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 I know in the past there has been a sticky thread for a beginner protocol, but it is now out of date and removed.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.
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Intramuscular injections (IM) is the most effective way to absorb exogenous testosterone.
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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.
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Exogenous testosterone will hamper or eliminate your fertility.
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Exogenous testosterone (taken alone) will shrink your fruits. Anywhere between 20 to 50 percent.
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Exogenous testosterone will increase estrogen in most men.
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Serum levels with exogenous testosterone will take about 6 weeks to stabilize.
Labs:
- 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.
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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.
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Blood draws should be taken every 6-8 weeks until serum labels are stabilized and symptoms are resolved.
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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!
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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.
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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.
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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:
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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.
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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.
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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.
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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).
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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.
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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.
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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:
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Inject testosterone cypionate IM at 120-200mg per week. With injection frequency of once per weeks to start.
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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
- 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.