T Nation

Systematic Protocol Testing Log

In this blog, I will record my experiences with different protocols. I will test each protocol for 8 weeks straight regardless of how I feel during that time, and then do comprehensive blood tests.

The protocols in question are: 70mg 2x/week, 60mg 2x/week, 80mg 2x/week, 18mg/day, 20mg/day, 22mg/day and 24mg/day.

I started TRT 3 months ago and made the mistake of changing protocols every few weeks, chasing the amazing high I felt initially. I’m now going to be disciplined and stick to each protocol for 2 months before moving on.

About me

I’m 41yo. Always lean and in good shape, I alternate lifting and cardio 3x/week each. Diet is very healthy; lots of fish/chicken, vegetables and rice, no sugar or processed foods.

My pre-TRT blood tests showed great lipids, no problems with CBC. Blood pressure 115/75 pretty much always, low resting heart rate.

TT was 900 ng/dL (MS), FT 6.5 ng/dL (Dialysis), SHBG 75 nMol/L and E2 (Ultra-Sensitive) 18pg/mL. DHEA average, same with IGF-1. TSH 2.5 (could be subclinically hypo, something I’ll explore after I find my sweet spot for T), Free T3 average, could be higher but it’s not low.

I felt like absolute shit all the time. Tired, no energy or drive, high anxiety, “beta” behavior (very apologetic, constantly living in my head in a state of regret and “I should’ve…”), crippling OCD and depression. I didn’t want to mess with SSRI’s or stuff like Lithium and still don’t, so here we are.

Since starting TRT I’ve had moments of feeling much better along all the above parameters. More confident and assertive, more “in the moment” and less in my head, less anxiety, etc…and moments of feeling much much worse than before TRT; mostly horrible fatigue and depression/apathy. I’ve been chasing my sweet spot since I started, changing protocols I realize now probably way too quickly.

My plan is to try protocols from around 120mg/week to 160-170mg/week, with either ED or 2x/week injections. I settled on shallow IM injections using 29G 1/2’’ insulin syringes alternating delts.

I just started my 70mg 2x/week protocol with a 70mg injection yesterday morning for a Monday morning / Thursday evening injection protocol. I feel ok coming into it from the last week or so, probably slightly better than before TRT but not by much. Let’s see…

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Your PRE TRT TT was 900?!

Were you prescribed TRT or are you doing this on your own? As pointed out your TT was pretty high. Though your FT was pretty dismal. I wish you luck on your journey. However, I dont think TRT is going to fix OCD. I mean if you have a serotonin problem then you are probably going to need an SSRI…it doesn’t go away.

How long have you had all of these symptoms?

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896ng/dL on one test and 980ng/dL on the second one.

I’m prescribed by an anti-aging doc. He explained that my SHBG was artificially inflating my TT by accumulating it in the blood, making it seem like I have high T when what really matters and correlates to my symptoms is my abysmal FT.

I felt amazing until early 20’s. I was very confident, crazy energy, didn’t care at all what anyone thought of me or what I believed, super high libido. Then it all started going down and I’ve been feeling horrible for over 10 years now. No drive to do anything, everything feels like a grind, erections are great but libido is gone.

When I felt great for a bit at the beginning of TRT 3 months ago, my OCD and anxiety were completely gone. I didn’t have those when I was younger, I was completely in the moment all the time, spontaneous and borderline impulsive. I believe higher T levels can put me back in that zone and once I’m out of my head I’ll stop obsessing over every little meaningless thing.

After that initial feel amazing period of about 2 weeks, i started feeling horrible. It wasn’t just the end of a honeymoon period, I became more depressed than I’d ever been in my life. So I started going from one protocol to another every few weeks to try to recapture those initial feelings.

I realize now it was a mistake, which is why I’m going to systematically try different protocols and make sure I stick to each for 8 weeks before doing anything else. Once I fine tune my TRT protocol I’ll look into DHEA, HGH and possibly optimizing thyroid also.

Ok so we are not talking about dr diagnosed depression or OCD? These are feelings you are just putting names to? When you say “crippling OCD” you aren’t meaning it takes you 3 hours to leave the house because you keep checking a light switch, etc?

It sound like after a while on a decent dose you may be able to get that FT up to a comfortable level. I will let others talk about shot schedule and SHBG as I think there is a trick to minimizing it getting bound up there.

