T Nation

Beginner Protocol Sticky Recommendation

Lately I’ve been seeing a lot of similar posts from guys complaining that their starting protocol is not working. I know in the past there has been a sticky thread for a beginner protocol, but it is now out of date and removed.

I would like to recommend that we add a new sticky with an updated protocol so the experienced guys on the forums are not having to repeat themselves on so many threads. This post does not need to be a sticky (of course it is welcome). And maybe a more experienced member can write one, but I would like to try to get this rolling.

Basic knowledge for a beginner:

There are some fundamental facts that beginners should be aware of.

  1. Intramuscular injections (IM) is the most effective way to absorb exogenous testosterone.

  2. Exogenous testosterone will shut down your natural production of testosterone and a full replacement dose is needed with any TRT protocol. You can expect full shutdown within about 1 month of starting a new protocol.

  3. Exogenous testosterone will hamper or eliminate your fertility.

  4. Exogenous testosterone (taken alone) will shrink your fruits. Anywhere between 20 to 50 percent.

  5. Exogenous testosterone will increase estrogen in most men.

  6. Serum levels with exogenous testosterone will take about 6 weeks to stabilize.

Labs:

  1. Before TRT you should take the following labs. It is recommended you do this twice, one month apart, if you can afford it. Please post these results to the forum or follow your doctors advice before staring a TRT protocol.

Total Testosterone
SHBG
Estradiol (sensitive)
CBC
CMP
FSH
LH
DHT
IGF-1
Hematocrit
Prolactin
PSA
25-hydroxy vitamin D
TSH
FT3
FT4

Now let’s talk about a beginner protocol.

  1. When staring a protocol it is important to find a doctor that will prescribe a full replacement dose. This is typically above 120mg per week up to 200mg per week. If prescribed less than the replacement dose, there is a good chance natural production will shut down and the exogenous testosterone will not be enough to bring testosterone levels to an optimal level. In that case, you will be worse off than when you started.

  2. Blood draws should be taken every 6-8 weeks until serum labels are stabilized and symptoms are resolved.

  3. When starting a protocol it is very important to start with 1 drug at a time. Staring with Testosterone, HCG, and/or an aromatase inhibitor causes too manly hormonal changes at once and it will be very difficult/impossible to tell which drug is doing what. Start with testosterone only; give it 6-8 weeks to stabilize, then reevaluate. THIS IS VERY IMPORTANT!

  4. Estrogen is not bad! Most guys on TRT do very well with estrogen levels above lab ranges. In fact, most guys need estrogen above lab ranges to help with libido and eliminate erectile disfunction (ED). A lot of doctors will prescribe an aromatase inhibitor (AI) to reduce estrogen to be within lab ranges while on TRT. This is an old train of thought and is not necessary in most cases. Due to side effects, an AI is not recommended unless there are extenuating circumstances.

  5. HCG is not recommended at the start of a protocol. It should only be used when fertility is necessary. If you are trying to have a child, it is recommended to get that done before starting a TRT protocol. HCG can return fertility and testicular size and is a good option when trying to conceive a child while on a TRT protocol. Your best bet is to think ahead. Although likely, there are no guarantees HCG will return fertility.

  6. Your fruits will shrink on TRT. HCG is an answer to that, but it may have unwanted side affects. As stated before, start with Testosterone only. I would highly recommend getting over your ego on Fruit size. If that is something you can’t get past, then add HCG AFTER fully optimizing your testosterone levels. You do not want to muddle the side effects of two or more drugs at the same time, or you will find it extremely difficult to know what dose and what drug is doing what.

Administration:

  1. Injection (IM or Subcutaneous (SubQ)) frequency should be no longer than once per week. Many guys need to split their dose into multiple injections per week. This should be the first thing to experiment with if you are not feeling the benefits of TRT. This is because testosterone levels will peak, then decline, after an injection. Injections closer together will keep serum levels from declining too far at the end of the week.

