The benefits of low dose T injections . . .

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Melody68

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I'm 68 and have chosen to pursue TRT primarily to treat fatigue, amongst other things.

After a bad 3 1/2 month experience on gel (detailed elsewhere), I've finally convinced my endo to switch me to enanthate; my first injection was Saturday. Thanks to Madman for seeing me through that.

The question I had to answer was . . .what dose? Having frequented the board for the last month, it becomes obvious that many problems are caused by taking too large a dose. Then side effects have to be treated with other drugs, and they themselves produce more side effects. Don't need that . . .

Being concerned about hematocrit and estradiol, and loathe to start with blood-lettings and estrogen inhibitors, I decided to try a very conservative dose of 70mg total per week, injected twice per week. It's a pretty small amount in that syringe. I know that most will say that's not enough to get the job done, but how many of you have found success with small doses? Success to me would mean improved low T symptoms while not needing any drugs other than the T application . . .
 
Defy Medical TRT clinic doctor
You need the newer oral testosterone undecanoate Jatenzo, Orlando or Kyzatrex! The clinical trials noted no cases of secondary erythrocytosis due to the 6 hour half-life, rapid peak and decline in hormone levels which also can only help with estrogen management.

 

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I'm 68 and have chosen to pursue TRT primarily to treat fatigue, amongst other things.

After a bad 3 1/2 month experience on gel (detailed elsewhere), I've finally convinced my endo to switch me to enanthate; my first injection was Saturday. Thanks to Madman for seeing me through that.

The question I had to answer was . . .what dose? Having frequented the board for the last month, it becomes obvious that many problems are caused by taking too large a dose. Then side effects have to be treated with other drugs, and they themselves produce more side effects. Don't need that . . .

Being concerned about hematocrit and estradiol, and loathe to start with blood-lettings and estrogen inhibitors, I decided to try a very conservative dose of 70mg total per week, injected twice per week. It's a pretty small amount in that syringe. I know that most will say that's not enough to get the job done, but how many of you have found success with small doses? Success to me would mean improved low T symptoms while not needing any drugs other than the T application . . .
That is similar to my dose, although I have used DHEA and HCG or clomid along with it. I have a theory that the lower dose hakes the other compounds more effective as well. I have never used an AI. You can always up your dose a little if needed but better to start low.
 
I'm just the opposite. I feel better on a higher dose. I'm presently 69 years old and have been on TRT for over 9 years. I'll show my protocol.

 
I should have added, I believe it's better to start with a lower dose. Even though I never did. It's easier to move up then down.
 
Vince, it's remarkable that your T could be that high, and yet your hematocrit, hemoglobin and estradiol are at ideal levels. That's not going to be me; my hematocrit was 47-49 before I ever started TRT, and crept up to 50 after my recent 3.5 month stint on that crappy T-gel . . . and from what I understand T-gel has less of a negative impact on hematocrit than injections. Now that I've started injections (albeit a very small dose), I hope that it stays under 52 when I next test my blood.

I also hate to admit it but ever since starting the 5mg/day gel 3 1/2 months ago, I've felt some sensitivity in the nipple area, which remains to this day. My endo didn't test for estradiol; I've got an appt soon to talk to another doctor that might help me with things.

I feel given my potential challenges that I should be conservative with my starting 70mg/week dose. Hopefully I'll feel better on a small dose, who knows? But if I have to move up then I'm thinking I may have some problems . . .
 
Vince, it's remarkable that your T could be that high, and yet your hematocrit, hemoglobin and estradiol are at ideal levels. That's not going to be me; my hematocrit was 47-49 before I ever started TRT, and crept up to 50 after my recent 3.5 month stint on that crappy T-gel . . . and from what I understand T-gel has less of a negative impact on hematocrit than injections. Now that I've started injections (albeit a very small dose), I hope that it stays under 52 when I next test my blood.

I also hate to admit it but ever since starting the 5mg/day gel 3 1/2 months ago, I've felt some sensitivity in the nipple area, which remains to this day. My endo didn't test for estradiol; I've got an appt soon to talk to another doctor that might help me with things.

I feel given my potential challenges that I should be conservative with my starting 70mg/week dose. Hopefully I'll feel better on a small dose, who knows? But if I have to move up then I'm thinking I may have some problems . . .
It's common to have nipple sensitivity with TRT. Most the time it has nothing to do with estrogen levels.
 
Vince, it's remarkable that your T could be that high, and yet your hematocrit, hemoglobin and estradiol are at ideal levels. That's not going to be me; my hematocrit was 47-49 before I ever started TRT, and crept up to 50 after my recent 3.5 month stint on that crappy T-gel . . . and from what I understand T-gel has less of a negative impact on hematocrit than injections. Now that I've started injections (albeit a very small dose), I hope that it stays under 52 when I next test my blood.

