TRT with or without HCG and Ai

[Systemlord]

What do you mean my labs are not typical of men with low SHBG? Can you explain a little more?

T-- 678 (range 250-1100)
Free T-- 158 (range 35-155)

Normally low SHBG would see Free T very high with Total T at or above mid-range. I would see Free T close to 30 pg/mL (6.8-21.5) with a Total T at 676 ng/dL.

My SHBG is 16-22.

 

[DDD]

So, is that good or bad? My results FT and TT at trough seem to mimic your numbers. Strangely, though, I haven't felt my best the last couple days.

 

[DDD]

Your lab results are not typical of men with low SHBG, Total T is above mid-range and Free T is near the top. You do not see a large decline in levels after 6 days either.

Twice weekly should do nicely.

When you say I do not see a large decline in levels after 6 days.......... my TT loses 600 points from day 1 to 7 (1200-600). Is that not considered a lot? Sometimes I think I can feel the differnce on days 6 and 7 even though 600 isn't considered low. Should I be able to "feel" a difference between a level of 1200 and 600? What did you think of my estradiol levels?

Why do you think twice weekly would work nicely for me? I would likely do .35cc or Mondays and Thursday with .1mg anastrozole the day after each injection on Tuesdays and Fridays. Thanks for your thoughts.

 

[DDD]

Once T is cleaved from the ester it either becomes free T or is bound to SHBG or Albumin.

Free T is very short acting and is used up rapidly.

Guys with low SHBG have much more essentially released into the system as free T which is used up rapidly and also rapidly excreted in urine if there is excess not bound to SHBG. These guys essentially burn up the supply faster and levels subsequently crash much faster, so smaller more frequent doses are appropriate to help keep levels more stable rather than running out after 2-3 days and crashing before the next dose. In terms of numbers, some of the guys on this forum have very low SHBG in the teens.


T bound to SHBG remains in the body much longer.

More SHBG means you bind up more T and it is retained in the body over a longer time period. As such, guys who have high SHBG tend to need larger cumulative total dose injecting T to achieve good Free T levels since so much is bound by SHBG. They tend to have lower Free T in relation to total T. It is kind of like there is a better long term storage system in place with higher SHBG, and this man does not burn up the available free T as fast. However, some men with higher SHBG like me actually also do better on more frequent dosing as well. For me theoretically it helps reduce estrogen by taking smaller more frequent doses compared to larger less frequent doses. My SHBG is currently ~52 which is high but not radically so. It can reach quite a bit higher in some men.


The bottom line is larger every other week or weekly doses create a "roller coaster" effect where Free T trough level is too low to feel good. The half life of T is about 8 days which means you lose close to half the amount of T you inject in about a week. 50% lower level can cause ill effects. Low SHBG guys burn up the Free T even faster and some need every day dosing to feel OK.

Don't remember if I posted this to you or not. In my last labs on a once weekly regimen of .75cc of T with .45mg anastrozole split into three doses, my SHBG was 13. But at peak my FT was twice the amount of the upper limit (325 on a range of 35-155), and at trough it was still slightly above the upper limit (158) My TT was 1278 and 678 respectively. One of the forum members said my results were not typical of guys with low SHBG and told me twice weekly would probably do nicely for me. I was thinking of going to a twice weekly schedule.

 

[Blackhawk]

Don't remember if I posted this to you or not. In my last labs on a once weekly regimen of .75cc of T with .45mg anastrozole split into three doses, my SHBG was 13. But at peak my FT was twice the amount of the upper limit (325 on a range of 35-155), and at trough it was still slightly above the upper limit (158) My TT was 1278 and 678 respectively. One of the forum members said my results were not typical of guys with low SHBG and told me twice weekly would probably do nicely for me. I was thinking of going to a twice weekly schedule.

Everyone's physiology is N=1. It can take experimentation to find your optimal dose and schedule. If I had SHBG of 11, I'd consider every day injections. As is, my SHBG is usually high 40's- low 50's and I do better on every other day dosing, quite small dose, currently 24mg EOD which produces TT around 1100-1200 and Free T in the low 20's (different scale than your numbers, essentially this is a good high normal, close to top of range number- and yes Madman, this is consistent with calculated Tru-T for me)

Your numbers of trough at around half of peak makes total sense to me.
Some guys will have pretty dramatic negative "roller coaster" type effects with peaks and troughs like that.

