T Nation

Klippe: An HRT journey


#1

Hi All. KSman was kind enough to help me with my restart protocol and provided invaluable guidance. My HPTA restart failed at the 1st hurdle. It seems that I am primary hypogonadal and also suffer from adrenal fatigue, at the minium. If it is at all possible, I also believe that I am seconday hypogonadal as well.
The original thread is here: http://tnation.T-Nation.com/free_online_forum/sports_training_performance_bodybuilding_trt/day_1_of_restart_attempt

In that thread I make mention of the hormones / supplements that I am using to support the HPTA in order to try and help the adrenals to rest. I will continue with these therapies for the foreseeable future, including the IR, just at a reduced rate as per KSman's suggestion. After some more research I have found that therapeutic dosing of VitC in the range of 2g - 5g per day can also help the adrenals. I have added this protocol as well.

Given the above, as far as I can tell, I have pretty much covered the bases that my limited knowledge will allow me to and all that remains is for the TRT to be put in place. The TRT will be consisting of the following:

1) 62.5mg's Test Cyp 2 * week (Monday morning / Thursday evening)
2) 250IU's hCG 2 * week (Monday morning / Thursday evening)
3) 0.5 mg Arimidex 2 * week (Monday morning / Thursday evening)

Keep in mind that these are starting amounts. I doubt that the hCG dosage would change, however, bloods 5 weeks out from starting the therapy would advise if my test dose is in the zone or not (Could I be a hyper metabolizer of test?) as well as to whether my AI dose is sufficient (I hope that I am not an over responder). So as you can tell, the therapy will be very fluid until I get it dialled in, hopefully with the kind help of the contributors on the forum.

I am also hoping that with the continuation of the other supplements, hCG therapy and the addition of the TRT, that my HPTA would be able to recover somewhat by not having to make all the hormones itself and that that would lend itself to my recovering some much needed vitality and energy.

I have also ejected coffee and refined flour from my diet (that is really difficult BTW) in the hopes of assisting the adrenals even further.

Having said all of that, I will be updating this log with progress reports and anecdotal evidence, but I would ask that the contributors to the forum would check in periodically to give any advice / guidance and answer any questions that I might have.

Write soon.


KSman is Here
KSman is Here
KSman is Here
KSman is Here
KSman is Here
#2

Excellent…

I received my “party pack” and can start with my TRT as adjunct to my HRT :wink:

For my own journey and the edification of others, below is a link pointing out the various time markers we can expect on TRT, everyone is different so it’s just ball park:

What I would like to know, as I am going to be injecting SQ, can I inject in the delts as well, or only in the outside of the upper leg (as if IM)? I would like to vary injection sites to avoid any possible scarring (even though it would be minimal with my using the insulin pins) or needle fatigue so I was thinking 1 week arms, 1 week legs…is that okay, or will I be setting myself up for a mess?


#3

PSA does not always increase. That might be so in the study population that probably was not managing E2 levels.

SC can be done anywhere that is comfortable. Some get lumps in their belly fat but not their legs, some the other way around.


#4

[quote]KSman wrote:
PSA does not always increase. That might be so in the study population that probably was not managing E2 levels.

SC can be done anywhere that is comfortable. Some get lumps in their belly fat but not their legs, some the other way around.[/quote]

Thank you for the reply Squire, as always, your advice and time is highly appreciated…

It’s Thursday evening here, so I have just started the TRT protocol with the whole shebang and I must say that the SQ T injection was a breeze…I am so glad I was advised of that protocol, thanks for that too… :wink:

I will endeavour to keep the log updated as to anecdotal improvements, as well as new blood results when I get them.


#5

Look, I do not know if it is the placebo effect or a legitimate reaction…but, after last nights 1st consumption of T, AI, hCG & Caber, I managed to wake up with morning wood, found myself actually looking at and getting aroused by my wife’s breasts and derrière, had sex and also knocked off an item on my to do list that has been bugging me for months, I actually had desire for everything again…

Placebo or not, I’ll take it !!

Will keep on updating.


#6

Some get a large boost in mood from hCG. We know that from when it is the only new item.


#7

Hi All.

Here is a sort of midway update…

Yesterday was my 4th shot of Test Cyp, 4th dose of Anastrozole, 4th shot of hCG and 2nd dose of caber.

What can I report? No changes in vitality / physical symptoms or feelings other than a mood that whilst sombre is more stable (no outbursts etc) and periods of extreme fatigue (like today after yesterdays shots etc).

I am about two weeks out from new labs but from anecdotal evidence it would seem that either I am a hyper metaboliser of test, which would mean that my test levels are low and the concomittant use of the AI drives my E2 to low as well, or I am an over responder to this AI and my E2 levels are to low…either way, E2 is my problem, I think

Now my question is, do I continue in this vain until new labs can be taken in two weeks in order to give me direction to change any / all dosages (my logic tells me this is the right thing to do). Or do I go for tests now and get new direction?