I also hate to admit it but ever since starting the 5mg/day gel 3 1/2 months ago, I've felt some sensitivity in the nipple area, which remains to this day. My endo didn't test for estradiol; I've got an appt soon to talk to another doctor that might help me with things.

I feel given my potential challenges that I should be conservative with my starting 70mg/week dose. Hopefully I'll feel better on a small dose, who knows? But if I have to move up then I'm thinking I may have some problems . . .
For the first 2 years of trt I donated blood every 8 weeks. Then I started daily injections, my HCT came down and I never had to donate again. So I don't know if it was because of longevity or daily injections.
 
I had read that nipple sensitivity was common amongst those beginning TRT, but goes away "eventually". Not yet for me. Are you saying that nipple sensitivity could just be a normal long run part of it, and is not necessarily tied to aromatization and gynecomastia? That would be a big relief for me.

I've read that hematocrit will balance itself out after 2 years or so, so that until then you can control it by donating blood. That strategy is in my "sh-t hits the fan arsenal" in case things go sideways. I have a bit of an extra challenge - I had Non-Hodgkins Lymphoma 8 years ago and they won't let me donate blood (I'm in Canada). I would need a phlebotomy ordered by a doctor, and I fear my conservative endo wouldn't do that. Hopefully another doctor would . . . it's never simple.
 
. Are you saying that nipple sensitivity could just be a normal long run part of it, and is not necessarily tied to aromatization and gynecomastia? That would be a big relief for me.
Nipple sensitivity is not a sign of gyno. I got intense burning on the nipples when approaching a steady state on cypionate, that went away after 6 weeks.

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I am one of the lower dosers on this forum. 6.8mg daily, T cyp/prop blend. I feel well on this. (also DHEA, pregnenlone and HCG). I won't be winning bodybuilding competitions, but I can make modest gains when I try, and I am quite active... in remission from lymphocytic leukemia *(a form of non hodgkins lymphoma)
 
Hey Blackhawk, I can't help but feel a bond with a fellow lymphoma survivor. I'm intrigued with the dosage at 47.6 mgs per week. Is this truly where you felt best, or did you limit the dose because of side effects like Hematocrit and E2? I sometimes think of what degree of improvement I'd have to see to prevent me from going back to where I was naturally when I had a 11(Cdn) or 330 (US) TT level. You state that you're able to make modest gains and you're quite active . . . I take it you'd be the opposite without the TRT?
 
Hey Blackhawk, I can't help but feel a bond with a fellow lymphoma survivor.

Likewise.

I'm intrigued with the dosage at 47.6 mgs per week. Is this truly where you felt best, or did you limit the dose because of side effects like Hematocrit and E2? I sometimes think of what degree of improvement I'd have to see to prevent me from going back to where I was naturally when I had a 11(Cdn) or 330 (US) TT level. You state that you're able to make modest gains and you're quite active . . . I take it you'd be the opposite without the TRT?

I am sorry I can’t give simple answers to your questions. There is too much to unpack.

I cannot attribute how I feel today compared to how I felt on higher dose during or prior to the cancer and its many severe complications. The symptomatic baseline was wildly shifting for the last 4 years because of the disease. I was seriously damaged by the illness, and do not expect to ever recover back to the pre cancer normal baseline.

I started injections in 2017 at 150mg/week. It was too much, my total and free T were too high and yes I was symptomatic with high E2 and a short round of high HGB/HCT. Lowered to 100mg the first drop. Then repeatedly further trying to get to a point that E2 symptoms were resolved without AI. The HCT remained fine for a couple years without intervention. My happy place pre cancer was 84mg/week dosed every other day. I had mild E2 symptoms, but HCT was fine. My Total testosterno and Free T levels remained above normal range. Through that period on Dr’s advice We were trying to maintain Free T at or just above high end of normal. (I respond well to TRT, and don’t need that much to feel well)

Cancer hit in late 2019. HCT went through the floor due to destroyed bone marrow from the cancer. I was transfusion dependent anemic, received over 80 units of blood over 2.5 years, and had dominoes in terms of further complications, not pertinenrt to the topic at hand. TRT may have helped marginally to help stimulate RBC production, but it was tanked.

When anemia resolved, RBC numbers rebounded too high. I also had transfusional iron overload. When the transfusions ended, the therapeutic phlebotomies began, both for excess iron (ferritin over 3000ng/ml) and for high HCT. I have had around 40 in the last couple years.

We (my doctors and I collectively), don’t think current high hematocrit is driven by the super low dose of TRT I am on currently. The speculation is that after the prolonged anemia, when I rebounded, my erythropoetic set point had changed. I also have been living at altitude >40 years (won't be much longer) and had sleep hypoxia (Not apnea) more recently treated by nighttime oxygen. These factors did not previously cause the HCT issue. But bottom line, yes, HCT/HGB is the main reason I have reduced dose this low after anemia resolved..

