Still Tweaking...

Pharma / TRT Testosterone Replacement
1

At the request of KsMan I have started my own thread.

33 y/o 230lbs. Physically strong. Tons of hair and facial hair.

Been on and off TRT for years. Without TRT my levels stay in 200 range without nocturnal erections.

Have had ups and downs with TRT. It seems to be day to day…

Feel like a porn star one night… Can barely get it up the next.

Tremendous workout one day. No motivation the next.

Have done just T. T + HCG.creams. Pellets.

Have done thousands of hours of research.

No doubt the protocol set forth on this side works best for me.

T + HCG + AI…

But finding the right dosing can be very tricky.

It still varies day to day.

I feel like I can go to sleep with low e2 and wake up with high e2. Is that possible?

Trying to stick with one protocol and get tested. My line between low e2 and high e2 is very thin. I can feel it.

Anyway this is long winded but my point is it’s so day to day.

60mg tcyp (2x/wk)
250iu HCG (EOD)
.25mg Adex (eod)

This is my current protocol.

Adex is not split evenly I cut the tablet twice so that could be a factor.

I just feel that the slightest adjustment makes a difference and I can’t get labs every three days.

My last e2 came back <15 on a similar protocol but that was WITHOUT HCG.

I am secondary. Ball shrinkage. Low Pregnenolone symptoms. Zero LH. This led me to believe I beed HCG.

Mood so much better with HCG.

But obviously will elevate e2.

So the minor tweaking makes a world of difference.

Would love to feel somewhat the same everyday.

E2 feels on the low side but e2 elevation from HCG.

It’s like this big puzzle.

Here’s my bottom line:

After thousands of hours of research it comes back to ksman protocol of T + HCG + AI.

Now it’s about finding the right dosage.

I guess I’ll stick with this and get labs. Just hate the ED on some days. That’s the worst.

But then again some days I am a porn star.

Hate the guessing game. Having patience.
Thank you T Nation.

No doubt you guys led me to HCG and I feel so much better. No doubt AI is needed.

But how much? And when?

I’m sure I’m not alone.

2

What are your labs like now? [with ranges]

Any thyroid labs?
Do you use iodized salt?

Please read the advice for new guys sticky and provide more info about you.

What syringes do you use and inject where. SC?IM

Some guys are anastrozole over-responders who need to use 1/4th of what most require. For those doses you need a liquid product and dispense by the drop.

3

You are crashing your E2.

Stop hopping from one protocol to another. Stick with T+AI+HCG. Keep restesting every 4 weeks till you land E2 at low to mid 20s. Dosing AI EOD will give you steady levels.

You don’t understand how HCG works. It is a LH analog, not LH itself. You LH will test zero on it.

4

Try lowering the doses of T and HCG and try dropping the arimidex altogether. It sounds counterintuitive but many guys get iffy sexual function when T is too high. Also, arimidex can play havoc with some guys’ sexual function even if the numbers look good. Others swear by it. Only way to know is to try both ways.

5

JQ,

In response to your post in the Protocol for Injections sticky:

This forum is not about discussing individual cases because it is a sticky. [Oddly, the folks who run this site will not to anything to restore the sticky symbols for the stickies. - I have asked many times]

When you do TRT, its really a sample of one and you find what works best for you. Many do feel better when near E2=22pg/ml and most do well using anastrozole to get there. And many do experience 24x7 testicular aching without hCG. There is also the body image, ones own as well as ones sexual partner with small testes and a tight scrotum. Also need to point out than many find that hCG greatly improves mood. We don’t know why. Seems to be some direct effect on the CNS, perhaps implying that some have a LH mood dependency [disclosed by TRT induced HPTA shutdown] that is addressed by hCG.

If you find that your best outcome is without anastrozole and hCG, that is perfect for you. You should not be attacking that works well for most just because these things were not of benefit in your case. What is recommended is starting point.

The method of adjusting anastrozole dose based on lab work also allows for one getting to a zero anastrozole dose outcome. We do acknowledge that some have have T–>E2 inside there testes with hCG and suggest that one explore lower hCG dosing in those cases. So again, one is directed to lower and individualized dosing and a few feel that they need a zero dose. You cannot hold what is recommended here hostage to the fact there there are some who have oddly different biology.

If you read the stories of guys who come here who have suffered from ignorant and indifferent TRT administration by their doctors, and note their progress here, you will see the value is what is happening here.

BTW, how did you become an expert on: “Those with successful protocols don’t need these forums.”
How do you know about men who are not on forums when by definition you then know nothing about them?

6

Ksman thanks for your response didn’t even see this…

Ignorant doctors yes. So I must be my own doctor.

I just feel so different day to day in what seems like a steady protocol.

I took your most recent advice and lowered hcG…

What do you think about this protocol:

MWF
40mg tcyp SC
166iu HCG
.25mg Adex

Stay on this for a month and get tested…

I have to be my own doctor and I feel so different day to day.

Some days great morning wood porn star sex great workout.

The NEXT DAY no wood no motivation etc.

Brain fog/mental sharpness changes day to day as well.

I’m trying to avoid peaks and valleys and yet that’s all I’m getting.

Tough to be present in the world when this is constantly on my mind. What should I take? What should I not take?

