Starting TRT - Protocol question and initial effects

[Powerlad]

Hi forum,

Stumbled on this site about a week ago as I'm preparing to start TRT, and have found all the information super helpful, if not a little overwhelming. =/ I'm super nervous about it, so I wanted to ask some questions based on my specific labs, protocols, and side effects.

Labs results:

• Hemoglobin: 15.4
• Hematocrit: 46.2
• Testosterone: 361.07
• SHBG: 36.57
• Free Test: 6.83
• Estradiol: 24.75
• Progesterone: 0.63
• Cortisol: 13.26
• Vitamin B12: 897.7
• DHEA-S: 166.85
• PSA: .48
• Free T3: 3.30
• Free T4: 0.81

So based on this, the doctor prescribed the following:

• Testosterone cypionate 200mg/mL: 0.3mL twice weekly
• Anastrozole 0.5mg/mL: Mixed in with the testosterone
• Human chorionic gonadotropin (HCG): 0.3mL twice weekly until bottle runs out
• Pregnenolone: 60mg troche, take 1/8th of a troche three times weekly; for the first 2 weeks, take half the dosage

Sooooo, my questions are:

• The doctor automatically prescribed the AI, and it's already mixed in to the test oil so I can't even NOT take it. Looking at the amounts, am I reading it correctly that essentially, with every injection, I would be getting somewhere around 66.6mg of Test-C and .16mg of Anastrozole? Does that sound reasonable? After reading some of these posts about E2 crashes, I'm a little terrified of that happening.
• I'm seeing different opinions about frequency of HCG and timing. The doctor said that it acts as an upper, so I shouldn't inject it at night, but some folks are saying they do it at night and haven't reported trouble sleeping. Also, with the quantity I have, I'll probably go 2x a week for 3 or 4 weeks until it runs out, then nothing for 5 or 6 weeks, I think. Does that sound right?
• I haven't nailed down the timing yet, but is it super important to do the 3.5 days? Or can I do every Thursday and Monday mornings, for example, and not notice a difference?
• And finally, I've had my stuff for about 3 days now, but I'm hesitating on doing the first shot because I'm an actor in community theater productions, and I'm going into production for a play that will last the next 4 weekends. I'm thinking about starting next Monday so if I experience any negative side effects, I'll at least have Tuesday through Thursday to recover before my next weekend of shows. Am I just paranoid?

Thanks for reading! Appreciate all the help.

 

[S1W]

You're not alone with your nervousness about starting. And I don't want to add to that, but:

- IMHO the AI mixed with the Test is a bad idea. Also, there is a good chance you may not need an AI at all.

- I no longer use HCG so can't comment on that. I don't remember it feeling like an upper - didn't make me feel much of anything really but did drive E2 higher...which is why I no longer use it. I feel better without it. Some guys swear by it though.

- I think you should do Mon AM Thur PM. The timing isn't critical to the point that the hours need to be exactly offset, but yes stick to that if you can.

- If you're nervous about it before your theater demands, perhaps hold off on it? In the meantime I would seriously make an effort to see if you can get your doc to prescribe you just plain 'ol Test with no AI mixed in. It may be a hassle, but it will likely be worth it.

In fact I'd recommend just starting on Test with nothing else at all. Get dialed in with that, then add HCG to see if it's beneficial for you. Only add in Preg or an AI if absolutely necessary. I might even suggest not even starting TRT at all at this time with all that stuff, and consider going with one of the site sponsors here for treatment. Worst case scenario is you wasted $ on your current prescriptions and you have a to wait a bit until they would be able to prescribe you more Test. But beats starting out on a protocol that may cause issues for you, not feeling good, and then having to unf*$k everything.

Sorry I know that's a shitty response and probably not what you wanted to hear. Once you have what you need in order, start without hesitation or fear. If you start at a reasonably low dose, simple protocol, there is nothing to fear and it'll be old hat before you know it.

 

[Vince Carter]

An AI mixed in the with test in this regard isn't going to be well received on this forum, will be widely panned and almost universally told not to do it. As mentioned...you may have absolutely no use for an AI in your treatment. The inclusion of one especially in this form is nothing but bad news.