I do believe that TRT helped keep me alive. I lost serious weight even while taking T during the illness, and think I would have perished from wasting without TRT. Once remission started, I believe it has helped me rebuild my body. I am back to normal weight, and was able for a while last year to actually push the weight training. Other medical issues knocked that down again, and I am at the point once again to start weight training. It has been 4.5 years now getting through the cancer (The first round, it is incurable) and doing my best to try to rebuild.

My latest labs on 7mg daily subQ were:

Testosterone Total 783.5 ng/dL 264.0-916.0 LC/MS/MS

Testosterone, Free 19.74 ng/dL 5.00-21.00
 
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I am on around 53 mg/wk and started close between 80 and 90. Managed that for a year but SHBG lowered and side effects became intolerable (anger, thinking of sex 24/7, no sleep, shakiness, anxiety, brain fog). I have been on a lower dose since around Christmas and feel so much better. Energy is better, sleep very good, word loss has almost disappeared. That is all I take. I am almost 60. Haven't had recent blood levels but not tool long ago I was on 63 mg/wk and levels were quite high. I wish I would have started around 50 mg/wk. I dose EOD.
 
Gibbon, that's intriguing that you have such a strong result from such a small dose. Why the dosing EOD; would one injection a week not suffice? Can I ask, have you always been more sensitive to other drugs that you've taken . . . meaning you don't need much drug to realize a good effect?
 
I cannot take high levels. I started on once a month shot and it was a disaster. Peaks were crazy and then I would crash. Emotionally I was getting destroyed. So when I started injections Defy had me start EOD and maybe do once a week at 3 days to make it the same. I just did EOD, I learned to inject quickly as I hated feeling like crap. I would inject 5 times a day to feel good if necessary.

I have been more sensitive to other drugs but like I said I tolerated 80 mg/wk for a almost a year until I didn't. SHBG went down and my free shot up. Lowering was the only way. I can take half of other medications to get an effect but I also have lots of side effects. I am a slow metabolizer of medications. Mom and older brother are the same. Sisters can take normal doses and higher with no side effects. Unlucky I guess. Test has way less side effects or none when I am on the right dose. Best for my mental and physical health compared to other crap I have been on. I was treated solely for anxiety for years. It was low Test all along.

Actually, I am not sure if I am on a small dose or not. It still is over 5 mg day and most males have a minimum of 3 mg with normal output so it doesn't seem crazy for my body to do well with what I am at. Gotta remember not everyone on forums probably has normal experiences on test. There are a lot of people doing just fine on creams and other types of test. Cream was great for me at low doses but I stopped absorbing. Was very frustrated at that time. I found this forum because of my struggles. I am a newby and lots more people have a lot more to offer than me.

Anyone with more knowledge and that has been around along time can educate me on my opinion but I can tell you there are some of us that cannot tolerate very high doses.

You can always go up but i think that is easier than going too high at the start and having it be very confusing with all kinds of side effects. I wish you great luck and success.
 
Thanks for the response. I suspect that I'm much the same as you regarding drug responses. I've always had a strong response to small amounts that the doctors say should not work. I've had a bad back for many years. I'll sometimes take 1/2 an aspirin a day for a two week period, and after a couple days will find great relief from it. I have to stop at 2 weeks because my stomach gets sore, but then a couple of weeks later I can repeat again. I haven't been on the 70mg injectible T for long, but am finding that I sleep much better with it . . . that's a game-changer in itself if you can sleep well. Hopefully the 70mg will suffice and I won't have to take any other drugs with it, fingers crossed!
 
I have been using about 70 mg injecting twice a week subcutaneous (35mg each time) for about a year now and my levels are at about 450 and I feel significantly better than I did when my levels were at 150.
I tried injecting last more often, but found it too much work and twice a week seemed to work well. Monday and Thursday. I also really like not having to worry about it Friday through Sunday. On this forum 450 T level sounds low, but I think it puts me in the average of most 25 to 30-year-olds and I’m 58 so that’s good and I’ve been adding muscle at the gym and losing fat and sexuality improving. I tried using higher doses, but did not like the acne so I reduced it until I found a point where the acne was manageable and I was getting benefits. Hematocrit is about 46 so that is good also. Another tip is that defy could no longer send me the compounded testosterone in California so I have to buy the pharmaceutical grade and it seems to work just as well if not better and even though they say the oil is thicker I don’t see any difference. Everyone is different so lots of trial and error.
 
Gell, that sounds GREAT to me; my goal through the whole TRT episode is to have basically what you're getting. I want to work my way through fatiguing too quickly with exercise and work, then to recover a bit quicker from pesky little injuries, and to finally change my body composition by losing some fat and building some muscle. I was starting to think that maybe I should up my 70mg per week because it just doesn't sound like enough to get the job done (especially when you read the dosages that some take on this board), but I'm going to stay here a few months and see about it. A final goal that I have in taking TRT is NOT to have to take other drugs to compensate for dosages that are too high, and not to place my hematocrit in jeopardy. Is your estradiol OK? Do you take anything else other than the T?
 
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