T Nation

Hypogonadism in Australia, Advice


I’m fully aware I’m in for a hormonal roller coaster, it’s gonna suck… at least I’ll be higher than 4.6nmol… for about two weeks… however it’s only for 6 weeks (2 shots)


Took first shot of sustanon 250 yesterday, used a 21 gauge needle. My ass hurts, hurts to flex my glute.


@systemlord @KSman
I need some advice, around what dose of testosterone (weekly) would put my TT at around 1000-1100ng/dl. I know this may seem like a high level, however it was the level of testosterone I naturally produced three years ago, I have low(ish) SHBG with the lowest test reading 19 and the highest reading 25. I have reason to believe I may hyper metabolise testosterone as I hyper metabolise many medicines. I am a hyper cyp2d6 metaboliser (although that has nothing to do with testosterone).

The every three week injection had me feeling great… for about six days, then I crashed and felt like shit, I’m due for my next shot tommorow however after my last set of bloods I’m doing twice weekly shots (extra test prescribed by… myself). I am able to acquire HCG if it is nessecary, however I am not concerned about fertility or the size of my testicles, is HCG still needed? Some men say they feel better when hcg is added to trt, however I don’t see the point aside from maintaining fertility. As for an AI, I have a bottle of arimidex left over from when it was prescribed to me to keep my growth plates from prematurely fusing (I have about 100-150 1 mg pills left over).

I would highly appreciate a reply as I am at a minor crossroad as on what dosage to start out with. I would like some relief as I’ve felt absolutely awful over the past two weeks due to my docs shitty protocol. I feel just as bad as I did at baseline if not worse and it feels like I’m running in circles and getting nowhere. It seems people are on TRT doses of anywhere between 100mg PW (50mg e3.5d) all the way up to 200mg PW (100mg e3.5d).

At my age I actually wouldn’t mind being up at 1300, I’m a teenager who Is supposed to be in the prime of his life but instead has to sleep 12-14 hours a day to (barely) function… this shit is messing with my social, academic and sex life and I need it fixed. (a study which measured men’s Testosterone levels showed 1322ng/dl is the top 1 percent for men, irresponsible I know, however it isn’t far off from what I naturally produced) I’m aware I will have an excess of free hormones due to my low ish SHBG however it didn’t seem to be a problem for the first 14 years of my life (now 17).

I am aware my hematocrit will slowly climb and I can get therapeutic phlebotomy if this becomes a problem… I also have the tools to preform a phlebotomy at home and I have tried it before out of mere curiosity. I currently take 100mg of aspirin daily as a safety precaution though. Also found out I have osteopenia in certain parts of my spine (t score of -1.5 around L4) otherwise t score was still around -.03-.1.0 everywhere else) and I want higher bone density. I attribute it being so low for my age due to the years I had tanked E2 followed by hypogonadism.


Your pituitary gland shut down, this is the crash you speak of and in weeks/months you will start feeling better.


Paragraphs please, my eyes will thank you.


@systemlord @KSman (either person responding would be appreciated), for primary hypogonadism is HCG recommended, my cause of hypogonadism appears to be primary (elevated LH and FSH in spite of the fact that I have been on TRT for a while) and due to other reasons I’m not going to explain fertility is a commodity I don’t have, I’ve heard anecdotally that HCG can improve sense of wellbeing, possibly a direct affect on the brain or by filling up hormonal paths that testosterone has shut down. Also when starting out with TRT (like legitimately starting, no more Australian regimen shit) is 50mg twice weekly a decent starting dose (I want to get dialed in ASAP, therefore I’d appreciate knowing if my starting dose is too low)? It seems doses vary wildly from person to person. My shbg is 20-27 and I believe I may metabolise test quite fast. My bloods 7 days post sustanon were 500ng/dl, soon I am going to see what my bloods are 2-3 days post sustanon shot, this will help me determine what my future testosterone dose will be. I won’t be using an AI as I barely aromatize and I have had nothing but bad experiences in the past with AI’s. The plan is to start with (X) amount of test pinned 2x weekly sub q or IM and get a private blood test in 4 weeks and go from there. I also know based on bloods I tend to start crashing when my TT falls below 600ng/dl


HCG will do nothing for the testicles on those who are primary, however can provide other mental, libido benefits. 50mg twice weekly is a good starting point, it could very well get you to high normal test levels. It sounds like either you’re over responding to the AI or you simply don’t need it unless you start out too high on test. Never say never.

