T Nation

Questions on Dosing Schedule (Doc Didn’t Clarify)

Hey boys,

So I’ve been on this whole TRT/low T adventure for about a year now. I’m 27 years old and I’ve been suffering the symptoms most of my life (labs below 300 going back to when I was 19/20, now about 180-220).

Basically finally got treatment for it and had a doctor who was jerking me around the last year with clomid and hcg mono therapy. Tried the clomid mono therapy route and just got insane sides within two weeks (lungs, eyes, besides estrogen stuff).

Then tried hcg mono therapy route. Felt some minor improvements on 1000 every other day but t levels only went up to like 280. So doc bumped me to 2500 IU every other day and then I had insane estrogen sides (I’ve had gyno surgery 3 times so I know what many of these are…) but the guy refused to give me anti estrogen. With the 2500 eod hcg my t was hardly cracking 500 on the labs.

Long story short found a new doc that I really like, did probably overkill in terms of labs and all kinds of analysis, but came to conclusion that I need real TRT, given that a ridiculous HCG mono dose (yes, 2500 EOD) was hardly putting me at 500. So new doc put me on 200 mg/ml test cyp at .5 weekly, along with .5 mg anastrozole taken twice weekly, and then the 500 IU hcg two-three times weekly.

But he also kind of said just play around with the dosing days based on feel and that nothing is concrete, other than that given my estrogen issues in the past he wants me taking one of my .5 anastrozole the same day(s) as the test.

So tldr my question is what kind of protocol has given you guys succeess? I’ve read that some people prefer the test cyp every 3.5 days instead of weekly, for example. I also am clueless as to when in the week I should be taking the hcg. Given that I was on eod hcg injections pinning multiple times a weeek doesn’t bother me at all so convenience is irrelevant for me. I’m basically down for anything and want to hear the opinions of you guys who have all been on this stuff a long time.

Thanks so much in advance for your help everyone

This sounds bad, esp twice weekly. I’d just take .5mg day after your 100mg shot and see how you feel after 4-6 weeks. Even better would be to not include the AI from the start, but I understand you’re nervous about e2 and will need to experience the effects first. Anyway, that’s how I’d start

If you get the glands removed, there almost no chance of gyno returning and no more having these doctors repeatedly charge more money down the road.

Also if you’ve had gyno before a once weekly protocol is the worst type of protocol because gyno is triggered by an imbalance of many hormones and a weekly protocol would have testosterone, DHT and estrogen swinging greatly between peak and trough.

A protocol when you’re injecting small doses most frequently would be much better and create minimal fluctuations in hormones.

Why are you wanting HCG to be part of your TRT protocol?

First of thank you both so much for the replies so far on this.

So something I learned (I’ve seen 5 different plastic surgeons about this for consults and surgeries) that might be news to you guys (it sure was to me…) is that the full breast gland is almost never removed from guys during surgery for gyno. It’s extremely rare to completely and totally excise it, any of guys who’ve had gyno surgery, take a look at your op reports. Most often they leave a sliver of breast tissue right under each nipple.

This is sometimes because of cosmetic issues (it could cause the nipple to cave inwards on the chest and look bad), or most often because that breast tissue gland is the only thing giving blood flow to the nipple, and fully cutting it out can result in a dead nipple. There’s actually some episodes of botched about this too, hahahah.

So, long story short, the gland isn’t fully removed in my case. I saw another doc about getting it fully removed and he said the best he could do is cut out parts around it but ultimately that fully removing it will kill the nipples. I’m not exaggerating the number I’ve surgeons I’ve seen about this, there is no “second opinion” to be had on this one haha.

So yeah I do still have estrogen concerns related to that, and also big time given my past estrogen related sides I had on HCG (the clomid stuff who tf knows what that all was).

On HCG when it went up to 2000 iu then 2500 IU EODc my estradiol was up around 33, with test at about 330, then around 42-46 with test at like 450ish. Obviously those aren’t SUPER high estradiol numbers, but when my test was only like 300/450 to go with it, it obviously wasn’t feeling great. To compare, when I was sitting at 190-230 test (my baseline) and having no estrogen sides, estradiol was consistently between 7-12. When I began the HCG mono therapy at just 1000 IU EOD, estrogen was hanging around 18-22 with test around 280.

Some of the sides I had from the higher dose HCG without AI were moodiness, lethargy, no libido, ED, zero motivation, sensitive nipples, the whole 9 yards… the worst of all was the no motivation, like literally couldn’t even get the motivation to get out of bed. Effectively if you google high estrogen symptoms, I had all of those issues haha.

So I’m for sure going to be taking an AI throughout this once I begin the test cyp. As for the question about why I will be taking HCG, it’s #1 to maintain fertility. I would say that’s 85% of the reason and then 15% of it is to maintain testicular size… but for sure fertility is the most important factor.

So you guys are thinking I should be doing more frequently weekly injections of the test and the hcg? But then the AI just once weekly after the test shot? Like I said in my OP, I was living for 8 months doing EOD HCG shots so pinning myself multiple times a week is no skin off my back (well it is, but yeah). Would like a 3.5 day protocol for the T be better? What about the HCG and AI?

Thank you guys again, I truly really appreciate the guidance.

I had a similar background with e2 and gyno. Had surgery 10 years ago, not all the gland removed, and every once in a while it acts up (more so on the right side) but I’ve found it’s very easy to manage and don’t stress about it anymore. And it’s tiny, compared to what I had removed before (I had a photo of the glands after removal, think it’s been lost).

Anyway, so my first 2.5 years on TRT I was terrified of estrogen. I ran up to 3mg of Anastrozole a week at one point (double that if I blasted) and got zero results and felt like garbage for a very long time. HCG was the only reason I felt any positives at all. I watched a video that recommended stopping everything and just using test, 2-3 times per week, and nothing else. Holy shit I started feeling better. Never added HCG back in and feel great. Take a tiny amount of AI here and there when I feel I need it. E2 stays in the 45-65pg range and I feel great. Finally seeing results in the gym. Can actually diet and lose weight now. All that was stalled with e2 < 20pg.

Take that for what you will. You could save yourself a lot of struggle and effort to not worry so much about e2.