T Nation

Just Started TRT Aged 30. Pls Help.

I’m a 30 year old male and 6 months ago was diagnosed with secondary hypogonadism. I’ve been taking Sustanon 250mg every 3 weeks since.

Before I go on, I want to point out that I am from the UK. I say this because HRT/TRT is still a relative unknown over here. Doctors are clueless and the endocrinologists are not up to date.

In the 6 months of receiving treatment, I have felt little benefit from the Sus. I have put more weight on around my midsection, feel quite bloated, and my body composition has not changed - still very soft looking, no definition, still finding it almost impossible to put on lean mass.

I have received no AI or HCG from my doc, and to be honest, I don’t think they have a clue that these can and should be used in TRT. On top of that, I have not had ONE single blood test since starting the Sustanon, which I’m sure you agree is a disgrace.

I have though, had my levels checked privately.

Pre treatment results:

E2 = 3.6* pg/ml (Lab ref range - 0.20 - 3.4)
FT = <46* pg/ml (Lab ref range - 46 - 285)

  • This value lies outside of the reference range of the laboratory.

Post treatment (4 weeks in, 1 week after 2nd injection):

E2 = 3.5* pg/ml (Lab ref range - 0.20 - 3.4)
FT = 140 pg/ml (Lab ref range - 46 - 285)

  • This value lies outside of the reference range of the laboratory.

I have read been reading a lot of the posts on this forum, particularly those from Ksman. I’m wondering if I should change to:

  • 100 test enanthate per week, taken EOD, possibly rising to 150mg
  • HCG shots at 250 IU’s EOD
  • AI - either 1mg anastrazole per week divided into 0.5mg or 0.25mg, or letrozole 2.5mg weekly or 1.25mg every 3.5 days

Or, can I simply divide the sustanon into 50mg injections EOD? I would need to purchase more sustanon on the black market however this is moot since I will need to purchase enanthate, hcg and an AI on the black market should I go down the other route.

I will be treating myself using the doctors for blood tests/health checks (I will be demanding far more checkups than they are currently giving me).

Any advice greatly appreciated.

[quote]kcoops wrote:
I’m a 30 year old male and 6 months ago was diagnosed with secondary hypogonadism. I’ve been taking Sustanon 250mg every 3 weeks since.

Before I go on, I want to point out that I am from the UK. I say this because HRT/TRT is still a relative unknown over here. Doctors are clueless and the endocrinologists are not up to date.

In the 6 months of receiving treatment, I have felt little benefit from the Sus. I have put more weight on around my midsection, feel quite bloated, and my body composition has not changed - still very soft looking, no definition, still finding it almost impossible to put on lean mass.

I have received no AI or HCG from my doc, and to be honest, I don’t think they have a clue that these can and should be used in TRT. On top of that, I have not had ONE single blood test since starting the Sustanon, which I’m sure you agree is a disgrace.

I have though, had my levels checked privately.

Pre treatment results:

E2 = 3.6* pg/ml (Lab ref range - 0.20 - 3.4)
FT = <46* pg/ml (Lab ref range - 46 - 285)

  • This value lies outside of the reference range of the laboratory.

Post treatment (4 weeks in, 1 week after 2nd injection):

E2 = 3.5* pg/ml (Lab ref range - 0.20 - 3.4)
FT = 140 pg/ml (Lab ref range - 46 - 285)

  • This value lies outside of the reference range of the laboratory.

I have read been reading a lot of the posts on this forum, particularly those from Ksman. I’m wondering if I should change to:

  • 100 test enanthate per week, taken EOD, possibly rising to 150mg
  • HCG shots at 250 IU’s EOD
  • AI - either 1mg anastrazole per week divided into 0.5mg or 0.25mg, or letrozole 2.5mg weekly or 1.25mg every 3.5 days

Or, can I simply divide the sustanon into 50mg injections EOD? I would need to purchase more sustanon on the black market however this is moot since I will need to purchase enanthate, hcg and an AI on the black market should I go down the other route.

I will be treating myself using the doctors for blood tests/health checks (I will be demanding far more checkups than they are currently giving me).

Any advice greatly appreciated.[/quote]

Man, I don’t know what would be worse… being secondary hypo or being on HRT in the UK. Are they allowing you to self administer your injections? If this is the case (I guess that I just assumed that you would have to go in for your shots), then yes, split your 250mg up into weekly injections.

You may not need more sus. Many are prescribed and very happy on <80mg of test/week. Just try it for a month or so, test and adjust accordingly.

I was pretty surprised that your E2 didn’t rise with this protocol. Nevertheless, it is still way too high and needs to be treated. I would agree that your chances of getting adex or hcg are slim to none. Ultimately, you already know what you need to get optimal hormone levels. You’ll have to decide if going the black market route is right for you.

Being secondary hypo in the UK is a nightmare! Are you from the UK? I get the feeling you understand how tough it is in this country suffering from this condition.

Thankfully, they are allowing me to self administer because my girlfriend is a nurse. She does my glutes and I do my quads. We will basically rotate the 4 sites.

This would be ideal because it would mean I do not need to purchase black market test (T), although human grade SUS250 and enanthate is readily available nowadways. However, how would I do this accurately? Draw up 80mg into three separate syringes and store in the fridge?

Also, I have read so many differing opinions on the use of SUS250, mainly focused on the different esters attached to the T (it’s worrying how many supposed gurus believe SUS250 has 4 different forms of T). I am on undecided on whether or not SUS250 is good for TRT. From experience, 3 weekly injections definitely is not the way to go. I don’t know too much about the different esters and whether or not weekly injections will make for table blood levels. I think the only way to find out, is weekly inject and retest after 4/6 weeks. Have one test done the day after an injection and then another an hour before the next injection (6 days later).

