T Nation

New on TRT from South Africa

Hi All

Ive been on trt for roughly 3 months now.
100 test cypionate once a week and an AI mixed in(not sure how much , currently go to the docs office for my jabs). Then HCG 0.5 once a week.
Im quite lean (1.78 meters @ 83kgs bodyfat roughly 13%).

Heres my last labs. I didnt know about this forum or when to do my bloods so its from a day after my injection (roughly 15-20 hours).


High free test is prob because i went shortly after an injection.

I feel fine. Not like a superhero or anything , but definitely better than before treatment.
I still have a little mood depression (not bad at all just slight). Im sure it will improve as months go by.

My question is more around treatment options. Ive read what i could find here on the forum.
Being in South Africa , we dont always have the nice treatment options available to the first world (hehe). Going to the doc weekly is disruptive. So id like to figure out how to keep my levels optimized but also easy to maintain. (i dont mind injections, just having to go to a docs office weekly).

Thanks in advance and apologies if i broke rules or screwed something up heavily…

Much of my family is and/or was heavily situated in SA. You Joberg? Durban, Capetown? Totes fine if you aren’t comfortable answering, I’m just curious.

No problem. Im in the Johannesburg area.

Diabetic patients inject insulin at home, so there is little reason why you couldn’t inject in the comfort of your own home. It’s outrageous to be inconvenience and be force to go for office visits 52 times a year, it may be that the clinic wants you tied to it for their financial gain. The way your doctor is doing things is sloppy and for his/her benefit, any doctor requiring you to disrupt your life 52 times a year doesn’t care about your health.

It’s going to take 6-12 months to see dramatic changes as hormones don’t work as fast a drugs do, this is going to be a marathon, not a sprint. Your Free T levels are what matters and are at a good level. The AI mixed in with the Test is a bad idea, it always leads to misery.

If you were working with an experienced hormone doctor, you could stop using the AI and simply lower the Test dosage and or increase injection frequencies to lower estrogen. I inject 20mg EOD for that purpose.

Any time is really going to be informative but midway gives a good picture but so does trough (the morning before injection for instance). Following this test, showing your max, the trough day would provide useful information.

Do you have the option of injecting at home? That would cut down on the visits. Is Test-Cyp available over the counter there in SA? You shouldnt need an AI with this protocol (especially if you are lean) and it can lead to side effects.

Your TT doesnt look crazy high at roughly 1880 right after injection with HCG keeping your testes producing test and the addition of the 100mg a week. Free T and E2 would also be useful tests along with SHBG.

Thanks for the replies.

My current doctor is the only one i could find in our province. (interested in t… can view info at http://the-t-clinic.com/). He more into aesthetic medicine, but i needed someone to help with my low t.
I think we might be quite far behind on hormone treatment in RSA.

I inject HCG myself subq so im ok with that.

Test in any form is only available with prescription. I should be able to get one if i ask.

Im not sure he will listen to my ideas though … i will however try. I have asked about subq test injections and he was extremely negative about it.

Doing IM twice weekly would be hard wont it?

heres the shbg … missed it in post 1


and free T.

(Also added to post 1)

The more i read on the forum and research , the more i think my doc just wanted me on testosterone. (prob for the return business).

Found my original labs he had me do , and from what i see there (with my untrained stupidity) , it doesnt look like i needed any treatment … My free test seems great even if the SHBG is high. Doctors confuse me.

I will appreciate any advice. This treatment has saved lots of men , but if i dont need it , i would rather not be on it. If that makes any sense. I want to feel better not try and get an advantage or do steroids. (i know its not steroids at this level). If testosterone wasnt the cause of my symptoms , i might just be masking it by being on treatment.


I should have researched before going ahead. I realize this now. Stupid for being so trusting.
Please assist. Thanks in advance.

A lot of these clinics are like a car dealership, they want to sell you products and services and care little able your health. Insurance based healthcare is restrictive because someone else is paying for everything, there’s that redline if crossed can hurt the career of the doctor.

Self paying for treatment is different, your doctor only loses a client, there are many more people out there waiting to be taken advantage.

It never ceases to amaze me how everyone is truly different, your SHBG is very high and yet Free T is better than midrange. This isn’t very common and suggests your SHBG isn’t binding testosterone very strongly which in your case is a good thing.

@systemlord :Thanks. I feel the same about the clinics.

Im at a loss though… Better than midrange means i shoudlve been ok without trt ,right? Maybe just changed my SHBG (no idea how yet)

What should i do? Should i work towards not being on trt or get the correct protocol and stay on?

Im quite confused hehe…

That may be a tough question to answer since everyone is truly different, I would have symptoms at midrange Free T levels which puts my Total T in the high 300 ranges.

Ask yourself why you went on TRT, was it do to longer recovery times between workouts, weak erections or did you just feel like something isn’t right with you. Depression has other causes besides being hormone related and therefore TRT can’t fix.

It could just be your weekly protocol which a lot of men would have trouble do to not keeping levels steady. The majority of success stories are from those injecting two or more times per week, there are a few outliers though.

i agree its a toughy.

I had mild depressed feelings which isnt my normal state.
Much lower libido. Interest only about once a month.
Drive was a lot lower.
Mind fog was intermittently present.
Sport performance down.
recovery down.
Extreme mood swings.

All probably to be expected at 43…

Its all better on trt… but is it the right treatment? maybe a really dumb self answered question.

These are all classic signs of low T reported in men with low T. Since your SHBG isn’t very sticky twice weekly injections might be best. Your estrogen is on the above ranges, that would cause low mood in myself, lower libido, softer erections and hurt my endurance.

@systemlord: thanks for the advice

spoke to my doc about it. He doesnt believe in the more per week injections, and doenst want to believe it takes down E2 without AI.
He now wants to add arimidex to my protocol.

Im still trying to convince him that going twice a week with lower dose will cause less spikes and thus less conversion to estrogen.

Ive searched around but also cant find what the general consensus is on subcutaneous injections. I would like to self inject but im not sure if ill be able to selfinject intra muscular. I dont fear needles , i guess i fear shoving them into my own muscle. Subq is easy and i do that with HCG without an issue.

This has nothing to do with belief, your doctor just isn’t experienced. Injecting more frequently can even lower hematocrit. How can he know if he hasn’t tried it?

20mg EOD E2 = 43
50mg twice weekly E2 = 70.