T Nation

Labs Review - Changing Service Providers


#1

Hi all,
I recently changed service providers, was being over charged and under serviced. My new provider did a full lab workup and provided guidance on a new protocol. Rather than being really prescriptive they gave me a range, as such looking for your feedback based on these results.

History:
Was on .3 200mg 2x/wk of T Cyp, 250UI HCG 2x weekly 24hrs before T injection, no AI
With this dosage I peaked at 649 Total T, 12.9 Free T everything else in normal range.
Felt ok in comparison to pre TRT however could feel that there was another level. If that makes sense.

Prep for these labs.
Last Test Cyp 14 days prior
Last HCG 8 days prior
Fasted 14 hrs
Labs were done at 10:00 AM

Results:
image
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Recommended protocol:
Continue TRT, increase dosage, add an AI, continue HCG, add B12

TRT recommendation
-.4-.75 of 210mg 2x weekly SubT, 250UI HCG, 1cc B12, and 1/2 tab AI 2x weekly 24hrs prior to T injection.

I started at .4 2x weekly after discussing with the Dr, he agreed a good start then monitor. Taking .75 cc Vit B12 (read there isn’t much benefit above that), AI and HCG as prescribed, Added a Vit D supp

Thoughts?


#2

What is the AI dose?
What is the purpose of hCG?
Any high E2 sides?


#3

AI = Anast .5MG 2x weekly

HCG = Was experiencing lingering testy pain when I wasn’t on it. Was added to my first protocol. My new Dr said he would keep me on it if I preferred however thought it not needed if I wasn’t having kids. That said he said some guys have persistent testy pain so it does help. Personally I may try again without, wondering if that may pass eventually.

E2 = tough to correlate. No fat issues, no breast issues, was experiencing low energy, low libido and trouble sleeping. May have been the Test dose too low or E2. Improved on my new protocol however adding B12 likely helped as well so tough to say. I initially asked to start without the AI, Dr preferred I start with and re-evaluate after my follow up labs. Was concerned that 35 was close to range and the T dose increase would tip over.


#4

A 649 Total T, 12.9 Free T was suboptimal, men start to feel off and or complain of low T when dipping below 15.0 Free T, so a 12.9 Free T is just pathetic. You need Free T high normal or preferably higher, more testosterone the better if you body responds well to it.

Your HCG protocol is low, those dosages are done EOD, not twice weekly.

You were underservice by someone who doesn’t really take this TRT seriously.


#5

You did not take your T shot for 2 weeks and then did this blood test? Thats crazy.


#6

No argument here. I won’t bash a provider on here but if anyone is curious who to stay away from PM me. What’s funny is I was so bad pre TRT that anything was an improvement so these numbers although not optimum had me feeling much better than before.

Can you elaborate more on HCG? What is the recommended UI per week?

What would you change?
I take my Test Monday mornings and Thursday evenings SubT.
Take the Ai, VitB12 and HCG Sunday mornings and Wednesday evenings.

Thanks for the comments.


#7

“You did not take your T shot for 2 weeks and then did this blood test? That’s crazy”

The clinic requested that protocol which was almost exactly what another clinic said I would need to do prior to my labs and Dr visit. Both were very consistent.
Oddly enough the result is very close to my pre TRT labs(before starting any TRT protocol). Exactly the same Total T, slightly lower Free T (was 10.1)and slightly higher E2(was 25). Very similar though.


#8

HCG isn’t really needed unless fertility is a concern or you care about having your testicles full size, some men don’t tolerate HCG at all, some feel nothing and others see mood and libido benefits. Typical dosing is 100-150 daily, 250 EOD, 400-500 2-3 times weekly.

Sub-Q for some will see estrogen increase, others decrease.


#9

Usually, initial testicular aching subsides within just a few weeks. If that was not the case for you and your current dose was preventing those symptoms, I would stay with it. For fertility, 250IU 3/week or 350IU 2/week usually works.

Very possible.

[quote=“deathon, post:3, topic:253622”]
Was concerned that 35 was close to range and the T dose increase would tip over. [/quote]

I would at least decrease the anastrozole dose and not worry about the range, but focus on any consistent high E2 symptoms.


#10

Thank you guys!

Don’t want to change much at the same time.

-Will change my AI dose to .25 1mg 2x weekly. Start right away and adjust based on E2 symptoms.
-HCG: I’ll think more about that as it hasn’t caused any poor side effects and subsided the testy pain. So is working as expected. Will consider removing and seeing how I respond in a few weeks. I have read there are metabolism benefits when combined with B12. Any experience there?


#11

Great feedback on my protocol. Any other comment on my labs?


#12

Your levels aren’t very high. More for sure. You will probably see less sides after removing hcg. I sure did. The chemical itself causes sides and the e2 it creates as well.

I dropped hcg and after a couple weeks the lingering pain dissapeared. Barely noticed the pain. Only one night it was bad and the next morning I never had any more issues. You can do what I did. Drop your dose to 200iu and then 100iu a week or ten days later. I noticed less pain and maybe it’s because of how I slowly lowered my dose? Don’t think so but worth a try.

Month later and there full as can be. Not shriveled and I actually don’t notice any difference. Maybe it takes longer to decrease in volume post hcg?


#13

IMO your T numbers and maybe your E2 numbers are not accurate enough to comment on since you waited 14 day. That is one hell of a trough. You need to take your blood draw on the day of your injection. For example to inject M/T so Monday morning you go get your blood drawn then go home and take your shot.

A general comment with an SHGB of 39 you should feel pretty good at a 30-35 E2 but I would not let it get much higher. If you stop HCG your E2 will more than likely drop. How much no one knows we are all different.
You HCT is pretty low for for the amount (120mg/wk and now 150) of T you are taking so that is a good thing. It will be interesting to see your real trough on 150/wk.

To improve your lipids I would clean up the diet stop all omega 6’s and add omega 3’s

Best of luck to you with the new doc.


#14

FYI and about HCT. Does Hct take a while
To increase when T levels are high. If I stabilize at 200mg let’s say and 1 week later labs show 50, will that normally stay at 50 or around there. Or does it normally keep rising if your free t is super super high like 30 or 40+… mins is super low but I suspect it will keep increasing if I stay at a free t levek that’s above range. I am Definitely not going to stay there.


#15

I have no idea if it is the same for others but if my Free T is over range lets say 33 with the top of the range being 18 in 6 week I will go from 46 to 51, YMMV


#16

Got it just curious when it plateaus is a better question and you answered that. What’s ymmw?


#17

your mileage many vary. In other words your rate of HCT increase might be different than mine.


#18

Here are my original numbers pre TRT.


#19

Although you were still shutdown(LH, FSH) you basicly went back to your natty levels after waiting 14 days. Probably don’t want to do that anymore. Looking forward to your next blood test taken at the right time. Good luck


#20

Update: I’ve switched to an EOD protocol for Day 1-T-Cyph, Day 2 - HCG and B12, and so on. I am currently doing 1/4 MG AI 2x a week(reduced from 1/2 mg 2x a week when switching to EOD.

Will do this for 6 weeks than run labs again.

Thanks for all the suggestions and help.

Mike