Need help with TRT protocol

[somedude]

Hi, I have been on TRT for 2 months now. I had two tests performed pre trt. The total for the first was 234. The total for the second was 184. I don't have the numbers for free or e2 prior to trt. I am 35 years old have have been experiencing the standard side effects of low t for years. Low libido, low energy, depression, etc....

My doctor put me on 100mg Test Cyp/per week and 250iu HCG twice per week.
I initially had a bump in energy and libido but that dropped off towards week 4.

At week 6 I went in for the next round of tests. These tests were taken one day after injecting T.
Total T: 1100
Free T: 106
E2: 33

My doctor recommended .25 arimidex twice/week. I have been on this protocol for a couple weeks and libido has improved but I'm more tired than normal. I'm having a hard time getting this dialed in. Over the last 8 weeks I've had 3 to 4 really great weeks. Almost like an awakening. Tons of energy, sex drive was great, felt fantastic in the gym, etc... However, I'm having a hard time finding a consistent balance.

Any suggestions? Is the Arimidex really necessary? Should I lower my T does and drop the Arimidex?

Thanks.

 

[PAUL-E]

when you first start TRT there is a honeymoon period where most guys feel really good and then it tapers off (just like real marriage JK lol)what's your SHBG?

 

[Vince]

At age 35, I think you should find out why you have low testosterone and see if a restart is possible.

 

[somedude]

Hey Paul-E, thanks for the reply. I don't have that number. When I was at my last appointment I just wrote down total, free and e2.

 

[PAUL-E]

no problem, next time ask for a copy or call and ask for them to send you a copy if you post it you can get more feedback otherwise its a guessing game

 

[Re-Ride]

Hey Paul-E, thanks for the reply. I don't have that number. When I was at my last appointment I just wrote down total, free and e2.

You are now entitled to a copy directly from the lab w/o MD authorization per DHHS rules. Your MD should also give you a copy. Many labs now let you view results on line.

"cc pt immediately upon result" I always have the MD write that on the lab order.

 

[ERO]

Your e2 level was fine so I have no idea why your doc would put you on 0.25 mg AI twice a week unless you have overt high E2 symtoms. Low E2 is as bad as it being too high. You might want to break your T dose into two 50 mg injections every 3.5 days for more even levels. Say Monday AM and Thursday PM as an example.

That and you should have done your labs on the day of your T shot, but before the shot to get your trough levels. 100 mg a week is a low dose so if anything you may need to go higher, not lower.

 

[somedude]

I'll call my doc and see if he can post the results to my online portal and then I'll share. I think I felt better before the AI. I spent the last decade on about every anti depressant and having problems with libido. Workout like crazy withour many gains. I've noticed a significant improvement in the gym since starting TRT. I love it. Libido has been better on and off. But def better overall. Depression has improved for sure. I'll try splitting into 2 dose twice per week and maybe drop the AI. I feel like I'm on the cusp of getting it right but it just hasn't been consistent. Thanks to all who replied.

 

[Periandros]

Next time do your blood test the day or the morning before your injection so you can test the level at your bottom, not your peak.

I'll call my doc and see if he can post the results to my online portal and then I'll share. I think I felt better before the AI. I spent the last decade on about every anti depressant and having problems with libido. Workout like crazy withour many gains. I've noticed a significant improvement in the gym since starting TRT. I love it. Libido has been better on and off. But def better overall. Depression has improved for sure. I'll try splitting into 2 dose twice per week and maybe drop the AI. I feel like I'm on the cusp of getting it right but it just hasn't been consistent. Thanks to all who replied.

 

[johndoesmith]

Peak levels don't give much information really. They will always test high but tell you nothing about how you metabolize testosterone. You spend very little time at peak so you want to know where levels are for most of your time.

The other risk is that your doctor lowers your dose because peak is high and then you have a dose that doesn't really help the symptoms.

Get trough.

 

[somedude]

Hey ERO, I broke my ejections up this week. 50mg T dose with 250iu hcg on Monday. Will do the other dose tonight(thursday). I didn't take the AI. This week I have been sweeting in my armpits during the day. I've never had that problem. Really bad sweating. I've also had pretty low energy and tired in the morning. What do you think?

