T Nation

Need Help Dialing in TRT Dosing


#1

On TRT for 4 months now with positive results. Looking for some assistance dialing in my dosing. I purposely only report Free Test, Total test and E2 in my test results below for ease of reading. My first two blood test were extensive and include most of what is normally requested in these forums. My last blood test was only FT, TT, E2 as a reference for myself.

8/7: Pre-TRT bloodwork
FREE TESTOSTERONE (DIRECT)(9.3-26.5)pg/mL: 8 Low
TESTOSTERONE, SERUM(264-916)ng/dL: 583
ESTRADIOL (7.6-42.6)pg/mL: 19.2

Prescribed 200mg once per week Test Cyp, 1mg Anastrozole 24hrs after test injection, 500iu Hcg 2x per week.

Bloated up like a balloon and felt pressure in my joints, not pain, more like they were full of fluid. Asked Doc to split test cyp dosing to 100mg twice a week with anastrozole split to 0.5mg 24 hrs after each injection. He agreed and I received the following test results after 11 weeks of that protocol.

11/9: 11 week bloodwork
FREE TESTOSTERONE (DIRECT)(5.05-19.8)pg/mL: 27.41 High
TESTOSTERONE, SERUM(241-827)ng/dL: 1278 High
ESTRADIOL, sensitive (8.0-35.0)pg/mL: 42 High

Still pretty bloated, asked how I could reduce my E2. Doc said I could double my anastrozole dose to reduce E2 (1.0mg twice per week). Instead, I reduced my Test Cyp dose to 50mg twice per week and left anastrozole and HCG the same. 6 weeks later I got the following test results.

12/21: 17 week bloodwork
FREE TESTOSTERONE (DIRECT)(9.3-26.5)pg/mL: 26.9 High
TESTOSTERONE, SERUM(264-916)ng/dL: 1223 High
ESTRADIOL, sensitive (8.0-35.0)pg/mL: 14.3

So my current protocol is as follows:
50mg Test Cyp IM, Monday AM, Thursday PM
0.5mg Anastrozole Tuesday AM, Friday PM
500 iu Hcg SC Wednesday AM, Saturday AM

I feel good and look better than I did before. The questions I have are the following:

  1. Is my E2 too low? Should I aim to get it between 20-30?

  2. Would it make sense to increase my Test dose until my E2 gets into the range stated above? There was very little change in Test levels when I reduced my Test dose from 200mg/wk down to 100mg/wk. Should I leave anastrozole the same and increase Test instead?

  3. Is my TT and FT too high? There was very little change in my levels after cutting my Test dose in half which is strange to me.

Thank you for your help.


#2

I’m confused. Are you currently taking 2mg of anastrozole a week, or 1?

I would aim to be in the 20’s with your E2.

I’m guessing your last labs were at 2mg/week, but you’re now at 1mg/week but have no labs for that? If so I would keep it right there for now.

Congrats at keeping the same total and free T numbers despite only half the dose of testosterone. Does anyone know if this is a sometimes occurrence when switching from once a week to twice a week?

*edited


#3

I would reduce the HCG to 250IU twice per week.
Your estradiol is too low. My recommendation is discontinuing the anastrozole and see if you even need it. Most men do not need an AI on 100mg Testosterone per week.

I also recommend getting Progesterone checked. You can have perfect Estradiol and still be bloated and estrogen dominant if Progesterone is too low. Supplemental Pregnenolone will help increase Progesterone.

I recommend all men on TRT take 12.5mg DHEA and 12.5mg Pregnenolone sublingually daily. Douglas Labs is the brand I use.


#4

Sorry, I think my post was confusing.

My current protocol is 100mg Test Cyp per week (divided), 1.0 mg anastrozole per week (divided), 1000 iu HCG per week (divided) as follows:

Mon AM: 50mg Test Cyp IM
Tue AM: 0.5mg Anastrozole
Wed AM: 500iu Hcg SC
Thu PM: 50mg Test Cyp IM
Fri PM: 0.5mg Anastrozole
Sat AM: 500iu Hcg SC

My current labs on this protocol is as follows:
12/21: 17 week bloodwork
FREE TESTOSTERONE (DIRECT)(9.3-26.5)pg/mL: 26.9 High
TESTOSTERONE, SERUM(264-916)ng/dL: 1223 High
ESTRADIOL, sensitive (8.0-35.0)pg/mL: 14.3


#5

Thank you for your feedback. I have the following questions:

  1. Why reduce the HCG dosage? From what I understand, a 250iu HCG dose would need to be EOD. Do you concur?

  2. I agree that my next step should be to stop the anastrozole and get labs to see where my E2 goes. Will try this and follow-up.

  3. Progesterone was 0.5 ng/ml (0.28-1.22) when checked with 11/9 labs quoted above. These labs were with higher Test dose of 200mg/wk, not current protocol.


