T Nation

Current TRT Protocol, Changing to SubQ

I started TRT about 5 months ago after getting bloodwork done (40yrs old). Had been mentioning a variety of symptoms to my primary care for years and each year I would get blown off and told "This is normal, getting older and stresses due to work/family life). Ended up going elsewhere, this is where my levels were at the time:

Testosterone: Serum: 294
Free Testosterone: 7.1
DHT: 19
DHEA: 142
T4: 1.19
TSH: 0.793
LH: 5.3
Estradiol: 11.7
IGF-1: 127
T4: 6.6
T3: 122
Insulin: 6.7
T3 Free: 3.3
SHBG: 33.5

Doctor put me on the following protocol for the first 10 weeks:

200mg Test Cyp per week
200mg Deca per week (to manage bad joint pain in knees)
500IU HCG twice per week
1mg Anastrozole twice per week

Everything went well, feel better than I could ever remember feeling in over a decade.

For the next 10 weeks, the only change was the removal of Deca (knees felt amazing). I ended up running into a few issues:

I started experiencing joint pain in my shoulders/elbows, something I had never had issues with before, to the point where I was missing workouts. In addition, I started battling lethargy, to the point where I was having trouble staying awake at points during the day. From reading around, it sounds like there could be two causes. My body is metabolizing the test rather quick. Also, my E may be crashing. I spoke with the Doctor, just waiting to get the script so I can get bloodwork done. His thoughts were it is possible that 1mg Anast 2x a week was fine when Deca was included, but once removed my E shot down.

Do the symptoms I mention sound like crashing E (obviously without bloodwork to confirm yet)?

I am thinking about just dropping the Anastrozole to 1x a week for now to see if that helps.

Also, I will move to 100mg Test Cyp 2x a week. My question on this, right now I am doing IM injections into my quads every week. Would it be just as effective if I changed over to SubQ injections (especially if I am going to be injecting 2x a week, I would prefer to get away from IM if possible)

2 mg of adex is too much. I take .375 mg per week, and that has me just about right.

You are probably on the right track thinking it is low e2.

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So just a quick update. I just changed my protocol to 2x a week (100ml Test each shot), going SubQ. Definitely prefer over IM, although it does take a while to get the oil loaded into the pin.

I have bloodwork scheduled for tomorrow, so that should hopefully give me a better view of where all my levels stand. I believe when I first started TRT my E was already on the lower side (11.7 where the range is 7-42), so I have to think that the Anastrozole dosage I was taking was crushing my E levels. It in part defeats the purpose of TRT if the joint discomfort kills my workouts.

You are right. 2mg a week is insane.

You should drop it asap.

200mg a week MAY Require an ai but no where near 2 mg let alone 1mg.

Your goal imo should be to eliminate the ai and adjust the dose so you can keep the estradiol where you have no high e2 symptoms.

I inject 100 a week no ai. That puts me over mid range in total t and free t. Am sure 200 would put be way high and I don’t want that on long term trt.
Am 42

Keeping your e2 low can do permanent damage. Dr failed you with 2mg a week.

You will get symptoms as your e2 goes back up but you need to stick it out and let everything stabilize. Can take a couple of months. Depending on you results you will probably reduce your dosage of testosterone.

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Ok, just got my bloodwork back (range in parenthesis):

Testosterone: Serum: 1,300 (264-916)
Free Testosterone: 33.8 (6.8 - 21.5)
DHT: 90 (30-85)
DHEA: 123 (102-416)
T4: 1.15 (0.82-1.77)
TSH: 0.65 (0.45-4.5)
LH: 0.1 (1.7- 8.6)
Estradiol: 11.3 (7.6 - 42.6)
IGF-1: 221 (83-233)
SHBG: 35 (16-55)

A couple things to add:

  • Test is 100mg 2x a week
  • About 1-2 weeks prior to bloodwork, deca was added in (100mg 2x a week, plan to drop to 1x a week soon) to hopefully help alleviate the joint issues
  • About 2 weeks prior to bloodwork I had dropped my Anastrozole dosage from 2mg per week to 1mg per week.

Given my Estradiol is still relatively low (it is actually slightly lower than when I started therapy), I am guessing that when I was at 2mg per week of Anastrozole it was crashing my E. For now, I have stopped taking Anastrozole and will just keep an eye out for rising E symptoms, does that seem logical?

Also, should I be concerned about the low LH?

The best thing for your joints is not deca it’s estradiol being over 20.

LH and fsh will be close to 0. You are shutdown once you introduced the testosterone. No need to test that anymore.

I wonder what you CBC looks like on these numbers??

I don’t think it’s healthy to run your high testosterone levels long term.

Shoot, sorry, email notifications were going to spam

My CBC numbers all came in line, pretty much right in range. I am do to donate blood soon.

I wish I had done the bloodwork two weeks prior to adding Deca so I could see where my levels were at without. I will make sure next time I get bloodwork done I am only on test (I think I only have a few weeks left of deca as of now).

Haven’t used an AI in over 3 weeks now. Joints are starting to feel better (combined with Deca). Had a little nip sensitivity these past few days, so possible just do something like 0.5mg of Anastrozole weekly.

NO… Stop taking anastrazole.

STOP…

If you don’t heed my words, you WILL regret it when you cant workout because of your FUCKED joints. Stop taking anastrazole, lower dose if you need to, but your are absolutely crushing your e2.

Agreed. Haven’t taken anastrazole in almost a month now. Aside from bloodwork, anything else I should be on the lookout for that may indicate my e2 is getting too high? So far only thing I have noticed is periodically I will get some nipple sensitivity, but that is pretty much it.