 

[Powerlad]

OK, that's kind of what I thought, so I appreciate you guys confirming! I've sent a message to the doc asking if I can have the test and AI separated, or if I could just start with test and see how it goes for a couple of months first.

I'm thinking I still continue with HCG as prescribed? I'm a little less nervous about that one, for some reason, but do wonder about the timing. Is it better to use it 2x a week until it runs out (which will happen before the test does), or to space it out so it lasts for the whole amount of test, but less frequently?

 

[Cataceous]

It doesn't really make sense to sample hCG monotherapy with such a small dose. This may be just enough to suppress natural testosterone production and make you feel worse. I would either go all-in with hCG or hold off until after being on testosterone for awhile. Ideally you try to isolate each variable so you can tell what's helping and what's not.

 

[Systemlord]

It's a pretty big gamble for a doctor to write a prescription for anastrozole mixed together with the T-cypionate, if the anastrozole dosage is too high, you are force to throw away the entire bottle of cypionate and reorder another. It's far easier to separate the two and dose separately, this is how one optimizes.

There are some men who are anastrozole over-responders, these men need micro doses (0.050/.125 1-2x per week).

If your doctor doesn't understand why this is a bad idea, it's time to locate another doctor.

 

[CoastWatcher]

What did your doctor say in regard to estradiol, estradiol testing, and anastrozole? It's a topic that tells a patient a lot about their doctor and how he or she approaches androgen management. In this case, it's a particularly important question in light of the blended prescription.

 

[Powerlad]

Thanks everyone for the comments. I did get in touch with the doctor, and his thought was that with my current numbers (summed up above), he felt a very low dose of the AI would not create any issues and help fend off any potential issues with the testosterone.

 

[CoastWatcher]

Thanks everyone for the comments. I did get in touch with the doctor, and his thought was that with my current numbers (summed up above), he felt a very low dose of the AI would not create any issues and help fend off any potential issues with the testosterone.

How does he know you will have an issue with estradiol? There is nothing easier than adding an AI when symptoms and lab values call for it. In your case, it's now an omnipresent part of your protocol, need it or not - and it's a somewhat heavy dose. Was your e2 measured via the sensitive test? If you aren't sure, post the reference range; it's a sure marker for which test was ordered. Well, you pay your money you take your chances. I do wish you the best.

 

[Powerlad]

How does he know you will have an issue with estradiol? There is nothing easier than adding an AI when symptoms and lab values call for it. In your case, it's now an omnipresent part of your protocol, need it or not - and it's a somewhat heavy dose. Was your e2 measured via the sensitive test? If you aren't sure, post the reference range; it's a sure marker for which test was ordered. Well, you pay your money you take your chances. I do wish you the best.

I didn't know enough to ask, but I did go ahead with the first shots yesterday. I'm definitely keeping a close eye on the way I feel from day to day. He said that if I feel anything off, to let him know and we can readjust, but I will ask if the next prescription can have the testosterone and AI separated.

On a separate note, I was really surprised at how little I felt the injection. I chose the outer quad for the test, and the shoulder for the HCG.

 

[CoastWatcher]

I didn't know enough to ask, but I did go ahead with the first shots yesterday. I'm definitely keeping a close eye on the way I feel from day to day. He said that if I feel anything off, to let him know and we can readjust, but I will ask if the next prescription can have the testosterone and AI separated.

On a separate note, I was really surprised at how little I felt the injection. I chose the outer quad for the test, and the shoulder for the HCG.

It won't be long before you will be able to inject on autopilot.

Please be sure you monitor estradiol with the appropriate lab test, the sensitive (LC, MS/MS) test. It is the only one men can rely on.

 

[Powerlad]

It won't be long before you will be able to inject on autopilot.

Please be sure you monitor estradiol with the appropriate lab test, the sensitive (LC, MS/MS) test. It is the only one men can rely on.

Appreciate the advice!! I'll be sure to ask next time my labs are up. And thanks for the vote of confident on the injection process. I think in all, the two 2 injections (plus mixing the HCG for the first time) took me a total of 30 minutes.

No discernible difference in anything that I can tell so far: no post-injection pain (though I did think maybe I felt a little sore after, but could have been from squats at the gym the day prior), no changes in mood or energy, and no other physical differences that I could tell. Next injection is tomorrow evening.

Feels like quite the adventure, this is...