What Would a Daily Protocol Look Like For Me?

[Storm]

It sounds like more members are injecting testosterone daily. It seems like it would be a tough protocol to follow. I was wondering, do the benefits of injecting daily really outweigh the disadvantages?

Hey guys! New here and have been on and off TRT for some time. Currently I have been on trt for 1 year with a popular clinic. I've been on an EOD protocol for a year and haven't really felt much better. My anxiety is through the roof and I have to take clonopin for it 1mg 2x daily usually. I used to take lexapro and before that paxil prior to that. My primary care doc wants to put me back on paxil but I'm wondering if I can get dialed in on TRT maybe I won't need it.

I'm lowish SHBG 12.4 on recent labs and 19.4 on the one before that (labcorp goes up to 55).

My current protocol is:

200 IU HCG EOD
40MG T cyp EOD
200mg of DIM daily
I've always had high hematocrit currently at 51 with donating. Pre TRT I was at 48 I believe.

What would a daily TRT plan look like for me? I'm guessing 20mg or 15mg daily of test cyp, 100iu or 50iu or 75iu HCG daily and 100mg DIM daily?

My sensitive estrogen is at 23.2 and has gone up to 40 without DIM. Free test 21.3 and total t at 897. In the afternoon the day after my t shot I'm in the low 500s for total T.

I also should mention I inject sub q in the belly with T with a 29 n 1/2" needle and use the same needle to do HCG in my upper thigh. I feel like since going sub q for test I've lost this since of well being because I used to use a 27 gauge 1 inch needle in glutes and felt better.

Any help is greatly appreciated I'm 29 and tried the clomid route and could only get up to 410 total t and then when I stopped I went back to my normal t level of 208.

I've missed a lot of work because of these panic attacks so I really need help.

Thanks so much!

 

[CoastWatcher]

Welcome to Excelmale. Your post was moved to start a thread of your own - you're far more likely to generate interest and discussion if you post in this manner rather than at the bottom of the third page of a previous thread!

I'm a big believer in the efficacy of a daily protocol, having followed one with great success for over two and a half years. Most men don't need to inject on a daily basis, and not everyone who does achieves their goal. That said, it's a rational approach for a man with low SHBG, which you have to deal with TRT.

However, you discuss what a potential daily protocol would look like - and you reference some of the medical issues you also deal with - but you don't post your most recent, complete lab results. Some are there, SHBG and estradiol, but what about total and free testosterone? What are you hitting with your current protocol and an SHBG of 12.4?

 

[Storm]

Welcome to Excelmale. Your post was moved to start a thread of your own - you're far more likely to generate interest and discussion if you post in this manner rather than at the bottom of the third page of a previous thread!

I'm a big believer in the efficacy of a daily protocol, having followed one with great success for over two and a half years. Most men don't need to inject on a daily basis, and not everyone who does achieves their goal. That said, it's a rational approach for a man with low SHBG, which you have to deal with TRT.

However, you discuss what a potential daily protocol would look like - and you reference some of the medical issues you also deal with - but you don't post your most recent, complete lab results. Some are there, SHBG and estradiol, but what about total and free testosterone? What are you hitting with your current protocol and an SHBG of 12.4?

Hey thanks so much for the quick reply, I really greatly appreciate it!

I read a lot of your posts and it is awesome to get someone in here who knows all about daily protocols like you!

Anyways though, what's the best way to post lab results from Labcorp through here? It has all of my personal information and it would take up several pages. Are there any specific results that you want? I have had 3 full labs done within the last year.

Here is an example of my most recent lab result:

SHBG: 16.0 (range: 16.5 - 55.9)
Free T: 27.6 (range: 9.3 -26.5)
Total T: 829
Estrogen Sensitive: 39.3 (range 8.0-35).

The 12.4 SHBG one that I was referencing looks like it was from a few months ago.

I can provide whatever you need so please help. Thank you!