  2. SubQ injections are another choice of injection, but should only be experimented with after stabilizing your levels on IM injections. As stated before IM injections are the most efficient delivery system for testosterone. Some guys do well on SubQ injections, but keep in mind that exogenous testosterone can be stored in fat cells and there could be a long delay before it enters your blood stream. This has been know to cause unwanted side effects or inadequate results.

  3. Common IM injection sites are deltoids, thighs, and glutes. Pick a needle length that will go through the fat tissue and into the muscle for IM injections. This is dependent on how much fat you carry in certain areas. General guideline for guys 10-25% BF would be 1/2” need for deltoids, 1” needle for thighs, 1-1/2” needle for glutes.

  4. SubQ injections only require a 1/2” needle since you will only need to pierce the skin (usually on the side of the belly button).

  5. Needle gauge is a preference of the user. Generally a higher needle gauge is recommended for both pain reduction and squeamishness, but you pay for that with the time it takes to draw the medication. If using a syringe that can switch needles you can draw the medication with a lower gauge (18-21g) needle and inject with a higher gauge needle (27-30g). Just be aware that some amount of medication will be wasted in the needle tips when doing this, and of course you will be paying for 2 needles per injection instead of 1.

  6. Creams and gels are another method for administering testosterone. There are risks involved, spreading medication to a loved one on contact with skin, as well as absorption into fat cells and poor results as stated above. Many guys report doing better on injections over gels or creams. If going the topical route, then it is recommended to administer the cream away from the arms where blood is taken for testing. If gels or creams are present on the skin or fat cells at the blood draw site, then falsely high serum levels will be measured.

  7. Pellets and another therapies should not be considered. They are inconsistent and unreliable. They are not worth your money, your time, or your health.

To wrap up, here is my cookie cutter starting recommendation:

  1. Inject testosterone cypionate IM at 120-200mg per week. With injection frequency of once per weeks to start.

  2. After 6-8 weeks check your serum levels and you can tweak your protocol. If not feeling well at the end of the week, increase injection frequency. If not feeling well in general, adjust your dose and give the new dose 6-8 weeks. After 6-8 weeks, Unless serum values were indicative of another Underlying issue, then only the following labs need to be taken:

Total T
SHBG
CBC
Estrodiol (Sensitive)
Hematocrit

  1. Resist adding HCG and AI until you are optimized on testosterone only. Please ask for help on the forums before adding either of these two drugs. You do not need to muddy the water if a few small tweaks are all that is necessary to make you feel great. I will repeat that most that are optimized on their protocol do the best on testosterone only. HCG and AI use are outliers and to be used only when absolutely necessary.

I hope this helps. I only wish you all the best to you all in your journey to good health.

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I will contradict you a bit on the HCG topic.
I will speak my experience and at least 50 other guys Ive spoken to that share the same experience.

Taking testosterone only in our cases has lead to decreased seamen, orgasmic intensity and sensitivity down there which can suck BIG time.

Adding minimum effective dose of HCG seems to fix that issues in most cases

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I’m not sure what the Navy has to do with TRT.

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This is not necessarily true.

My wife said that my “fruit” aren’t noticeably smaller than they were 25 years ago.

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That is a very nice overview. I would add lipids and free testosterone to the initial evaluation, maybe drop DHT. Hematocrit is part of the CBC and does not need to be ordered separately. The immunoassay E2 test will suffice, you don’t have to get the more expensive LC/MS/MS test.

Also, most guys dosing once or twice a week use a 23g 1inch needle and use the glutes.

I think that is probably true for most, but I would say roughly one-third of the guys deny that, so many do not experience testicular atrophy.

Here’s my perspective on implementing TRT. I wrote this post a couple years ago in another forum because I kept getting asked the same questions over and over. So, I share the sentiment of needing a 'Best practices in TRT" sticky. However, given the varying opinions on certain subjects (especially E2 and the use of AI’s), I’m sure there will be debate. I only hope that forum etiquette prevails.

