T Nation

Starting TRT Next Week. I Have Some Questions


#1

Hey guys,

I’m new to TRT and I’ve got some questions before beginning TRT on Tuesday. I don’t have a copy of my lab scripts since I am out of state working at the moment but I do know the total numbers of testosterone and estrodial. I will post them below.

Age- 29
Weight- 180
Height- 5’9"
Body Fat- 22%
Testosterone- 403 ng/dl (250 - 1100)
Estradiol- 37 pg/mL

The first lab I got back in April my test levels were much higher (T- 763 ng/dl E- 32 pg/mL) but I had been taking some of those over the counter test boosters 4 weeks prior to the test, and I made the mistake of eating before my lab. The results above were taken after I had fasted 14 hours, and had not been on over the counter test boosters for 10 weeks.

I’m feeling symptoms associated with Low T. Tired all of the time, no motivation, brain fog, no libido, haven’t had a morning erection in months, fat build up in my stomach, and especially around the areole area on my chest(man boobs). Anyway, my doctor suggested TRT, and prescribed me 100mg Test Cypionate/1mg Anastrozole subcutaneous. So it’s Test Cyp- 50mg/Anastrozole-.5mg Every 3 days. He also has me on 500iu of HCG on injection days. I’m just looking for some guidance here. I’ve read that using an AI when starting TRT can sometimes be bad but I’ve read others saying it’s the best way to start. Since my estrogen levels are in the normal-high range my doctor wanted to try and clear that up. He didn’t want estrogen to keep rising along with testosterone. Do you guys think using an AI is the right thing to do from the start? Let me know if you guys think I’m on the right track. I’m scheduled for my next blood screen 10 weeks from now.

Thanks guys.


#2

Post all lab results when you can and we do need lab ranges.

Travel: hCG when reconstituted needs to be kept cool at all times and shaking can damage it. So that is a problem.

Your script is for 100mg/week and that is 50mg twice a week. Every 3 days, E3D, is not twice a week. Pick to days of the week, Sunday and Thursday for example. If you want E3D, dose if 100/7 mg per day X 3 days/dose = 43mg/dose

hCG is best at 250iu subq every other day EOD/E2D, or 375 E2D. Its all about half-life, should be EOD but may not be that critical. Larger doses cost a lot more and can cause problems with increased E2. If mixed to typical 1000iu/ml, inject subq “25” on an 0.5ml insulin syringe, #31 5/16" works or #29 1/2"

You can inject T subq with #29 1/2" 0.5ml

Guys typically need 1mg anastrozole for every 100mg T. You should try that. You can take 0.5mg twice a week. You may find that injecting 50mg T twice a week and taking 0.5mg anastrozole at the time is an easier routine.

Objective is E2=22pg/ml which is good for almost all guys.

Do start anastrozole at time of first injection.

You do not want to push E2 too low. If you start anastrozole and feel crashed quite soon, you are an anastrozole over-responder. Stop for 5-6 days and resume at 1/8th mg twice a week.

You did not have FT tested or LH/FSH. At your age that is malpractice and if LH/FSH were low, then prolactin needs to be tested.

Your high E2 indicates a problem with E2 clearance. Liver should be tested. And some medications, Rx or OTC can interfere with liver E2 clearance.

Thyroid function can be part of fat gain. See last paragraph to evaluate. This is not optional.

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.


#3

I’ll be sure to post my lab results when I get the chance. I appreciate the reply.

The hCG I am being prescribed to is an oral version. I’m assuming I could just split them up into 1/4’s and take them EOD?

The doctor I’m going to prescribed me Test Cypionate and Anastrozole in pre loaded syringes. So the doses are already set.

I’ll get the numbers for my liver. He mentioned my liver enzyme is a bit higher than he’d like it to be. I’m currently taking Milk thistle to try and bring that down. Is there anything you would suggest to help bring the liver enzyme down?

I’ll look into the thyroid information you mentioned. My doctor said the thyroid numbers came back perfect on the blood test but I’ll still try what you mentioned.

Thank you for the knowledgeable reply, I’m new to this forum so I will definitely check out all of the stickies you mentioned.


#4

Thyroid lab ranges are useless. Normal can be a big problem.

Oral hCG does not absorb. The peptide molecule cannot get through skin, oral or nasal tissues. Oral hCG is a scam. Ask for hCG 5000 or 10000iu multi dose vial.

Anastrozole is an oral medication. I have seen it put into testosterone, but if the dose is wrong you can’t fix that.

Your doc is stating to seem odd.
Where are you located? Perhaps some restrictions there.
Guys here mostly load their own syringes.


#5

I didn’t know that about hCG. I will mention it to him when I talk with him next. They may not offer injection hCG but I will see.

I’ve noticed a lot of people take Anastrozole orally rather than injection. That seems like something I need to get out on.

I’m located in Jackson, MI. I go to this clinic. https://www.genemedics.com

I’ve learned of Dr. John Crisler and he is only 30 minutes from my house. If my current doctor cannot prescribe me the right things I’m thinking I should go have a consultation with Dr. Crisler. I’ve heard he’s a good one.

Do you know much about injectable IGF-1 and B-12? They have me on both of those as well.


#6

Also, I’m taking an hCG Troche. I should have made that more clear. You hold the lozenge under your tongue on test/Anastrozole injection days.