T Nation

Starting HRT Today

After reading through everything I could on here all of you guys have great info in regards to HRT. Anyway here I am at 35 and I have to start HRT. I’ve been feeling like crap for years now. Zero libido, mild depression, chronic fatigue, etc. I had a difficult time obtaining HRT because my endo says I’m “fine”. Yeah right…

Does this look fine:

TT: 379
Bioavaialable T: 44
Free T: 1.4
LH: 1.5
FSH: 1.7
SHBG: 49
E2: 46

All by quest labs.
A year ago my family doc checked my T and it was:
TT: 525
Bioavailable T: 70
Free T: 1.4

I wasn’t feeling that great then either and I was having fatigue and libido issues. The most recent numbers were done after I told him I was really starting to feel like crap. After my endo denied me I took the blood work back to my family doc and he agreed that we should try HRT. He just gave me 5grams of Androgel to start and it basically returned me to normal in two weeks. The best I’ve felt since I was 17! I debated going on HRT permanently for the last several months and decided to just do it.

After reading that everyone is switching to the shots that’s what I’m starting today. He prescribed 200mg of test cryp a week which seems really high. What do you guys think of that? It seems like I know more about this than him or the endo so that is a little frightening. Also I plan on trying some protocol of Clomid with HRT to keep from totally suppressing HPTA function. I’d still like to have a child so I need to keep my testicles going to some degree. If that doesn’t work I’ll switch to HCG. My doc doesn’t even know what that is. He’s trying to find another endo to take over my treatment but it just seems like they’re all clueless.

I have a few questions for you guys:

  1. Has anyone tried Clomid with HRT to limit suppression? I have read where some people have luck with it.
  2. Is 200mg a week to much for HRT? I haven’t read where anyone is on that dose.
  3. I had a hard time getting on HRT because of my physical appearance. I’m thin, toned, and muscular which is why the endo denied me. He said there was no way this was my problem given my appearance. Is there any truth to that?

I had in the past. Clomid put me in PMS mode big time. I guess my estrogen receptors LOVED it.

Something to watch out for.

I’m happy with T+HCG+Adex.

bigdawg like so many others, had negative effects from Clomid. The current school of thought is HCG to stop HPTA shutdown and keep the boys in full production. I’m on 200mg/week of T-Cyp, and my blood work stays around 1000, and my doc is okay with that. It just depends on how you react. You may get 1500, or you may get 800 on 200/week it’s kinda trial and error on blood levels for some guys.

Some doctors think if you’re not fat and depressed with man boobs your hormones are okay. What a stupid way to think. Since you are on HRT now, you should keep watch on your E2 levels. You start out feeling like Superman, turn into Lois Lane, and wonder what’s wrong… Estrogen, that’s what’s wrong. As KSman so elegantly puts it T+HCG+AI are the three complimentary compounds for successful HRT. Do your best to get all three to keep feeling like your still 17. For some it’s possible to always feel that way.
Keep us posted.

Do you think it is best to start out with all three right away? My estrogen/estradiol tested at 30 with a 13-54pg/ml reference range. On my second week Test eth 100mg divided at 50mg 2x week and 500iu HCG 2x per week. I have L-Dex just in case, Dr. said my E levels are normal, won’t script Adex. I see the Doc in 5 weeks for retesting.

C36,
Personally, I think a 500iu shot is a bit much but it may be fine for you twice a week.
The original thought is to inject the HCG the day before your T injections. Even the guys that inject small amounts EOD (like me)still do 250iu on the (EOD)other days. You may be a rare exception (and there are many) that don’t readily convert T to E. You having little body fat may be one of the lucky ones. Fat storage = E production, E production = fat storage, and on and on. As far as L-dex goes, you may want to start on 1/2mg/week just to be safe as finding out the hard way you are making Estrogen sucks.
2 drops, seven days a week is close enough to 1/2 mg to be safe. My doc recommends 2mg/week for his patients, but I have discussed with him I feel better at 1-1/2mg/week and he sees that as reasonable. He’s way cool…
Seeing as how your T dosage is reasonable, you decide if 500iu is too big a shot. If it is, your boys will shrink in spite of the shots, and you’ll wonder what’s wrong. Easy answer; switch to 250iu shots. If you don’t experience any negatives from 500iu, then don’t sweat it.
The guys doing big juice do big HCG too, but you and I don’t qualify for those kinds of dosages. I had huge positive obvious changes after about a month on HCG.(I had been on HRT for a year plus previous)

If you want the gory details PM me.