This post is for both the Newbies who want a basic understanding of a “good” protocol to formulate questions for their perspective docs or TRT clinics. Guys with experience in TRT might also find this helpful to consider if they should modify their current protocol.

My general philosophy for Testosterone Replacement Therapy (TRT) is that you want to make it simple and sustainable. You want to strive for consistency and minimize side-effects. I’ve been on my basic protocol for about 8+ years and have only made minor adjustments. It was prescribed to me by one of leading authorities in TRT. It’s simple and it works for me.

Type of Testosterone

  • I only have experience with Testosterone Cypionate (T-cyp), and that’s what I recommend. I’ve used both pure T-cyp and a blended with a small amount of Testosterone Propionate (T-prop). My experience is that it doesn’t make much of a difference. T-prop is faster to release than T-cyp, so it can be useful to jumpstart your TRT protocol to feel better faster, but we are only talking a day difference in when the two reach peak values in the blood.
  • *From what I’ve read, Testosterone ethanate (T-eth) has the pretty much the same absorption kinetics as T-cyp and can be used interchangeably. T-eth is more popular in Europe and T-cyp is more popular in the USA.
  • I do not have experience with gels or creams, but from what I’ve read they are messy and absorption is variable. Also, it’s just too difficult to absorb enough to help you if you have high SHBG.
  • I’ve never used pellets or scrotal patches, but pellets sound like a pain in the rear (literally) and the scrotal patch belongs in a medieval torture chamber (I think a woman must have invented it).

Dosing

  • Small frequent dosing is the key to success. This keeps you within the desired therapeutic range at all times. What folks (and many docs) just don’t get is that the more frequently you inject, the lower you can go on the overall dose, and the better you’ll feel because you eliminate that hormonal roller coaster to hell.
  • I suggest starting at a total of about 100 mg/week divided into at least 2 injections per week (e.g. 50 mg twice weekly) . However, I find that Every 3 Day (E3D) dosing is much easier to administer, gives more constant hormone levels, and makes lab testing easier because you don’t have to pick a specific day of the week for the lab draw (e.g., the 3-day or the 4-day interval). I recommend starting at 44 mg E3D (which is 0.22 mL of a 200 mg/mL solution).
  • After 6 weeks, you should retest for a minimum of Total T, Free T, and Estradiol (E2) and assess your symptoms. Have they improved? Have they improved enough? Use the results of these tests and symptom assessment to determine if you need a dose adjustment and/or need an AI to control E2 (most guys will not need an AI and it’s very difficult to dose). You need to wait at least 6 weeks after starting your TRT protocol because there’s a cascade of numerous downstream hormones and neuroendocrine changes that occur once you start TRT and it takes that long for your system to stabilize.
  • Most guys do not need to go over 120 mg per week if you use frequent dosing. However, you need to base your final dosing decisions on: 1) Free T levels, 2) How you feel, and 3) Your personal goals (some guys have gym performance as a goal and that’s OK).

Here’s some comparison graphs of the amount of testosterone released from T-cyp per day using various protocols. Keep in mind, that the average adult male secretes about 7 mg of T per day. I’m guessing that there’s about 45% variability in secretion rates because that’s the variability around midrange in LabCorp’s Total T ranges. So, the range for daily T secretion from the testicles is probably 7 ± 3 mg per day, or about 4 - 10 mg. For argument’s sake, let’s say we naturally top out at around 10 mg per day, which not so coincidentally is where I begin to feel my best.

Here is a graph of my prescribed dose at 0.2 mL E3D of 200 mg/mL T-cyp = 40mg T-cyp E3D = 93mg T-cyp/week. Keep in mind too that T-cyp is only about 68% T. The rest is the cypionate ester. As you can see by the graph, this protocol delivers an average of about 9 mg of molecular T per day after stabilizing at about 6 weeks (Range 7.9 - 11.2 mg/day over the 3 day injection cycle).


