T Nation

Need Protocol Advice

I’m currently 47 and 6’ and 195#.

I started TR in late 2012 on the advice of my PCP based upon my complaints of low energy, poor sleep, low libido and anxiety.

He started me on 60 mg daily of Axiron then 1 month later he added 1 mg of AI per week ( .5 twice weekly). I don’t have my exact numbers from that time period but I felt significantly better on all my previous symptoms.

In the last year some of my symptoms have returned i.e. lower libido, slightly lower energy and 10# weight gain. My new Doc ordered a panel from LabCorp and here’s the results.

T, Serum 249 (348-1197)
FT, direct 5.4 (6.8-21.5)
Estradiol <5 (7.6-42.6)
SHGB. 31.3 (16.5-55.9)
Hematocrit 48.9 (37.5-51)

After reading thru the newbie stickies, I realized my E2 is too low and T is too low. I’ve since doubled my dosage of Axiron to 120mg per day and am taking the AI at .25 mg twice per week. I feel slightly bettter but not as good as my first year on TR. I’d like to change my protocol with a caveat: I travel as a pilot and cannot take needles or refrigerate HCG. I’m typically gone for 1 week and home 4 days or alternatively I’m gone for 6 days and home for 3.

Would the following protocol work?

On day 1 of 6 or 7 work period

  • test cyp 100mg single dose
  • AI 1 mg per week in .25mg doses
  • HCG at 250mg single dose

On day 1 of 3 or 4 at home

  • test cyp 50 mg
  • HCG 259 mg single dose
  • AI .25 mg on days 1 and 3 at home


  • continue Axiron 120 daily
  • AI 1mg per week in .25mg doses
  • HCG 250mg on day 1 of 6 or 7 day work periods and every 3rd day at home

This is a common issue with tropicals treatments, sometimes absorption rates decline over time. It’s likely you be needing to continue increasing the Axiron until you get to the point where it becomes useless. There are some who are perfectly fine with one injection per week and notice little in the way of feeling low towards the end of the week, or you might find that you feel better injecting twice a week. My advice is to ditch the tropical treatments, why cramp your lifestyle by not being able to shower, workout or swim a few hours after application? You might even find you don’t need an AI with injections, when I was low-T I to have very low E2, it felt like death!

I’ll let KSMAN advise on HCG and the AI since I have no experience with either.

A pilot could not be injecting insulin?

You could use low dose 10mg EOD nolvadex instead of hCG. After a while as part of your TRT labs, test LH/FSH to see how nolvadex is working.

You could inject 125mg sustanon per week which has a longer effective half-life. https://en.wikipedia.org/wiki/Sustanon

Your ideas are sound. But should have higher AI dose in beginning of week with weekly T injections and less anastrozole in your system as T levels decrease.

Subq T injections also release slower for smoother T levels.

HTC=48.9 is high relative to your low-T. Maybe this is from very low E2 and cholesterol could be adverse as well. When you get T levels up, you need to watch HTC as TRT will increase.

Your transdermal is not effective and T levels were low, AI needs to match T levels so was way too much. Low E2 was also making you feel bad.

Do you have thyroid labs?
Any other labs?

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

Evaluate your overall thyroid function by checking oral body temperatures as per the thyroid basics sticky. Thyroid hormone fT3 is what gets the job done and it regulates mitochondrial activity, the source of ATP which is the universal currency of cellular energy. This is part of the body’s temperature control loop. This can get messed up if you are iodine deficient. In many countries, you need to be using iodized salt. Other countries add iodine to dairy or bread.

KSman is simply a regular member on this site. Nothing more other than highly active.

I can be a bit abrupt in my replies and recommendations. I have a lot of ground to cover as this forum has become much more active in the last two years. I can’t follow threads that go deep over time. You need to respond to all of my points and requests as soon as possible before you fall off of my radar. The worse problems are guys who ignore issues re thyroid, body temperatures, history of iodized salt. Please do not piss people off saying that lab results are normal, we need lab number and ranges.

The value that you get out of this process and forum depends on your effort and performance. The bulk of your learning is reading/studying the suggested stickies.

I do not currently have thyroid labs. I have an appointment tomorrow for a new PCP. I will ask for this.

It seems you’re recommending something like the following:

Home protocol (at home 3-4 days)

  • T cyp subq 50 mg
  • 10 mg Nolvadex EOD
  • .5 mg AI at time of injection

Work protocol (on road for 6-7 days)

  • T cyp subq 100 to 125 or Sustanon 125
  • 10 mg Nolvadex EOD
  • .75 mg AI at injection and .25mg 3 days later

I’ll keep you posted on what I can get from my new doc and insurance. My plan is to get hormones stabilized in 6-8 weeks then get more lab work such as CBC and cholesterol but I’ll ask for thyroid labs tomorrow.