My concern is that two weeks of TRT therapy via SQ injections is not enough time to allow blood levels to stabilise to give a clear picture of what is happening. Problem being, I feel terrible / crap / like a truck ran over me. The idea of another 2 weeks of feeling like this is not entertaining.

Catch 22.

Any guidance would be highly appreciated.


#8

Hang in there Klippe. In your wait for KSMan I suggest you do a search on ‘adrenal fatigue’ in the searchbox, KSMan has some good advice and he doesn’t regurgitate it for everyones personal thread. I’m sure he’s just taking some time off and celebrating Thanksgiving. Some notables:

  • progesterone cream (helped me)
  • selegiline (since stims aren’t really an option)

I’m not knowledgable on this but from my understanding it’s best to wait for blood levels to stabilize. My assumption is that with a half life of a week a couple days in on the third week is when the new ‘normal’ is being set and then I’m sure the body adapts.

I recommend figuring out any way possible that you can relax. That is what is helping my recovery the most from adrenal fatigue: learning to relax.

Also, I highly recommend HCG EOD. I definitely feel better on HCG. Apparently that’s beause the testes produce pregnenolone and that’s the only source.

You may just be ‘hitting the wall’ that KSMan mentions that adrenal fatigue people hit when they get on TRT. Metabolism goes up and the adrenals can’t handle it. I feel a lot worse on a higher dose. I stayed at 100mg even though it just gave me 600 total T.


#9

Thanks for the reply. My apologies if I came across as impatient, there was genuine concern there…we don’t celebrate thanksgiving here so I lost sight of that completely.

As it turns out I am on progesterone cream and pregnenolone supps at the moment, along with hCG, so I am hoping that I have those bases covered…


#10

Whatever is going on with T and E2, it takes time for the brain to adjust and some of that is physical. It can take 4-6 weeks for effects to get established. Vitamins are not a factor re labs etc. I am on the road, will be more active her later next week.


#11

Thanks for the reply KSman.

Just an interim report back to where I find myself:

It’s been about 3 weeks since I started with the TRT protocol, on top of my other HRT protocol.

I still “feel” like crap, I don’t even feel as though I am on TRT, but as we all know anecdotal evidence is not the end all and be all of TRT, but it does play a big role. I have set myself a target of new bloods around the 15th of Dec, so only a few days to go before I can see what it going on inside.

My original bloods indicated a measure of adrenal fatigue on top of the fact that we proved that I was primary.

I started, in a way to treat the adrenal fatigue by way of HRT in the hope that seeing as the adrenals no longer have the responsibility to make these hormones that the adrenals could rest. I have added in Vit B complex & 12, selenium, magnesium and multiple daily doses of Vit C. my ACE should arrive shortly and I will be taking that for 3 months to see if it can help the adrenals rebuild. (This is based on my reading of Dr WIlsons book as suggested by KSman.)

So, at the end of the day, I will just about be supplementing with almost everything that the HPTA axis is responsible for…here’s hoping for success.

I do believe however that the new labs on the 15th will hold a big piece of the puzzle.


#12

Hi All, KSman. I trust all are well and enjoying the Christmas break?

So, it has been 5 1/2 weeks since starting my TRT with the standard TRT protocol, to refresh, I have been taking:

  1. 62.5mg Test cyp twice a week SQ for a total of 125mg’s Test Cyp a week
  2. 250 IU hCG twice a week SQ at the time of Test injection
  3. 0.4mg’s Anastrozole twice a week in water at the time of Test injection for a total of 0.8 mg’s a week.

Whilst the above dosages are not exactly what is recommended, they were chosen for their proximity to the recommended amounts and the units my stuff came in.

I am still supporting my adrenals and my thyroid as per previous posts with the addition of 600mg bovine ACE and the addition of Zinc and Copper to my daily supplementation.

I have received the new blood results today and they confirm my suspicions as verbalized earlier.

It seems that I am a hyper-metabolizer of Test and an over responder to Anastrozole. Keeping in mind the above dosages, my results are:

Date 17/12/2015

Test---------------Range--------------Result
E2-----------------40-161 pmol/L------43 pmol/L (Ideal is around 80 isn’t it?)
TT----------------->12nmol/L----------12 nmol/L
SHBG---------------11.1-78.1nmol/L----14.10 nmol/L
FT-----------------180—739pmol/L----355 pmol/L

Now, I am not sure how these results relate to the American ranges (except for E2…) so even though I can see that my levels of FT are in the lower quarter for our ranges, I cannot deduce how they would compare to your ranges…

From what I have read from the stickies, the relationship between FT and E2 is more or less linear when on this protocol, so, I could quite conceivably double my Test dose, keep my Anastrozole dose the same and I should end up with upper levels of FT and optimum levels of E2…correct? This is of course assuming that SHBG remains more or less the same throughout.

So, that is my supposed course of action for the next 5 / 6 weeks until I retest, unless KSman or someone else here can advise me better. That is in fact the point of this post after all.

