T Nation

NH_Watts' TRT Log


#1

I started TRT in November with a low dose of 100mg/1ml every 14 days. I noticed the second week was kind of hard for me so I switched myself to 50mg/.5ml every week. Labs came back lower than my previous T reading so my doctor increased to 200mg every 14 days. So I have been injecting 100mg/1ml every 7 days and things have seemed better.

My question, my doctor wants labs again towards the end of the month and Im wondering if for the injection leading up to the appt if I should give it 14 days like he had prescribed? I realize the second week I will feel awful as my T bottoms out BUT this is the protocol he prescribed. I feel like if its only been 7 days then my T number will be slightly inflated.

Thoughts?


#2

need to read the stickies. should be injecting 2x per week. some do even more with a low SHBG. if only 1x a week. by day 6 you will not fell good - to many ups and downs.


#3

I’ve read them; however that wasn’t my question.


#4

I see you are trying to work with the dr. who is incompetent. Most guys take things in their own hands and inject on a better protocol, at least you got the script from Dr. Tough situation - if you think you get low T by waiting the 13 days - the dr may up the dose and still will not prescribe 2x a week. What is your goal with the dr?


#5

Thanks charlie12.

Well he definitely isn’t up to date on TRT but so far he has done what I wanted so I haven’t yet searched out a new doctor. This is also relatively new although I had been tracking T for the last 5 years via blood work at yearly labs at my request. He was also kind enough to double the dosage after the initial amount showed my T dipping below previous lab tests so that now I am on an actual therapeutic amount.

The timing is up to me as far as I am concerned. It is still within HIS script as I am still only getting 200mg per 14 days.

I mean I really dont want to bottom out my T waiting 14 days for until the lab but I also dont want to show him a false positive either by having injected 7 days prior. Maybe he would drop the dose? I dont know. Im feeling better but my gut tells me to give it 14 days after the injection to show the doc what he needs to see. Maybe he ups it again from there or maybe he drops the script and points me to a endo? Im feeling better so I dont really want that. Just not sure so looking for advice.


#6

I hope the other veterans on here will come in to advise you. Just curious if you are on HCG if not why? I maybe going in injections soon and am looking for info too. Thank s


#7

Thanks.

Just testosterone cypionate so far. The physiological effects have been good and I have been on since 10/24. Not sure how seasoned my doc is with TRT but when I brought up splitting the dose and injecting every week he scoffed at it. That being said if he doesnt bring up HCG I may.


#8

The doctors that run on a weekly or bi weekly shot schedule usually have you test right in the middle of injections.

Can you get the script to take home? If so, you need to self inject twice a week, if the doctor doesn’t like it, just tell him your doing it his way…(which, in my experience, they will argue against it even though they have no research/reason to back it up)

Smoother levels this way. Injecting once every 2 weeks is buffoonery. Causes e2 spikes and spikes and valleys in your test/mood. Injecting once a week is OK, some say its better with those with high SHBG. Do you have your SHBG lab?

So relative to your shot schedule, when does he want you to do labs?


#9

He didn’t specify @alphagunner, just said labs in 4 weeks, and he didn’t specify last time either so I went on day 14 of the two week cycle knowing it would be at its lowest and he’d hopefully up the dosage (which he did).

I have the script at home and have been self injecting from the start so timing is up to me. Weekly seems good for now. I don’t notice the drop. Based on steroidcalc.com Im probably not dropping below 600ish injecting weekly where as I did notice the drop injecting EOW which may have dropped me below 200, again based on steroidcalc.com

He hasn’t done SHBG labs.


#10

SHBG is vital to know for injection frequency. Also, you should ask what your Dr. wants, so you are both on the same page!

If those numbers are true, then you are doing alright as far as numbers. But I would imagine it cant be very accurate without a SHBG number.

Never seen that site before, gonna take a look.


#11

TRT is more than just prescribing testosterone, it’s about monitoring and managing your hormones and it seems like your doctor doesn’t even know how, any doctor that has his patient injecting every 14 days is clueless. You act as if he is doing you a favor by upping your dose, he’s struggling and it sounds as if he scuffles at a mere suggestion about injecting more frequency which he should already know is the correct move and should be onboard with that wise move.

SHBG is the foundation for activating and regulating sex hormones, he has missed the most important test possible because if your SHBG is low these 14 day intervals will leave you feeling subpar. My SHBG is low and it wasn’t until I started inject EOD that I really started noticing a difference, I alright on weekly but nowhere near as good as I do now. So far your doctor has scored an grade F for failing to run SHBG and estradiol! You may not feel so bad now, but as your body starts getting used to higher test levels you will start to feel worse as time goes on with the infrequent injections and towards the end of the weeks you get lower and lower as the dead space gets wider and wider. You doctor doesn’t understand the half life of the medicine he’s prescribing, you are not in good hands!


