T Nation

Doctor Gave Me Bad Regimen, How Do I Fix It?


#1

I’ve not been feeling right the whole time Ive been on TRT (9 months) my libdo and erections are non existent. I know Ive waited too long to research this but now that I have I realize my doctor might not know what he is doing.

I was prescribed
Test- E 200mg one shot per week, anastrolze of 1mg per day and HCG daily .5ml bottle is 10,0000 IU.

From what i’ve read here the Anastrolze at 1mg per day is really high and should be at .5 every time I Inject. and I should probably split my test shots to every 3.5 days vs 1 per week.

My question is can I just cut the daily Anastrozle out and switch it only to injection days or will this further damage my system.?

I recently started getting back in the dating scene and not being able to get it up is really messing with my mind.


#2

Wait a minute, have you really been taking 1mg AI daily? 200mg once weekly is insane unless your SHBG is super high. It’s so no wonder your having problems, you need to post your labs including SHBG, this will dictate how often you should be injecting. Unless you have high SHBG you should be injecting twice weekly. You’re supposed to base you AI dose off of your E2 labs, LC-MS/MS method.

You likely have extremely low E2 which is dangerous long term! You also need to find a competent doctor, the one you currently have should be disciplined for prescribing an AI dose designed for a female with breast cancer. There’s no way in hell that protocol would work for anyone, that protocol is setup up to fail!

You want a protocol better suited to you, post all your labs including lab ranges.


#3

Sorry maybe I put that wrong the test is 1ml week. Yes I’ve been taking 1mg per day for about 9months.

I’ll call and get copies of my labs tomorrow.

Should I take my AI dose today or can I just cut it cold turkey?

Thanks


#4

1 mg a day is crazy. Your rock solid bottomed out on E2 guaranteed. It’s a terrible place to be. You need to get a better doctor or educate yourself enough that you can manage your condition within the confines of his practice. 200 mg a week is high. I would talk to the doctor about dropping to 100 mg split in 2 doses unless like systemlord said you have drastically high shbg. Post bloodwork.


#5

Ok but can I just stop the AI or do I have to continue at this point?


#6

You can figure 1mg per 100mg of t.
Reference sticky TRT: Protocol for Injections


#7

You can stop the AI whenever the hell you want you just have to understand that E2 will rise. I’m sure you are crashed out hardcore so a rise in E2 would be a welcome thing. At 200 mg it shouldn’t take to long to bring E2 back up.


#8

Most Cypionate and Ethanate vials come in 10mL 100mg/mL and 10ml 200mg/mL, so if you inject 1mL from a 200mg vial than it’s 200mg, 5.mL would be half that which would then be 100mg. Most guys start out injecting 50mg twice weekly as most inexperienced doctors start guys out way too high, 100mg total weekly is the gold standard in the beginning and then you get a baseline and increase or decrease based on labs. Monitoring E2 levels is important, if E2 levels get high it prevents testosterone from working and you will not get better.

I know for a fact that your doctor has failed to monitor your E2 levels otherwise action would have been taken to address what must be super low E2 levels, most doctors fail to monitor E2 levels including my own. When it comes to male hormones most doctors are clueless, being able to interpret lab value is an art form and like most artists only a few are exceptional.

You need to educate yourself so you can vet a doctor that is clueless, you are the customer and the first visit should go like an interview, you interviewing the doctor to see if their qualified enough. Ask question about their protocols and if the monitor E2 levels and prescribe HCG, if not walk out of the office and keep looking for a new doctor. Use the internet and look for reviews from people who have been to a doctor you are considering.


#9

what is the best AI to be taking and how much ? i will be starting TRT with HCG 400iu 3x / week and 100mg test (.5 ml 1x/week)


#10

We need your pre-TRT labs to be able to make suggestions. Mainly E2 levels, if they were midrange or even towards the high normal then we would be in a better position to make a good suggestion. Make sure your E2 labs are LC-MS/MS assay method. If you don’t have those correct labs 1mg of AI per 100mg of testosterone, if you inject twice weekly take .5mg at time of injection. Note some guys are over responders to AI’s, redo E2 labs in a few weeks.


#11

I have posted my full infomration and labs on my forum here: 25 Y/O, Low Test.. Should I begin long term TRT *need advice*

but my doctor never checked SHBG … and he is supposed to be a specialist and runs a mens clinic , another member mentioned to have this checked before I begin TRT . would you agree? I want to do this the right way for me .

How would a protocol change if my SHBG is high or if it were to be low? does that change the Test dose or what?


#12

If SHBG is high you need large injections of T to force overly high SHBG down to free up some FT, SHBG goes down FT goes up and you feel better. Low SHBG you need smaller injections otherwise you will force already low SHBG even lower, you still need SHBG to activate T to the receptors.

Back when I was on 75mg weekly the improvements were subtle, then I went to 50mg twice weekly which was little better, it wasn’t until I started injecting 25mg EOD that my muscles really started getting sore and harder. I had some high E2 symptoms and reduced dosing down to 20mg EOD, it’s been 3 weeks since I lowered it and am already feel better. My erections seemed to come alive on 25mg EOD, but now at 20mg EOD they seemed to have waned.

My point is everyone has a sweet spot that is unique to them and why these cookie cutter protocols will not work for everyone.


#13

BeastMasterz are you in miami fl by any chance ? Curious if we have the same doc…


#14

Please read the stickies found here: About the T Replacement Category

  • advice for new guys - need more info about you
  • things that damage your hormones
  • protocol for injections
  • finding a TRT doc

Evaluate your overall thyroid function by checking oral body temperatures as per the thyroid basics sticky. Thyroid hormone fT3 is what gets the job done and it regulates mitochondrial activity, the source of ATP which is the universal currency of cellular energy. This is part of the body’s temperature control loop. This can get messed up if you are iodine deficient. In many countries, you need to be using iodized salt. Other countries add iodine to dairy or bread.

KSman is simply a regular member on this site. Nothing more other than highly active.

I can be a bit abrupt in my replies and recommendations. I have a lot of ground to cover as this forum has become much more active in the last two years. I can’t follow threads that go deep over time. You need to respond to all of my points and requests as soon as possible before you fall off of my radar. The worse problems are guys who ignore issues re thyroid, body temperatures, history of iodized salt. Please do not piss people off saying that lab results are normal, we need lab number and ranges.

The value that you get out of this process and forum depends on your effort and performance. The bulk of your learning is reading/studying the suggested stickies.