#6

You run the risk of Leydig cell desensitization from too high an HCG dosage. A higher than necessary HCG dose will also increase aromatase activity in the testes where anastrozole will not help.The goal of HCG is to keep the testes functioning; 250IU twice per week is sufficient. So, no not EOD: Twice per week.
Progesterone 0.5ng/ml is decent, but it may be dropping. Mid-range is better, which is closer to 0.7. I recommend Pregnenolone 12.5mg sublingual every morning.

wx14
December 30 |

TRT_Phoenix:I would reduce the HCG to 250IU twice per week.
Your estradiol is too low. My recommendation is discontinuing the anastrozole and see if you even need it. Most men do not need an AI on 100mg Testosterone per week.I also recommend getting Progesterone checked. You can have perfect Estradiol and still be bloated and estrogen dominant if Progesterone is too low. Supplemental Pregnenolone will help increase Progesterone.I recommend all men on TRT take 12.5mg DHEA and 12.5mg Pregnenolone sublingually daily. Douglas Labs is the brand I use.
Thank you for your feedback. I have the following questions:

  • Why reduce the HCG dosage? From what I understand, a 250iu HCG dose would need to be EOD. Do you concur?
  • I agree that my next step should be to stop the anastrozole and get labs to see where my E2 goes. Will try this and follow-up.
  • Progesterone was 0.5 ng/ml (0.28-1.22) when checked with 11/9 labs quoted above. These labs were with higher Test dose of 200mg/wk, not current protocol.
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TRT_Phoenix
December 30 |

I would reduce the HCG to 250IU twice per week. Your estradiol is too low. My recommendation is discontinuing the anastrozole and see if you even need it. Most men do not need an AI on 100mg Testosterone per week. I also recommend getting Progesterone checked. You can have perfect Estradiol and st… Visit Topic or reply to this email to respond. To unsubscribe from these emails, click here.


#7

Thank you I appreciate the feedback. I’ll keep an eye on Progesterone. I’m interested to see where my e2 goes after dropping the Anastrozole.


#8

E2 is definitely too low, you may or may not have some immediate symptoms, but the long term symptoms are what suck. (Ai induced arthralgia)

You made the mistake of lowering your test by half and keeping the same AI dose.

Low e2 SUCKS, and it cause knee pain so extreme I couldn’t bike for a year, just recovering. Don’t make the same mistake I did.


#9

I reduced my T and maintained my AI dose to lower my high E2 (42). Going to go off the AI and maintain my T dose to see where E2 goes. Thanks for the feedback.


#10

I believe my TT and FT levels are too low on the new 100mg/wk dose. I am getting blood work tomorrow to check.

My previous 200mg/wk protocol left my E2 at 42. I am considering increasing my AI dose from 1mg/wk to 1.5mg/wk by taking 0.5mg every MWF. Does anyone have experience dosing Anastrozole like this? I don’t want to double my dose and tank my E2. This seems like the next logical step. Protocol would be:

100mg Test Cyp 2x/wk
0.5mg Anastrozole MWF
500iu HCG 2x/wk


#11

Make one change at a time. You changed test dose ( and stayed off the AI, right?) since the last post, and you should wait to see where your lab numbers are before you start planning what your going to do next.

I hope your not on the AI still.

If you take your original numbers on 200 a week. Divide those by 2 because your only taking half the dose, your Free test and TT numbers would still be good. Obviously that’s not exact, but should be close enough. I doubt they are low.

It would have been good to see where your e2 was on the 100mg a week without an AI. To see if you even need it!


#12

I haven’t changed anything yet. I’ve been on the 100mg/week Test dose for 7 weeks. I haven’t taken AI for 4 weeks of that 7 total weeks. I am going tomorrow to check TT, FT, E2 to see where they are at on current protocol.

Curious if anyone has taken Anastrozole on a MWF dosing schedule.

Thanks.


#13

Keep note of how you feel when you go for the blood test. This way you can compare lab values with actual symptoms.


#14

Results for 50mg test 2x/wk, no AI, 500iu HCG 2x/wk

FREE TESTOSTERONE (DIRECT)(9.3 26.5)pg/mL: 19.2

TESTOSTERONE, SERUM(264-916)ng/dL: 1013 High

ESTRADIOL, sensitive (8.0-35.0)pg/mL: 41.6 High


#15

Did you get SHBG value?

E2 is a little high obviously (what are your symptom

You could even lower your Testosterone a little if you don’t want to mess with an AI… you may still end up needing something for e2 control, maybe not AI even.


#16

SHBG was not checked with these labs but it was checked back in November.

11/9/17 labs
SHBG 40.7 nmol/L (13.3-89.5)

Nipple sensitivity and minor swelling of lower legs and fingers are the only noticeable symptoms.


#17

You can either attempt to use an AI or other e2 control to bring the number down, or you can lower your dose a little. I would lower my dose if it were me.

I like not having to take any additional medications if I don’t have to.