*updating with labs below*

Here is my labs from before TRT, on Clomid, and finally on TRT ([FONT=&quot]The labs from March 2015 are prior to TRT when I was just doing a bunch of Male Blood Tests and found out I had higher cholesterol.[/FONT]
[FONT=&quot]
[/FONT]
[FONT=&quot]The labs from December 2016 are prior to TRT but when I was on Clomid 25mg ED trying to restart my levels but it did not work so I went to Defy.[/FONT]
[FONT=&quot]
[/FONT]
[FONT=&quot]The labs from April 2017 are when I was on TRT for 3-4 months at 40mg of Test Cyp and 200iu of HCG EOD.[/FONT]
[FONT=&quot]
[/FONT]
[FONT=&quot]The labs from August 2017 are on TRT for 8 months total at the same protocol above).[/FONT]

 

[Systemlord]

40mg EOD is a a bit much for a guy with low SHBG, I'm having trouble with 20mg EOD with an SHBG of 18-20 nmol/L. We low SHBG guys can barely tolerate estrogen since we have so much of it free in the same way we have more free T do to low SHBG.

I had to lower my dose to 17.5mg EOD (70mg total weekly) and am starting to feel a little better every day since my reduction. If your E2 and free estrogen are high than that would explain why you feel nothing, when E2 is high it limits testosterone's effects on your receptors.

When my E2 started climbing gradually 3 months ago I notice my testes start pulling up and very slowly TRT eventually stopped working and brain fog was returning, this was exactly how I felt before TRT. E2 is going down and I'm starting to feel the way I did before I increased my dosage, reducing my dosage is making me feel better, so perhaps it can for you.

There are those who believe including myself that in order for a low SHBG guy to get dialed in you need to focus on your free estrogen.

Here's a thread on E2 levels for low SHBG guys -->

https://www.excelmale.com/forum/showthread.php?10375-E2-levels-for-low-SHBG-guys

 

[Storm]

Welcome to Excelmale. Your post was moved to start a thread of your own - you're far more likely to generate interest and discussion if you post in this manner rather than at the bottom of the third page of a previous thread!

I'm a big believer in the efficacy of a daily protocol, having followed one with great success for over two and a half years. Most men don't need to inject on a daily basis, and not everyone who does achieves their goal. That said, it's a rational approach for a man with low SHBG, which you have to deal with TRT.

However, you discuss what a potential daily protocol would look like - and you reference some of the medical issues you also deal with - but you don't post your most recent, complete lab results. Some are there, SHBG and estradiol, but what about total and free testosterone? What are you hitting with your current protocol and an SHBG of 12.4?

Please see first post it has my labs from 2015 (before TRT) all the way until August 2017. I have new labs from November but don't have files of them yet. Those are the ones I just gave you in my previous post though. Let me know if you need any other numbers from the November 2017 ones. Thanks!

 

[ratbag]

Your numbers look good except that when doing a daily or EOD protocol your numbers usually show higher because there is less trough between injections. So typically when someone does daily protocol we see even higher numbers. With that in mind I'd say your numbers look a little low. Have you tried more T in the past and did it help? Coastwatcher states an important point about low shbg guys using daily shots, it's s common protocol. So if you want to try it I would suggest this as a daily starting protocol. 20mg Test, and 100iu of HCG. Wait 6 weeks and then get labs. You may not need DIM anymore. Also you can put testosterone and HCG in the same syringe together and do just one injection per day. That's what I do and Nelson does too. There is a video on it here.

Also you should get some labs for your thyroid and DHEA etc and see if it looks good or not. Regular physicians do not check thyroid properly compared to some HRT doc's who know what they are doing.

Ok I see your labs now. Your ferritin is low and that causes lower FT3. So my guess is Dr. Saya may get you to supplement some iron. Dr. Saya is one of the best MD's so that's good. Once you raise your ferritin your FT3 should go up some and the T3 will start to get into your cells which means you would start feeling better.

 

[Storm]

Your numbers look good except that when doing a daily or EOD protocol your numbers usually show higher because there is less trough between injections. So typically when someone does daily protocol we see even higher numbers. With that in mind I'd say your numbers look a little low. Have you tried more T in the past and did it help? Coastwatcher states an important point about low shbg guys using daily shots, it's s common protocol. So if you want to try it I would suggest this as a daily starting protocol. 20mg Test, and 100iu of HCG. Wait 6 weeks and then get labs. You may not need DIM anymore. Also you can put testosterone and HCG in the same syringe together and do just one injection per day. That's what I do and Nelson does too. There is a video on it here.

