Possible to be healthy @ 250mg/week? What blood markers do you want to see?

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This is an open challenge to explore the possibility of walking the enhanced boundaries, while keeping absolutely all possible negative TOT side effects in check, especially anything related to health.

The main question I am trying to answer via blood work, BP measurements, WIP lifestyle changes and a TOT protocol that I am still refining is:
Is it possible to be healthy @ 250mg/week? What blood markers do you want to see?

This blog post is inspired by:
1) The advice to "lower the dose and hope for the best" + "calling 170mg/week a cycle" on this BP post [ need to complete some final tests before I answer that one, stay tuned ;) ]
2) Stan Efferding's TOT protocol:
Stan Efferding is on top of his blood work, blood pressure, etc. afaik has never had any CVD issue (unlike many other enhanced athletes that died, too many to name...) and his protocol appears to be the following:
TOT @ 300mg/week, injecting 100mg x3 / week MWF, trying to keep total T between 1000 and 1500, using testosterone proprionate to minimize aromatization.
^ From:

My preliminary protocol is the following, but this will likely change slightly as I lose some fat in the next few weeks/months:
Testosterone Enanthate @ ~250mg / week, injecting ~80-90mg x 3 / week TTS [ ~250mg/week is the real injected amount, based on my math on ampule loss, injection loss, the fact I get at least 2 extra shots when I preload syringes, etc. ]
HCG @ ~390 IU x twice a week TT [ Lowered from x3 week previously, due to water retention and +20 increase in BP during refeeds on weekends ]
Anastrozol @ 2mg/week TT [ because my E2 runs too high otherwise, even at lower 140mg/week doses, stay tuned for a bone density post ;) ]

Current Supplements & Meds:
- 1/day x Temilsartan 80mg [ for BP, HCT, lipids, etc. stay tuned for blood work :) ]
- 2/day x Nebivolol 2.5mg [ for BP, lowered from 5mg x2/day before, due to gastric reflux ]
- 2/day x Doxazosin 2mg/2mg [ for BP ]
- 2/day x Cialis 5mg [ for many reasons ]
- 3/day x Astralogous (1xam/2xpm) [ for Kidneys ]
- 2/day x NAC 750mg [ for Kidneys/Liver ]
- 2/day x Aava Labs Omega3 (1xam/1xpm) [ 2 = 1000mg EPA + 500mg DHA ] [ for "general health" ]
- 1/day x 100mg DHEA [ because DHEA was low in blood work ]

Other things:

Citrulline Malate [ for NO ]
Electrolites [ for fasting days ]
MCT C8 Oil [ for first 2 fasting days / week, to ease the transition to Keto ]

Other things Before bed:

1 x B complex [ always ]
1 x 50mg pregnenolone [ always ]
1 x 3mg boron [ always ]
~3h before bed: 1000g Magnesium Citrate [ on fasting days only ]

Open question to the ninjas in this forum:
Anybody willing to suggest improvements to the above and/or propose things to check to ensure this is done safely?

Before you ask:
I am on my own, my endo has no clue, etc. (the usual) but all of the above are either legit prescription meds (no black market BS) or supplements sourced from supposedly reputable companies (ofc, I have no equipment to check, but blood work will guide tuning).
 
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Defy Medical TRT clinic doctor
Obv opinions are gonna vary, but I personally could run 250mg/ week indefinitely without worrying even the slightest about decreasing my overall health or longevity. I personally would be very confident that I could live a long and healthy life using 250mg/ week indefinitely. So as long as the person is focused on optimizing his health in regards to his diet, exercise regimen, stress levels and sleep, I wouldn’t worry at all using 250mg/ week, if I were them. This is obv assuming they don’t have a genetic disorder that would be effected by the increased androgen levels

Imo, guys eating a crap diet, living with high stress, not getting good sleep, and not working out, are at an insanely higher risk of overall cause mortality, than a guy using 50-100mg more per week than most guys do on HRT. But of course, certain men will make the guy using 250mg/ week feel like he just signed his own death certificate, while not saying a word to all the men that have horrible eating and lifestyle habits

So my personal advice is to simply take the 250mg/ week if u feel good on it, and if it helps u achieve ur goals, and if it’s an ideal balance for u in ur life as far as what makes u happy. Would just focus as much as u can on diet, sleep, stress, and exercise, if ur gonna bump ur dose up and push the limits a bit
 
TOT @ 300mg/week, injecting 100mg x3 / week MWF, trying to keep total T between 1000 and 1500, using testosterone proprionate to minimize aromatization.

I will start here. Peak, trough or mean?



