T Nation

Dr Wants to Up Dose of TRT to 300mg/Wk


Results back,
at Lab-Corp
E2 at 31 20-47
TT 493.14 205-781
SHBG 22.3 13.3-89.5
FT % 2.57 1.60-2.90%
FT calculation 127 33-227
Bioavailable 297 131-682

2 weeks earlier the private lab "CK labs
did ultra sensitive and
E2 53.4 1-47

Dr today upped my script from 1 Ml (200mg) a week
1.5ml a week (300mg)
and increase Anastrozole from 1.5mg to 2 mg a week spit into even doses

said the E2 is under control but with increase T we increase AI equally.
Said at my weight the increased dose should bring me to a 700+ TT which should help my continued symptoms of low energy, low libido. and possibly help Ed problems.
He Still thinks Hcg is a waste of time and money at my age and increased T is better approach.
Testicular pain has stopped the last couple weeks, he said that would eventually happen.
but if I took Hcg my testes will reactivate, E2 would be harder to control (due to testicular Test.) and if I stopped taking Hcg the testicular pain will start all over again and last until complete shut down. Makes sense there?
BUT doesn't 300mg a week sound a bit high for TRT? or since my other blood labs are great just try it and see how I do?


We have some T hyper-metabolizers here who typically require 300mg/week.

What is missing from your post is how often you inject per week and when the labs were done relative to prior injection.

For most, 250iu hCG EOD does not create any E2 issues. You can rationalize testicular organ failure any way that you want.

Inject T twice a week, take anastrozole at same time. Always to labs 1/2 way between injections, not at time if office visits.

With your T metabolization rate, EOD injections 1.5ml/3.5 would be a good idea, with anastrozole 0.5 at that time.


It is possible that you are a hypermetabolizer, but hypermetabolizers are usually people with very low SHBG, which is not your case. So just make doubly sure that you are in fact injecting the dose you think you are injecting, and that the testosterone is in fact 200 mg/ml and not 100 mg/ml. Are you getting a pharma brand or compounded? If compounded, it could be mislabeled or prepared incorrectly.


Yes I self inject currently .5ML T 2x a week
injected Sunday pm and tested on Tues afternoon
Next injection due Thur am
The increased dose would be same protocol 2x a week but .75ml each
A-dex with new dose would go to .5mg sun am, tues am, thur am, fri am total 2mg a-dex/week
currently Same spacing schedule but just the 2 doses that are not on injection day are .25mg so currant protocol total 1.5mg/week
yes test cyp 200mg per 1ml
E2 started at 79 before a-dex 7 months ago first tested at 12 weeks on TRT when face was burning, hot flashes, bloat and BP elevated those issues changed almost immed on A-dex


When injecting twice a week, and all the more when a hyper metabolizer, you will do better taking anastrozole only at time of injections so curve of serum anastrozole dosing roughly tracks T curve.

It is very unusual to need that much anastrozole. Serum T levels are a balance of E2 production and E2 clearance in the liver. Do you have labs for AST/ALT? 2.0 mg anastrozole per week is a lot and my calculations indicate that with 300mg T/week, you will need 3mg to get near E2=22pg/ml.


ALT 68 (7-52)
AST 32 (13-39)
That could be a big factor, but what is the fix for poor liver function?


Now we see some interesting numbers and want to know “why”. The first thing is to be aware that training and sore muscles can also increase AST/ALT. So does that apply to you when the labs were done?

Liver can be affected by:

  • diseases/conditions
  • drugs, OTC or Rx
  • chemical exposure
  • too much alcohol/weed
  • some things applied to your skin
  • some foods, like too much grapefruit


No alcohol no weed
no grapefruit
Chemical exposure? I ha worked in paint and body for years as youth but out of that 25 years
Well water in N ga. mountains (been tested) but chemical exposure is a hard to determine
Meloxicam is a concern !!! hard on liver, and many years of Ibuprofen before Meloxicam
Sore muscle YES SIR training for a Power lifting event in march, been training heavy through those labs, train 4 days a week pretty intense… cardio 3x a week 20min each on bike (helps knee issues)
Fatty liver yes
I would be interested in heavy metal testing always been a concern of mine because of years of symptoms
Even though Dr wants to go up on T and A-dex I really want to go down to 100mg a week possibly eliminating need for AI and see if I still feel the same or better


You don’t say how you are feeling. How are energy, libido? If those are fine I wouldn’t worry much about precise lab values.

If libido or erections are a concern, drop Saw Palmetto - it can negatively affect sexual function in some men.