Also you should get some labs for your thyroid and DHEA etc and see if it looks good or not. Regular physicians do not check thyroid properly compared to some HRT doc's who know what they are doing.

Ok I see your labs now. Your ferritin is low and that causes lower FT3. So my guess is Dr. Saya may get you to supplement some iron. Dr. Saya is one of the best MD's so that's good. Once you raise your ferritin your FT3 should go up some and the T3 will start to get into your cells which means you would start feeling better.

Thanks so much for the reply! So it sounds like you agree on my starting protocol for daily test/hcg injections which is awesome! I stopped DIM on my recent labs and my estrogen was at almost 40 sensitive but like you said, maybe I won't need it. I have actually already started doing iron (just one pill with vitamin C 500mg) daily but the only concern there is my Hematocrit going up even more with the Iron so I definitely need to keep an eye on it.

I have heard of putting the test and HCG together but isn't it easy to drop say test or hcg into the other ones bottle this way? What size syringe do you use and where do you inject? Like I previously stated, I used to do intramuscular injections for test cyp in my glutes with a longer needle and felt like it worked way better than what I'm currently doing (injecting test into my stomach with a 29 1/2" needle). Also I switched hcg to my upper thigh with the same needle as well. Since switching this up, it doesn't seem like I feel as good either. Any opinions/suggestions on this? I don't get what shallow IM injection is? Do you just not pinch the skin and inject in the upper thigh or shoulder? I need to get back to work and this stuff is driving me crazy. Please help . Thanks

 

[Storm]

System lord- For some reason I can't quote your post here is my reply to you:

40mg EOD is a a bit much for a guy with low SHBG, I'm having trouble with 20mg EOD with an SHBG of 18-20 nmol/L. We low SHBG guys can barely tolerate estrogen since we have so much of it free in the same way we have more free T do to low SHBG.

I had to lower my dose to 17.5mg EOD (70mg total weekly) and am starting to feel a little better every day since my reduction. If your E2 and free estrogen are high than that would explain why you feel nothing, when E2 is high it limits testosterone's effects on your receptors.

When my E2 started climbing gradually 3 months ago I notice my testes start pulling up and very slowly TRT eventually stopped working and brain fog was returning, this was exactly how I felt before TRT. E2 is going down and I'm starting to feel the way I did before I increased my dosage, reducing my dosage is making me feel better, so perhaps it can for you.

There are those who believe including myself that in order for a low SHBG guy to get dialed in you need to focus on your free numbers free estrogen.

Here's a thread on E2 levels for low SHBG guys -->

https://www.excelmale.com/forum/showthread.php?10375-E2-levels-for-low-SHBG-guys

Hi there thanks so much for the reply! What do you mean by free estrogen? Is that non sensitive or sensitive estrogen? For the most part my estrogen has been controlled with just DIM 200mg ED. The recent labs I just had where my estrogen was closer to 40 sensitive was when I stopped taking the DIM completely to see where it would fall without it. Can you please look at all of the labs I posted? I posted 2015's lab results for when I first noticed I had low T, 2016's where I was on clomid and then 2017's on T with Defy. Thank you much!

 

[ratbag]

I use a 27guage 1/2" syringe and when we say shallow IM we mean using a 1/2" needle and injecting into the muscle . Normally IM (Intramuscular) injections use a 1" needle. Pinching the skin and injecting under the skin only is called Subcutaneous or SC or SQ. Some people respond well to SC and others don't. I respond better to shallow IM. I inject into my shoulder. No worries mixing into the syringe. I sometimes load my syringe with 4 different products at once. There is never a problem providing you do not allow a vacume to happen in any of your vials. So every day I take a syringe and pull the plunger out and I insert the needle into the vial to equalize it so there is no vacume or pressure. This way you are assured that nothing will get sucked out of the syringe into the vial.

 

[Systemlord]

System lord- For some reason I can't quote your post here is my reply to you:


Hi there thanks so much for the reply! What do you mean by free estrogen? Is that non sensitive or sensitive estrogen? For the most part my estrogen has been controlled with just DIM 200mg ED. The recent labs I just had where my estrogen was closer to 40 sensitive was when I stopped taking the DIM completely to see where it would fall without it. Can you please look at all of the labs I posted? I posted 2015's lab results for when I first noticed I had low T, 2016's where I was on clomid and then 2017's on T with Defy. Thank you much!

