T Nation

New TRT Protocol. Help?


I just started a TRT protocol and I wanted to see if anyone had any advise.

About a year ago I started to experience severe abdominal pain. I assume it was from drinking, because I was drinking alcohol almost everyday at that point. I was pretty fit before but I fell into a bad drinking habit especially the 6 months leading up to this.

I went to the doctor and he thought maybe I had gastritis and told me to take some PPI’s and quit drinking. I quit drinking abruptly and started to experience anxiety and de-realization symptoms. My stomach issues started to clear up with cleaning up my diet, but I still had some issues here and there. I had an endoscopy, body CT scan, ultrasound and more blood work than I can count and everything came back fine.

My doctor was convinced it was all mental and told me to take clonazepam twice a day. I started taking it and within two weeks I started to feel very weird, I was super lethargic and depressed, I could hard work. I found out it’s not good to be taking a benzo every and found to new doctor. I had to wean myself off the clonzepam which made my anxiety even worse. I also started getting a weird pressure on the sides, front and back of my head. My new doctor had me get a brain CT scan and everything came back normal. She tried to put me on an anti depressant called Cymbalta. I’ve been off the clonazepam for 3 months.

I didn’t take the cymbalta and started to get back into the gym. I also started doing yoga, seeing a counselor, getting massages/acupuncture and neurofeedback. At first right after getting off the clonazepam I was too anxious to even go to the gym, but slow it started getting easier.

I still felt a little bit lack of motivation, slight depression, anxiety in big groups and pressure in my head semi regularly, especially if i get really worked up at work. But I started to make some decent progress in the gym.

I went to a hormone clinic and these were the levels they found with my blood work:

Estradiol - 105pmol/L
Free Test - 300.6 pmol/L
DHEA - 7.7umol/L

The prescribed me the follow protocol:
DHEA 25mg once per day
HCG 500IU biweekly SUBQ injection
Test Cypo 40mg per week intramus injection
Arimdex .5mg twice weekly

I just did my third test injection yesterday and I don’t really feel any different. In fact on days I inject the test, my anxiety goes up and i feel strong denationalization the whole day, and paranoia that I messed up the injection. My erections are still average, my strength hasn’t really gone up and my energy seems to have only a slight increase. Yesterday I took my injection in the morning and then the arimidex before bed and I couldn’t fall asleep, it was like coming off the clonazepam all over again.

What does anyone think of my protocol, should i stick with it or quit? After doing 3 injections to I need to get on clomid and do PCT?

Also, I quit taking the DHEA after the 3rd day because I felt i was messing with too many hormones at once.

Help please!

Please provide lab ranges because I have no idea if Free T low, midrange or high without ranges and all labs have the own ranges as there are no standards. Clonazepam caused me to have low testosterone and benzos cause permanent memory impairment and sedate the pituitary gland. Cymbalta isn’t much better as its a chemical not natural to the body, there are always consequences some irreversible to taking drugs prescription or not.

TRT isn’t like a party drug where you get instant relief, testosterone repairs tissue and it takes time, 6-12 months to see significant improvements. If you’re not prepared to give TRT at least a year, then your future looks grim. This is a process of trial and error, the only way to know if something works is to give it a try, by learning what doesn’t work you begin to understand what does.

Everyone must go through the growing pains when first starting TRT, your body is in a broken state hormonally and getting testosterone elevated quickly can be a shock to your system, it will get easier as time goes on. More frequent dosing can greatly help as the peaks and troughs are what cause the emotional instability, the smaller EOD and even 10-12mg daily injections seems to make this transitional period easier. You can lower estrogen by injecting smaller doses more frequently.

It takes 6 weeks for all hormone levels to stabilize, during this first 6 weeks all your levels will be swinging wildly, you may notice good days and bad days. As you get closer and closer to the 6 week mark, you may notice these swings get smaller and then you start having good hours and bad hours right before your levels stabilize at 6 weeks.

These swings will happen everytime you change dosages forcing your body to re-adapt. Anastrozole dosage seems a little high given we don’t yet know if you are an AI over-responder, 0.050 anastrozole is enough to knock my estrogen low. You may find the dialing in process easier without HCG which can increase estrogen ruining the good feeling TRT brings.

Did you by any chance have SHBG tested?

Onset of effects of testosterone treatment and time span until maximum effects are achieved

Thanks for the response,

Ref. range from the lab on my free test is (175-700)pmol/L, the hormone clinic I’m going to said the optimal range is (350-700) pmol/L.

I have been 3 months off the clonzepam which i was on for 2 months total. Do you think I still need time for the long term withdrawal symptoms to subside? Is the sedation to the pituitary gland permanent or can I do something to fix this.

I’m willing to commit to TRT for 6 months for sure, however my fear is that it doesn’t work for me and I need to go on Clomid to come off. I heard Clomid is pretty nasty and I don’t want to experience something similar to the clonazepam withdraws again. Is clomid really that bad to be on?

I would consider not taking the HCG, however I’m looking to possibly have children in the next few years. Also, I live in Canada and the pharmacies can only supply bottles of 10,000 ui, so I pay for the whole thing and have to through it away when it’s half filled.

No i didn’t have my SHBG tested.

That’s a problem for you, SHBG regulates testosterone, estrogen, thyroid hormones and insulin. Men with SHBG on the lower end will find a higher concentration of testosterone in the urine than in the bloodstream, frequent injections is the name of the game when SHBG is lower.

It’s why I inject 20mg every 2 days and if you look at all of the other low SHBG men here and elsewhere, you’ll notice they find success injecting multiple times per week.

If you are serious about giving TRT a chance and are working with incompetent doctors, I see you walking away from TRT in less than a year with the thought TRT didn’t agree with you all the while the doctors had no idea what they were doing and you never stood a chance.

It’s very difficult to locate doctors who know what their doing as there are no guidelines or books for doctor s to read up on TRT, doctors that are knowledgeable learn through trial and error and tend to not share in their knowledge in order to stay competitive.