[quote]KNB wrote:
C36,
Personally, I think a 500iu shot is a bit much but it may be fine for you twice a week.
The original thought is to inject the HCG the day before your T injections. Even the guys that inject small amounts EOD (like me)still do 250iu on the (EOD)other days. You may be a rare exception (and there are many) that don’t readily convert T to E. You having little body fat may be one of the lucky ones. Fat storage = E production, E production = fat storage, and on and on. As far as L-dex goes, you may want to start on 1/2mg/week just to be safe as finding out the hard way you are making Estrogen sucks.
2 drops, seven days a week is close enough to 1/2 mg to be safe. My doc recommends 2mg/week for his patients, but I have discussed with him I feel better at 1-1/2mg/week and he sees that as reasonable. He’s way cool…
Seeing as how your T dosage is reasonable, you decide if 500iu is too big a shot. If it is, your boys will shrink in spite of the shots, and you’ll wonder what’s wrong. Easy answer; switch to 250iu shots. If you don’t experience any negatives from 500iu, then don’t sweat it.
The guys doing big juice do big HCG too, but you and I don’t qualify for those kinds of dosages. I had huge positive obvious changes after about a month on HCG.(I had been on HRT for a year plus previous)

If you want the gory details PM me.
[/quote]
I am very low BF. I weigh 160 and only 10% BF. Years of hard training has kept me in superhuman shape, I train all the time. Get my 8 hours a night. My Doc scripted 600iu 2x per week. I cut it down to 500iu after reading much info. I did not feel a thing from the HCG at all, it was only my first shot yesterday. I will be doing my third test shot tomorrow. Again, this HCG dose is for 6 weeks until my next blood test, then see the Doc again and adjust from there. I have been taking Rez V 200mg EOD but I read it counteracts Cialis which I need to use still. I hear Liquicialis f/AG is good and more cost effective. Hopefully in time my libido will get better, it’s too early yet.

The lidquid cialis or viagra from the research chem compaies is very reasonably priced should you need it. Their adex tends to be much more cost effective as well unless of course yours is covered by insurance.

From any of the reading ive done and any other research 250iu 2x/wk of HCG is plenty.

Id also drop the Rez-V as you are now supplementing with test and using the proper AIs>

I haven’t used the LDex yet. I just started my test and Hcg shots. My Doc would not script it, said I did not need it yet. I bought the LDex in case I started getting nipple issues. I really don’t want to self medicate, just wish Docs would script all. At least this on gave me Hcg right away and didn’t wait. So even if my E level is considered normal right now, I should be using the LDex? How do I measure 1/4 of 1mg from the dropper and this would be EOD or E3D? Thanks.

Many in good muscular form are rejected as juice seeking.

You cannot stay on SERMs long term. hCG is a natural HRT for LH.

200mg test cyp per week is too high. Do 100 then see what the labs bring.

Your E2 is high and can only get worse with TRT. You need Arimidex from the get go and could have had benefit from that even before TRT.

When you reduce E2, SHBG should go down and that would increase FT; increasing the benefits of whatever TT levels you have or from any given TRT dose.

[quote]KSman wrote:
Many in good muscular form are rejected as juice seeking.

You cannot stay on SERMs long term. hCG is a natural HRT for LH.

200mg test cyp per week is too high. Do 100 then see what the labs bring.

Your E2 is high and can only get worse with TRT. You need Arimidex from the get go and could have had benefit from that even before TRT.

When you reduce E2, SHBG should go down and that would increase FT; increasing the benefits of whatever TT levels you have or from any given TRT dose.[/quote]

I am only on 100mg weekly of Test Eth. How do I dose the LDex (measure etc.) and do you think my intitial E is high at 30? I get great erections with Cialis and since my 1st HCG dose I have been getting spontaneous also. I also use ZMA, melatonin and 7keto 100mg. nightly.

Hey Brent,

Just curious. Do you lift weights on a consistent basis, eat lots of protein, etc.

I guess what I’m seeking to find out is have you tried a serious weightlifting natural approach to bring your T levels back up?

Would using treatment for a season and attempting to address it naturally, thru a weightlifting lifestyle, be an option?

E2=30 is in the “normal lab statistical range”. But that does not mean that it is optimal.

Do you know your E2 level while on TRT yet? If you are not getting E2 tests from your doc, then order on your own from LEF.org. If you get tested and your E2 is in the lower 20’s, your doc will take note.

One Ldex has 1/4ml markings on the dropper and 1mg/ml. There might be 30 drops per ml, count for 1/2 ml and double. If 30 and 1mg/ml, 10 drops EOD would be 1.16ml/week.

Do you know the signs of been an adex over-responder and what to do if that seems to be the case. [Doctors probably never raise this issue.]