We have out total testosterone and free testosterone, TT is inactive (reservoir) and FT is active hormone which is what's responsible for actual feel good changes that occur in the body. We also have estrogen and free estrogen, if your estrogen is 20 your free estrogen can change without your regular estrogen changing.

I believe this is why I hear so often low SHBG guys claiming TRT doesn't work, not all but some of those cases. I spent 3 months with my TT in the 800-900's and FT at the top of range (no AI, no HCG) and slowly TRT felt as if it's effectiveness was waning and I was beginning to feel low T again. I got to a point where I couldn't remember one of my neighbors name, I knew something was wrong as this was when that light in my head went off.

My labs indicated my E2 levels were mid 40's, for a low SHBG guy this is bad. My SHBG is higher than yours so I could only imagine your free estrogen level. The lower your SHBG the higher your free testosterone and free estrogen, if regular estrogen is high for a low SHBG guy, free estrogen is expect to be high!

I believe calcium D glucarate and DIM should be used on low SHBG guys do to the abundance of free hormones do to low SHBG. a regular estrogen of 19 could still be high for a guy with low SHBG if free estrogen is high.

 

[HealthMan]

If fertility is a concern i would reconsider small daily HCG dosages and stick to at least 400-500IU 2x a week. A higher peak in plasma HCG in my experience is important to preserve fertility.

 

[Storm]

I use a 27guage 1/2" syringe and when we say shallow IM we mean using a 1/2" needle and injecting into the muscle . Normally IM (Intramuscular) injections use a 1" needle. Pinching the skin and injecting under the skin only is called Subcutaneous or SC or SQ. Some people respond well to SC and others don't. I respond better to shallow IM. I inject into my shoulder. No worries mixing into the syringe. I sometimes load my syringe with 4 different products at once. There is never a problem providing you do not allow a vacume to happen in any of your vials. So every day I take a syringe and pull the plunger out and I insert the needle into the vial to equalize it so there is no vacume or pressure. This way you are assured that nothing will get sucked out of the syringe into the vial.

Thank you so much for this info. I will definitely do the shallow intramuscular. I did 20mg of test in my thigh today with a 29 1/2 needle. Do you do the same for hcg or should I just stick to sub q stomach injections for hcg? I was just going to do 2 separate needles and cannot decide if I should do daily hcg or 2x per week in higher doses since I am concerned with fertility. Thoughts on fertility? I'm only 29 newly engaged. I definitely want kids in a few years.

We have out total testosterone and free testosterone, TT is inactive (reservoir) and FT is active hormone which is what's responsible for actual feel good changes that occur in the body. We also have estrogen and free estrogen, if your estrogen is 20 your free estrogen can change without your regular estrogen changing.

I believe this is why I hear so often low SHBG guys claiming TRT doesn't work, not all but some of those cases. I spent 3 months with my TT in the 800-900's and FT at the top of range (no AI, no HCG) and slowly TRT felt as if it's effectiveness was waning and I was beginning to feel low T again. I got to a point where I couldn't remember one of my neighbors name, I knew something was wrong as this was when that light in my head went off.

My labs indicated my E2 levels were mid 40's, for a low SHBG guy this is bad. My SHBG is higher than yours so I could only imagine your free estrogen level. The lower your SHBG the higher your free testosterone and free estrogen, if regular estrogen is high for a low SHBG guy, free estrogen is expect to be high!

I believe calcium D glucarate and DIM should be used on low SHBG guys do to the abundance of free hormones do to low SHBG. a regular estrogen of 19 could still be high for a guy with low SHBG if free estrogen is high.

Holy cow man I'm sooooo confused now. So you don't think the new protocol I'm thinking will work? Have I not tested free estrogen then yet on the labs I posted? I just know pre-trt my anxiety was through the roof and now it is back to that. What do you feel like your levels need to be at to feel good again? I can definitely start taking calcum D glucrate as well. Thanks

If fertility is a concern i would reconsider small daily HCG dosages and stick to at least 400-500IU 2x a week. A higher peak in plasma HCG in my experience is important to preserve fertility.

