The TRT "trifecta"...Why?

[JimBob]

I see that most guys new to trt seem to start out on the trifecta of test-hcg-anastrozole, at least the guys starting their protocol with Defy. It strikes me as strange, since several of the more reputable trt docs like Crisler, Kominiarek, Matschke, et al, are pretty much down on A.I.s except as a temporary fix to resolve a manifested symptom. Some of the more experienced guys here have expressed the opinion that one should start out with just testo, but I never see anyone do it. Very strange.

When a guy goes on a temporary regimen of anastrozole to get his estradiol into a comfortable range, and then goes off the anastrozole, won't his estradiol level creep back up? I don't understand this "temporary" A.I. protocol, since so many guys are on it permanently.

 

[BenM]

It really depends who is treating you.

I’m in Australia and it is obviously different here but I started TRT a few months ago on just testosterone, no AI or HCG. I’ve discussed them both with my endocrinologist but at this stage I’m doing just fine without both.

From what I have read here and elsewhere, going vanilla TRT to begin with is a good way to get started and only add an AI or HCG if it is required.

 

[Mountain Man]

It really depends who is treating you.

I’m in Australia and it is obviously different here but I started TRT a few months ago on just testosterone, no AI or HCG. I’ve discussed them both with my endocrinologist but at this stage I’m doing just fine without both.

From what I have read here and elsewhere, going vanilla TRT to begin with is a good way to get started and only add an AI or HCG if it is required.

I agree. Common sense says that 3 variables are more complicated than figuring out 1 variable at a time. How can you get dialed in when you don’t really know what is wrong? I think that the money must be in writing the scripts for these doctors. Testosterone cypionate is cheap, but HCG and AI may be where the money is. Every time I read the words “crashed my estrogen levels” on this site I shudder. Who wants to look good if you can’t get aroused or have an erection?

 

[Vince Carter]

I do have it from the horses mouth that one of those clinics mentioned prescribes the AI, albeit in a very low dose .125mg capsule almost solely because guys think they have to have it and basically expect it to be prescribed and balk if they're not given the script. Though in that same instance the philosophy there remains for when negative symptoms are present and not as a basic requirement in treatment. (those are my own words and no one elses...its not a quote)

It could be better to start on Cyp alone but I think, too, that in how you look at it that no HCG and allowing the testes to go dormant (die) can be seen as inducing organ failure and there could be some liability to the standard of care being given.

 

[Vince]

When I first started trt. I just injected testosterone cypionate and HCG. I then had labs in 12 weeks and everything was good. I've never had to or considered using and AI. TRT is a very individual treatment and it's very different for everyone.

 

[S1W]

It could be better to start on Cyp alone but I think, too, that in how you look at it that no HCG and allowing the testes to go dormant (die) can be seen as inducing organ failure and there could be some liability to the standard of care being given.

Does anyone know if this is true regarding the testes actually dying? I've heard that on TRT doses, the testes do come back after cessation of treatment. I've also heard that HCG in certain doses may damage the testes. With the HCG/no HCG choice, it almost seems like a "damned if you do, damned if you don't" kind of thing.

That said, hadn't people been on TRT (and some presumably came off of TRT) for far longer than HCG has been used in TRT?

 

[Jiu Jitsu Dude]

I'm only 9 weeks in and I take only T cyp for now. This forum is helping me dial it in. Every step they suggested from getting off the every 2 week injections, to 1 week, then every 3.5 days has made obvious improvements to me. If I jumped on the AI when I was doing every 2 weeks to control E2 it would have added another unneeded variable and possibly tank my E2 etc...

I couldn't imagine trying to listen to my body with all 3 variables working on my system at once. If I'm going to be on this the rest of my life, I better be very slow and methodical as to my adjustments and additions to my protocol. I know we have blood work that helps steer the ship but from my experiences and others we are all different as to what works. There are generalities that many will fit neatly into for a protocol but I've read enough about guys unique experiences to believe that my protocol may not be the same as others even though our labs may look similar. I'm going low and slow.....T cyp only for now. I may add HCG much later down the road if warranted.

 

[JimBob]

Thanks, Vince Carter, for your comment on this. Speaks volumes, I think.
So, how does anastrozole work as a temporary fix, does it? Estradiol doesn't creep back up quickly after one goes off the A.I.?

 

[JPB]

always preferable to avoid polypharmacy

 

[DragonBits]

Does anyone know if this is true regarding the testes actually dying? I've heard that on TRT doses, the testes do come back after cessation of treatment. I've also heard that HCG in certain doses may damage the testes. With the HCG/no HCG choice, it almost seems like a "damned if you do, damned if you don't" kind of thing.

That said, hadn't people been on TRT (and some presumably came off of TRT) for far longer than HCG has been used in TRT?

Not for me, and I was on nebido TRT for 5 years, I had some testicular shrinkage. Then went off for of TRT and recovered in ~4 months and recovered full sperm production. I used clomid to speed things up, but I think even without that it would have just taken longer.

I tested my TT 6 months ago before going back on TRT, it was the same as when I first went on TRT 7 years ago.

Perhaps if I had been on TRT for a couple of decades things might have been different.