Compare this with an old but still used protocol of 100 mg/week in a single injection. This protocol delivers an average of about 10 mg T per day after stabilizing at about 6 weeks (Range 6.2 - 15.4 mg/day over the 7 day injection cycyle). Note that it is much more variable in both the peak and nadir (low point) T levels.
100 mg T-Cyp Every 1 Week
Now Compare this with the really archaic protocol of 200 mg/2 weeks sometimes still prescribed by some dinosaur docs. Again, this protocol delivers an average of about 10 mg T per day after stabilizing at about 6 weeks (Range 3.4 - 22.3 mg/day over the 14 day injection cycle). Note that it is much more variable in both the peak and nadir T levels. With this protocol too you spend significant amounts of time in both the superphysiological range (which define as over 10 mg/day) and frequently come close to the suboptimal range (which I define as less than 5 mg).

How to Inject

  • The great thing about small frequent dosing is that you don’t need a harpoon to get it into you. I recommend that you only use one-piece insulin syringes to draw up and inject. There’s no need to go bigger than a 25G needle. I MUCH prefer and recommend a smaller 28G 1/2 inch needle.

  • I recommend injection straight into (no angling) the upper middle quadriceps muscle (see diagram). If you’re using an insulin syringe, there’s no need to aspirate. You will not go deep enough to come even close to an artery or vein.

  • I do not recommend subcutaneous injections, though some have had success with this technique, but I always bruise when I use it. There have been some very recent publications that show that there is absolutely no difference in effectiveness with either IM or subcutaneous injections. Again, don’t let your doctor convince you that you need a harpoon to get it into the deep muscle tissue. It’s simply not necessary to endure that pain.


    Use of HCG

  • I highly recommend that you do incorporate HCG into your protocol. It replaces the lost LH/FSH signal and that is important for several reasons.

  1. It helps to maintain normal testicular size. Yes, it’s a cosmetic benefit, but what guy want’s almond size testicles?
  2. For younger guys it helps maintain testicular function and preserve fertility.
  3. For all guys, it’s important for synthesis of intermediary steroid hormones (like DHEA and Pregnenolone), which have various health-promoting functions in the body.
  4. For all guys, it helps to maintain normal ejaculate volume. There’s good histological evidence that the seminal vesicles, which produce about 60% of the ejaculate, need both T and LH to function properly. HCG substitutes for the lost LH while on TRT.
  • I recommend a dose of at least 450 IU per week divided into at least 3 doses (e.g., 150 IU M, W, & F). Alternatively inject on an E3D protocol.

  • If you desire to conceive a child while on TRT, consider increasing your HCG dose to 1000 IU per week. There is really good evidence from two publications that about 1000 IU per week will restore normal intratesticular testosterone (ITT) values. ITT is a well-known marker of fertility. Here are two peer reviewed papers that support the use of 1000 IU of HCG per week to help maintain fertility while on TRT: https://www.ncbi.nlm.nih.gov/pubmed/15713727 and https://www.ncbi.nlm.nih.gov/pubmed/...t%3A+an+update. Both are available with free full text. The first one is particularly interesting. You have to do a little digging and interpreting the data to fully understand the implications. When you plot out the recovery to baseline Intratesticular Testosterone (ITT) levels in the groups receiving various doses of HCG (see graph below), you see that it crosses 0% suppression at a dose of about 1000 IU per week. That is, in healthy adult male subjects receiving a whopping 200 mg T-eth per week, approximately 1000 IU of HCG was able to fully restore ITT levels (a known marker of fertility).

  • Even if fertility is not your goal, I do believe there are benefits to 1000 IU per week. I personally use 450 IU on an E3D dosing schedule (same days as my T injections), which amounts to 1,050 IU per week. Keep in mind that HCG is the most expensive part of your protocol, so if you are price-sensitive, you can certainly get by with a lower dose.