What do you think the subject's SHBG would need to be to reach 1500 ng/dl TT MEAN on a weekly equivalent dose of 300 mg/week Test Prop?

What do you think his mean free Test levels would be? Care to take a guess?

Is it possible to do above and be healthy, blood work, etc? Absolutely. Be born to the right parents.

RE your questions...Is it possible to be healthy on 250 mg/week? What bloodwork?

I don't think blood work by itself if going to cut it. You better be getting regular heart surveillance to compare to baseline, echo, ECG, etc. Cardiac MRI to check for cardiac myocyte damage? Blood pressure, RHR, HRR, autonomic dysfunction?

Logically speaking this question is similar to me coming on here and asking the group could I ever total 2500 lb in a PL meet? How would this group know? @BigTex did it but I personally could never do it for a number of reasons.

If you really want to know then try it. The old expression F around and find out seems applicable. Even with my attention to detail I grow tired of this useless merry go round. For vast VAST majority of humans 250 mg/week of Test Ester does not remotely resemble anything close to TRT or medically appropriate testosterone therapy for hypogonadism. Do you understand why that is?

With that said if you wanna get big or die trying I personally fully support your quest (except the potential for that nasty ER visit where you tie up the bed for some more deserving person). But as @Gman86 challenged me there are plenty of other people tying up those beds unnecessarily for other things (eating, smoking, drinking). In short, these are all about excess and the diseases that come with excess.

Best wishes.

Currently at 160 mg/week / 30+ ng/dl FT peak and body dysmorphic. Should probably up the dose as my Hct is only 51 and I am not quite purple enough just yet.

#left ventricle gains!
 
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It would be interesting to know how many guys on TRT ever walk into the front door of a gym and how many have actually changed the way they eat, including cutting all the alcohol my wife and I commonly see in baskets in the grocery store.

Unfortunately, other than the contact I have here, the only guys I know on "TRT" are old bodybuilders/powerlifters. Only a few of them have trusted a doctor to help them out or even dared to mention the word testosterone to a doctor. Out of those, none of them have any confidence their doctor has a clue what they are doing, so they take the script and continue using UG products. All have good diets and all believe in what exercise does to help the body. Not sure this is an accurate view of most on TRT.

Women have an even more difficult problem. My wife went to an endocrinologist for help and got put on a statin. He refused to even listen to her telling him she was on a keto diet. Never even did blood work to see how her hormone levels were. She won't give it another try now. She doesn't trust any doctor. I guess I fall in the same category as the other guys I know, My doctor mentioned TRT to me 10 years ago and I refused and told him insurance won't cover it and I can get it much cheaper. So he just did blood work and eventually I did that myself. I finally took him up on a script a little over a year ago and I am back on UG products again. But I also fall into the category of eating a good diet and putting in around 4 hours total in the gym each week.
 
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It would be interesting to know how many guys on TRT ever walk into the front door of a gym and how many have actually changed the way they eat, including cutting all the alcohol my wife and I commonly see in baskets in the grocery store.

Unfortunately, other than the contact I have here, the only guys I know on "TRT" are old bodybuilders/powerlifters. Only a few of them have trusted a doctor to help them out or even dared to mention low T to a doctor. Out of those, none of them have any confidence their doctor has a clue what they are doing, so they take the script and continue using UG products. All have good diets and all believe in what exercise does to help the body. Not sure this is an accurate view of most on TRT.

Women have an even more difficult problem. My wife went to an endocrinologist for help and got put on a statin. He refused to even listen to her telling him she was on a keto diet. Never even did blood work to see how her hormone levels were. She won't give it another try now. She doesn't trust any doctor. I guess I fall in the same category as the other guys I know, My doctor mentioned TRT to me 10 years ago and I refused and told him insurance won't cover it and I can get it much cheaper. So he just did blood work and eventually I did that myself. I finally took him up on a script a little over a year ago and I am back on UG products again. But I also fall into the category of eating a good diet and putting in around 4 hours total in the gym each week.
That’s unfortunate that ur wife had a bad experience that left her with such a bad taste in her mouth that she’s not even open to the idea of HRT anymore. Hopefully she’s doing fine without it tho.