#12

You’re right. I will call the office and find out.


#13

“TRT is more than just prescribing testosterone, it’s about monitoring and managing your hormones and it seems like your doctor doesn’t even know how, any doctor that has his patient injecting every 14 days is clueless. You act as if he is doing you a favor by upping your dose, he’s struggling and it sounds as if he scuffles at a mere suggestion about injecting more frequency which he should already know is the correct move and should be onboard with that wise move.”

I guess in my mind its better than nothing and need to take what I can get while I shop for a new doctor…which to be honest I dont even know where/how to start. I don’t want to have to go to a TRT center and pay out of pocket. Insurance is covering this as of right now so it’s like $30 for a 10 week supply.

“So far your doctor has scored an grade F for failing to run SHBG and estradiol! You may not feel so bad now, but as your body starts getting used to higher test levels you will start to feel worse as time goes on with the infrequent injections and towards the end of the weeks you get lower and lower as the dead space gets wider and wider.”

I did notice it with the EOW injections which is why I moved to every 7 days to feel that out. IF I notice that by weeks end I am in the toilet I with try E3.5 days and go from there. I am also going to ask for the full panel that KSman has laid out and if my doctor refuses I will probably get my own testing done while I look for a new doctor. He may say no and refer me to an endo for the extra lab work.

How does one go about finding a good TRT doctor in an insurance network?


#14

That exactly how I felt in the beginning, grateful to be on TRT with one injection every 3 weeks. I promise you when the excitement of being on TRT wears off you will find another doctor, self preservation is a powerful motivator. Your location matters more than anything, outside the USA and it’s not going to be easy.

As far as finding a doctor, what does one do when they want to buy something off Amazon, you read the reviews. I don’t buy toilet paper without reading the reviews first, lol!


#15

I understand. With the added benefit of feeling a bit better, and libido starting to come back, it’s hard not to feel excited about the whole thing. That being said I would like to do it properly.

I’m in the US. Massachusetts.

Where can you read doctor reviews systemlord?


#16

You want to have labs tell you something about what is going on. If you inject once a week there is a very large change in TT, FT and E2 and then your lab results are then mostly determined by lab timing and quite useless.

Inject 50mg subq, not IM, twice a week with #29 1/2" 0.5ml insulin syringes and do labs always halfway between injections. Doing labs at times of random office visits is not good enough.


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.


#17

Thanks @KSman I have read everything over the last 6 months or so in prep of treatment and for posting here. Unfortunately I do not have all of the required labs as my doctor had only ordered testosterone on top of my usual yearly physical labs. This is why I kept my initial question simple because I am just not prepared to fully answer all that is required and I apologize for that.

I have been taking a kelp supplement for the last year and my multi has the required selenium. I also converted to iodized sea salt about 3 months ago. Is there an validity to the iodine patch test?

As far as temps go I am generally always 98.4 first thing in the AM in bed. I have been monitoring, albeit infrequently, morning and night time temps since August. I was having an early morning hot flash 30 minutes after waking (usually 99.4) before my current TRT protocol. Those seem to have subsided. Mid day temps are 98.5 or 98.6.

Also thank you for the Finding a TRT doctor link. THAT sticky I had not read as I hadn’t yet disqualified my doc.


#18

The doctor “suggested” (nurses word) that I get my blood work done on the morning of the day of my injection, before my injection.

My question now is…will there be a difference in my total Test number on that day between?:

A) Injecting 200mg and getting the test done 14 days later (his protocol)
B) Injecting 100mg and getting the test done 7 days later (my protocol)


#19

Injecting more frequently keeps your total testosterone higher.

So more than likely, your TT would be higher on the 100mg a week dosing, testing on trough days.

I think that’s pretty standard to check right before your next shot.


#20

The whole point to checking your trough is doing labs to see where you are at your lowest point, if you do labs a day early then that’s not your lowest point. At 100mg weekly put me around 550-600 ng/dL, twice weekly 780-800 ng/dL and EOD 830-860 ng/dL. The latter ended up being too high for me and would like to solve the high E2 without an AI. I’d like to use the least amount of drugs to feel normal, adding more drugs to the mix takes you furthest away from nomal as one can get, I’ve spent my whole life on prescription medication which is why I need TRT in the first place.