T Nation

My TRT Protocol with Klinefelter's Syndrome


I found out that I suffer from a chromosome problem called Klinefelter’s syndrome “XXY 47” I am a male and been married for past 10 years with a wonderful fine lady, 6 years ago I found out about my problem and started treatments.
currently, I am taking TRT “test-E (Cidoteston 200mg” every 10 days " and .25 Arimidex EOD " " I started Arimidex only lately only for past 5 weeks" also I am taking medicine for uric acid as I had gout attack 2 months ago
as I started to have a good level of T in my blood my life went much better and I started to take care of myself as you know low T makes people damn depressed and lazy, now I am much more alive.
so, I made a checkup lately and would like you guys to take a look at it and tell me your opinion. And how well my protocol is working and if I should adjust anything around.
my current problems are:
sever PME, depressed, 20 kg of extra water retain.
currently, I am on Ketogenic diet with 20% defect.
I am 181 cm tall, and 161 kg. BMI 49.8 PBF 50%
my results are the following: “this test been made at 8:30 AM the day right after my T- shoot.

hematocrit 46% (N.40-53)
hemoglobin 15.7 N.13-18 d/l
RBCS 5.4 n4.5-6.5 x10^6ul
MCV 86.3 n80-94 fL
MCH 29.1 n27-33 pg
MCHC 33.7 n31-36 g/dl
RDW 13.9 n11.5-14.5 %
**Leucocytic count 14.06 N.4-11 x10^3/ul **
Comment (Leucocytosis with absolute neutrophilia)
Fasting blood glucose 106 N.70-110 mg/dl
Total cholesterol 248 N. upto200 mg/dl
Uric acid 4.6 nm:3-7 mg/dl
Cystatin C .81 N.63-1.33 mg/L
GFR 120 n59-137 ml/min
Albumin / creatinine in urine 8.6 N.less than 30 mg/alb/g creat
Urinary albumin 20.8 mg/L
Urinary creatinine 2.42 g/L
Total serum bilirubin .31 N.upto 1 mg/dl
Direct serum bilirubin .11 Upto .25 mg/dl
ALT (SGPT) 18 N.m upto 41 U/L
AST (SGOT) 14 N.m upto 40 U/L
Serum albumin 4.2 N.3.5-5.4 g/dl
ESR (first hour) 8 N.M: less than 13
Second hour 21
LH 0.23 N.M 0.8-9.1 mIU/ml
FSH 1.12 N.M 1.6-11 mIU/ml
E2 21.8 N.M upto 45 pg/ml
SHBG 25.1 N.M 14.5-48.5 nmol/L
Testosterone 9.98 N.M 2.6-10.1 ng/ml
Free Testosterone 281 N.M 50-300 pg/ml
DEHA -s 323 N.M 59-452 ug/dl
Cortisol AM 8.32 N.M 5-25 ug/dl
Insulin like growth factor -1 IGF-1 66.1 n115-307 ng/ml
Reference ranges were corrected for age.
fT3 2.98 n1.68-3.54 pg/ml
fT4 1.32 n0.9-1.9 ng/dl

Many thanks for your time and sorry for my nonperfect English . cheers

TRT and Klinefelter Syndrome

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

When on TRT, LH/FSH–>zero, not need to test these again.
Do you use iodized salt and have selenium in your vitamins?
Outer eyebrows are sparse?
Feel cold easily?

  • did you have TSH tested?

IGF-1 is a measure of your GH status. You are GH deficient.
How old are you?

I am taking TRT “test-E (Cidoteston 200mg” every 10 days " and .25 Arimidex EOD " " I started Arimidex only lately only for past 5 weeks"

That is not good as T levels go very high then decrease. Your lab results are then mostly determined by your lab timing.

You need to self-inject T twice a week and take anastrozole at that time.
Anastrozole needs to match T levels and if T levels are changing a lot, anastrozole dose is not right and E2 levels will be moving too.

Fasting glucose? - 106, indicating a small problem
Fasting cholesterol? - high
Blood pressure OK?

Do you take Vit-D3? 5000iu/day suggested.