Same goes for DHEA if either of those concerns exists or you have bloat. DHEA may cause elevated estrogens in many men.


libido very low, Ed problems for years before TRT but worse in the past several months. Morning wood great. but oral ED meds have stopped working in last few months


I would want to look deeper into what would have caused the low T and your symptoms, diet, stress, meds etc. More info on you and your tests would help. what part of N Ga are you in ?


Blue Ridge ga 5 miles from Tenn. border. I don’t know why low T. My theory, in my 20’s I would not take pharmaceuticals when in my prime weight lifting days but took all the BS over the counter crap. androtestin, tesatropinol, DHEA, noratestin, and much more, you name it I took it, I think that’s the possible culprit. I’ve had problems for 15++ years since I quit that practice.


[quote]jimp4155 wrote:
libido very low, Ed problems for years before TRT but worse in the past several months. Morning wood great. but oral ED meds have stopped working in last few months[/quote]

Yeah, then definitely drop the Saw Palmetto (and any other vitamin supplements containing it). And experiment with dropping the DHEA - DHEA gives me major ED unresponsive to boner pills.


I’d be able to compete in the Mr.O next year on that dose.


I don’t know about competing in Mr. O comp. at 300mg/week? but my theory on TRT is find the lowest dose that gets results. I’m going to cut the DHEA and saw palmetto. Also going to slow down on trying to fix problems with Rx and try to cut weight a little more consistently and see where that takes me. Thanks guys your help is appreciated


TOtal 25 OH Vitamın D  =  15 ng/ml

Hard to read that mess!
?? Vit-D25 = 15??
Is your fasting cholesterol low? <=160

Very safe and effective as daily mg dose is very low
Only take once a day, easly to not miss doses if you take at bed time
Very effective for my osteoarthritis in hands
Very cheap, $40/year at Walmart

When you inject T twice a week, take 1/2 weekly anastrozole dose at time of injection. That way, serum T levels and serum an anastrozole levels will roughly track each other. Also easier to live with.

Libido issues should resolve with more T if you can get near E2=22pg/ml.
If E2 goes low, joints may ache [more]
Understand ‘anastrozole over-responder’.

Liver issues may be reducing E2 clearance rates. So not needing any AI may be a pipe-dream.


I’m on 150mg 2x a week and anti e 0.5mg 2x a week.
I love it. Haven’t had labs recently, but I can tell when my e is high or low and I’ve adjusted to come to this dose.
I was perscribed 1mg 2x week. Felt like crap. Always pissed off. No sex drive at all. As soon as I adjusted my e, bam! Great mood, killing it in the beedroom, energy increased. I think you’ll really enjoy 300mg, especially with your workouts. Just get your e dialed in. 1 mg 2x week & mine was not measureable! Actually pretty bad for you to bottom out your e.


I just started hrt also, 200mg week of test cyp, does anyone get insomia on this? He didnt prescirbe a ai, said wanted to wait a month to see where it tracked to then prescibe to counter it, but getting sensitive already and its been only 5 days. Starting test was 189, and e2 was 20 at 34 yrs old


What kind of Dr do you go to? Do you like him, is he easy to get along with? You’re not too far from where I’m at and I sure would like to find a knowledgeable Dr. Did you start taking the 300mg a week or did you go to a100mg like you wanted and has it made a difference?


Dr paula Boyle is my primary, and I love her. She unfortunately is not an expert with MHR. BUT she has listened to me and worked with my every justified concern. I have been switching over to Dr James Heaton he is very knowledgeable with HRT but is strongly opinioned. He trains and is personally on TRT so his opinions are quite similar to me.

But he is a lab guy and wont allow you to far out of the box. He is the one that bumped me to 300mg a week mainly due to labs. I started on 1ml (200mg) every 2 weeks “Sucked” then 1ml (200mg) a week better then E2 spike very shitty. Had to educate Dr Boyle but she did finally agree. Neither would go for Hcg. I GOT EDUCATED… and switched to .5nl 2x a week SC and 1mg AI and did pretty well.

Then last 2 labs still had me under 500 TT so because of still low libido low energy, ED etc Heaton bumped me up .75ml 2x a week and 2mg AI (E2 still around 30). I have jumped through hoops for 9 months to get to this point, My bench has gone fro 275 to 435 doing an event in late March hoping for a 450# raw bench. squats and dead lift I’ll train for another year before I compete, knees and age slowing down increase in those but nothing time and patience wont overcome.