Need help with protocol. Can't get dialed in.

[GerryGerrison]

I have now been on TRT for 16 weeks. I've had quite a few ups and downs, and now cant seem to get on the right protocol.

Current protocol:
54mg test cyp e3.5 days Subq
250 IU hcg e3.5 days
.25 Arimidex e3.5 days

Latest Labs : 02/06/2017 (test was 56mg e3,5 for these labs)
Total Test 741 ( 350-1200)
Free test 22.6 ( 8.7-25)
Sensitive e2 33.3 ( 8-35)
ALT 141 (0-44)
*took advil the night before like an idiot, and got sick with flu like stuff the monday night after giving blood that morning, not sure if those are contributing to the high ALT


Labs before Arimidex was added: 01/09/17 (Test was 56mg e3.5 and hcg same)
total test 934
free test 179 (35-155)
e2 sensitive 60 ( 8-35)


So as you can see my estradiol got quite high at one point, and I had to add an aromatase inhibitor. I started with .25mg, and after two doses my high estro was messing with my concentration so much I went to .5 for one dose. Immediately felt the effects of low e2(I had naturally low e2 before TRT, very in touch with what those symptoms feel like) I felt like shit. So naturally I went back to .25 mg after that and decided I had been too hasty. The two days before my latest labs I literally was crying at the drop of a hat. I felt like a pregnant woman, emotions were insane, even though my trough value shows it only being at the top of the range on the latest labs. Since I didn't want to add anymore AI I dropped my test dose down to .54mg instead. Yes I know too many protocol changes, and I understand I shouldn't be doing that. I am a pre med student and had midterms, stress was high, and I couldn't keep crying so much so I dropped the test dose so that I could hopefully study. It worked for the time being but now I just feel meh.

This is my second run with TRT. First run was 100mg IM once a week, 250 iu hcg twice a week. At the end of around 7 weeks I was starting to get more energy and better libido, but I was not ready for TRT mentally and decided to get off. Wanted to exhaust every natural option completely, did that, and then decided I didn't have a choice so made myself ok with injections indefinitely. Now all my shots have been sub q. I have had maybe two-three days throughout the whole time period where I felt 100% like my old self. Other than that libido has improved some, I am able to train again, and mood is slightly better. However fatigue is still very bad, and runs my life pretty much.

I am pretty much just unsure of how to proceed. I am interested in keeping the same e3.5 dosing schedule, but switching to IM vs sub q since I seem to aromatize a lot on sub q, and maybe would respond better to IM. Really just looking for some input from some experienced guys. My doc is open to different ideas, but at this point I am just not sure what to go for. I was contemplating just dropping down to

50mg e3.5 days IM
hcg ed3.5 sub q
No AI

Go with that for 5 weeks and then titrate up from there trying to keep arimidex out of the picture.

 

[Will Brink]

I have now been on TRT for 16 weeks. I've had quite a few ups and downs, and now cant seem to get on the right protocol.

Current protocol:
54mg test cyp e3.5 days Subq
250 IU hcg e3.5 days
.25 Arimidex e3.5 days

Latest Labs : 02/06/2017 (test was 56mg e3,5 for these labs)
Total Test 741 ( 350-1200)
Free test 22.6 ( 8.7-25)
Sensitive e2 33.3 ( 8-35)
ALT 141 (0-44)
*took advil the night before like an idiot, and got sick with flu like stuff the monday night after giving blood that morning, not sure if those are contributing to the high ALT


Labs before Arimidex was added: 01/09/17 (Test was 56mg e3.5 and hcg same)
total test 934
free test 179 (35-155)
e2 sensitive 60 ( 8-35)


So as you can see my estradiol got quite high at one point, and I had to add an aromatase inhibitor. I started with .25mg, and after two doses my high estro was messing with my concentration so much I went to .5 for one dose. Immediately felt the effects of low e2(I had naturally low e2 before TRT, very in touch with what those symptoms feel like) I felt like shit. So naturally I went back to .25 mg after that and decided I had been too hasty. The two days before my latest labs I literally was crying at the drop of a hat. I felt like a pregnant woman, emotions were insane, even though my trough value shows it only being at the top of the range on the latest labs. Since I didn't want to add anymore AI I dropped my test dose down to .54mg instead. Yes I know too many protocol changes, and I understand I shouldn't be doing that. I am a pre med student and had midterms, stress was high, and I couldn't keep crying so much so I dropped the test dose so that I could hopefully study. It worked for the time being but now I just feel meh.