Have you been sick or had an infection?
**Leucocytic count 14.06 N.4-11 x10^3/ul **
Comment (Leucocytosis with absolute neutrophilia)

Cortisol AM 8.32 N.M 5-25 ug/dl
-when was this done? 8AM, ~1 hour after waking up?

  • 8:30AM, cortisol seems low

Weight gain/loss and energy determined by:

T levels, FT or Bio-T
E2, should be ~ 22pg/ml 80 pmol/L
Cortisol, should be better than 10 in AM
GH status, IGF-1
Thyroid: Body temps need to be as discussed in the thyroid basics sticky
CoQ10, which can be low if using statin drugs
Vit-D25 labs, get to near 60 with Vit-D3

Where are you? - Affects diagnostic and treatment options.


I am 32 yrs old
Yes, i am taking iodized salt , taking R-ALA , B complex , D3 5000 , C 1000 CoQ10 100.
yes I do feel cold very easily
no, i didn’t test for TSH but I can do the test if needed .
The T levels were tested one day after my injection at 8:30 am .
For blood pressure it is ok , never had any problem with BP or Blood sugar .
PSA / A1C I can make the if needed .
For infection yes I had some nasty flu and inflammation in my chest / throat .
Cortisol was exactly taken after 1 hour 20 min after waking up .
I am currently living in Alexandria / Egypt .
please let me know if I should make any other blood test .

  • PSA not required!

A1C is a better measure of blood sugar.

fT3 was close to optimal. If you are feeling cold, your fT3 may be getting blocked by rT3. rT3 is increased by stress which can fatigue the adrenals. Low cortisol can be a result.

Do you use iodized salt and have selenium in your vitamins? -yes to iodized salt

  • selenium unknown
    Outer eyebrows are sparse?
    Thyroid: Body temps need to be as discussed in the thyroid basics sticky

Please read the thyroid basics sticky.

When thyroid function is low, weight gain is one result.

Please describe diet. Glucose=106 may mean that you are going to become diabetic. You need to understand what foods are a problem. You need to avoid white rice, bread and potatoes. Brown rice is a bit better. Get more protein.

Do you have heart burn? - acid reflux?


Gout: Take 1000mg Vit-C three times per day, with food is OK.


regarding my blood sugar , the only risk I have for diabetes is being obese i guess .
well, I am stressed but by nothing , I just feel depressed , and lacking motives .
what about the IGF-1 , should I be concerned by the results or is it not that serious problem ?
for selenium , no I am not taking it but I can easily add it to my daily supplements .
Are outer eyebrows sparse? no, they are not .
I do not suffer from any heartburns or acid reflux .
many thanks for your fast replies . truly grateful .


Get selenium as part of a daily multi vitamin that also contains iodine, selenium and other trace elements.

Men should avoid vitamins that list iron.

Get body temps posted.

You are growth hormone deficient. Injecting growth hormone is very expensive. So I you do not have the money, its almost pointless discussing this. Low GH reduces energy and this is contributing to your body weight problem.

With a darker skin color, your body makes less Vit-D3 from sun exposure. You may also be avoiding the heat of the sun which reduces your Vit-D3 production.


I read the post “TRT: Protocol for Injections” and willing to follow exactly what is written there , but there are 2 things I don’t understand what should I do about .
1: HCG
Am I needing HCG even with my condition ?
Do HCG help my depression ? could it be one of the reasons ?
can HCG help in my PME ?
any help with my weight ?
how to split the HCG injection as they selling it here in 1500ui or 5000ui . can I use the same bottle for multiple time or once its opened it expired ?

2 : based on my test numbers should I stick to the same total per month dosage but split into 8 injections instead of 3 ? or I should just stick to the 100mg per week ? correct me if I understood wrong , currently am getting (3x200mg) per month"32 days" , meaning if I will keep the same dosage but on 8 injections that would be 75mg per shoot , 150mg every 8 days and 600mg monthly 32 days* .

one last thing , I totally understand the issue regarding HGH , but things here are much cheaper than in the US , HGH injection 4ui cost around $6.5. not sure how much it cost in the US .
in the end , I can’t thank you enough for all the help and efforts you put in writing down all these guides I learned from them 100 times more information than I could get from a doctor around here . truly, much appreciated .
PS: sorry for my many questions :slight_smile: