 days for years and my lab results are identical on the Sustanon.

 

[goga]

Do you refrigerate of freeze the syringe?
How log do you wait for it to thaw/warm up?

I saw a thread here, saying one should not refrigerate it more than once.

 

[Heedcase]

No need to chill and certainly don't freeze it,you must be thinking of hcg. I keep mine in a drawer away from sunlight

 

[goga]

I appreciate this info. Thank you, indeed.
I may begin with 100 mg E6D for convenience.
When do you advise me to go to a first lab?

I also have Nebido. It did not help me (was too much). I may apply similar protocol to it then.

 

[Heedcase]

I'd get your shbg tested to decide how often you will inject. mine is low so I inject more frequently.

Get tested after 6 weeks, 40% of Sustanon is made up of testosterone decanoate which supposedly has a halflife of 15 to 18 days so will take a while to reach steady state too

 

[goga]

So, here is my short history so far:
12 June - injected full ampule of Omandren (Sustanon 250), containing 250 mg of T. I felt the week very well - my mind began to function as a proper mind.
19 June - injected full ampule again and that week was terrible..
30 June - injected 0.5 and the first two days were bad again. I'm feeling better now.

I intend to inject 0.4 (i.e. 100 mg) on the 7th of July.

No signs of libido yet.

Is it normal? Did you wet through this bad period. These overlapping days after injections are so bad.

 

[bm1981]

I can kind of relate to what your experiencing, 1ml of Sustanon can have a peak of around 70nmol ( 2000 in us format)after 24-48 hrs