 

[johndoesmith]

Hey ERO, I broke my ejections up this week. 50mg T dose with 250iu hcg on Monday. Will do the other dose tonight(thursday). I didn't take the AI. This week I have been sweeting in my armpits during the day. I've never had that problem. Really bad sweating. I've also had pretty low energy and tired in the morning. What do you think?

Has your stress level suddenly increased from something in your life? Work, relationship, or money related possibly?

Armpit sweating is more of a stress sweating than it is for cooling down your body. That combined with tiredness in the morning sounds like poor sleep due to stress.

This is all just guessing really, it could also be due to hormonal changes from going to E3.5D. If it is, the body adjusts and will go away with time, unless it's high E2, but I doubt you have high E2 since you had a 33 E2 level at 1100 total level.

 

[somedude]

I finally have my full set of lab results.

Pre T -
E2 III - 12.8 (6 to 38)
Total T - 248 (249 - 846)
%FTI - 33% (Range 34 - 106)
FSH - 3.02 (1.27 - 19.26)
LH - 2.3 (1.2 - 8.6)
Prolactin - 5.24 (4 to 15)
PSA Total - .65 (0 to 4)
PSA Free - .26

Here are my test results after 6 weeks of 100 MG of Test Cyp every Wednesday, and 500 IU HCG on Fri and Monday. This test was taken on my Wednesday around 12pm after my T shot at 7am. So this is kind of peak. I still wasn't feeling great. Libido low and energy a little off. I'd get a couple good days each week and thats about it.

E2III - 33 (6 to 38)
Total T -1100 (249 - 846)
%FTI - 107 (Range 34 - 106)
FSH - .10 (1.27 - 19.26)
LH - .1 (1.2 - 8.6)
Prolactin - 8.54 (4 to 15)

Switched up protocol in a number of ways. Split dose of T to twice per week. Lowered HCG to 250iu twice per week. Same thing as before. A few good days each week. I noticed the day after my T shot and day after my HCG shots were my worst. No morning wood and no energy. I took a trip for work and wasn't able to take my HCG for a full week. That was by far the best week I had. Morning wood every day. Great energy. Felt great. After playing around with the dose I landed back on this prior to my latest round of labs...100mg Test cyp on Wed, 250iu HCG on Fri and 250iu HCG on Monday. This test was taken at trough. On Wednesday BEFORE my T injection:

Total T - 230 (249 - 846)
Free T - 27 (Range 34 to 106)
E2 III - 5.42 (6 to 38)

My doctor upped my T does to 140mg/week and asked me to go back to 500iu HCG twice per week. He also recommended I take .25 Arimidex the day of T shot. Just started on that so we'll see.

Any insight into all of this? Damn, this has been hard to figure out.

 

[CoastWatcher]

I finally have my full set of lab results.

Pre T -
E2 III - 12.8
Total T - 248
%FTI - 33% (Range 34 - 106)
FSH - 3.02
LH - 2.3
Prolactin - 5.24
PSA Total - .65
PSA Free - .26

Here are my test results after 6 weeks of 100 MG of Test Cyp every Wednesday, and 500 IU HCG on Fri and Monday. This test was taken on my Wednesday around 12pm after my T shot at 7am. So this is kind of peak. I still wasn't feeling great. Libido low and energy a little off. I'd get a couple good days each week and thats about it.

E2III - 33
Total T -1100
%FTI - 107 (Range 34 - 106)
FSH - .10
LH - .1
Prolactin - 8.54

Switched up protocol in a number of ways. Split dose of T to twice per week. Lowered HCG to 250iu twice per week. Same thing as before. A few good days each week. I noticed the day after my T shot and day after my HCG shots were my worst. No morning wood and no energy. I took a trip for work and wasn't able to take my HCG for a full week. That was by far the best week I had. Morning wood every day. Great energy. Felt great. After playing around with the dose I landed back on this prior to my latest round of labs...100mg Test cyp on Wed, 250iu HCG on Fri and 250iu HCG on Monday. This test was taken at trough. On Wednesday BEFORE my T injection:

Total T - 230
Free T - 27 (Range 34 to 106)
E2 III - 5.42

My doctor upped my T does to 140mg/week and asked me to go back to 500iu HCG twice per week. He also recommended I take .25 Arimidex the day of T shot. Just started on that so we'll see.