This is my second run with TRT. First run was 100mg IM once a week, 250 iu hcg twice a week. At the end of around 7 weeks I was starting to get more energy and better libido, but I was not ready for TRT mentally and decided to get off. Wanted to exhaust every natural option completely, did that, and then decided I didn't have a choice so made myself ok with injections indefinitely. Now all my shots have been sub q. I have had maybe two-three days throughout the whole time period where I felt 100% like my old self. Other than that libido has improved some, I am able to train again, and mood is slightly better. However fatigue is still very bad, and runs my life pretty much.

I am pretty much just unsure of how to proceed. I am interested in keeping the same e3.5 dosing schedule, but switching to IM vs sub q since I seem to aromatize a lot on sub q, and maybe would respond better to IM. Really just looking for some input from some experienced guys. My doc is open to different ideas, but at this point I am just not sure what to go for. I was contemplating just dropping down to

50mg e3.5 days IM
hcg ed3.5 sub q
No AI

Go with that for 5 weeks and then titrate up from there trying to keep arimidex out of the picture.

Then perhaps it's not your T levels. There's plenty of other possible causes for fatigue. Thyroid always the obvious place to look, to less obvious such as stress, high cortisol levels, low grade viral infections, anemia, etc.

Best way to keep arimidex out is to lower your TT a bit (700-800) and biggest of all, lose some body fat. More bodyfat tends to = greater peripheral conversion to E2 and all but ignored because simply adding a AI easier than loosing some bodyfat. Now, if you don't really have much fat to lose, then may not apply to you.

- Will @ BrinkZone.com

 

[GerryGerrison]

Almost every other avenue has been exhausted. Everything you mentioned plus lots more. My e2 has been so high throughout TRT I believe if I can get it in range I will be good to go with energy, but I cant say for sure. I would like to experience a few months of dialed in e2 and then reassess.

 

[CSI007]

Are you testing on the bottom of the trof?

 

[GerryGerrison]

All tests are trough. Monday morning before injection at 8-9am.

 

[Vettester Chris]

If just going by numbers, your latest labs look fine, but that only reflects a few areas of your health, leaving too much out there that's unknown and speculative(?).

I concur with Will's comments, stating that there's other factors and "causes" that could be in play. There are so many variables that contribute to the overall wellness program, e.g., Thyroid and Adrenals as noted by Will. IMO, you will find a better balance with your well being when more of an emphasis is placed on the macro-function of your program.

 

[Vettester Chris]

Also, just to be safe, I would suggest running a follow up enzyme test with both ALT and AST. I know you were sick and taking some meds, but it was still (in my book) a bit unusually high. It would just be good to know for sure, just my .02

 

[CoastWatcher]

Also, just to be safe, I would suggest running a follow up enzyme test with both ALT and AST. I know you were sick and taking some meds, but it was still (in my book) a bit unusually high. It would just be good to know for sure, just my .02

Just a reminder that yiu can get a CMP at a reasonable cost through discountedlabs.com. Chris does raise a good point.

As has been noted before, some guys inject subQ and swear it makes a difference as far as e2 levels go (and they have labs to back that up). Others inject IM and insist it's the variable that allows them to hold e2 in check (they have supporting labs, too). Having done both, I can tell you it made no difference (I have the appropriate labs that indicate I'm right). It all depends. - as does so much in the TRT game.