Use of an Aromatase Inhibitor (AI) or Estrogen blocker

  • If you stick to the recommended protocol of small frequent dosing, you should not need an AI or E blocker.

  • NEVER start an AI unless you have the correct labs to show you are high in E. It’s a simple fact that in the human body, E is made from T. If you keep T within normal physiological ranges at all times, E should also remain within normal physiological range.

  • GUYS NEED E TOO. Without we go limp with a bad case of ED. We also need it for normal libido and for growth hormone secretion. I’ve seen way too many guys crush their E with an aromatase inhibitor (AI) like Arimidex (anastrozole) and then wonder why TRT is not working for them.

  • Guys get nipple erections too! Most guys who have low T also have low E and have forgotten what it’s like to have nipple erections when stimulated. When their T suddenly comes back into range and their E climbs back to normal, they start getting normal nipple erections and immediately think they are coming down with gynecomastia. This is simply not the case if you are dosing properly.

  • If you have labs to support you need an AI, I strongly suggest you try the ‘Vodka/Eye Dropper’ method. It’s the only way I’ve found to dependably dose small amount of anastrozole. Even with this method, it is still difficult to accurately dose an AI.

  • There’s a lot of controversy surrounding E2 and whether anyone should use and AI at all. I’m in the camp that is should only be used if E2 goes way out of range (which I define as >100pg/mL) and/or you are messing with other synthetic anabolics which have progesterone-like activity (i.e., nandrolone). The combination of high E2 and high progesterone is a recipe for gynecomastia. Add in high prolactin, and guys can even begin to lactate. I’ve seen videos of bodybuilders lactating. It’s not pretty!

The minimum Pre-TRT Labs you should have done

  • If your doc won’t order them, get them done yourself. Here’s a source that I regularly use to supplement my doc’s once per year testing. https://www.discountedlabs.com/
  • Minimum labs for screening for low T: Total T and especially Free T.
  • Minimum follow up labs if either or both Total T or Free T (the more important of the two) are low: SHBG, LH/FSH (first thing in the morning!), PSA, Estradiol (sensitive LC/MS/MS method only!), Lipids, CMP, CBC.
  • Consider also: Prolactin, DHT, TSH, Free T3, Free T4

Follow Up Labs

  • You should never do a dose adjustment or add in an AI without labs to support that you need it.
  • I suggest you follow up at least twice per year with the minimum follow up labs discussed above.
2 Likes

What website did you use to generate those graphs?

Edit: Found it at https://www.steroidplotter.com/

Hey, thanks for finding it! now I understand why the link I’ve been using doesn’t work. They changed their web address.

I’m not so sure this tool is very accurate. I get what the overall gist is supposed to be, but it doesn’t seem to account for absorption rates.

For example, serum concentrations for Test-C seem to be assumed to be at maximum on the day of injection, where in reality they would be at maximum several days afterwards.

You are correct it is just a tool, I use it because it make it easier to educate guys on the differences between long and short intervals. More importantly, it does not predict serum T or (more importantly) Free T. Serum levels will vary depending on a number of factors, probably the most important being SHBG levels.

I encourage guys to do their own dose-response testing to optimize their protocols. Not only looking at lab results (i.e., Free T), but also how you feel. I see way too many guys jumping to unnecessarily high doses with infrequent (e.g., weekly) protocols with the thinking that more is better. Not necessarily so.

Why?

Here are two good reads on the subject. Both are available OPEN ACCESS at the links.


