Really Struggling Dialing in TRT

Welcome to TRT, this is what happens every time you change your dosage or injection frequency, fluctuations for 6 weeks. Imagine constantly changing your dosages every couple of weeks, it’s going to be a long, long time before you start seeing benefits on TRT.

Your TSH is too high and is not normal like a lot of doctors were taught, most of the healthy population has a TSH <1.5. You need all free thyroid hormones tested. Some are AI over-responders and simply get wrecked everytime they touch an AI. If you find yourself over-responding to medications, caffeine, it’s likely you will be an AI over-responder.

You will not make new estrogen until the AI detaches from the aromatase enzyme at which point you may experience the E2 rebound effect which is not fun!

Pain behind the eyes, sore clicking joints is a sure sign estrogen is very low. You may need daily dosing to control estrogen, these AI’s may be a losing battle.

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How long were you on the protocol originally?

Get off the fucking AI and let the test take its course , your jumping around way to much . Stay off the AI !!!

60mgs of test twice a week for 5-6 weeks and go get levels checked



Likely not high since his ft is high.

My entire test duration was 9 weeks. I started at 150 per week, but ran into sides and issues within 3 or 4 weeks, and subsequently reduced the dose to 125. Again sides, and again slightly reduced the dose to 37.5 eod in order to deal with possible SHBG and high free test issues. Bloodwork was flagged as noted above with the hematocrit. And now here I am. I’m not feeling quite as bad as I did yesterday, but it’s still pretty gnarly. I am gonna see if I can get ahold of the urologist tomorrow.

Some other factors I should add, or may add.

  1. I live at elevation (a mile high) and often hike up another 1000 feet. Not sure how much that may impact my h&h

  2. I have a non communicating hydrocele. I can’t figure out why such a low dose of test seems to be putting me at such high levels and wondered if maybe i’m basically still producing my natural test along with adding exogenous test.

This is my experience: Every side effect I had fixed itself after 2-3 months. That’s after 6 months of switching shit every 4 weeks because I didn’t feel great. The most important thing I’ve learned on my TRT journey is that you have to bite the bullet and give it enough time before making major changes. Not saying that’s the case for you but it was for me. Daily injections are the major game changer for me. It’s when the negatives disappeared and the positives flourished. Even changing to daily injections (same dose) took about 2 months before I felt good.


Thanks for that man. I really didn’t recognize the long delay that goes into this stuff. It just seemed like once you’re there, you could back off if you over did it, and up it if you underdid it.

One added question for you since you’re pinning each day: A poster on reddit suggested that more frequent pinning will push hematocrit and hemoglobin higher. Do you know anything about this?

Generally frequent smaller doses lowers hematocrit, when I was on 50mg twice weekly my hematocrit was 50%, daily dosing with similar levels hematocrit was 46%. Sometimes we see a guy that just gets high hematocrit on even twice weekly dosing, these cases are more rare.

Testosterone increase hematocrit, so using less testosterone usually creates less hematocrit, more frequent dosing will need less testosterone than if injecting infrequently to achieve desired levels.

I know a guy on another forum who got tired of donating blood to lower hematocrit because he was crashing his ferritin levels in the process, he’s been on daily dosing a for a couple of years and has done away with blood donation all together.

Wow, good to know. My levels on my last dosing protocol were about 1400 (probably higher since that was 3 days after the last pin), so when I do decide to jump back on after I get ahold of the urologist, i’ll probably cut my dose by 25%. I still can’t understand how I attained those levels at 37.5 eod. I plan to drop to 25 eod.

You need more testosterone when injecting infrequently to account for the decline in levels that occurs between injections, then increasing hematocrit because levels are in excess.

I can, this dosage is excess and only necessary when dealing with a hypersecretion where SHBG binds androgens poorly and excreted quickly via kidneys.

That’s interesting too. Maybe the EOD protocol was actually adding to it. I was mainly trying to avoid the estrogen sides. But a major problem for me is the inability to accurately identify what i’m feeling. Was I feeling hematocrit? was i feeling high T? Was I feeling high estrogen? All I knew is i was feeling bad.

It’s hard to know exactly what we are feeling when on new protocols, it could be all of the above.


My hematocrit was 47 on daily injections 200mg/week IM (same for 185mg sub-q daily)

500-600s total t is very suboptimal for most guys. Im also there and will most likely start TRT in a few months but first to consider and plan well the fertility issue.

Thanks for the education. TT is far less important than FT regarding what’s optimal. Also, coming from someone who’s been on trt for years, many go on TRT and deal with a rollercoaster of horrible side effects and experiences for years. The question becomes is that risk worth it when weighed against your current quality of life? In the 500s in my opinion, the answer becomes less clear. My TT initially was as low as 190 and there have been times I regretted going down this path.

This is also true and I agree. But for most guys 550 is just not enough and free test of 17 ng/l that is mine is also far from enough. We know everybody is unique but many people start to feel really well with free t above 30ng/l, some need 50 even.

I know it can be tough and hard. But from what Ive read most people struggle to dial in due to suboptimal protocols with once per week injections, starting trt with AI and staff like that.

But fertility is real issue, especially if you cannot handle HCG

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Finally some sane advice in this thread

If you have ever regretted going down the TRT path with a level of 190 then you have been mismanaged from the beginning. I all due respect the poor advice you have been giving on this thread is not a reflection of you but instead the poor teaching of evidence based medicine Defy has provided you