Switching Protocol Before Vacation

[Omar]

I've been wanting to switch my protocol from once a weak injections to a split twice a week protocol. I've been reading a lot on this & it seems to be working really good for people. I asked my Dr. DR Rand McClain about switching to splitting my injections a year ago & he told me to just stick with once a week. He's open to new protocols but he' a pretty pricey Dr & i don't have the money to see him every time i want to switch protocol so i want to just try it on my own. He will let me draw labs anytime i ask for them which is good & my insurance covers that.
I'm going on vacation at the end of September & wondering if i should wait till i get back from my vacation to start a new protocol since it takes roughly 8 weeks to see how your body reacts to a new protocol & I don't want to be feeling like crap while on vacation. I feel way better now compared to when I 1st started TRT but i know i'm not dialed in all the way in yet. Libido still lacks drastically orgasams are mediocre almost never morning wood, ED & energy isn't the best, acne is pretty bad to, but over all mood is really good I've been on 200mg once a week since April 2016 heres some qick numbers of current protocol & labs. Any input/info is greatly appreciated!
This is my protocol as of now:
200mg cyp one a week
1mg anastrozol twice a week (1 mg day after injection & 1mg 2nd day after injection)
.5mg cabergoline twice a week (cut back to .25mg since recent labs)
last labs (6/18):
test total 851 ng/dl (usually around 1200+)
test free/direct 36.5 pg/ml
estradiol 24 pg/ml
DHT 17 ng/dl (was on finasteride but stopped 5 weeks ago DHT was 39 before starting finasteride)
prolactin <0.3 ng/ml (15.2ng/ml before starting caber)

 

[MarkM]

I like Dr Rand but I sure wouldn't want the protocol you state he has you on. Is your SHBG extremely high, like through the roof? 200 mg injected once weekly is successful for very few people. That's why you are taking 2 mg of anastrozole a week. That amount of test on one injection probably has your E2 spiking through the roof without the anastrozole.

Your Free T looks really good but has lots of room to come down and you'd still be in good shape. DHT of 39 is not even mid range,not at all high, so being on finasteride was not a good choice in my opinion. Now your DHT is below range which is an important androgen for a man being a man. Why did Dr Rand have you start on the finasteride? Are you predisposed to MPB or did you have symptoms of hair loss? Levels of DHT like you have can impact your libido. You should read up on PFS (Post Finasteride Syndrome). Good thing you stopped but you can carry side effects of it for a long time.

Your protocol is why you have the symptoms and feel the way you do. What is your SHBG? You need to test and find out that that is because that will tell you what type of injection schedule/protocol you should have. Unless it is extremely high then you won;t need to be on once weekly injections.

I would wait until after vacation before making any changes since it is right around the corner. In the mean time get tested and find out where your SHBG sits so you can get on the right injections schedule. It seems to me that you would be able to reduce your test, still have good numbers, and drastically reduce the anastrozole. That is just a preliminary thought without knowing the SHBG.

I would surely consult with Dr Rand and ask him some more questions. He is the doctor and I am just a layman attempting to help people.

 

[madman]

I've been wanting to switch my protocol from once a weak injections to a split twice a week protocol. I've been reading a lot on this & it seems to be working really good for people. I asked my Dr. DR Rand McClain about switching to splitting my injections a year ago & he told me to just stick with once a week. He's open to new protocols but he' a pretty pricey Dr & i don't have the money to see him every time i want to switch protocol so i want to just try it on my own. He will let me draw labs anytime i ask for them which is good & my insurance covers that.
I'm going on vacation at the end of September & wondering if i should wait till i get back from my vacation to start a new protocol since it takes roughly 8 weeks to see how your body reacts to a new protocol & I don't want to be feeling like crap while on vacation. I feel way better now compared to when I 1st started TRT but i know i'm not dialed in all the way in yet. Libido still lacks drastically orgasams are mediocre almost never morning wood, ED & energy isn't the best, acne is pretty bad to, but over all mood is really good I've been on 200mg once a week since April 2016 heres some qick numbers of current protocol & labs. Any input/info is greatly appreciated!
This is my protocol as of now:
200mg cyp one a week
1mg anastrozol twice a week (1 mg day after injection & 1mg 2nd day after injection)
.5mg cabergoline twice a week (cut back to .25mg since recent labs)
last labs (6/18):
test total 851 ng/dl (usually around 1200+)
test free/direct 36.5 pg/ml
estradiol 24 pg/ml
DHT 17 ng/dl (was on finasteride but stopped 5 weeks ago DHT was 39 before starting finasteride)
prolactin <0.3 ng/ml (15.2ng/ml before starting caber)

Dr. McClain is well aware of how to treat his patients as he treats many men on trt and is very experienced/knowledgeable.