Hey thanks for the reply I'm 29 and engaged so definitely want kids in a few years when fiance gets out of pharm school. Will I feel better on hcg 100iu daily though? Why won't that give me good fertilty since I'm ending up with around the same per week overall? Please explain this more so I know. What protocol do you think is best? Thanks much

 

[madman]

We have out total testosterone and free testosterone, TT is inactive (reservoir) and FT is active hormone which is what's responsible for actual feel good changes that occur in the body. We also have estrogen and free estrogen, if your estrogen is 20 your free estrogen can change without your regular estrogen changing.

I believe this is why I hear so often low SHBG guys claiming TRT doesn't work, not all but some of those cases. I spent 3 months with my TT in the 800-900's and FT at the top of range (no AI, no HCG) and slowly TRT felt as if it's effectiveness was waning and I was beginning to feel low T again. I got to a point where I couldn't remember one of my neighbors name, I knew something was wrong as this was when that light in my head went off.

My labs indicated my E2 levels were mid 40's, for a low SHBG guy this is bad. My SHBG is higher than yours so I could only imagine your free estrogen level. The lower your SHBG the higher your free testosterone and free estrogen, if regular estrogen is high for a low SHBG guy, free estrogen is expect to be high!

I believe calcium D glucarate and DIM should be used on low SHBG guys do to the abundance of free hormones do to low SHBG. a regular estrogen of 19 could still be high for a guy with low SHBG if free estrogen is high.

Not all of TT is (inactive), Total Testosterone = SHBG bound t and albumin bound t and Bioavailable Testosterone (active)= free testosterone+ albumin bound t.

Not only free t but the weakly bound albumin t is also active hence BIO AVAILABLE TESTOSTERONE.

 

[Systemlord]

Thank you so much for this info. I will definitely do the shallow intramuscular. I did 20mg of test in my thigh today with a 29 1/2 needle. Do you do the same for hcg or should I just stick to sub q stomach injections for hcg? I was just going to do 2 separate needles and cannot decide if I should do daily hcg or 2x per week in higher doses since I am concerned with fertility. Thoughts on fertility? I'm only 29 newly engaged. I definitely want kids in a few years.


Holy cow man I'm sooooo confused now. So you don't think the new protocol I'm thinking will work? Have I not tested free estrogen then yet on the labs I posted? I just know pre-trt my anxiety was through the roof and now it is back to that. What do you feel like your levels need to be at to feel good again? I can definitely start taking calcum D glucrate as well. Thanks


Hey thanks for the reply I'm 29 and engaged so definitely want kids in a few years when fiance gets out of pharm school. Will I feel better on hcg 100iu daily though? Why won't that give me good fertilty since I'm ending up with around the same per week overall? Please explain this more so I know. What protocol do you think is best? Thanks much

Everyone is different and just because it didn't work for me doesn't mean it won't work for you. E2 is metabolized by the liver and cleared out of the body through the bowel, if this process is not working optimally it can lead to either high levels of estrogen. Keep working your way down until you start to feel better, when that happens you can lower your dose again until you find that sweet spot. It's a marathon not a sprint.

Not all of TT is (inactive), Total Testosterone = SHBG bound t and albumin bound t and Bioavailable Testosterone (active)= free testosterone+ albumin bound t.

Not only free t but the weakly bound albumin t is also active hence BIO AVAILABLE TESTOSTERONE.

I learn something new everyday. Thanks

 

[Storm]

I use a 27guage 1/2" syringe and when we say shallow IM we mean using a 1/2" needle and injecting into the muscle . Normally IM (Intramuscular) injections use a 1" needle. Pinching the skin and injecting under the skin only is called Subcutaneous or SC or SQ. Some people respond well to SC and others don't. I respond better to shallow IM. I inject into my shoulder. No worries mixing into the syringe. I sometimes load my syringe with 4 different products at once. There is never a problem providing you do not allow a vacume to happen in any of your vials. So every day I take a syringe and pull the plunger out and I insert the needle into the vial to equalize it so there is no vacume or pressure. This way you are assured that nothing will get sucked out of the syringe into the vial.

We have out total testosterone and free testosterone, TT is inactive (reservoir) and FT is active hormone which is what's responsible for actual feel good changes that occur in the body. We also have estrogen and free estrogen, if your estrogen is 20 your free estrogen can change without your regular estrogen changing.