My ex eventually let me sign her up with defy and get her hormone levels checked. She was 31 at the time. Had the lowest test level I’ve ever seen, even for a woman. It was like rock bottom, again, even on the women’s range. She ended up getting on testosterone, and was able to get off of the antidepressant she was on for like 12 years. She had tried to get off of it before, but wasn’t able to. While on testosterone she was finally able to get off of them. I’ve had horrible experiences with doctors too, in regards to my hormones. But luckily I didn’t let it deter me, eventually found defy, and everything has been amazing since. Night and day difference compared to other hormone clinics/ doctors that I had in the past
 
Actually it just left a bad taste in my mouths mouth about doctors here. She has been like the typical gym rat I know that has taken steroids herself for 30+ years. So she just continues self medication. The testosterone stigma for guys is nothing compared to women who use it. Most doctors feel the same. Testosterone has always worked so she continues using it. Glad to hear your ex was successful in using testosterone. Happy also Defy is working for you. If they took insurance, I would give them a call in a minute.
 
Actually it just left a bad taste in my mouths mouth about doctors here. She has been like the typical gym rat I know that has taken steroids herself for 30+ years. So she just continues self medication. The testosterone stigma for guys is nothing compared to women who use it. Most doctors feel the same. Testosterone has always worked so she continues using it. Glad to hear your ex was successful in using testosterone. Happy also Defy is working for you. If they took insurance, I would give them a call in a minute.
They do for labs at least. And that’s by far what would cost me the most on HRT if I had to pay out of pocket for them. The medications are relatively cheap. Even cheaper if u run low dosages, or just run test by itself at a low dose. With the labs I just have them write me a lab requisition, I then print out and take the requisition to the nearest quest diagnostics or lab corp, the lab takes my insurance info, and the labs I have done get billed to my insurance. All I have to pay is my copay at the lab. Think it’s like $25 or $50. Defy writes the lab requisition for no charge. They’re honestly amazing. Total godsend for me and my HRT journey. Can’t recommend them enough
 
They do for labs at least. And that’s by far what would cost me the most on HRT if I had to pay out of pocket for them. The medications are relatively cheap. Even cheaper if u run low dosages, or just run test by itself at a low dose. With the labs I just have them write me a lab requisition, I then print out and take the requisition to the nearest quest diagnostics or lab corp, the lab takes my insurance info, and the labs I have done get billed to my insurance. All I have to pay is my copay at the lab. Thinks it’s like $25 or $50. Defy writes the lab requisition for no charge. They’re honestly amazing. Total godsend for me and my HRT journey. Can’t recommend them enough
Truth.
 
@BigTex there’s also a guy here that had his fertility medication covered by insurance through defy, and meds filled via empower. So maybe they do in some circumstances. I’ve only used insurance with them in regards to my labs tho personally
 
They do for labs at least. And that’s by far what would cost me the most on HRT if I had to pay out of pocket for them. The medications are relatively cheap. Even cheaper if u run low dosages, or just run test by itself at a low dose. With the labs I just have them write me a lab requisition, I then print out and take the requisition to the nearest quest diagnostics or lab corp, the lab takes my insurance info, and the labs I have done get billed to my insurance. All I have to pay is my copay at the lab. Think it’s like $25 or $50. Defy writes the lab requisition for no charge. They’re honestly amazing. Total godsend for me and my HRT journey. Can’t recommend them enough
Here is my problem. My insurance covers 100% of my lab work and the doctor has a Quest lab in his building. I pay $5 copay for the doctor and CVS changes me $15 for the 10ml cypionate. Anastrozole for some reason is no charge. Hard to beat that. Even though I am not using the cypionate I get the TU I am using for free (one of my perks as a board administrator). I would however at least like to get their evaluation and opinion.

Dr. Lipshultz is also here but I will not drive to downtown Houston, or sit in an office as long as I hear people wait on him. Plus, parking fees in the medical center. Then fighting Houston traffic, it would take 1/2 a day to go there and back.
 
Here is my problem. My insurance covers 100% of my lab work and the doctor has a Quest lab in his building. I pay $5 copay for the doctor and CVS changes me $15 for the 10ml cypionate. Anastrozole for some reason is no charge. Hard to beat that. Even though I am not using the cypionate I get the TU I am using for free (one of my perks as a board administrator). I would however at least like to get their evaluation and opinion.

Dr. Lipshultz is also here but I will not drive to downtown Houston, or sit in an office as long as I hear people wait on him. Plus, parking fees in the medical center. Then fighting Houston traffic, it would take 1/2 a day to go there and back.

Sounds like you got it pretty well handled if your Hct continues to behave. Well done.

You could do consult with Saya and get his thoughts. That is your problem @BigTex...a little too much experience and good brain.
 
You are right. At my age I have a good pension paid Medicare Advantage and it pays just about everything. Paying out of pocket or even more than I do makes little sense.

Here is one of Dr. Crisler's postings about higher doses. I do miss this guy's knowledge.


Yet another good posting about E2.


