T Nation

1 Week In, Reading a Lot, Now Confused

Started on Wed Nov. 27 with .4ml of TC twice a week. Today was my second shot. My math is equating this to 160mg a week. I do need help with math and conversions. Anyway, here is my confusion. Im 5’7” fit. I have no lower abs but uppers are slightly visible. I work out 5x a week. Lift weights, eat right, drink a glass of wine with dinners, but Im not overweight. My protocol includes .5mg of anastrozel, and 20 units of HCG with every .4ml of TC.

I brought up that I felt no need for an AI but the doc suggested that I follow his protocol. I do believe that I aromatase since heavy drinking could make me feel emotional and sensitive. But reading the forums makes me feel like I should not take the AI or the HCG. What is the consensus regarding a non overweight newbies protocol?

brace yourself, incoming replies on quitting the AI, lowering the dose and focusing on too many things at one time is coming

Can you stop this until you get synced up with a TRT protocol? That’d be great.

How much T is in the vial? 200mg/mL? 160mg a week seems to be way too high a dose. Do you have high SHBG?

20 IUs? or 200?

Staring out on TRT, HCG and AI’s are a ticket to failure, too many moving parts to analyze. TRT should be started in isolation and this will make the dialing in process easier. HCG is very individual meaning a lot of men cannot tolerate it at all, so if you’re one of those men then things aren’t going to go well.

Your prescribe anastrozole dosage is pretty high, starting doses should be .125 anastrozole when you have attempted to control estrogen by adjusting your injection frequencies, but wait a minute nothing indicating high estrogen, just a belief, in fact you are not overweight. You were more than likely prescribe what’s known as a cookie cutter protocol prescribed to everyone without concern for your biomarkers.

AI’s also cause hair loss. You want to control estrogen, inject smaller more frequent doses will go along way towards lowering estrogen, also AI’s have side effects and may in fact degrade how you feel on TRT. I hear men report they feel better since stopping their AI’s, sure some people will need them, just not at the dosage you’ve been prescribed.

I inject T daily when on TRT, I’m not a typical case, far from it needing only 7mg daily (49mg weekly). I had difficulty controlling estrogen on all other protocols. The moment I switch to a twice weekly or weekly protocol, all of a sudden I need 100mg weekly and lots of estrogen problems.

A once or twice weekly protocol, right around 100mg, I could give a better recommendation if I knew your biomarkers. I need a minimum TT, FT, SHBG and estrogen. If you don’t have all of these then this would suggest you put your trust in someone who doesn’t deserve it.

As pointed out, the strength of the Cypionate is useful information to do the math. It’s kind of foolish to start three different drugs at the same time, for starters. That being said, it’s not good to go changing everything willy nilly. Stick with whatever you’re doing for at least 6 weeks before you change anything. You probably don’t need the AI at all, or the HCG unless you’re trying to conceive, but it’s best to let it ride for at least 6 weeks. If at that point there are issues, change ONE thing and wait some more. ONE thing at a time, it is faster in the long run to wait and change one thing at a time.

He hasn’t even been one week on his current protocol. I’d just stop and try with T Cyp for 6-8 weeks as it would give a better baseline going forward.

That would be my approach, but I don’t want him to have too many issues with his doc. Some of them get pissy if you don’t give their protocol a go first.

That’s true, although I would just do it anyway. If it works, you tell the doc it worked without needing the other stuff. The doc is just getting money out of him by making him try a million things. Fuck that.

The TC container says 200mg/ml
I didnt pin my HCG today but I did take .5 of the AI. I can still try the .4ml twice a week of TC without the AI and HCG. Wont my testes shrink with TC only?

This is only a question you can answer, but not everyone will see testicles shrink completely. For some a choice has to be made, shrunken testicles and controlled estrogen or high estrogen and full testicles.

While on TRT your testicles are purely cosmetic, the testicles serve no purpose because testosterone is being injected from an external source. I notice a dull ache in my testicles for the first couple of months, eventually the aching stopped and testicles were about 25% smaller.

Yeah, they’ll lose some size but it’s not like they’ll become the size of a peanut. I might have lost 10 - 15% but honestly I’m not sure I can tell the difference. Unless someone actually measures them, I doubt you’ll notice much. You can always add it back in later if it bugs you.

Of course I’d had a persistent ache in one since I had a vasectomy years ago, that ache has all but disappeared with them shut down, so I’ll take the minor shrinkage to get ride of that.

I think Ill try TC alone. Wont use the AI or HCG. Could TC by itself cause erection issues?

Starting a new protocol will see erection problems, when ever you change anything about your protocol, levels will be in flux for 6 weeks, during this time you will feel good on and off, your symptoms will come and go.