I’ve heard of some reaching 1000+ ng/dL on 50mg twice weekly. If you’re a hyper T metabolizer like myself you may need to inject higher doses three times (every 3 days) a week instead of two. A hypermetabolizer will not see a drop in testosterone levels, but will feel mediocre with excellent levels as his free T supply is low. A hyper-excreter (low SHBG) will see big dips in his total testosterone levels at trough or right before injection.

You can’t metabolize testosterone that is bound to SHBG.


Whoops, then I meant I think I’m a hyper excreter as in my levels were suprisingly low 7 days post shot. I don’t take AI anymore, haven’t taken it for over a year, and I took it (prescribed by endocrinologist), to stop premature closure of growth plates, thanks for the response. Seven days after a 250mg shot (a hefty dose) I was only at 500ng/dl


There’s a variability in the stickiness of SHBG from person to person, even though my SHBG is 18-20 I see little loss before my next injection. When I was injecting 75mg once weekly three days after injection I would peak in the 530’s and 4 days later I was still in the 440’s but felt as if I was in the 200’s. My body had used up all my free T in short order.


Out of mere curiosity, once you were dialed in, what weekly dose did you settle on and what level did it get you to? How long did it take for you to get dialed in?


25mg EOD got me 800-900.


I have a smidgen of an update, things turned for the better around fairly quickly. Doc saw my bloods from sustanon and put me on .5ml of test E every 8 days. This equates too 109mg of test/wk, a solid long term hrt dose.

Over the next five weeks I proceeded to follow the exact instructions of what I was told to do, however instead of using the pre filled 1ml syringes I pre loaded exactly .5ml into seperate syringes as to be able to inject the exact amount needed and give exact readings on my bloods.

I felt far better on this protocol, I feel great for the first day or two and normal up until day five, from day six to eight I feel sub par but I’m still able to function normally.

Bloods showed that two days after injection my testosterone was at 22nmol (I believe that’s around 600ng/DL) and on day eight I was at 12nmol (350ng/DL?? Can’t be bothered to check now will check later). This surprised me as this seems like a low reading for such a solid hrt dose, anyhow the doctor decided to keep the dose the same and not change anything, especially since I feel quite a bit better. I believe the reason my dose wasn’t increased is due to the stigma around prescribing testosterone here. My SHBG is low to low normal (seems to get lower the lower my TT is) and my Free T ranges from low to mid normal. My E2 hovers around low to mid normal. I should point out my baseline testosterone value before I had any issues was 36nmol

My insulin sensitivity and glucose tolerance is impaired, blood tests over the past one and a half years have consistently shown boarderline to impaired glucose tolerance which is strange as I’m not fat (I would say I am very muscular for someone of my stature, I lift weights around 5-6x/week at the moment) and my family doesn’t have a history of diabetes, I hypothesize prolonged hypogonadism may have caused impaired insulin sensitivity. I believe I have another glucose tolerance test in around three months.


Just to reiterate when I say I feel good from day one to five I’m referring to my energy, I don’t sleep literally 16 hours a day like I used to.

My libido is slightly improved but is otherwise still quite low compared to how it was back when I had super high test levels. I don’t get morning wood, sexual desire/ thoughts is low (anyone not wanting to hear about an underage person talking about his sexual life skip over this), I haven’t been sexually active since I was fifteen, mainly due to lack of interest. I have occasional bouts when I’ll feel “ready to go” however they come about infrequently, still better than what it was though.

I may be aromating slightly for the first time in ages as I’ve noticed slight water retention around my face, however it’s nothing significant and even if it was I’m never using an AI ever again due to bad experiences.