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No, the OCD was diagnosed by a shrink who immediately wanted to put me on meds. I declined then and always will. I know people on SSRI’s; their libido is completely gone (and their dick doesn’t even get hard anymore) and they look and act like zombies, completely numb with a stupid smile on their face. I’d rather suffer the way I did until now.
My OCD isn’t light-switch like, it’s more along the lines of staring at a book for 6 hours straight without being able to open the first page because I’m trying to optimize how to read the book (should I look every single word in the dictionary to make sure I really understand the book? And then go sentence by sentence? And then paragraph by paragraph? Then read the translation of the book in 2 other languages to make sure I get the most out of it? Etc…)

(for some reason my previous post didn’t register as a reply to you)

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They dont if its next inline in the thread.

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Analysis paralysis. I get it. I think it’s linked with confidence which would make sense if its tied to your low FT. Afraid to start something improperly, ie failing.

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Exactly, that’s exactly what it is. And it’s 100% rooted in fear and lack of self-confidence, I can feel it clearly.
And that’s probably why it started melting away initially on TRT. I definitely felt more confident and started caring so much less about a host of small things that had been hogging my mental resources for years. After a couple weeks though, I just started feeing horribly tired and depressed all the time, sleeping 12 hours/day kind of thing.

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Thats the honeymoon phase (TRT + Endogenous T) ending as your body shuts down its own production. Some go through it worse than others. I guess that means there is hope for you somewhere down the track of TRT protocols.

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Nice methodical layout of the plan. I appreciate your attention to detail here. Regarding your 8 week intervals, effect of T (and any AAS) on neurotransmitters/brain takes time. Maybe you read this paper:

image

Genuine question: if low free T is your issue, how will address this using exogenous testosterone? Is the hypothesis that exogenous T will somewhat lower your SHBG or you’ll just titrate dose up until desired functional improvement?

Since you provided bloodwork and excellent assays (MS and dialysis), your case is good example to compare against calculators available.

Vermeulen:

Tru-T:

I am surprised at your dialysis result as typically dialysis free T will be bracketed by these two methods. If I use your experimental values I get 6.5/900 = 0.72%.

An experimental finding of 0.72% percentage free T is very low. How many times have you tested your free T using equilbrium dialysis?

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Thanks for taking the time to reply; what you wrote about “fear of starting something improperly” resonated with me a lot more than all the times I thought of it in terms of “fear of failure”, for some reason. I think it just captures the nature of that fear more accurately.

It’s my hope also that if I can be disciplined enough to eventually converge onto something close to an optimal protocol, TRT will enhance my life to the point of changing it completely. Hence why I’m doing this systematic protocol testing.

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Happy to help. Looking forward to following your log.

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Some additional context:


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I tested FT by dialysis twice also (TT 896ng/dL first time and 980ng/dL second time), and it was just a tiny bit higher the second time but still the very bottom of the range, around 8ng/dL. First time was Quest and second Labcorp.

My hope with TRT is that my SHBG will lower over time through the use of exogenous Test, or as you said that I can reach good FT levels by pushing my TT above the normal range.

I did read the paper you linked and I can see how it would take longer than 8 weeks to see the deepest changes on TRT. I’m just hoping that 8 weeks will be enough to see whether I’m at least going in that direction.

Very informative. Thank you. Always great to see someone who has done their homework. Kudos!

Thank you for linking the articles, I didn’t know about the second one. It’s interesting to see the different degrees of correlation between calculated FT methods and dialysis FT. Less than 1% FT seems very rare indeed.

I was surprised by your data points. Your free T is not below the 2.5%tile, but as a % of TT, it’s really down there.

Thanks. In the spirit of the analysis paralysis that has plagued me for years, I researched TRT on and off for almost 5 years before taking the plunge. When I started, I immediately went to daily subQ injections using 30G 5/16’’ insulin syringes, 20mg/day.

I thought I had it all figured out, and the sad thing is that maybe I actually did if only I’d been patient enough to tough out the rough patch when my natural production died, instead of overreacting. Even as I write this I’m thinking maybe I should go back to my initial protocol instead of the 70mg 2x/week I just started. But I have to fight that tendency and just see this through.