Crisler was always listening to others, never came off as the end all to TRT.

Higher doses

Listening to your peers

More on highere E2 levels
 
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You are right. At my age I have a good pension paid Medicare Advantage and it pays just about everything. Paying out of pocket or even more than I do makes little sense.

Here is one of Dr. Crisler's postings about higher doses. I do miss this guy's knowledge.


Yet another good posting about E2.


Crisler was always listening to others, never came off as the end all to TRT.

Higher doses

Listening to your peers

More on highere E2 levels

Great links @BigTex. Thank you. I will read all of these. Maybe some of that moderation can rub off.
 
This is an open challenge to explore the possibility of walking the enhanced boundaries, while keeping absolutely all possible negative TOT side effects in check, especially anything related to health.

The main question I am trying to answer via blood work, BP measurements, WIP lifestyle changes and a TOT protocol that I am still refining is:
Is it possible to be healthy @ 250mg/week? What blood markers do you want to see?

This blog post is inspired by:
1) The advice to "lower the dose and hope for the best" + "calling 170mg/week a cycle" on this BP post [ need to complete some final tests before I answer that one, stay tuned ;) ]
2) Stan Efferding's TOT protocol:
Stan Efferding is on top of his blood work, blood pressure, etc. afaik has never had any CVD issue (unlike many other enhanced athletes that died, too many to name...) and his protocol appears to be the following:
TOT @ 300mg/week, injecting 100mg x3 / week MWF, trying to keep total T between 1000 and 1500, using testosterone proprionate to minimize aromatization.
^ From:

My preliminary protocol is the following, but this will likely change slightly as I lose some fat in the next few weeks/months:
Testosterone Enanthate @ ~250mg / week, injecting ~80-90mg x 3 / week TTS [ ~250mg/week is the real injected amount, based on my math on ampule loss, injection loss, the fact I get at least 2 extra shots when I preload syringes, etc. ]
HCG @ ~390 IU x twice a week TT [ Lowered from x3 week previously, due to water retention and +20 increase in BP during refeeds on weekends ]
Anastrozol @ 2mg/week TT [ because my E2 runs too high otherwise, even at lower 140mg/week doses, stay tuned for a bone density post ;) ]

Current Supplements & Meds:
- 1/day x Temilsartan 80mg [ for BP, HCT, lipids, etc. stay tuned for blood work :) ]
- 2/day x Nebivolol 2.5mg [ for BP, lowered from 5mg x2/day before, due to gastric reflux ]
- 2/day x Doxazosin 2mg/2mg [ for BP ]
- 2/day x Cialis 5mg [ for many reasons ]
- 3/day x Astralogous (1xam/2xpm) [ for Kidneys ]
- 2/day x NAC 750mg [ for Kidneys/Liver ]
- 2/day x Aava Labs Omega3 (1xam/1xpm) [ 2 = 1000mg EPA + 500mg DHA ] [ for "general health" ]
- 1/day x 100mg DHEA [ because DHEA was low in blood work ]

Other things:

Citrulline Malate [ for NO ]
Electrolites [ for fasting days ]
MCT C8 Oil [ for first 2 fasting days / week, to ease the transition to Keto ]

Other things Before bed:

1 x B complex [ always ]
1 x 50mg pregnenolone [ always ]
1 x 3mg boron [ always ]
~3h before bed: 1000g Magnesium Citrate [ on fasting days only ]

Open question to the ninjas in this forum:
Anybody willing to suggest improvements to the above and/or propose things to check to ensure this is done safely?

Before you ask:
I am on my own, my endo has no clue, etc. (the usual) but all of the above are either legit prescription meds (no black market BS) or supplements sourced from supposedly reputable companies (ofc, I have no equipment to check, but blood work will guide tuning).
I understand people who make their living in fitness and/or sports pushing the limits because that's how they pay the bills. That being said, internet personalities aren't known for being 100% forthcoming. How do you know Efferding's true health status?

My TRT journey began at 200 mg weekly on the advice of a TRT doc. My life became a neverending cycle of side effect mitigation, specifically acne, constant blood donation and corresponding iron deficiency and awful sleep. I spent countless hours and dollars in trying to solve these which led to more meds and more supplements with only limited success. It was careful study of the moderate voices on this site that led me to pursue more frequent injections at much lower doses (my doctor was no help). Years in, with the benefit of experience, I inject 15 mg a day of test prop (105 mg a week) and 500 IU of HCG twice a week. No AI. No meds for sleep or acne. I haven't needed to donate blood in three years and my lab values are right down the middle. I am 53 and not a day goes by that I don't get a compliment on my physique, but I attribute that as much to diet - I have a nutritionist and in order to train hard five days a week (Crossfit) I do not drink at all anymore.