As an aside, I assume that I will have to regularly check my E2 levels to adjust the AI dose as my BF% reduces as this will have a direct effect on aromatise activity?

So, thanks for reading and I look forward to your comments and suggestions.


#13

When were labs done relative to prior injection?

Because your T is burning so fast, hard to know what to do without the above.

Yes, doubling down on T and holding AI seems like a good path.

More to the point of the fast burn is the need to inject more often as your T half-life is short. Please try injecting EOD. Adjusting AI then needs a liquid dispensed EOD by the drop.

80 pmol/L is the same as 22pg/ml, so a good target.

Need to point out that we do see T hypermetabolizers who need 300mg/week to get where others are on 100mg. So you are in uncharted territory. If you get things close, you may feel that things a better.


#14

Hi KSman, thanks for the reply.

My last shot was Monday morning, the labs were Thursday morning. 3 days.

Okay, if I understand you correctly, double the Test dose to get closer to the upper range. This would increase my E2 to roughly 86. 86 is almost 10% higher than the present “ideal” figure of 80. Currently my AI dose is 20 drops per week supplying 0.8mg of Anastrozole. I plan to increase my AI dose by 5% to 21 drops, this will get me closer to the 80 we are striving for, leaving me at around 82/83 and fits in nicely with my 3 doses per week (explained below). My Test dose would be 1ml of 250mg/ml Test Cyp per week (double my current dosing). With the EOD dosing (explained below) that equates to .35ml EOD (giving 1.05 ml / week, which allows for the small amount of test left in the needle after injecting). My current hCG seems to be spot on at 500iu’s/week. So I will split that 500iu’s into three doses which will supply 525iu’s. A moderate 5% increase

Timing…I am a stickler for routine, so my EOD routine will be split into one week, this is achieved by dosing every 2 days 8 hours, so Monday morning 6am, Wednesday 2pm and Friday evening 10pm. Works perfectly. Given the above my suggested dosing protocol is as follows…

Monday 6am: 0.35ml Test Cyp (250mg/ml) / 7 drops Anastrzole (supplying 0.28 mg’s of the AI) / 0.07ml hCG (supplying 175iu’s)
Wednesday 2pm: As per Monday
Friday 10pm: As per Monday

Rinse & Repeat weekly.

Follow up labs on Wednesday morning 27 Jan 2016, 5.5 weeks from this coming Monday (start of new protocol) and 2 days since the shot on the Monday.

How does that sound in light of my hyper metabolisation of Test and over response to the AI? Or did I misunderstand you?

I think that this could be a keeper…


#15

Klippe there’s a conversion tool for nmol/l to ng/dl at:

https://www.nebido.com/tools/index.php/en/default/index/conversion-tool

And also at:

http://www.endmemo.com/medical/unitconvert/Testosterone.php

There’s an estradiol converter at:

http://www.endmemo.com/medical/unitconvert/Estradiol.php

So:

TT: 12 nmol/L = 356 ng/dL
FT: 355 pmol/L = 0.355 nmol/L = 10.2 ng/dL
E2: 43 pmol/L = 11.7 pg/mL

My E2 level is broadly the same as yours, and I believe that optimal is about twice as high.


#16

Hi Graemsay, thanks for the reply, those tools will make life a lot easier!!!

I do believe that I have a type of the final solution here, I do not think any major changes will be needed after this, maybe some further fine tuning but no more doubling etc.

I am curious as to what KSman will say about the suggested new protocol as well as to how often I should check E2 as my BF% decreases due to the higher T…


KSman is Here
#17

That sounds good. 3x/week does not equal EOD. EOD cycle repeats every 14 days.

If you inject with #29 1/2" 0.5ml insulin syringes there is no waste in the needle.
Otherwise: If a needle has a tiny bubble, it will push out what is in the needle.

FT ranges can vary wildly from one lab to another, so simply using a conversion is not very useful.

You can do labs after 3 weeks and see where you are. But if things are feeling right, you can wait longer to allow things to be closer to a steady state end point.


#18

Hi All, this is Klippe, now going by Stones…for some reason my password changed??:persevere:

Just wanted some advice, its been 3 weeks since changing my injection protocol to a more frequent EOD and doubling down on T whilst keeping Ana the same (according to the above labs)

Now, nothing seems to have changed / improved except for a creeping, nagging semi depression that seems to be following me around.

Above, Ksman hinted that I could go for new labs before the 5 weeks was up…so I am planning to do that.

What worries me is that 250mg of Test Cyp for 3 weeks has made no real difference in my symptoms other than improving fatigue (which was E related anyway). I will post new labs once I have them, but what would this be, a problem with E2? To high or to low?

Caio


#19

E2 too high or too low can do this.
Joints might ache if too low and feel depressed.
Can get emotional when high and short tempered after a while.


#20

Thanks KSman, what would you suggest?

  1. New Labs
    then
  2. Choose a direction in which to adjust AI dose and expriment with dosage according to anecdotal feelings (how I feel)?
  3. How would I choose a direction?

Thanks