T Nation

Does this Sound Right? Starting w/ HCG and an AI?

Hey what’s up guys? Posted here a few weeks ago and decided to go ahead with TRT.

38 y/o, super high SBGH, low free T. Symptoms include fatigue, brain fog, depression/anxiety, difficulty gaining muscle etc. Weight is 150. Height is 5’10". I’m a skinny dude.

Doc at the specialty clinic gave me this protocol to start with:

150mg T-Cyp 1x per week
500IU HCG 2x per week (last 2 days of week before T injection)
1mg Anastrozale 1x per week
5mg Danazole 1x per week (to lower SHBG)

Schedule that they gave me:

I see a lot of guys on the forum who recommend starting without an AI.

Total noob here, so I’d love to hear some feedback. Does this protocol sound decent? Would you recommend any changes?

Here are my labs:


You shouldn’t have been started on an AI without expecting high estrogen do to obesity or labs and symptoms of high estrogen. You’re lean and aren’t expected to have high estrogen, an obese guy is expected to have high estrogen.

If fertility is of no concern and you’re done having kids or you don’t care about a little testicle shrinkage, you may not need the HCG and may feel better without it. Some men who have been on TRT long term when trying to get the wife pregnant will restart HCG and if HCG isn’t enough add FSH injections alongside the HCG to increase sperm production.

There are also some men who seem to benefit from HCG, wellbeing and libido improvements.

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That’s an interesting approach. I think I would have started with 200mg once a week. With that, hope to get your total test to 900 and double your free testosterone. I would expect SHBG to drop, but not sure by how much. It may remain high enough to negate any adverse effects you may have from high E2.

No hCG unless you want children now. No anastrozole. No danazol.

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I would definitely not take the anastrozole initially. Your E2 is only 16.6 now with a total test of 666.7, no way do you need that. Your E2 is too low already, hopefully TRT will bring it up a little. I don’t know much about danazol.


Thanks so much, guys. Think I’m going to start with just the T and the Danazol. Can you tell me what the reasoning is for not doing the HCG? I see in the sticky for protocols that it does recommend HCG. I’m not worried about fertility, but it would be nice to not have my balls shrink. I also see the note about HCG helping your body/balls to continue to produce pregnelone for mental performance in the sticky.

And I think I’m going to split the T dose into 75mg twice weekly. Does that make sense @systemlord?

Really appreciate the feedback. This forum has been amazing as I gear up to get started with this. Looking forward to reporting on back on how everything goes!

There is your reason, testicular atrophy. Purely personal and subjective. However, if it the pregnanolone you’re after, just supplement that.

It’s not going to hurt you to inject more frequent, it can only do more good. I would start out on 75mg twice weekly and the Danazol, then months later give the HCG and try and see how you feel, if you notice you feel worse, then you know HCG may not be for you.

If you start out on TRT and HCG you will not be able to determine what is causing the problems because there are too many moving parts to analyze.

Some men only see a small reduction is testicle size, so it may not be the problem you believe it will be. My testicles hang maybe 20% less when estrogen isn’t elevated.

Ok. Ended up injecting 150mg on Monday. So it’s been about 2 days. No HCG/AI etc. Feel kind of shitty so far. Anxiety and whatnot. Normal at this early stage of the game?

@systemlord I’m a patient at Defy and on eod I kind of want to switch to ED just for the routine basically. Is this something i should talk to them about? Would they be looking for a consult fee just for me to call and tell them my plans? Or is it something I should just do and mention at my follow up? @hrdlvn do you have any thoughts on this?

I had it bad for a a while too. Pretty sure it increased my cortisol at first.

Do you have any anxiety/ptsd type stuff? I have PTSD issues, and it seemed to exacerbate them at first.

It goes away eventually.

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Just do it. No need to contact them. Make sure you keep your weekly dose the same you don’t want to run out early. They will not give you more until your scheduled script refill time.

I was just going to split the same dose up furthur. Im sitting on a couple years worth my dose but I’m not messing with it unless im going to blast when i have an adequate time span. However I just realized i only have like 3-4 weeks until i will be getting labs done so im thinking i should probably wait till after that. Im sure it wouldn’t change things drastically but i guess technically things could be flucuating when i get them done

Hi Michigan, Starting out on TRT can have a ton of bad sideffects. Mood swings, water weight, sore nipples, acne, the list is huge. The good thing is they go away on their own in time. Something I have noticed is guys who start out with large doses for their first protocols seem to get the most and worst side effects. Guys who start low like 80-100mg/wk even though this is not the best dose in the long run get used to the injected T with less bad side effects.
So I am suggesting you cut your 150 to 80-100 just until you get thru the side effects. If your balls start aching get back on the HCG there are lots of reasons to take it it is not just for future kids. Good Luck

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It’s 100% normal, when you inject exogenous testosterone, your bodies natural production will shut down in 1-3 weeks and where you had both the natural testosterone and exogenous testosterone in your body, now you are left with just exogenous testosterone and now have to spend 6 weeks building up the half lives in your body.

HCG and an AI would send you into full on extra symptoms on top of what you are already dealing with. TRT, HCG and AI’s is the worst way to start out. So many end up on TRT in isolation with maybe a small dosage AI if they are obese at the start.

It’s shock to your system to be injecting 150mg of T and even though it’s mostly attached to the ester, you’re still getting more than what you body produces naturally everyday, we naturally produce <10mg daily.

If you think about it men just starting out on TRT have more in common with women on their period or menopause, these hormonal profiles on TRT are not natural.