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Testosterone Replacement, Low T, HCG, & Beyond
Testosterone Basics & Questions
TRT Dose and AI
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<blockquote data-quote="madman" data-source="post: 209210" data-attributes="member: 13851"><p>This is a horrible protocol.</p><p></p><p>The standard cookie-cutter protocol high dose T injected once weekly with an AI thrown in off the hop to boot!</p><p></p><p>Have no clue where your SHBG sat pre-trt but you most likely drove it down further from the once-weekly high dose T injections.</p><p></p><p>You have low/lowish SHBG and would most likely do much better injecting lower doses of T more frequently as in EOD or daily.</p><p></p><p>Most men can easily achieve a healthy trough let alone very high trough FT injecting 100-150 mg T/week whether split twice weekly (every 3.5 days), M/W/F, EOD let alone daily.</p><p></p><p>Not only will you be clipping the peak--->trough but more importantly blood levels will be more stable throughout the week.</p><p></p><p>200 mg let alone 250 mg T/week is a whopping dose of T and will have your peak levels post-injection/during the first few days absurdly high only to be followed by much lower levels come weeks end let alone for many men trough levels can still be high.</p><p></p><p>The downfall is the big swings in the peak--->trough which can have a negative effect on energy/mood/libido/erectile function throughout the week.</p><p></p><p>Some men may do well injecting once weekly but most end up injecting more frequently.</p><p></p><p>SHBG is critical to know as not only will it have a significant impact on TT/FT but can also dictate what injection frequency may suit you best.</p><p></p><p>Sure some men may need what would be considered the high-end dose of 200mg T/week but it is far from common.</p><p></p><p>Keep in mind that although TT is important to know FT is what truly matters as it is the active unbound fraction of testosterone responsible for the positive effects.</p><p></p><p>Have no idea where your FT level truly sits as it was most likely not tested using an accurate assay.</p><p></p><p>The only way to know where your FT level truly sits is to have it tested using the most accurate assays such as the gold standard Equilibrium Dialysis or Ultrafiltration (next best).</p><p></p><p>On your first set of labs 200 mg T/week protocol although your trough TT 757 ng/dL is far from what would be considered absurdly high your trough FT will be on the higher-end (most likely high 20s ng/dL) due to your lowish SHBG 15 nmol/L.</p><p></p><p>Peak levels will be much higher.</p><p></p><p>FT 5-10 ng/dL would be considered low.</p><p></p><p>FT 16-31 ng (high-end) is healthy.</p><p></p><p>Most men will do well with FT 20-30 ng/dL and many tend to fair better with levels on the higher end.</p><p></p><p>Your current protocol 250 mg T/week is even worse as your trough TT 1273 ng/dL is very high and more importantly seeing as your SHBG is lowish 20 nmol/L than your trough FT would be absurdly high as in close to 50ng/dL.</p><p></p><p>Peak levels will be much higher.</p><p></p><p>Upping your dose from 200-250 mg T/week will drive up TT/FT/estradiol let alone RBCs/hemoglobin/hematocrit further!</p><p></p><p>The downfall of such protocol when injecting high doses of T once weekly is the big swings in peak--->trough let alone many end up trying to manage elevated estradiol using an AI and in many cases too high of a dose.</p><p></p><p>Much more sensible to start low and slow on a T-only protocol without the use of an AI as we want to see how our body reacts to testosterone.</p><p></p><p>Many would prefer to avoid the use of an AI if possible as having healthy estradiol levels are critical to your overall health due to its beneficial effects on (cardiovascular health, brain health, libido, erectile function, bone health, tendon health, immune system, body composition).</p><p></p><p>Unfortunately, you are trying to control the elevated estradiol with an AI let alone are trying to manage elevated hematocrit by donating blood which in many cases if done too often will only result in crashed ferritin which can open up a can of worms.</p><p></p><p>All due to running a high trough FT.</p><p></p><p>You would most likely feel better overall injecting lower doses of T more frequently and will still be able to achieve a healthy trough FT level using a lower overall weekly dose and chances are you may end up avoiding the use of an AI.</p></blockquote><p></p>
[QUOTE="madman, post: 209210, member: 13851"] This is a horrible protocol. The standard cookie-cutter protocol high dose T injected once weekly with an AI thrown in off the hop to boot! Have no clue where your SHBG sat pre-trt but you most likely drove it down further from the once-weekly high dose T injections. You have low/lowish SHBG and would most likely do much better injecting lower doses of T more frequently as in EOD or daily. Most men can easily achieve a healthy trough let alone very high trough FT injecting 100-150 mg T/week whether split twice weekly (every 3.5 days), M/W/F, EOD let alone daily. Not only will you be clipping the peak--->trough but more importantly blood levels will be more stable throughout the week. 200 mg let alone 250 mg T/week is a whopping dose of T and will have your peak levels post-injection/during the first few days absurdly high only to be followed by much lower levels come weeks end let alone for many men trough levels can still be high. The downfall is the big swings in the peak--->trough which can have a negative effect on energy/mood/libido/erectile function throughout the week. Some men may do well injecting once weekly but most end up injecting more frequently. SHBG is critical to know as not only will it have a significant impact on TT/FT but can also dictate what injection frequency may suit you best. Sure some men may need what would be considered the high-end dose of 200mg T/week but it is far from common. Keep in mind that although TT is important to know FT is what truly matters as it is the active unbound fraction of testosterone responsible for the positive effects. Have no idea where your FT level truly sits as it was most likely not tested using an accurate assay. The only way to know where your FT level truly sits is to have it tested using the most accurate assays such as the gold standard Equilibrium Dialysis or Ultrafiltration (next best). On your first set of labs 200 mg T/week protocol although your trough TT 757 ng/dL is far from what would be considered absurdly high your trough FT will be on the higher-end (most likely high 20s ng/dL) due to your lowish SHBG 15 nmol/L. Peak levels will be much higher. FT 5-10 ng/dL would be considered low. FT 16-31 ng (high-end) is healthy. Most men will do well with FT 20-30 ng/dL and many tend to fair better with levels on the higher end. Your current protocol 250 mg T/week is even worse as your trough TT 1273 ng/dL is very high and more importantly seeing as your SHBG is lowish 20 nmol/L than your trough FT would be absurdly high as in close to 50ng/dL. Peak levels will be much higher. Upping your dose from 200-250 mg T/week will drive up TT/FT/estradiol let alone RBCs/hemoglobin/hematocrit further! The downfall of such protocol when injecting high doses of T once weekly is the big swings in peak--->trough let alone many end up trying to manage elevated estradiol using an AI and in many cases too high of a dose. Much more sensible to start low and slow on a T-only protocol without the use of an AI as we want to see how our body reacts to testosterone. Many would prefer to avoid the use of an AI if possible as having healthy estradiol levels are critical to your overall health due to its beneficial effects on (cardiovascular health, brain health, libido, erectile function, bone health, tendon health, immune system, body composition). Unfortunately, you are trying to control the elevated estradiol with an AI let alone are trying to manage elevated hematocrit by donating blood which in many cases if done too often will only result in crashed ferritin which can open up a can of worms. All due to running a high trough FT. You would most likely feel better overall injecting lower doses of T more frequently and will still be able to achieve a healthy trough FT level using a lower overall weekly dose and chances are you may end up avoiding the use of an AI. [/QUOTE]
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