Any insight into all of this? Damn, this has been hard to figure out.

It would help if you provided the ranges for all tests. Can you edit them in? Was SHBG tested?

 

[somedude]

Yep, just did a quick edit to the original post. SHGB was not tested. Thanks.

 

[johndoesmith]

I finally have my full set of lab results.

Pre T -
E2 III - 12.8 (6 to 38)
Total T - 248 (249 - 846)
%FTI - 33% (Range 34 - 106)
FSH - 3.02 (1.27 - 19.26)
LH - 2.3 (1.2 - 8.6)
Prolactin - 5.24 (4 to 15)
PSA Total - .65 (0 to 4)
PSA Free - .26

Here are my test results after 6 weeks of 100 MG of Test Cyp every Wednesday, and 500 IU HCG on Fri and Monday. This test was taken on my Wednesday around 12pm after my T shot at 7am. So this is kind of peak. I still wasn't feeling great. Libido low and energy a little off. I'd get a couple good days each week and thats about it.

E2III - 33 (6 to 38)
Total T -1100 (249 - 846)
%FTI - 107 (Range 34 - 106)
FSH - .10 (1.27 - 19.26)
LH - .1 (1.2 - 8.6)
Prolactin - 8.54 (4 to 15)

Switched up protocol in a number of ways. Split dose of T to twice per week. Lowered HCG to 250iu twice per week. Same thing as before. A few good days each week. I noticed the day after my T shot and day after my HCG shots were my worst. No morning wood and no energy. I took a trip for work and wasn't able to take my HCG for a full week. That was by far the best week I had. Morning wood every day. Great energy. Felt great. After playing around with the dose I landed back on this prior to my latest round of labs...100mg Test cyp on Wed, 250iu HCG on Fri and 250iu HCG on Monday. This test was taken at trough. On Wednesday BEFORE my T injection:

Total T - 230 (249 - 846)
Free T - 27 (Range 34 to 106)
E2 III - 5.42 (6 to 38)

My doctor upped my T does to 140mg/week and asked me to go back to 500iu HCG twice per week. He also recommended I take .25 Arimidex the day of T shot. Just started on that so we'll see.

Any insight into all of this? Damn, this has been hard to figure out.

I'm a bit confused, you said you split your dose to test twice per week, but you injected 100mg on Wed, is that a typo perhaps?

Would you happen to have other tests recently ordered?

I would urge you to NOT take AI, as your E2 is very low, and low E2 is something I think should be reserved as a torture method.

BTW, what is "E2 lll"? I have never seen that before, is it a sensitive test?

 

[CoastWatcher]

Your taking an AI when you have an estradiol level below the reference range????? Do I understand you correctly???? It's no wonder you aren't experiencing success if this is the sort of medical advice you're receiving. Seriously, what did your doctor say to justify such a decision? That's unbelievable.

 

[somedude]

Sorry for the confusion. I tried splitting my doses and that didn't work so I went back to the protocol I mentioned...100mg shot once per week. The last test I posted is from 3 weeks ago. I'm not sure about E2 III. Thats just the way its listed on my paperwork.

 

[Leesto]

I would urge you to NOT take AI, as your E2 is very low, and low E2 is something I think should be reserved as a torture method.

Haha johndoesmith. Isn't that the truth. Low E2 certainly seems like torture. It is obvious you have experienced it.

 

[CoastWatcher]

Sorry for the confusion. I tried splitting my doses and that didn't work so I went back to the protocol I mentioned...100mg shot once per week. The last test I posted is from 3 weeks ago. I'm not sure about E2 III. Thats just the way its listed on my paperwork.

But why the AI and why no SHBG testing to see just how quickly you may be clearing your testosterone? Your being ill-treated by your current doctor and deserve better. There is no indication that an AI is necessary. In fact, your estradiol is at an absurdly low level - which may be contributing to your overall dissatisfaction with your protocol.