What at we see make a difference is protocol alteration, fewer smaller injections. I finally hit the jackpot two years ago when I started injecting 16mg every morning. That's radical, and very few guys need to consider daily injections, but we have guys achieve success on an eod schedule. I understand what you're saying, you don't end to inject more often, but hold the idea in reserve. Good luck with your IM effort.

 

[GerryGerrison]

As I said below all other areas have been tested multiple times. Adrenals, sleep study, thyroid, etc. It has all been tested and re tested. I take ashwaganda for adrenal support. I take b vitamins, vitamin C, and magnesium.

I guess my main question is would it hurt to drop down to 50mg e3.5 days, hcg 250 iu, and no arimidex and go up from there. I started off at 150 a week and have been working backwards the entire time. I would really like to not have to take an AI so I figured that by basically starting over at the low end of doses I could slowly titrate up and find my sweet spot.

 

[GerryGerrison]

AST was slightly high 41 (0-40)

Last labwork ALT was high 91 (0-40) (141 now)

So ALT is creeping higher and higher.

I attributed it to the increasing estradiol and the liver having to get rid of it, plus the increased training in the gym. Now I am not so sure.

 

[Will Brink]

Almost every other avenue has been exhausted. Everything you mentioned plus lots more. My e2 has been so high throughout TRT I believe if I can get it in range I will be good to go with energy, but I cant say for sure. I would like to experience a few months of dialed in e2 and then reassess.

What is your bodyfat levels?

 

[Will Brink]

As I said below all other areas have been tested multiple times. Adrenals, sleep study, thyroid, etc. It has all been tested and re tested. I take ashwaganda for adrenal support. I take b vitamins, vitamin C, and magnesium.

I guess my main question is would it hurt to drop down to 50mg e3.5 days, hcg 250 iu, and no arimidex and go up from there. I started off at 150 a week and have been working backwards the entire time. I would really like to not have to take an AI so I figured that by basically starting over at the low end of doses I could slowly titrate up and find my sweet spot.

Kinda what I suggested above no?

 

[GerryGerrison]

19% dexa tested. Too high I know. Even that body fat I was pretty damn strong and fit before the hormones took a dive ( over 20 strict pull ups, under 6 min mile, 275/345/405, strict muscle ups, etc.) I eat clean with no bullshkt, and don't drink anymore .

 

[GerryGerrison]

Sorry Will I'm on mobile and it's hard to track the replies. Just saw what you posted and I agree. Plan is to switch to lower dose, drop the AI, and push hard to get leaner.

 

[Will Brink]

Sorry Will I'm on mobile and it's hard to track the replies. Just saw what you posted and I agree. Plan is to switch to lower dose, drop the AI, and push hard to get leaner.

My guess is that will do the trick. Even 19% to say 12% would make a difference and not hard to maintain per se. You might want to go IM vs sub Q also. I doubt that would make a major difference, but same tiny needles can be used.

 

[GerryGerrison]

Thanks for all the help man. Currently working hard on dropping the BF( tracking macros, meal prepping, training 3-5 days a week), and will talk to doc tomorrow about dropping dose and switching to IM.

 

[Vettester Chris]

AST was slightly high 41 (0-40)

Last labwork ALT was high 91 (0-40) (141 now)

So ALT is creeping higher and higher.

I attributed it to the increasing estradiol and the liver having to get rid of it, plus the increased training in the gym. Now I am not so sure.

I personally don't think that's the attribute. I would reach out to your physician to look deeper into it, possibly run some further assays (ALP, Bilirubin, GGT, etc.). Rule out Hep C and other things ...

 

[GerryGerrison]

Those values were never high before TRT, and weren't high in the beginning when e2 wasn't high. All the other markers you mentioned were in range. I had a full cmp done, but I only listed the out of range values.

 

[johndoesmith]

All the other markers you mentioned were in range. I had a full cmp done, but I only listed the out of range values.

Why? If you want help, help us help you, you're leaving out information and making it difficult to help.