T Nation

Evolving with TRT, Evaluating Adjustments to Endocrine System; Estradiol, HCG, Supplements?

46, Free Test 5.2, Testosterone Serum, 293: I ate a lot of beef the week before this one, my previous test 3 weeks early was 4.8 FT and 248 or so when i was on my normal diet. I’ve sustained some groin impacts from contact sports when i was younger when i was very athletic (football, basketball,etc.).

10 years ago was tested for fertility and my T scores were low, but didn’t think about myself, was trying to have a kid. Didn’t realize how it would affect physiology, muscles, etc. Just overlooked that aspect…MD at the time didn’t mention anything (i have since gotten a new GP).

So, i’m starting .5 injection 1x per week of Testosterone Cyp Oil. Felt great for a 5 days, then could feel it start to crash (least i perceived that…last day i was really wanting that next injection but waited). Not taking anything for estrogen yet. I am > 300lbs, 6’4", my blood work is good (164 Cholesterol, 74 Triglycerides, 49 HDL) but i have a hard time keeping muscle… I have already noticed a difference…i’ve lifted a few times, fairly light and feel much stronger, more energy…and i realize this is not really strong stuff…least that’s my perception.

New MD is into it, understands, and uses himself for health reasons…which i really appreciate.

Going to get another blood test in 1.5 months I believe, wondering if i should go ahead w/ estrogen blockers proactively.

Getting good Test, insurance covers it. Using a 22mm needle, that seemed to work fine. Filling the syringe is the biggest challenge.

Big thanks.


also: started taking 5000iu of Magnesium every day or two, B12, and a B Complex a couple times a week cramps have abated. Sometimes these affect my GI so i reduce accordingly. Used to get crazy leg cramps, but those have abated w/ the vitamins or …something. Take probiotics everyday and supplement with psyllium fiber 3x a week.

Did you ever find out what was causing your leg cramps? Been dealing with it myself, everything seems fine.

Many do not do well injecting once a week, T spikes, T–>E2 spikes, T levels drop into a cesspool of estrogen dominance. Your body fat is making that worse.

#22 needles is insane

  • self-inject 50mg T twice a week, subq, not IM, #29 1/2" 0.5ml insulin syringes, so to load, injection time is OK
  • 0.5mg anastrozole at time of injections
  • Option: 250iu hCG subq EOD to preserve testes

Target is E2=22pg/ml. With AI as above, you should feel if things are right and E2 lab can be done in 10 days to see where you are. More reading is needed for you to grasp the variables.

With your weight, your thyroid function may be low. Please see “oral body temperatures” further down.

Most MD’s get most of TRT wrong and your doc may be lacking.

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.

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A good indicator for a clueless doctor is one who prescribes huge 22 gauge syringes, my doc had me using 19 gauge harpoons, now using 27 gauge insulin syringes. Also no SHBG and E2 testing or HCG with no AI prescribed tells me your doc is clueless. How many mg of test are you on? .5 is volume.

Example 200mg .5ml once weekly is 100mg week. Your fertility is at risk without HCG unless you are primary meaning testes damaged.

Leg cramps: My Vitamin D was very low for one, now i’m taking the 5000iu of them every other day, about. I’m going to start logging everything. Also, I stopped most of my carbs a couple times and , my cramps became more prominent, really bad. My abs and hammies cramped up severely a twice at the same time…it was really painful. And I was also trying to increase my metabolism by sleeping in a cold room w/ a fan on…and my legs would tend to cramp up badly when i did that (that probably sounds like i’m crazy, but it is the truth) they would be very cold…i found that drinking more water and warming up with some blankets helped them. Now I cover up w/ a blanket…my legs would be cold before and they would cramp right up. That’s embarrassing to describe.

I swim a lot in the summer and when i swim in a cold pool i can also get some odd cramps, but that’s cooling off your whole body…of course. I was thinking about getting a sauna…anyone have an opinion on that? thanks, M

Thanks you very much KSman, I appreciate it.
So, it says inject .5ML, once a week.
Testosterone CYP, 200MG/MIL

So, i have a 22g syringe, i fill up to the 1/2 mark, and injected 2x so far (one week apart), into my thigh, intramascular (IM), a 90 degree plunge into the outer park of the thigh and expel the Testosterone into my leg.

The doctor said the goal is to get my testosterone up to 900 or so. Said after the next blood work in 1 to 1.5 months from now, we’ll evaluate for estrogen blocker strategies.

injecting 2x a week with 50% dosage does make a lot of sense to me. Have to get some needles.

Thanks, Magellan

is the HCG from a doctor or over the counter? What is AI? I’ll ask my doctor.
it is .5 ML injection of 200MG/ML, so 100MG a week i guess.

all indications are y fertility is close to nonexistent. I got checked out a 3 times over 3 years ten years ago and they said my mobility and motility was extremely low. As a young man i worked around a lot of toxic chemicals with no real protection. The HCG helps to lose weight though, and helps the testes health (although i have no expectation of fertility to lose, I think it’s been gone for many years).

thanks Systemlord.

An AI is used to control the conversion of testosterone to estrogen, not everyone requires an AI but most do. HCG is used to prevent testicular atrophy and to preserve fertility, some guys get some pain down there do to your testes starving from a lack of LH hormone that TRT greatly decreases. Have your testes pulled up tight yet? I guess I’m not surprised you and your doctor didn’t discuss this important topic, because he doesn’t know therefore he won’t be able to balance your hormones.

