Protocol change after one year - from Enclomiphene to Test

[JmarkH]

Protocol change March 2023

My men’s health provider and I decided I had plateaued in the last quarter of last year and entered diminishing returns by January. If I had no other options, I could do okay on my present protocol, but why do that when other options exist? So, I’m going off my enclomiphene 50mg 4x wk and hcg 250iu 4xwk. I will begin with Testosterone Cypionate 200 mg/ml at .20cc 4xwk with hcg 250iu 2xwk. Labs in 8 weeks. My guess is this may be high, and we will have to back off, but who knows. They want me to donate blood before I start the new protocol.

I know some have an interest because of the enclomiphene year-long use.

 

[aneuman]

Protocol change March 2023

I know some have an interest because of the enclomiphene year-long use.

I definitely am one. Could you summarize the pros, cons and diminishing returns that prompted the change?

Wish you good luck on your new protocol.

 

[Guided_by_Voices]

That's a monster dose to start with if it equates to 160mg per week. Pretty much the opposite of start low and go slow. It's much easier to judge dosages if you're increasing rather than decreasing.

 

[JmarkH]

Could you summarize the pros, cons and diminishing returns that prompted the change?

As for the old protocol: Looking back it is easier to see how things changed rather than in real-time. I gained back ten pounds, two inches to the waist and brain fog was becoming noticeable again. All in all not horrible but going backward nonetheless.

Even with MK677 10mg daily IGF-1 was only 94 and prolactin was below normal low.

Tendinitis has also become an issue limiting my workouts. I did ask them for nandrolone and testosterone but they said only testosterone at first.

That's a monster dose to start with if it equates to 160mg per week.

I’ve been with this clinic for a year. They went with that dose based on my past treatment and levels. When I was at my best [so far] TT was right about 1000 ng/dL, FT 17.3 out of a 6.6 to 18.1 pg/mL. If I get to feeling off I can contact them. Labs will be at 8 weeks.

 

[aneuman]

Tendinitis has also become an issue limiting my workouts. I did ask them for nandrolone and testosterone but they said only testosterone at first.

JMarkH, interesting you mention this. I have started suffering from tendinitis as well, something I never had before in my life, but I had never been 60 years old before either, so I don't know what to make of it.

Do you think the tendinitis might have been cause/made worse by EC and/or HCG? I'd be interested in your opinion.

 

[JmarkH]

The Doc's thought was that TC should help heal the tendinitis. Only time will tell. It has limited my workouts for the last month. There's no real way of telling if EC had a part in it. We all know correlation doesn't always point to causation.

 

[Guided_by_Voices]

Even if you had gotten the Nandrolone, DMSO, BPC-157, and much of what is in the "Fixes for joint issues" thread would all be things to try first. I'm not opposed to Nandrolone, but some people have a bad reaction to it that none of the other things I just listed seem to provoke. For example if you have a food sensitivity or form issues, to name just two examples of things that could promote tendonitis, Nandrolone would not be the best answer.

 

[JmarkH]

Eight-week labs are in. I was impatient waiting on these to come in. I'm on a MWFSa TC injection for a total of 160mg/week and HCG MThSa for a total of 600iu/week. These labs were two days after last injection on a Friday and skipped the Saturday. What are you guys' thoughts on these?
At about or right after week 6, I notably felt "normal." It is an odd answer for people who know I'm on trt and ask how I feel. I have to explain the answer to them.

 

[aneuman]

Eight-week labs are in. I was impatient waiting on these to come in. I'm on a MWFSa TC injection for a total of 160mg/week and HCG MThSa for a total of 600iu/week. These labs were two days after last injection on a Friday and skipped the Saturday. What are you guys' thoughts on these?
At about or right after week 6, I notably felt "normal." It is an odd answer for people who know I'm on trt and ask how I feel. I have to explain the answer to them.

Congratulations @JmarkH! It seems your nee protocol is working quite well. It was very nice to see the free T in the upper range while HCT is very low at 39.8. It'll, probably take a while to see the results of the change long term, but you're definitely off to a good start I think. Very encouraging.

I understand you feel normal, could you please compare how you feel now compared to your previous protocol (Enclomihene/HCG M-W-F-S)? Any areas of improvement, or degrading experience?

You were also getting some tendonitis, has it been resolved? Do you think it had to do with your previous protocol? How would you comparatively rate your impression in the following areas?
- Arousal/Libido
- Erection
- Mood/Anxiety
- Body composition/strength
- General Wellbeing

I'll be seeing my doctor in 3 weeks and I was thinking switching to TC as well, but at a much lower dose than you (50-80 mg/week), so that's why your experience is so valuable for me, given we are both about the same age.

Thanks for sharing

 

[madman]

Eight-week labs are in. I was impatient waiting on these to come in. I'm on a MWFSa TC injection for a total of 160mg/week and HCG MThSa for a total of 600iu/week. These labs were two days after last injection on a Friday and skipped the Saturday. What are you guys' thoughts on these?
At about or right after week 6, I notably felt "normal." It is an odd answer for people who know I'm on trt and ask how I feel. I have to explain the answer to them.

Remove your personal info!

