T Nation

Struggling to Dial in TRT


#22

It will take 4-6 weeks for blood levels to stabilize and even longer for low e2 side effects to go away. Be patient and consistent with your dosage. Good luck.


#23

Stop taking AI. Your have high test, let your E2 come up a little bit.


#24



So this blood test was 120mg test cyp/ split between Tuesday and Friday
Zero Arimidex
500iu HCG twice a week.

My Total Testosterone barely changed from my last blood test at 160mg a week, not sure if this is because I added back in HCG.
I’m still not right, erection quality diminished slightly as e2 went too high.
I Still can’t figure out this difficulty reaching orgasm and having trouble orgasming more than once a day.

Just started working with Defy, really believe they have a lot of knowledge base and are more about how you feel rather than obsessing about doses and being in the correct range. To be honest though Im not sure how much faith I have in the protocol they are putting me on.
Here is the protocol they want. Im going to start it but not sure if its going to bring me to where I want to be at.
BEGIN T Cyp 200 mg/ml – Pt will inject 0.38 ml IM/SQ twice weekly

BEGIN HCG 400 iu SQ 2-3 times weekly as needed for testicular atrophy

BEGIN Anastrozole 0.2 mg 2-3 times weekly, as needed per E2 symptoms (reviewed with Pt.) – h/o elevated E2, titrate on follow-up


#25

I agree.

What other supps and medication are you taking?


#26

just fish oil
multi vitamin
and maca.

Im not really sure how low Id have to drop dosage to get to 1000 though. My guess is roughly 70-80mg cyp a week.


#27

Focus more on getting ur free t within range.


#28

I agree, what would be your suggestion getting it within range.


#29

I agree with the others that your dose is still too high. I would drop to 50mg E3.5D and drop the HCG and the AI. Give that a 6 week cycle and re assess from there.

You kind of approached this backwards. Instead of starting high and lowering over time, you should have started way low and gradually increased over time.


#30

A lot of new guys mistakenly think in range equals feeling good, a lot of guys feel perfectly fine in the 600-700 ranges. Your SHBG isn’t grabbing ahold of testosterone like you would expect to see.

In your case the higher the Free T, the higher your estrogen and that’s why you are struggling.

I prefer to start TRT in isolation and dial everything in and add other stuff later, this way I know if I add HCG and I start feeling bad, I know to back off on the dosage or cease HCG altogether. There are too many variables when starting out on TRT, HCG and AI’s.

How do you know what’s causing what?


#31

yeah I admit I went in the opposite direction of what I should have attempted, I just figured I would be able to feel normal like I had in the past because I didn’t have any issues the first couple times I cycled years ago. So last blood test I was not on arimidex while using 60mg E3.5D. 100mg/week does seem like a starting point for most people but I just wonder if that will lower me enough.


#32

True an isolated study is definitely a much better approach, and I was definitely able to tell that with the higher e2 levels I suffered last blood test, I had increased penile sensitivity but weakened erection quality. So Im getting much better at feeling high vs low e2. The thing is though its irregular to suffer lack of semen volume or the need to release when using hcg.
Also I can probably get to 600 total in 4-6 months after I came off everything. Not really in a place where I want to do that and Defy suggested against it because I would probably feel like shit and be lethargic for a while. If I had an idea about how to root out my sexual issues before I had got on TRT, I would have taken a much different route, but alas this is the situation I’m in and am trying to take the best advice from Doctors and people with signifigant experience.


#33

Decreased semen volume and high testicular hang have always been an indicator of high E2 for me.


#34

Do you have any ideas why you didn’t have issues in the past?


#35

Cycles of 10-12 weeks, probably didn’t shut down my own production at pituitary immediately, then by the time I came off, things started to come back to normal. The only issue I had in past was loss of erection quality, but never had any issues with sensitivity or orgasm. Thats my best guess though.

Also to note: when I used enenthate or cypionate in the past, I was injecting once a week. I wonder if my Free T to E2 ratio gets out of whack from multiple injections per week even on a much lower dose of testosterone than when I cycled.


#36

Your SHBG is on the high side, You can get by injecting once a week. It wouldn’t hurt to try but my advice to you would be to give enough time between protocols before deciding wether it works or not. Also try not to make more than one change at the time and again wait for at least 6 weeks before assessing your situation. I was on TRT for a year and did that mistake, wanting to feel great as soon as possible made me impatient and as a result I was not able to dial in for the entire year and decided to come off completely now and take a break.

Keep us posted man and don’t ghost on us…work with the folks on here, they know better than most endos ! & Best of luck!


#37

Haven’t made any progress at this time. Heres a few things I can express. Since October 14, Ive had just 1 solid day where I believed things were working correctly. This basically meant erections were working fine and could orgasm multiple times in one day without it taking way too long like it usually has. Also HCG does work for me in regards to testicular size but It doesn’t last very long and I also don’t benefit from increased semen volume like I had the first time I used it over a year and a half ago. So I’m currently at 75mg 2x week, and 0.20 arimidex twice a week. Just came off the HCG a week ago.

I still have no clue why I feel backwards of how I used to when I would cycle. Main concern is back then I didn’t suffer with orgasm and semen volume, or the urge or “pressure” that some people describe, but I did have erectile issues. Now Id say erection quality is 90% there which I would describe as excellent, but now I can barely orgasm and don’t have any urge. Back when I cycled I would shoot my long ester 1 time a week. Now Im obviously on much lower dose and doing a week.

I’m getting bloods after the new year but I’m pretty sure they will reflect vary similar to blood tests in the past.

Systemlord mentioned getting to the 600-700 range. How low a dose would I have to take to get there? 70 or 80mg a week? I shouldn’t even need to think about an AI but again would that solve the issues I’m having?

I don’t plan on changing anything till next blood test but looking for some input I can take with me to Defy so I can be effective in making progress.


#38

Also one more important thing to add, testicles are not filling up with blood during arousal or sex and they stay fairly cold while penis reaches normal temperature. Not sure what this indicates but It definitely seems to be part of the contributing factor in regards to the feeling/ “pressure”/tingling sensation one feels( which has been pretty much nonexistent).


#39

I think you are very very wrong how you standardize an ai dose lol. Everyone is so different. I take .125 with 100mg. If I took 1mg and I have I’d be hurting very badly. So I think you need to rethink your information. 1mg is way to much. Dr. John Crisler world renowned trt doctor starts his patients on .25 e3d so yea stop giving medical advice because you are gonna hurt someone. Again everyone is very different. Some guys can do a shot of 100mg with no ai whereas another might need .5…


#40

Microbeast, KSman has not posted here for quite some time. Doubt he will see that.

Dr. Crisler passed away about six weeks ago.


#41

@KSman just curious - why do you suggest 22 as a target for E?