Running total and free T that high works for some, not others. Depends on your goals, and whether you develop side effects like high hematocrit at that level.

 

[DDD]

If you take EOD 24 mg, then your total weekly dose is about 96 mg per week, right? Do you "feel" a difference on that dose. Is your libido more consistent?

May I ask, what was your baseline T level before you started TRT. Mine was measured at 159 and 243. I don't know if a EOD 24 mg dose would get me to 1100-1200. Wouldn't it matter what your baseline T was? My current does is 150mg weekly.

My goals are simply to feel good, have consistent energy. and a consistent libido.

I feel a spike for 2-3 days after a weekly injection, but I think on days 6 and 7 I sense the difference as it decreases. I thought about increasing my dose to 200mg weekly so I'd have a higher level on days 6 and 7. But I think I'm going to twice weekly with .1mg of anastrozole after each injection.

 

[keithc2485]

in ur opinion , how long after starting HCG with my Test. cyp regeiment would i most likely need to add an AI....?

for the past 2 years I have been on Test cyp 100mg a week in two 50mg doses.. .and my estradiol has been in range ... no AI was needed all this time.

since adding 1000IU of hcg a week ive lowered my Test. to 80mgs a week bc my total and free went up from 440 to 860 . and free went from 21 to 32 ...

But its been 6 weeks and my Estradiol/ Hemaglobin/ HMC have been also still in the normal range . so Myself and the doc are holding off on the AI ....

I think its just a matter of time before the estradiol creeps up and i will need it, so we are doing blood again in another 6 weeks.... also to make sure i dont need to give blood monthly

i do have have a prolactin issue with a very small prolactinoma .... could that have anything to do with my estradiol not going up ?

any thoughts would be great

-K

 

[Blackhawk]

If you take EOD 24 mg, then your total weekly dose is about 96 mg per week, right? Do you "feel" a difference on that dose. Is your libido more consistent?

May I ask, what was your baseline T level before you started TRT. Mine was measured at 159 and 243. I don't know if a EOD 24 mg dose would get me to 1100-1200. Wouldn't it matter what your baseline T was? My current does is 150mg weekly.

My goals are simply to feel good, have consistent energy. and a consistent libido.

I feel a spike for 2-3 days after a weekly injection, but I think on days 6 and 7 I sense the difference as it decreases. I thought about increasing my dose to 200mg weekly so I'd have a higher level on days 6 and 7. But I think I'm going to twice weekly with .1mg of anastrozole after each injection.

First off, my dose and relative levels may be entirely irrelevant to yours. Different men have different levels of physiological response to TRT. I do better on pretty small dosage. You may do better at higher dosage. But here's the thing that helps me: EOD small doses keep my peak-trough range narrow. I feel better this way.

Second, no, my 24 EOD is equivalent to 84mg/week. "feel a difference"... compared to what? The total T level pre TRT (241) was less relevant than my free T (3.1 (low end of range 7.2)) and I felt like utter crap, but libido has never been a problem for me. I can't give you any direct comparison in "feeling different" because I went through several bad TRT protocols over the course of 1.5 years before getting it right. Adjustments were a nightmare until I finally stabilized on protocol close to what I am on now. So all I can say is now I am more stable on my TRT protocol than ever and doing well.

 

[Gman86]

in ur opinion , how long after starting HCG with my Test. cyp regeiment would i most likely need to add an AI....?

for the past 2 years I have been on Test cyp 100mg a week in two 50mg doses.. .and my estradiol has been in range ... no AI was needed all this time.

since adding 1000IU of hcg a week ive lowered my Test. to 80mgs a week bc my total and free went up from 440 to 860 . and free went from 21 to 32 ...

But its been 6 weeks and my Estradiol/ Hemaglobin/ HMC have been also still in the normal range . so Myself and the doc are holding off on the AI ....

I think its just a matter of time before the estradiol creeps up and i will need it, so we are doing blood again in another 6 weeks.... also to make sure i dont need to give blood monthly

i do have have a prolactin issue with a very small prolactinoma .... could that have anything to do with my estradiol not going up ?

any thoughts would be great

-K

What brand of HCG are you using, if you don’t mind me asking.