Sounds like you are speaking from prior knowledge of this? Or if you have any evidence to support this I would greatly appreciate it. I am always learning.

Me too. But it does explain why I am not feeling the full benefit of the T - it’s aromatizing into estrogen. But crazy as this sounds, I was delighted to see my E2 levels were high - it just backed up what I have thought all along and why I have been suffering from all the E2 related sides, and atleast now I know what needs to be done. If they had been low, I would be at a complete loss. I will be ordering HCG today.

I already have letrozole on order. I appreciate there are opposing views about the use of anastrazole compared to letro. I have read that it is easier on the lipid profile. I am going to use letro for 4/6 weeks and test accordingly.

Any more advice would be greatly appreciated.

Your E2 range is very odd. Was that serum or saliva? Total or free E2. But the fact that you are at the top of the range is troubling. Elevated E2 can easily explain all of the factors that you list that are diminishing your QOL [quality of life]. Serum E2 here typically is 0-54 pg/ml.

Sust only exists to reduce injection frequency. If you are going to inject EOD, then it has no value. T ethanate may be lower costs if that is an issue. I have seen some questions about what ester flows better. I do not know if T ethanate with its sesame oil base flows better that test cypionate with its cotton seed oil base. But when you get gear you may not have any idea about what the oil base is. Viscosity may only be a concern when using insulin syringes.

Your wife the nurse might find it strange with insulin syringes as it can take time to do the injection, even with the small amounts needed for EOD dosing.

You really do need T+AI+hCG. You seem to be seeking to give your self permission to manage your TRT properly.

If you want to be able to gave kids, you need hCG to prevent the functional loss of your testes - aka organ failure.

Can you also get testosterone cream there. Here [in the USA] we have compounding pharmacies providing such things. It can be used as a supplemental to increase DHT and libido.

Do not neglect other vitality issues such as iodine intake, vitamins/minerals and high dose vit-D3.

Write down the protocol that you want and tell you doc that this is what you need to do.

Will you be able to get insulin syringes without a prescription there? Pay cost attention to my recommendations for 0.5ml syringes - not 1.0ml.

When injecting hCG, there is a lot of unused injection capacity and you can co-inject B12 if that is something that you want to do.

When mixing hCG, you can mix to 2000iu/ml and inject smaller amounts. You cab load 1000iu into a 0.5ml syringe and use that for 4 injections, swabbing the needle and returning to refrigeration until empty. No advantage other than less waste.

The one pitfall that I see is not not giving your self permission to take large amounts of T.

At your age one should be wondering why your pituitary is damaged, testes are damaged or your HPTA is down regulated by high E2 levels. Any signs of gyno? Drugs, Rx and OTC can drive up E2 levels, as well as alcohol and some ‘life style’ drugs.

You need to get these things fixed so you can keep your wife happy.

Saliva. Test was free, however no idea if E2 was total or free.

I can inject weekly if this is good practice. It would be better to use the prescribed sustanon, and perhaps top it up with black market sus, than use 100% black market enanthate. But, if enanthate is that much better for my TRT needs, I am happy to go down that route.

Not looking for permission, just more knowledge so that I can manage it effectively. I only know what I read, and if I read from experienced guys like yourself, it only increases the chances of succeeding at self medication. So far from this forum, and you in particular Ksman, I have learned that I definitely need an AI, and HCG too.

I have a 3 year old and do not plan to have any more (that could change ofcourse). Is wanting to have children the only reason someone on TRT should take HCG? I just ordered some today and wonder now if I have wasted my money. I do know I have some issues with my testicles but would not feel comfortable making public. Perhaps a PM if this is a need-to-know piece of info.

Yes we can get gel. But I’m not sure I like the idea of the application process. Injections will be fine if I can perfect the dose and injection frequency.

Iodine intake? Vit-D3? Could you elaborate? I take a multi vit and that is all. I do know my LDL is right at the top of the normal limits, and I am anaemic. But my diet is good. But guess what… my doctor says not to worry. No treatment, no advice, just ‘you are within normal limits so it’s fine’.

I’m not looking to cycle. I’m looking for optimum levels. I have no interest in supraphysiological levels.

I have had (what my doctors would claim to be) extensive investigations, including an MRI scan and several blood tests. The doctors have diagnosed secondary hypogonadism and as far as they are concerned, that is that. Not much more I can do other than try and get my levels to where they need to be, hopefully with the help of this forum. Also, I do not take drugs - OTC or RX. I drink moderate amounts of alochol.

Doctors in the UK are either ignorant to TRT or too arrogant to listen to their patients. If there is anyone from the UK reading this I wonder if you concur.

I ordered those syringes yesterday in preparation for taking HCG. I will probably stick with standard needles for the testosterone since I rotate 4 injection sites and this is fine for me.

Welcome to the club!

7.5 to 10 grams of Androgel has worked like a charm for me for 8 years.

Bump for more input on this. Possibly from KSman?

Totally bummed by the lack of help here

Saliva is free hormones as they cannot be SHBG bound in saliva. While the saliva range does indicate a problem, if you use anastrozole to lower E2, we have no idea what the target should be as we know for serum E2=22pg/ml. You could go by how you feel. Need to understand the issues of anastrozole over-responders.

Most guys need 1.0mg anastrozole per week as a starting dose when they have elevate E2 problems. That dose gets adjusted based on serum E2 results.

When the testes are functioning normally, they make most of the pregnenolone. That supports mental function and DHEA production in the adrenals, that then supports progesterone which supports cortisol. Most report an improvement in mood with hCG. You should test DHEA-S and probably need to supplement starting with 50mg/day.

Supplement with that?

Thanks.