Anyway in answer to the question in the title of your post - is it possible to be healthy? I am skeptical. What blood markers would I like to see? At baseline before and at steady state on new regimen:
AST/ALT
Hematocrit
Hemoglobin
Cardio IQ advanced lipid panel from discounted labs
Trough AND peak values for TT, FT, SHBG and E2.

Non blood markers before and after:
Lean body mass
Body fat percentage
VO2 max
Blood pressure

Some of these are pie in the sky but hey a guy can dream. You are actually doing the board a service in even submitting yourself to scrutiny on this and for that I thank you. You may be right - you may be able to pull this off - but this board is littered with guys who tried to push test levels and failed.
 
Great links @BigTex. Thank you. I will read all of these. Maybe some of that moderation can rub off.
I don't know if you can read these old postings from Professional Muscle. Dr. Crisler went by SWALE and was a member there since 2002. I love the conversations he had about Anthony Roberts.


What a humble guy Dr. Crisler was.

If you live in my own State of Michigan, I must personally examine you (licensure issue). Actually, that is better for me because it gets me out from behind the computer and in front of a patient. For those of you in the other 49, I can also direct your care via the Internet. For the AAS Consult, I prescribe according to Medical History (your answers to my 152 questionaire). Labs are desirable, but not necessary. For HRT, you must have a current physical, then we get labs. In all cases, I remain available to my guys 24X7 (and have taken phone calls in the middle of the night following a bad Tren injection). Try not to be too hard on your own docs, guys. They are operating at a real disadvantage, because physicians treat according to what they know and are comfortable with. This stuff isn't taught in any residency program in the US! So I had to go off on my own, out to the woodshed with a pile of books for months, and spend literally hundreds of hours on Boards like this one. You see, it's really you guys who trained me. That is why I am so very thankful and happy to try to give as much back as possible. Because, in return for my willingness to step outside the conventional medical community, I have been rewarded with the best medical practice on earth. Armageddon, I am looking forward to meeting you. Let's make sure we leave enough time to sit down for a good cup of coffee.
 
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I don't know if you can read these old postings from Professional Muscle. Dr. Crisler went by SWALE and was a member there since 2002. I love the conversations he had about Anthony Roberts.


What a humble guy Dr. Crisler was.

If you live in my own State of Michigan, I must personally examine you (licensure issue). Actually, that is better for me because it gets me out from behind the computer and in front of a patient. For those of you in the other 49, I can also direct your care via the Internet. For the AAS Consult, I prescribe according to Medical History (your answers to my 152 questionaire). Labs are desirable, but not necessary. For HRT, you must have a current physical, then we get labs. In all cases, I remain available to my guys 24X7 (and have taken phone calls in the middle of the night following a bad Tren injection). Try not to be too hard on your own docs, guys. They are operating at a real disadvantage, because physicians treat according to what they know and are comfortable with. This stuff isn't taught in any residency program in the US! So I had to go off on my own, out to the woodshed with a pile of books for months, and spend literally hundreds of hours on Boards like this one. You see, it's really you guys who trained me. That is why I am so very thankful and happy to try to give as much back as possible. Because, in return for my willingness to step outside the conventional medical community, I have been rewarded with the best medical practice on earth. Armageddon, I am looking forward to meeting you. Let's make sure we leave enough time to sit down for a good cup of coffee.

Damn.

Compare to this....



The stripes rarely change. If there was ever a time to take a pause from promoting yourself you would think this would be the time. Sharing someone's personal medical details and trying to make yourself look good right after they pass?
 
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Beyond Testosterone Book by Nelson Vergel
Here is my problem. My insurance covers 100% of my lab work and the doctor has a Quest lab in his building. I pay $5 copay for the doctor and CVS changes me $15 for the 10ml cypionate. Anastrozole for some reason is no charge. Hard to beat that. Even though I am not using the cypionate I get the TU I am using for free (one of my perks as a board administrator). I would however at least like to get their evaluation and opinion.

Dr. Lipshultz is also here but I will not drive to downtown Houston, or sit in an office as long as I hear people wait on him. Plus, parking fees in the medical center. Then fighting Houston traffic, it would take 1/2 a day to go there and back.
I have an appt with Lipshultz that I made four months ago. It’s in October.

But I will get a script, the. Will use insurance. Currently at Defy and have been happy there. Just looking to save a few dollars. I’m retired so all I have is time. Don’t mind the drive.
 
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