 

[DDD]

First off, my dose and relative levels may be entirely irrelevant to yours. Different men have different levels of physiological response to TRT. I do better on pretty small dosage. You may do better at higher dosage. But here's the thing that helps me: EOD small doses keep my peak-trough range narrow. I feel better this way.

Second, no, my 24 EOD is equivalent to 84mg/week. "feel a difference"... compared to what? The total T level pre TRT (241) was less relevant than my free T (3.1 (low end of range 7.2)) and I felt like utter crap, but libido has never been a problem for me. I can't give you any direct comparison in "feeling different" because I went through several bad TRT protocols over the course of 1.5 years before getting it right. Adjustments were a nightmare until I finally stabilized on protocol close to what I am on now. So all I can say is now I am more stable on my TRT protocol than ever and doing well.

Thanks for your answers. I know that everyone's response to TRT is different. I'm just trying to learn from other men's experiences, plus it helps me to better understand what I am/my experience. My pre TRT level was 159 and 243. I started on once a week protocol and did well until my estradiol went up. It didn't happen right away though. I've done a couple different protocols since then. I also switched to Defy. Right now I trying to find the protocol for me. On a once a week protocol, my recent labs had my free T just above the upper range at trough (a 158 on a range of 35-155) and a 325 at peak. Since my FT at trough is above range (and my TT at rough in the 600s). Would that not mean that I should feel "good" even when my TT is in the 600s, since my FT is above range then? Would that mean I don't necessarily need to have a higher TT level? My SHBG level is 13.

Within the last week, I switched to a twice weekly schedule 75mg twice a week. I took my last once weekly injections of 150 mgs on Monday, then I started the twice weekly on Thursday (75mg) because I was going to be doing a Mon/Thur protocol. I think I should have waited until the next Monday to start. After the Thursday injection, the next day, I didn't feel that good.

How is it that some guys and only doing 100mg a week or less and feeling good? I'm on 150mg, and I see others who are on more.

The only protocol I haven't tried yet is the EOD.

 

[sh1973]

I do 60-70mg per week with high shbg and feel good. I’ve been at this nearly a decade now and more t isn’t always better. There’s lots of men including myself for years that struggle on trt. One trend I can tell you for certain is the guys that claim they’re doing the best are all under 100mg of t per week and sit between 500-800ng. 40,50,60 year old men don’t need t levels over a 1000ng to feel good nor do you need a cocktail of meds to counter the side effects. Trt is about feeling normal, not building a physique. I think if more men started low and worked their way up slowly there would be more happy men on trt. I cannot for the life of me understand why some of these doctors start men off 150-200mg per week of test with hcg,dhea,ai and all this other crap without knowing they need it.

 

[jmzwy]

I'm not a dr. and can only speak from my own experience, so for what it's worth... I say you just start with testosterone. My original protocol was T, HCG, and some dhea, and an AI to be used when needed for symptom resolution. Within one month I had side effects all over the place.... bloating, wate retention, itchy, temper, irritability on certain days.

Took me between 6-9 months to get it all worked out. I discovered I'm extremely sensitive to HCG, and dhea I swear is just toxic to me. I took the AI about 7-10 times in those first few months, which had side effects of its own. And I was really only taking it to battle to spiking estrogenic effects I'd get from the HCG. The AI really did nothing since most of the estrogen symptoms I was experiencing was due to the conversion in the testes due to the HCG.... which the AI does nothing to prevent.

So I had to hit the reset button at about 6 months and just go with the testosterone. Everything got much easier for me. I've began HCG intermittently (1 week per month daily at very low doses of 100 iu a day) to give the boys some stimulation. It's about all I can tolerate.

My advice would be to dial in the T as a standalone first, then add the HCG in after you feel good and stable. Then anything else if necessary. Again, this is just my experience. And in regards to the HCG, I am certainly envious of those that can tolerate it with no issues. The reasoning and science behind it appear very sound. But if you are new to this, I think one med is enough to start before you start chasing yourself in circles to identify what med of the 3/4 might be giving you side effects.... not too mention what dosage of each of those meds.

 

[jmzwy]

And as a brief follow-up... I would definitely use a clinic that at least offers all the meds and options. You want all the avenues available, even if you never use them.

 

[keithc2485]

im sorry im just reading this ... im using Pregnyl 10,000iu vial at 800iu a week