10 Months Into TRT - Difficulty Dialing In

Hi all, what’s the best way to dial in? I’ve been on TRT for 10 months and having a god awful time dialing in.

For the first 6 months I was on Testosterone, Anestrozole, HCG, DHEA, and Pregnenolone. After having trouble, I reset to just Testosterone (154mg/week test cypionate injected subQ daily) to see where my estrogen naturally lands.

See Labs on 7/30/19 (Estrogen ~70, note SHBG is relatively low):

Symptoms through 7/30/19

  • Weak erections
  • No sex drive/libido
  • Less pleasure from orgasm or penis
  • Irritability

After this lab I began experimenting with Anastrozole in 2 week increments.

  • First two weeks: .125mg Anastrozole 3x a week
  • Second two weeks: .125mg Anastrozole 4x a week
  • Third two weeks: .125mg Anastrozole 5x a week

See Labs on 9/17/19 (Estrogen ~29):

Current symptoms:

  • Weak erections (no change)
  • No sex drive/libido (no change)
  • Less pleasure from orgasm or penis (no change)
  • Irritability (worse)
  • Fatigue (new)

I never passed through a sweet spot as I brought my estrogen down from 70 to 29.


  • Should I drop my estrogen to low 20s and see if that helps?
  • Are two week increments experimenting with Anastrozole too small to find my sweet spot? (Dr recommended this)
  • What should I do to properly dial this in?

Drop the anastrozole altogether and ride it out for at least 6 weeks. 70 isn’t a big deal for most of us and it will likely drop on it’s own after a while.

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You’ve got plenty of room to lower your dosage, but HCG and low SHBG is not advised especially if already having trouble with estrogen.

No wonder you’re having problems. I had higher estrogen on SQ than I did IM, it was a huge difference.

I’m not a fan of AI’s, but trying to balance your testosterone, HCG and AI dosing rarely works out for us men unless we clear estrogen out of our liver quickly.

Low SHBG means you lack the natural buffer to soak up all that estrogen and the majority is free to interact with your aromatase enzymes.

@systemlord: What should i lower my dose to? 100mg/wk?

I stuck out high e for about 10 weeks with no anestrozole. It didn’t have an effect on the following symptoms:

  • Weak erections
  • No sex drive/libido
  • Less pleasure from orgasm or penis
  • Irritability

What could be the issue if its not estrogen?

I always thought my high estrogen value was the cause of my symptoms because it was the only lab value out of range. It turned out I was borderline iron deficient at the start if TRT, but felt excellent with SHBG at 16 and estrogen at 70 pg/mL.

When I ran out of ferritin, I started feeling the effects which was iron deficiency, but that wasn’t the first domino to fall. The very 1st symptom I had on TRT was strange curls in my hair, inflamed gums and aching teeth.

Once you become vitamin C deficient, iron deficiency follows. I wasted 3 years of my life working with ignorant doctors.

Your FT is at the top of the ranges, not everyone needs FT at the top to feel normal. Try 120mg and split it up daily, drop the HCG and AI.

DHEA also increases estrogen, you are taking too many compounds that are creating estrogen excess.

Your protocol screams I want more and more estrogen.

Great. I think I’ll drop A.I. and drop my injection to 100mg and work up. How long should I stay at 100mg? How often should I increase the dose? How much should i increase the weekly dose each time?

Also, do you have a link for using insulin needles for shallow IM? I’m searching the form for instructions on how to properly do IM with an insulin syringe.

This is a good question, it takes our bodies 6 weeks to stabilize levels, 8 weeks for your body to work things out. Whenever somebody changes their dosage you will feel like crap for 4 to 6 weeks, there’s no way around it.

If you’re the type of guy that changes doses every 2 weeks, you’re going to be lost for a long time.

Oh shit. I am the guy who changes A.I. doses every 2 weeks because my doctor told me to do that.

So every 8 weeks should I increase by 10mg or so? And see where i feel best with no AI?

Anastrozole takes 10 days to reach a stable state. Increasing your dosage by 10mg every 6-8 weeks and you’ll still be dialing in after I die of old age.

If you’re injecting daily, dosage reduction is by 7mg, so make moves by 14mg or 21mg.

Sorry, I didn’t understand. Assuming I reset to 100mg Testosterone Cypionate a week (with no A.I.), how much and how often should I begin raising my testosterone dose to find my sweet spot?

I guess you could start out a little lower, but you need to give each new dosage change at least 6 weeks, preferably 8 weeks. Your levels may become stable at 6 weeks, but your body may not actually show full benefit until 8 weeks.

I found my sweat spot lower than I would have guessed, right around 400 ng/dL and FT midrange at around 15 pg/mL (ranges 6.8-21.5 pg/mL). My estrogen without the use of an AI is <35 pg/mL.

I started on Sust 250 once every 3 weeks which didnt work, then every 2 weeks which helped but i was still experiencing the same symptoms as you. a few months ago I changed to 1 shot per per week of 1ml sust 250 and feel great. libido is back, acne is controlled by aromasin but i try to avoid using it due to cholesterol issues.
you did the right thing imo by removing everything and going back to just test. from there increase your dose until you feel good, Keep in mind if yo are not happy in the rest of your life then test isnt a magic cure for depression though it can greatly improve your mood in the right environment. I also experienced this problem but i took a lifestyle change to flip things around and now i feel great. look at your life in general as depression can impact some of the same things that you are experiencing

Maybe daily injection isn’t best for you. Maybe sub-q is not the best for you. Shallow IM is easy, use a 1 inch or 5/8" needle and poke straight in to a thigh or deltoid. I would definitely try IM before changing dose.


@ripped40s Life is actually going pretty well these days and I’m not experiencing depression. My mood swings on trt are worse than when i was depressed years ago lol (just moodiness, irritability, and no patience).

@hardartery I’m doing daily injections with subQ. Should i do daily IM? or 3x a week? (My SHGB is low and I’ve read daily can raise it).

Yeah, I’m getting the sense that I approached this ass backwards over the last year. I was started on the high end of TRT for my body with the 3 variables of HCG, AI, and Test. Couldn’t dial in, and we’re trying to work backwards now. I think I’m going to take system lords advice and hard reset, as well as hardartery’s advice and switch to IM (although I’m going to hard reset at the same time, and start low).

@systemlord Do you happen to have a link to detailed instructions on how to properly structure dialing in on a “new protocol”? I read the sticky linked from 2009, but it didn’t go into depth with details.

You know nothing is written and why doctors follow guidelines, 200mg every 2 weeks. Most of what’s known is from trial and error, it’s difficult because you never know what may work for you until you try it.

Maybe weekly injections won’t work well for you. It took my 2 years to learn that I feel amazing on a 7-10mg daily protocol.

For your own health don’t use anything other than IM from a legal source through a doc’s prescription.

Ahh, ok. I will begin my process of trial and error. Thank you for the guidance!

It took me 2 years to figure out what works, of course if I had known low SHBG men do better on very frequent dosing, this would have cut the time in half.

Using androgens is not going to raise your SHBG, but you may respond better to IM.