T Nation

Our Initial Treatment Protocols




@getcutgetbutt hey man. I am so sorry to hear about your experiences with physicians. Your dosing looks ok but on the high side for HC. You’re taking in more than your body typically produces. How long have you been on this protocol? What do you do for work? How are sleep and stress levels? What are your temps like ? You appear to be developing Addison’s symptoms and this needs to be addressed as this is a life threatening condition. What state are you in?


I wish I could give out my info but because I post in the pharmacy section about AAS use I can’t. /( @tbeach




@physioLojik correct me if I’m wrong, the body producing between 40-45 mg of cortisol a day. I know my dose is high currently, it was much higher because I was stress dosing because traveling out of state to a doctor (I have/had Lyme disease). We have been lowering it by 5% at a time. Tomorrow is my next scheduled drop to 45mg per day. When initially starting the cortisol my temperature raised to 95-96 average. During the road trip which was just driving in a car, nothing too bad, my temperature dropped into the 80’s again. My naturopath told me to stress dose. My temperature increased to 97 within a few days to a week. We stayed stress dosing till returning home and have been dropping 5% almost every week since. So currently my temperature averages 97 when waking and about 97.2 in the afternoon.

Background (sorry for throwing so much more info at you in advanced): I’m 20 years old, currently not working but just started online college. Not a stressful life other than dealing with so many doctors and feeling so bad a lot. It’s a lot less stressful now then when I was in and out of the hospital. I sleep at least 9 hours a day right now.

If you want any other blood numbers, chances are I’ve had it done recently.

I realize how crappy I’m giving information too you so sorry about that, it’s just been hell before starting HC and I wasn’t even functioning. If you asked me my name for 1 million dollars I couldn’t have said it. Currently I feel stable and not like I’m dying.


Holy shiiiiitttt @getcutgetbutt I’m not an expert but previously some of the symptoms you described such as shaking, vomiting, body pain sounds like adrenal crisis which is a complication of Addison’s disease. That can actually be a legitimately life threatening situation, I’m very sorry you had to go through that, must’ve been terrifying.

do you have any other autoimmune diseases?
Do you have bloods of serum potassium or sodium?


@unreal24278 @physioLojik There’s not a doubt in my mind I went through adrenal crisis. Trust me I know it’s life threatening lol. During that I had a heart attack, or my heart stopped, or something bad happened with it. Not exactly sure what it was and frankly don’t care. I’m assuming it was from either the super low body temp. Or lack of cortisol. I also lost consciousness a few times when doctors kept telling me to come in for morning bloods and morning appointments when I couldn’t even function. Thanks man. Yeah it was pretty terrifying all the crap I’ve been through. I remember most nights right before starting HC waking up out of sleep thinking my heart stopped or I wasn’t breathing. Super bad muscle pain, nerve pain, joint pain, chest pain, lower back pain, oh and bone pain. Hell the bone pain suckkks, that hasn’t gone away yet. When I step I feel like my shins are going to break in half.

I know you’ve been through a lot too so I bet you understand first hand when life sucks, it really sucks lol. As for other diseases, just Lyme disease, which I think I am finally over. Traumatic brain injury. That’s it, nothing else that I’m remembering right now.

I have gotten that tested but somehow it slipped away from my records. I am actually getting that rechecked in a few weeks though because (which I forgot to mention earlier), I’m taking Florinef along with my HC.


@getcutgetbutt I will send more later - but your case has me concerned. It’s complicated - remember that exogeneous testosterone lowers cortisol and due to that is contraindicated to some degree in patients with adnreal insufficiency. That being said - having trash testosterone levels requires TRT. We need to find a balance between your cortisol and test. Also Lyme disease is no joke. Sorry for further details as of yet I am traveling currently.


@getcutgetbutt you’re on TRT? What’s your dose?

Hopefully this helps (or it might make an uncomfortable situation worse). If you and physiolojik are open to contacting each other you @getcutgetbutt could put up your Reddit username on this forum. Reddit is anonymous and allows people to PM. However it’s probably still risky to give your identity to people you talk to on a forum, it’s just a suggestion, I’ve done this successfully before. After the individual is contacted you simply delete the post giving your username to avoid people haphazardly messaging you.