The first is a position paper from the Endocrine Society on the challenges of measuring E2. It covers both men and women. For a quick synopsis of men, read the first paragraph on that subject on page 1382. Here’s and extract:

Comparison of the measurement of 12 steroids by GC/MS or LC/MS/MS
and 6 steroids by RIA in fasting samples from 20 healthy
men (aged 50–65 y) revealed significant differences. RIA
showed higher E2 levels, suggesting greater cross-reactivity
compared to other methods (336 compared to 21
5 pg/mL). Although each assay showed good reproducibility,
the authors caution about comparing absolute levels
across assays or studies (55). Thus, concordance in
assays is required to define normal and abnormal E2 levels
in males.

Don’t start with HCG. There’s too many folks that have issues with it. Start with T only so you know how you respond then later if you feel the need add HCG.

Start at TRT at 150mg/week and go from there. 100mg is going to be too little for most. You can argue those people can always adjust their dosage higher but I’ve found its much easier of a transition to decrease dose than it is to raise it. Plus a majority of folks on TRT are at 150-200mg/week and doing fine.

IA LC 15-21

IA LC 21 18 IA LC 23-23 IA LC 26-21 IA LC 28-27 clear IA LC 33-31 IA LC 37-49 IA LC 38-52 IA LC 41-53 IA LC 50-68 IA LC 55-79

I just have not found any differences in the two to be clinically significant.

ECLIA vs LC/MS/MS TESTING FOR E2

The ECLIA test (aka immunoassay or IA) for E2 management is commonly used for those on TRT. It is not an incorrect test or a test for women, but simply one way to check estradiol levels. The other commonly utilized test is the LC/MS/MS method (aka liquid chromatography dual mass spectrometry, sensitive or ultrasensitive). It is the more expensive of the two. There are inherent advantages and disadvantages to each of these two methods. I have been fortunate to be able to speak with professionals who work with both methods. One is a PhD researcher for Pfizer and the other is a medical doctor at Quest. I’ll summarize their comments.

The ECLIA method is the more reliable of the two in terms of consistent results. The equipment is easier to operate thus accuracy is less reliant on the skill of the operator. If the same sample were to be tested twenty times, there would be very little, if any, difference in the results.

The ECLIA method is not as “sensitive” in that it will not pick up E2 levels below 15pg/mL. If your E2 level with this test is 1-14pg/mL, the reported result will be “<15”. Because of this, it is not recommended for menopausal women, men in whom very low levels of E2 are suspected, or children. In other words, if your levels are below 15pg/mL, and it is important to know if the level is 1 or 14pg/mL, you do not want this test. For us, this is likely moot, since if you are experiencing low E2 symptoms and your test comes back at <15, you have your answer. For a woman being treated with anti-estrogen therapy for breast cancer, it may be necessary to know if the E2 level is zero or fourteen because therapeutically, they want zero estrogen.

A disadvantage to IA testing is that it may pick up other steroid metabolites, which in men would be very low levels, but still could alter the result. Another potential disadvantage is that elevated levels of C-reactive protein (CRP) may elevate the result. CRP is elevated in serious infections, cancer, auto-immune diseases, like rheumatoid arthritis and other rheumatoid diseases, cardiovascular disease and morbid obesity. Even birth control pills could increase CRP. A normal CRP level is 0-5 to 10mg/L. In the referenced illnesses, CRP can go over 100, or even over 200mg/L. Unless battling one of these serious conditions, CRP interference is unlikely.

The LC/MS/MS method will pick up lower E2 levels and would be indicated in menopausal women and some men if very low E2 levels are suspected and it is desired to know exactly how low, children and the previously mentioned women on anti-estrogen therapy. It will not be influenced by elevated CRP levels or other steroid metabolites.

While some may believe the ECLIA test is for women, on the contrary, as it pertains to women on anti-estrogen therapy, such as breast cancer patients, the LC/MS/MS is the test for women as CRP levels are a consideration and it is necessary to know if the treatment has achieved an estrogen level of zero.

On the other side of the coin, LC/MS/MS equipment is “temperamental” (as stated by the PhD who operates both) and results are more likely to be inconsistent. Because of this, researchers will often run the same sample multiple times.