You don’t really have any labs to share, so I couldn’t tell you if you are on the correct protocol.

This… though I’d noticed testicular atrophy prior to TRT… the reduction on was probably 20-30%… and only became apparent after about a year

Much depends on the rationale for everything you are doing. Without lab results, it is difficult to comment considering the doctor possibly knows something I don’t.

  1. Testosterone, I’ll assume your levels are not good and you have low test symptoms. You need testosterone. I’d be fine with your starting dose.

  2. Anastrozole? You stated you didn’t think you needed it, but the doctor suggested it anyway. Why? Is there any reason you couldn’t start without it, see how you respond, and add it later if needed? Is there anything in your history indicating you will likely have trouble with elevated E2? Fluid retention, past AAS use, gyno? Where is your E2 now (prior to starting), is it high?

  3. hCG? How old are you? Are you currently trying to conceive? Are you concerned with testicular atrophy? Those are the reasons for anastrozole.

There are some doing what you are and doing fine. However, some TRT clinics (maybe a lot of them) will load guys up, as mentioned by systemlord, with a cookie cutter protocol which seems driven by profit. Some will always offer multiple products, but back down if you protest, though your guy didn’t and seems to have insisted. I know guys who had vasectomies placed on hCG to preserve fertility, plus some other guys in their late 60s. What’s with that? Some are given prescriptions and not even told why, just take this, it’s the program.

Ultimately, you should have a clear understanding of the reason(s) for whatever you are taking.

This is rarely the case. Possible, and likely if one considers increased erections a problem…………

One must also factor in the fact that a large majority facet of ED is psychological. Nerves, preconceived notions of what will/wont work etc all diminish the ability to get it up… neurology is also vitally important, vastly, deleteriously imbalanced neurotransmission? Good luck getting it up…

I find a lot of people worry about small details of situations (myself included) because we have nothing else to do at the time, and thus whilst caught up in our own thoughts we pick at minuscule topics and problems (should my dose be 55mg 2xwk or 58mg 2xwk… like at that point it really doesn’t fucking matter

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Very good point. There are too many guys taking 200mg once a week and doing great while they have no clue what a half-life is, what estradiol is, what an aromatase inhibitor is, or what gynecomastia is.

TESTOSTERONE, TOTAL Your value327 ng/dL Standard range240 - 871 ng/dL

Standard range7.0 - 36.7 ng/dL|

Your value22 nmol/L
Standard range11 - 78 nmol/L

Your value
5.4 %
Standard range
4.6 - 5.6 %

These are results from Kaiser about 3 months ago. I was tested at the male clinic less than a week ago and my total t levels were at 318 so Ive dropped a few points. No mention of Estrogen. He said would test my estrogen after 5 weeks once Im settling into my protocol. The problem Im having is that everything I read here is saying not to start with an AI or HCG. So Im trying to make a decision. He mentioned that the majority of his patients require and AI and he wants to start me off this way. Also 200mg/ml at .4ml twice a week should be about 80mg x2 so 160mg. He wants to boost me up and then work my dose down to keep me cruising at a good T level. I get that. Still the anti AI and anti HCG talk on this forum has me second guessing the doc. I am 46yo btw

A SHBG of 22 pre-TRT is already on the low end. I would expect this value to lower more due to injecting testosterone. Lower SHBG guys do better on a more frequent injection protocol. For example, every 3 days or even every other day. This is because there is not enough of the protein to bind to testosterone and many excrete the testosterone much more quickly leaving you with lower trough levels on injection day.

It is much easier to start with Testosterone by itself and draw labs after 6 weeks. This will allow you to keep the variables at a minimum and then really dial in on your dosage/frequency. Adding too many variables too quickly can do more harm than good. For example crashing your E2… and such. Also 160mg/week might be too much of a starting dose but that is my two cents.

Without knowing your E2 it is hard to say where your baseline is… Im curious to see your lab work after 6 weeks. If I were you I would stick to your current dosage for a minimum of 6 weeks, Testosterone only. Post your labs here and we can adjust from there once we have a full picture of everything.

I would not have started with anastrozole given what you have posted. Regarding hCG, again, why? You’re 46, starting a family soon? Concerned with testicular atrophy? If no to each, no hCG.

What does that mean? Eleven out of twenty? Forty-nine of fifty? Unless the odds are overwhelming (and in totality they are not), that is no reason to place a patient on any medication.

The vast majority of men in the US taking testosterone do not use aromatase inhibitors. GPs don’t prescribe it and most underground gym meatheads have never heard of it. I doubt many endos and uros use them either, certainly not a majority of them.