7

Seekonk,

If I take HCG im gonna need arimidex.

Guys I really appreciate your help I’m driving myself crazy here.

8

I can only dose Adex .25mg at a time.

So I go from too high to too low.

I don’t know man. I don’t know.

9

[quote]JQ wrote:

I’m driving myself crazy here. [/quote]

And this sounds like half of your troubles. You’ve been in your own head for to long. been there done that…

10

100% Ned.

i need help with my protocol.

I am reaching out and asking for help. I have to be my own doc.

Yet the advice I’m getting is so conflicted.

11

Listen guys…

I know I must figure this out myself and maybe I’ll go back to my normal 200 levels.

I’m just saying I have high e2 sides from HCG and low e2 sides from Adex at the same time.

This trifecta is practically impossible to dial in.

Maybe liquid Arimidex is the way to go so we aren’t slaves to the tablets.

But this is rough…

I added HCG to the mix them needed AI and ever since its been disastourous with some magical moments in between.

Sweet spot comes and goes.

12

It’s amazing how some say HCG is a must and others say avoid it.

875iu a week is a hefty dose.

No doubt HCG has its benefits but not at a cost.

13

Why don’t you try a fresh start with just testosterone replacement - without AI or hcg?

I’d try that and give it at least a couple weeks. Run labs. If you need it add a small dose of hcg (after the couple weeks) and if labs show high E2 start low dose AI. You should be doing very small adjustments/tweaks, doing lab draws at same time between doses, and not jumping around to different meds without adjusting dosage first.

14

[quote]acfixerdude wrote:
Why don’t you try a fresh start with just testosterone replacement - without AI or hcg?

I’d try that and give it at least a couple weeks. Run labs. If you need it add a small dose of hcg (after the couple weeks) and if labs show high E2 start low dose AI. You should be doing very small adjustments/tweaks, doing lab draws at same time between doses, and not jumping around to different meds without adjusting dosage first.[/quote]

Exactly what i was thinking, although expensive to have labs done as often as necessary it is the only true way to dial in TRT.

The symptoms of low and high e2 are exactly the same for some. I personally get these symptoms any time I change e2 levels. Up or down, The symptoms are nearly identical…For me.

15

Thank you guys for your responses.

How will I know if i “need” HCG?

I don’t care about ball shrinkage.

Is Pregnenolone a concern without HCG? Or will the body produce Pregnenolone through other channels?

I don’t mind getting labs as often as it takes… I just feel like the results of my labs would vary day to day… Which is why you say get them done on the same day.

16

the HCG has positive effects as far as mood and libido and mental sharpness are concerned no doubt…

But it causes too much of a fluctuation with the estrogen and becomes an absolutely impossible juggling act.

An impossible juggling act.

17

From the sticky - TRT: Protocol for Injections

hCG is a water based peptide hormone can be injected to replace the lost LH hormone that TRT shuts down. Without hCG, the LH receptors in the testes are no longer getting activated. The results are:

  • The testes shrink. Over time for some the testes can eventually become small undifferentiated lumps of collagen. This is drug induced organ failure. The degree of shrinking varies from guy to guy and may be more of a problem for the older guys.

  • Fertility can be greatly reduced or eliminated. If making babies is important, you need to inject hCG. If hCG is not used, its use after a long time may or may not recover fertility.

  • When the testes get smaller, some feel an ache in their testes 24x7. hCG injections can eliminate that pain or avoid the whole episode.

  • The testes are the single largest producer of the hormone pregnenolone. Pregnenolone is important for proper mental functioning, and is the precursor to all of the steroid hormones such as DHEA, testosterone, DHT, estrogen, cortisol… Injecting hCG prevents a drug induced pregnenolone deficiency and helps support the other hormones. When guys are on T without hCG and then start hCG, they report a significant improvement in mood that many attribute to restored pregnenolone levels. [If that is not the case, hCG must have some direct effects in the brain.]

Research using SC injections in men has demonstrated the effectiveness of the 250iu EOD dosing.

18

E3D on the testosterone injections if you think your lvls are fluctuating too much on that end.

Don’t take the AI unless you get labs back showing high E2 - you may be able to maintain and live with lvls higher ideal without the AI.

If you do end up needing the hCG I’d get that going for a couple weeks (start at lower dosage than 250iu) and see how that helps. If you do start hCG don’t start the AI until you know E2 lvls on it. A lot of people don’t need an AI at all.

19

Thx acfixer…

Yes very familiar with KsMan protocol it’s why I started HCG in first place…

But 875iu HCG will give me an estrogen surge that Anastrozole can barely compensate for…

I guess the 1,000,000 question is:

Is HCG needed on a trt protocol?

Thank you for your advice and your responses.

I really appreciate it man.

I’m not looking for off the chart numbers.

Just want a decent protocol WITHOUT fluctuations.

Consistent morning wood good libido and mood and the ability to put on some mass.

And mental sharpness.

Without trt I sit in the 200-300 range.

I have always been lower end shbg.

20

Before I started HCG my Pregnenolone levels came back low?

Does that mean I need hcg?

I don’t care about shrunken balls and I don’t care about fertility right now.

Pregnenolone is my main concern in regards to HCG.