It is not clear if FDA approval is significant, but this appears on Quest’s lab reports: This test was developed, and its analytical performance characteristics have been determined by Quest Diagnostics Nichols Institute San Juan Capistrano. It has not been cleared or approved by FDA. This assay has been validated pursuant to the CLIA regulations and is used for clinical purposes. This statement is on LabCorp’s results: This test was developed and its performance characteristics determined by LabCorp. It has not been cleared by the Food and Drug Administration.

It is unlikely that any difference in the same sample run through both methods will be clinically significant. Estradiol must be evaluated, and it should be checked initially and ongoing after starting TRT. It obviously makes sense to use the same method throughout. Most important are previous history and symptoms related to low or high E2. Those are correlated with before and after lab results. Any estradiol management should not be utilized without symptoms confirmed by lab results.

Bullshit. You want this to be a sticky? Back it up with evidence. There are a half-dozen things that are questionable before I got to pellets.

Besides pellets, there are a number of gel users that would disagree with you.

I’m guessing your source for everything is t-nation only.

How about this for beginners: GO TO A DOCTOR and don’t read posts from people who think they have mastered the TRT world.

2 Likes

Reading comprehension issue? Where did I say I wanted this thread to be a sticky? What I said was

“ This post does not need to be a sticky (of course it is welcome). And maybe a more experienced member can write one, but I would like to try to get this rolling.”

In the same paragraph I stated I wasn’t an expert, and not even one of the more experienced members.

“ This post does not need to be a sticky (of course it is welcome). And maybe a more experienced member can write one, but I would like to try to get this rolling.”

I think you’re trolling at this point. I stated a couple of facts about gels. I didn’t even dismiss it as a viable protocol. All I said is there are risks of it transferring, and that injections are more efficiently absorbed.

As far as pellets are concerned, I haven’t heard much good about them, only guys with complications and inadequate results. If you believe differently, then feel free to post your experience with pellets. Like I said, I only wanted to get the ball rolling on a discussion to come up with a sticky tread.

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although going to doctor is recommended, its not the end all be all.

Forums like this literally exist because doctors are failing their patients left and right.

If you don’t agree, just come with evidence to the contrary and state your opinons. Nobody said this was dogma.

But being butt hurt doesn’t help a thing.

My experience with pellets.

You are giving advice on something you admit to knowing nothing about – only “haven’t heard much good about them”.

Thread Title: Beginner Protocol Sticky Recommendation.
Just after the reading comprehension comment

Yet you feel confident in making a blanket statement that “Pellets and another therapies should not be considered”.

And Barryallan1, I am far from butt hurt. What I am is a person who wants to stop incorrect statements from being made without the slightest inkling of evidence – or even experience or knowledge.

The OP admits to knowing NOTHING about pellets, yet feels qualified to tell people to stay away from them.

You’re saying pellets are a viable option for beginners? Why? And why over other protocols?

I didn’t say I didn’t know anything about pellets. I know quite a bit. I said I haven’t heard much good about them. That is a lot different than saying I don’t know anything about them. Nice try twisting my words.

This post is about beginner protocols and I don’t think pellets should be considered as a beginner protocol. Why? Because there is no way to adjust your dose without going in for surgery. There is no way to stop your treatment without surgery. There is no way to fine tune your dose. Your dose on pellets declines over time resulting in suboptimal serum levels towards the end of the treatment cycle.

It is common sense to start with the most flexible and effective form of administration, have the ability to make changes, and know how the drug is affecting you. Pellets are not that.

If pellets work well for you, I’m am glad for you.

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Some people just can’t inject themselves with needles, others are away from civilization for long periods, so unless someone meets these specific circumstances I would never recommend pellets to newcomers to TRT.

I haven’t heard too many positive experiences regarding pellets on any forum, quite the opposite, but every now and again you hear it working well for some folks and they are in the minority and have heard the doctors make the same claims.