I believe this is why I hear so often low SHBG guys claiming TRT doesn't work, not all but some of those cases. I spent 3 months with my TT in the 800-900's and FT at the top of range (no AI, no HCG) and slowly TRT felt as if it's effectiveness was waning and I was beginning to feel low T again. I got to a point where I couldn't remember one of my neighbors name, I knew something was wrong as this was when that light in my head went off.

My labs indicated my E2 levels were mid 40's, for a low SHBG guy this is bad. My SHBG is higher than yours so I could only imagine your free estrogen level. The lower your SHBG the higher your free testosterone and free estrogen, if regular estrogen is high for a low SHBG guy, free estrogen is expect to be high!

I believe calcium D glucarate and DIM should be used on low SHBG guys do to the abundance of free hormones do to low SHBG. a regular estrogen of 19 could still be high for a guy with low SHBG if free estrogen is high.

If fertility is a concern i would reconsider small daily HCG dosages and stick to at least 400-500IU 2x a week. A higher peak in plasma HCG in my experience is important to preserve fertility.

Everyone is different and just because it didn't work for me doesn't mean it won't work for you. E2 is metabolized by the liver and cleared out of the body through the bowel, if this process is not working optimally it can lead to either high levels of estrogen. Keep working your way down until you start to feel better, when that happens you can lower your dose again until you find that sweet spot. It's a marathon not a sprint.



I learn something new everyday. Thanks

So just go with the every day protocol of 20mg of test and hcg daily too or just hcg 2x per week? I'm so confused with all of this info and just want to feel better!

 

[Systemlord]

I'm sorry I thought you meant 20mg EOD, 20mg ED is too much.

 

[Storm]

I'm sorry I thought you meant 20mg EOD, 20mg ED is too much.

If I did 20mg EOD that would land me probably in the 400s for total T though? I'm trying to switch to an every day protocol. So you think low SBGH guys need a low total t number to feel good ? What would I do for hcg dosing and day Then? There are so many different opinions it's hard to figure this out.

 

[Nashtide]

I'm switching to daily injections starting today. My current protocol is 50mg T cyp E3.5D. 0.30 adex at time of injections. 250iu of Hcg Monday and Friday. My goal is to lower my total T dose to 70mg per week in hopes of being able to drop the adex altogether. I'm not going to change Hcg protocol. I'll run labs in four weeks and monitor any high E2 symptoms.

 

[Vince Carter]

Given that E is such a personal thing I went to EOD and then to daily and it never changed the large amount of aromatase that I have going on and still require anastrozole. The point here is that when you get to 70mg +/- you're well below what anyone would consider a basic starting weekly (cumulative) dose of 100mg. To a point its chasing your tail if you get a Total trough of 500 just to control E then there's absolutely a point of diminishing returns. One point of caution is that there's absolutely no linear value to any of this, anywhere. It's a totally individualistic journey if you will. because one guy says he controls E with X dose, it's extremely unlikely that that will work of be of any therapeutic value for you.

 

[Nashtide]

Given that E is such a personal thing I went to EOD and then to daily and it never changed the large amount of aromatase that I have going on and still require anastrozole. The point here is that when you get to 70mg +/- you're well below what anyone would consider a basic starting weekly (cumulative) dose of 100mg. To a point its chasing your tail if you get a Total trough of 500 just to control E then there's absolutely a point of diminishing returns. One point of caution is that there's absolutely no linear value to any of this, anywhere. It's a totally individualistic journey if you will. because one guy says he controls E with X dose, it's extremely unlikely that that will work of be of any therapeutic value for you.

I understand what you're saying. For whatever reason, I respond very well to the T cyp. At 100mg/week, my TT and FT are in the upper range. I'm going from memory, but I was around 900 TT the last time I tested. So I'm thinking reducing the dose to 70mg will still have me around high 600's. If I can get to that level and not need an AI, I'll be happy. Providing I feel good. As you stated, E2 is individual. I spent too much time chasing a number. I was convinced my E2 needed to be in the mid 20's. Now I'm not so sure. Anyway, I appreciate your input. I will keep y'all updated on my progress and will post labs in 5 weeks or so.