Otherwise maybe someone can recommend you another doctor with expertise in adrenal insufficiency

Also @physiolojik I was under the impression androgens stopped cortisol from binding to various receptors, therefore blocking the effects of cortisol. Do they also lower levels of cortisol?


@unreal24278 actually testosterone does both - lowers binding and lowers production in MOST people. There have been cases in our practice where this doesn’t occur, which is a testament to how individual this stuff is.


So if I had an issue with low cortisol before TRT it’s possible TRT May make the low cortisol issue worse?


@physioLojik I knew about the testosterone and cortisol thing. I read a lot about that which is why I knew we needed to support my adrenals before adding the test or I would crash further. But I get what you are saying. The Lyme was tricky cus we couldn’t tell if my problems were from Lyme, lack of test, adrenal problems, it was a giant mess and no doctor could help. One of the times I was in the ER (my mom made me go cus I was throwing up blood) the doctor walks in and my mom is going well he has Lyme disease but I think he also is going into adrenal crisis. The ER doctor straight up goes “Lyme disease doesn’t exist west of the Mississippi” so already he was an idiot but then he addressed the adrenal crisis by saying “we don’t test for that here and I rarely see it so it’s not that”. My mom was pissed. I barely remember it cus I was so out of it. Hence another reason why I hate doctors and that wasn’t even an endo. Just horrible experiences with them lol.

Sorry to bother you while you are traveling. Have a safe trip Doc!

Shoot another random fact to add to the case. Before starting HC and Florinef, I was experiencing POTS symptoms. Every time I stood up I got super super dizzy and my blood pressure would drop very low. Since starting the rest of the stuff my blood pressure is now normal both when standing and seated.

Also I have this one random blood test I got that says my cortisol was normal. It was before the others but not by much time. My Dr. said it was a really bad stress getting up in the morning and driving to go get the blood test so my adrenals pumped out as much cortisol as possible to not die and that resulted in normaler levels. But she also said that was my reserves and then I was out of it. That test has always confused me. Blood has always been iffy. Urine and saliva have always been dirt low.

EDIT: Forgot to say the outcome of that ER visit. I was itching to leave cus I didn’t think highly of him. Anyways he gave me some anti nausea stuff that was stupid and didn’t work and I was diagnosed with… A cold.


@unreal24278 So far it has helped!! I don’t look like I have epilepsy anymore. I had some real bad muscle shaking before starting. Which was separate from what I call lack of cortisol shaking lol. I am on 50mg 2x per week so 100 total. I shoot sub Q. Awaiting results on 6 week bloods to adjust the dose. Levels the morning I first injected were 125 (400-1200). And no HCG or AI. No hcg because I didn’t want to add anything else into my body right now. Heard mixed reviews on it and my body was already dealing with enough. And no AI cus my estradiol was <10 (12-56).


For those of us that still want kids, what do you suggest to protect fertility if not using HCG?


Also interested in this.


Yes I’m not a fan of HCG. Docs are finally starting to realize it’s actially not healthy to use for long durations. For fertility I think tomaxifen can work quite well with or without being paired with clomid for when you want to try to have a baby. I’ve seen it work without (myself being a notable case).


Any chance you can elaborate what “not healthy” means? How are docs finally realizing it? Studies?
I’ve been struggling with getting my trt dialed in for 10 months. I’ve been asking my doc about hcg hoping it is the missing puzzle piece. My doc has agreed to work with me and Defy to get me hcg, but now you are placing doubts in my mind.


More to follow. On my way to Mexico for a wedding :slight_smile:


This is awesome, thanks man. Would tamoxifen be run concurrently with TRT for fertility or would you have to stop the test?


I asked this earlier in this thread after watching Physiolojiks video:

Does anyone have any links or information regarding teenagers/early 20s men having e2 around 75-100pg/ml? This contradicts every study I’ve seen that says the range is more around 20-30pg/ml.