You may not feel a major difference from adex as you have not had time for estrogen poisoning. But a jump in libido would not be a surprise. But libido is in a state of change early on with TRT and changing anyways.

If you are on insurance, your doc needs to have lab reports of high E2 AND your reports of feeling bad with no libido, to justify the prescription. So the system can be stacked against you where you have to suffer estrogen poisoning first. So E2 preventative medicine may not be possible via many doctors.

[quote]KSman wrote:
E2=30 is in the “normal lab statistical range”. But that does not mean that it is optimal.

Do you know your E2 level while on TRT yet? If you are not getting E2 tests from your doc, then order on your own from LEF.org. If you get tested and your E2 is in the lower 20’s, your doc will take note.

One Ldex has 1/4ml markings on the dropper and 1mg/ml. There might be 30 drops per ml, count for 1/2 ml and double. If 30 and 1mg/ml, 10 drops EOD would be 1.16ml/week.

Do you know the signs of been an adex over-responder and what to do if that seems to be the case. [Doctors probably never raise this issue.]

You may not feel a major difference from adex as you have not had time for estrogen poisoning. But a jump in libido would not be a surprise. But libido is in a state of change early on with TRT and changing anyways.

If you are on insurance, your doc needs to have lab reports of high E2 AND your reports of feeling bad with no libido, to justify the prescription. So the system can be stacked against you where you have to suffer estrogen poisoning first. So E2 preventative medicine may not be possible via many doctors.[/quote]

Just my second week in TRT I may have caught a stomach bug. Just to be safe since I am bloated a bit, my Doc ordered full bloods again so I will have the results by Tuesday. If the Estro went high this rapid then I was told a script for Anastrozole will follow. I do have the LDex but don’t know if I should start it. Feel like crap right now.

I actually tried everything imaginable to raise my testosterone before starting HRT. I was even on Adex at several different dosages and it never worked consistently for me. The difference both times on HRT has been pretty amazing. I didn’t realize how bad of shape I was in until going on HRT. I really felt like an old man at 35.

My body after only 5 days is starting to feel refreshed. My joints feel way better already. One strange thing that I noticed so far is that my mind is sharper already. I would find myself searching for words before. Maybe this is the brain fog people talk about that I didn’t know I had?

When will I start to see libido improvements on the shots? Androgel vastly improved that for me in about three days (I think I was an over responder) but I haven’t had any improvement on the shots yet. I hate the gel so I don’t want to go down that road again.

brenf13,
Most of the gel/creams have Tprop which is a fast acting it usually maxes out T levels in a day or so, that’s why you apply every day. T-Cyp, or T-Enth, will take somewhere between 3 and 5 days to “kick in” but will take 3 to 4 weeks to maximize blood levels.

So don’t be in a hurry and think it doesn’t work. It does. I speak from two years experience it just takes time…
Shots won’t convert T to E like gels will, but they still will, and you need to remember that. You don’t want to go from Superman to Lois Lane and not understand what happened; Estrogen happened.

I have a friend whose dosage is very small and his joints stopped hurting too, so he is convinced about HRT. He also takes one drop a day of adex, just to be safe, and keep the wife busy. (LOL) Feel free to PM if you want.

KNB

My E2 has gone up to 43 from 30 in just 3 weeks. That is only with two HCG shots at 250iu’s each. No prescribed AI. (No Doc will script, says up to 54 is normal) Test went from 551 to 836, Free test from 63 to 124.

I wish my bioavailable T was 124! The highest mine has ever been naturally was 70. Almost half of what it should be for my age. I’m 4 days into my second shot of 200mg T Cyp and so far no difference. I started taking .5mg of Arimidex this week to see if E2 is the problem. After reading the unbelievable results that guys report with the shots so far they’ve been a dud for me. (WTF?) Strange thing is AG worked great for me before it faded.

Knowing what I know now I think if I would had added Arimidex to my AG therapy I would have had successful treatment. I’m going to stick with the shots for a couple of months to see if they finally kick in.
Frustrating…

[quote]christopher36 wrote:
My E2 has gone up to 43 from 30 in just 3 weeks. That is only with two HCG shots at 250iu’s each. No prescribed AI. (No Doc will script, says up to 54 is normal) Test went from 551 to 836, Free test from 63 to 124.[/quote]

Getting an AI is easy without a doctors’ help, but you know that. I’m sure you also know you don’t want your E2 up to 54 either.
HCG is great stuff, and I know I don’t want do without it ever again. I don’t have current blood work, and I’m not sure I really need to know what my numbers are as things are pretty good right now…