I would try to get in and see him asap and explain to him how you have been feeling overall on this protocol and that you want to try switching things up.

You state "I feel way better now compared to when I 1st started TRT but i know i'm not dialed in all the way in yet"

Than go on to say "Libido still lacks drastically orgasams are mediocre almost never morning wood, ED & energy isn't the best, acne is pretty bad to"

Which tells me you have a lot more going on and not in a good way and definitely need to look into changing things as there is absolutely no point in sticking with what you have been doing as it is clearly not benefiting you.

I would say e2 levels is a big part of the problem!

All we can do is offer advice but your doctor is the expert and the one managing your protocol so you need to discuss this with him before changing things on your own!

 

[Omar]

I like Dr Rand but I sure wouldn't want the protocol you state he has you on. Is your SHBG extremely high, like through the roof? 200 mg injected once weekly is successful for very few people. That's why you are taking 2 mg of anastrozole a week. That amount of test on one injection probably has your E2 spiking through the roof without the anastrozole.

Your Free T looks really good but has lots of room to come down and you'd still be in good shape. DHT of 39 is not even mid range,not at all high, so being on finasteride was not a good choice in my opinion. Now your DHT is below range which is an important androgen for a man being a man. Why did Dr Rand have you start on the finasteride? Are you predisposed to MPB or did you have symptoms of hair loss? Levels of DHT like you have can impact your libido. You should read up on PFS (Post Finasteride Syndrome). Good thing you stopped but you can carry side effects of it for a long time.

Your protocol is why you have the symptoms and feel the way you do. What is your SHBG? You need to test and find out that that is because that will tell you what type of injection schedule/protocol you should have. Unless it is extremely high then you won;t need to be on once weekly injections.

I would wait until after vacation before making any changes since it is right around the corner. In the mean time get tested and find out where your SHBG sits so you can get on the right injections schedule. It seems to me that you would be able to reduce your test, still have good numbers, and drastically reduce the anastrozole. That is just a preliminary thought without knowing the SHBG.

I would surely consult with Dr Rand and ask him some more questions. He is the doctor and I am just a layman attempting to help people.

I dont know what my SHBG is. ive looked at all my labs & couldnt find it. does it say SHBG or something else? i started finasteride because of acne & MPB but hair is still thining out & acne is still bad so i stopped taking it after reading up on PFS

 

[Omar]

Dr. McClain is well aware of how to treat his patients as he treats many men on trt and is very experienced/knowledgeable.

I would try to get in and see him asap and explain to him how you have been feeling overall on this protocol and that you want to try switching things up.

You state "I feel way better now compared to when I 1st started TRT but i know i'm not dialed in all the way in yet"

Than go on to say "Libido still lacks drastically orgasams are mediocre almost never morning wood, ED & energy isn't the best, acne is pretty bad to"

Which tells me you have a lot more going on and not in a good way and definitely need to look into changing things as there is absolutely no point in sticking with what you have been doing as it is clearly not benefiting you.

I would say e2 levels is a big part of the problem!

All we can do is offer advice but your doctor is the expert and the one managing your protocol so you need to discuss this with him before changing things on your own!

i am going to schedule an appointment as soon as i can but like i said hes pretty pricey so i have to wait till i got a little extra cash to see him because he doesn't take insurance & a 30min phone appointment i believe he charges $250

im pretty sure my e2 is a big part of the problem. i inject Wednesday mornings & have got labs done friday & e2 was <10 pg/ml & then did labs again wednesday before injecting & e2 was 24 pg/ml

 

[MarkM]

I dont know what my SHBG is. ive looked at all my labs & couldnt find it. does it say SHBG or something else? i started finasteride because of acne & MPB but hair is still thining out & acne is still bad so i stopped taking it after reading up on PFS

SHBG = Sex Hormone Binding Globulin, usually it is spelled out. I think you were smart in stopping the finasteride. PFS has really hurt many men.

 

[Systemlord]

Your SHBG has got to be low with the FT numbers your getting, below 20 for sure. Twice weekly may not be good enough. I was hitting Total T 677 and FT was 29.6 pg/mL, I would score similar numbers if I were as high as you are now. My SHBG fluctuates between 16-18.