We have tons of LH receptors throughout our body, LH restores the lost hormone do to TRT. Most docs believe when a man is low T that only prescribing TRT solves the problem, but TRT affects other hormones (E2 & LH) that often go out of balance, now T is restored and now others are out of balance and this goes unnoticed by most docs because their knowledge and training is seriously lacking.

Where are your pre-TRT labs? I don’t expect you to have any lab values where E2 is measured, that’s a red flag you’re dealing with a clueless doc. Another red flag is the size of syringes you were prescribed, insane.


Free Test 5.2, Testosterone Serum, 293: I ate a lot of beef the week before this one, my previous test 3 weeks early was 4.8 FT and 248 or so when i was on my normal diet. I’ve sustained some groin impacts from contact sports when i was younger when i was very athletic (football, basketball,etc.).

AI, that’s right , the inhibitor for estrogen, i’d read about that but didn’t realize the acronym. I don’t think a lot of folks would think I was low T unless they’re expert like the forum’s experienced guys. I’m overweight, but still fairly strong relative to the population, but I know i’ve lost a lot of strength over the years and feel week. Funny you mention the testicle pain, because today I noticed a little testicle pain when i was standing in a hallway talking to a co-worker…

So, i should get the AI and the HCG over the counter / Amazon. Do the MD’s prescribe those too, or just buy them?

the first test i’m reciting from memory so it could be slightly off (not much) i didn’t get a hard copy and it seems to have disappeared or been archived from the MD’s portal.

HOLESTEROL, TOTAL 166 100-199 MG/DL Final 01
TRIGLYCERIDES 74 0-149 MG/DL Final 01
LDL CHOLESTEROL CALC 102 0-99 MG/DL Above High Normal Final 01
COMMENT: NP Cancelled 01

From May 2017

22	6-24	MG/DL		Final	01

CREATININE, SERUM 0.90 0.76-1.27 MG/DL Final 01
EGFR IF NONAFRICN AM 101 >59 ML/MIN/1.73 Final 01
EGFR IF AFRICN AM 116 >59 ML/MIN/1.73 Final 01
BUN/CREATININE RATIO 24 9-20 Above High Normal Final 01
SODIUM, SERUM 142 134-144 MMOL/L Final 01
POTASSIUM, SERUM 4.5 3.5-5.2 MMOL/L Final 01
CHLORIDE, SERUM 102 96-106 MMOL/L Final 01
CALCIUM, SERUM 9.1 8.7-10.2 MG/DL Final 01
PROTEIN, TOTAL, SERUM 6.3 6.0-8.5 G/DL Final 01
ALBUMIN, SERUM 4.2 3.5-5.5 G/DL Final 01
GLOBULIN, TOTAL 2.1 1.5-4.5 G/DL Final 01
A/G RATIO 2.0 1.2-2.2 Final 01
BILIRUBIN, TOTAL 0.4 0.0-1.2 MG/DL Final 01
AST (SGOT) 28 0-40 IU/L Final 01

TRT: Protocol for Injections

100mg test cypionate or ethanate injected per week with two or more injections per week.-UNDERSTAND
250iu hCG SC EOD [every other day]-WHAT IS “SC”? you get an Rx or buy online?
1.0mg Arimidex/anastrozole per week in divided doses. THESE are the tablets, i presume? Rx or buy online?

thanks KSman, you’re helping me and I thank you for it.

Sc. Subq: Abbreviation for subcutaneous. Subcutaneous means under the skin. It implies just under the skin. With a subcutaneous injection, a needle is inserted just under the skin. A drug (for example, insulin) can then be delivered into the subcutaneous tissues.
I believe you inject in fat.
Am curious where can you inject T with the insulin syringe? And do you pitch the fat?

i switch to Sea Salt a few years ago, didn’t notice that it lacked iodine, never thought about it. Temp last night was 97.2 and when i work up this morning temp was 96.7. I took some iodized salt last night that i had in pantry…maybe this is coincidence, but i woke up very hungry (unusual) and so had a couple eggs w/ my coffee (normally don’t eat until 1030). thanks for guidance, KSman.

So, i’ve done four .5mL IM injections into my legs with testosterone 1x a week for a month. I feel much better, not a revolution, but steadily more energy. I bought the 29 gauge needles and my Dr. said it was cool to do it 2x a week SC and spread the injections out, per much good and appreciated advice (thanks KSman).

Asked my Dr. about hcg injections…he said they’d wait for more blood work. Also said insurance doesn’t cover that and it is $700 per month…I also asked about AI, and they want to wait on that, although i disagree with that, but i’ll hold off for the present.

I ordered some elemental iodine, waiting it to come in. Switched from sea salt to iodized salt (good ole Morton’s). Been looking for excuses to eat that salt/iodine, so i’m reaching for the celery stalks a little bit :).

First month of TRT was good overall. I did hit a something tender in week 3 of the IM shots, my right thigh was quite sore for a few days, and it went away. I did wife the materials and skin w/ the alc. swab, i just assume that i hit the muscle or maybe a little nerve directly.

Thanks, magellan.

switched to 29g needles, and switched to injections 2x a week SC at .25 ml each injection. First was today…WAY, WAY, more pleasant. the 22g was huge, in hindsight. I hit something with the 22g doing IM. the 29g makes this a way more pleasant experience. thanks KSman and others of the forum.

I know my terminology isn’t always spot on, but hey, i’m working on it.

I did switch to 29g needle, E3.5D at .5 dosage. 2 Benefits:

        1. Needle is much more comfortable.
        1. I’m not getting the tanking on the last 1 to 1.5 days before the weekly injection. the more even distribution seems to work much better for me.