Not sure why they would have had you donate blood pre-trt as it is highly doubtful your RBCs, hemoglobin, and hematocrit were high seeing as these markers are sitting right on the low end now.

If anything your ferritin/iron should have been tested.

Not a big fan of your M/W/F/Sat injection schedule.

Would have been easier going with the M/W/F or EOD and even then not sure why you felt the need to jump into injecting 4X/week let alone 160 mg T/week + hCG off the hop.

As you can see you are hitting a very high trough TT and high-end FT.

Keep in mind peak levels will be higher.

Should have had your SHBG tested as it is most likely high.

 

[aneuman]

As you can see you are hitting a very high trough TT and high-end FT.

Keep in mind peak levels will be higher.

I did not consider that, but it's absolutely true @madman. These are trough values, not peak. I'm not on TRT yet, so I tend to miss those "pesky details". Thanks for pointing that out.

This is the reason I'm on this forum, for posts like this.

Thanks again.

 

[JmarkH]

Remove your personal info!

Where do you see any of my personal info? I thought I removed it all.

 

[JmarkH]

Should have had your SHBG tested as it is most likely high.

With the quality TT and FT assay I figured SHBG could be calculated. When calculated SHBG is high, around 72.

 

[madman]

Where do you see any of my personal info? I thought I removed it all.

It is fixed now but I had seen your name in the upper left-hand corner.

 

[JmarkH]

It is fixed now but I had seen your name in the upper left-hand corner.

That's wild. I haven't edited it since posting. I hope my Acrobat isn't glitchy.

 

[JmarkH]

HCT was 47.3 before giving blood and before starting TRT. So after 9 weeks HCT is down 8 points. I'll add a regular iron supplement and test hemoglobin every 6 weeks or so to see if it rises.

I understand you feel normal, could you please compare how you feel now compared to your previous protocol (Enclomihene/HCG M-W-F-S)? Any areas of improvement, or degrading experience?

I'm grateful for the steady improvement over the last 17 months. The previous protocol helped a lot and if I was stuck there, I could live with that, but I also knew I wasn't fully back to normal. The protocol switch to TRT has added the extra lift and body composition has picked back up and fat is coming off again.

You were also getting some tendonitis, has it been resolved? Do you think it had to do with your previous protocol? How would you comparatively rate your impression in the following areas?
- Arousal/Libido
- Erection
- Mood/Anxiety
- Body composition/strength
- General Wellbeing

The TRT has helped the tendonitis and my workouts have improved. However, if I push the workout harder I get tendonitis and joint pain flareups. Mind you nothing crazy just doing trisets of 35lb - 40lb cable curls and tricep work. I'll have the low dose nandrolone conversation with the doctor in a week.
As for the other stuff, I'm well pleased and can only hope it all stays at this level.

While waiting on the labs I was concerned about what the E2 and HCT might be. Gratefully labs are sweet. Sure the HCT could be a little higher but I much prefer that to it being a little high. I'm sure it will rise to stronger levels.

 

[JmarkH]

In terms of trough and peak values:

As you can see you are hitting a very high trough TT and high-end FT.

Keep in mind peak levels will be higher.

The best tool I've found to calculate these values is the SteriodPlotter which charts the peak and trough over time.
With that and using a EOD dosage I have a 21.46% difference in the peak and trough. That would put me at 1270.47 TT and 17.65 FT at peak.
Is that high? Sure. But is it crazy high? No. Is that more than TRT? Top end, yes, but more than, I don't think so.

 

[tareload]

In terms of trough and peak values:

The best tool I've found to calculate these values is the SteriodPlotter which charts the peak and trough over time.
With that and using a EOD dosage I have a 21.46% difference in the peak and trough. That would put me at 1270.47 TT and 17.65 FT at peak.
Is that high? Sure. But is it crazy high? No. Is that more than TRT? Top end, yes, but more than, I don't think so.

Note steroid plotter is useful but will be way off on the ratio of peak to trough and the actual transient after injection since it does not consider the absorption phase and true flip flop kinetics inherent with test esters. See my table of peak to trough ratios if you want decent estimates.

Low Dose Sustanon250 Cycle?

Same dosing schedule modeled with either first order elimination or first order absorption plus elimination: Adding the additional realism of 4-6 hr absorption half life lops off the pronounced peak and slightly raises the trough on an injectable with ~5 day elimination half life. Now in...

forums.t-nation.com

Tool to Assess your TT Dose Response -- Percentile Curves

Summary: Tools to estimate your individual dose response for injectable testosterone ester in comparison to a normal distribution (95 percentile confidence estimate) of adult males (Ref). Plot below shows a summary of data from (1) clinical trials gathered from the literature + (2)...

forums.t-nation.com

 

[JmarkH]

@readalot Thank you. That is very helpful. I'm no good at manual calculations. Although moving your calculations from ED to EOD it doesn't look to be much different from the plotter I used. Of course, you tracked Sustanon, which will have a different absorption from TC. But I get the idea. Not to disrespect the cost of your time, but do you have a plot for TC EOD at 40mg per?
Thanks again.

 

[tareload]

The table shared above was actually for TC with apparent elimination half life of ~4.5-5 days.

Here's a rough estimate using your results above taking into consideration your estimated clearance:

More stats (EOD vs E7D):