This protocol is forcing you to rely on a heavy dose of anastrozole which could be reduced if your protocol was more reasonable. FT is almost double the reference ranges.

 

[MarkM]

i am going to schedule an appointment as soon as i can but like i said hes pretty pricey so i have to wait till i got a little extra cash to see him because he doesn't take insurance & a 30min phone appointment i believe he charges $250

im pretty sure my e2 is a big part of the problem. i inject Wednesday mornings & have got labs done friday & e2 was <10 pg/ml & then did labs again wednesday before injecting & e2 was 24 pg/ml

I think you have a problem with E2 being too low because of the 2 mg of anastrozole you are taking a week. But I think your entire protocol is wrong with one 200 mg injection weekly without knowing what the SHBG is. You should really have that tested on your own though DiscountedLabs, https://www.discountedlabs.com/.


I would speak with Dr, Rand as soon as you can.

 

[Omar]

SHBG = Sex Hormone Binding Globulin, usually it is spelled out. I think you were smart in stopping the finasteride. PFS has really hurt many men.

its not in my labs guess he never checked my SHBG. i kind of regret taking it now after what i read about PFS sounds like most of its damage is irreversible

 

[MarkM]

its not in my labs guess he never checked my SHBG. i kind of regret taking it now after what i read about PFS sounds like most of its damage is irreversible

How long were you taking finasteride? If you only took it for a short period of time you will probably be fine.

 

[Omar]

Your SHBG has got to be low with the FT numbers your getting, below 20 for sure. Twice weekly may not be good enough. I was hitting Total T 677 and FT was 29.6 pg/mL, I would score similar numbers if I were as high as you are now. My SHBG fluctuates between 16-18.

This protocol is forcing you to rely on a heavy dose of anastrozole which could be reduced if your protocol was more reasonable. FT is almost double the reference ranges.

so is it not good to have numbers this high? dr rand had me thinking higher numbers were good as long as we could get my libido back

 

[Omar]

How long were you taking finasteride? If you only took it for a short period of time you will probably be fine.

since feb 2017

 

[ratbag]

Was finasteride a cream or was it a tablet?

 

[Omar]

Was finasteride a cream or was it a tablet?

5mg tablet

 

[ratbag]

We know that finasteride cream does not cause PFS only the tablets do. As per John Crisler

 

[Omar]

We know that finasteride cream does not cause PFS only the tablets do. As per John Crisler

hopefully PFS goes away quickly

 

[Omar]

just got labs back 200mg once a week (10/3/18) here are my results with SHBG
test total 775 ng/dl
test free/direct 39.2 pg/ml
estradiol 77 pg/ml
DHT 49 ng/dl
prolactin 9.9 ng/ml
SHBG 11.3 nmol/L

my labs prior to this last blood work (6/27/18)
test total 851 ng/dl (usually around 1200+)
test free/direct 36.5 pg/ml
estradiol 24 pg/ml
DHT 17 ng/dl (was on finasteride but stopped 5 weeks ago DHT was 39 before starting finasteride)
prolactin <0.3 ng/ml (15.2ng/ml before starting caber)

why is my test total dropping? i was always at 1200-1500 now im at 775 & before that my last labs 851
i am now on a test only protocol. I stopped taking anastrozo,l finasteride & caber. any suggestions on how i should adjust my protocol?

 

[Jiu Jitsu Dude]

I have little experience compared to most on this forum but from what I gather with low SHBG your T is not binding well so your Free T may be too high. Free T is what matters the most. You probably should be doing more frequent injections at a much lower amount. Your E2 is super high and would negate any positive aspects of TRT.

I'm still relatively new to trt but have read a ton on this forum. So wait for others with more experience to chime in. Good luck! I'm still dialing in my protocol too

 

[fifty]

FreeT is more important than total T.

What did you think of the caber? Any benefits?

 

[Omar]

I have little experience compared to most on this forum but from what I gather with low SHBG your T is not binding well so your Free T may be too high. Free T is what matters the most. You probably should be doing more frequent injections at a much lower amount. Your E2 is super high and would negate any positive aspects of TRT.

I'm still relatively new to trt but have read a ton on this forum. So wait for others with more experience to chime in. Good luck! I'm still dialing in my protocol too

Can’t get my e2 dialed in I when I would take my anastrozol it would crash my e2 & when I wouldn’t take it my e2 jumped way up