T Nation

TRT and Some Issues


#1

Hi.

Asking advice and insight on the more experienced trt fellows.

I'm curious if you can develop sore nipples and possibly even gyno while on trt. Dosage i've been perscribed to take is one ampoule of sustanon 250mg every 10 days. That makes it roughly 25mg per day, or 175mg weekly.

Before trt my total test was around 11 nmol/l and last time the levels were checked total test was 20 nmol/l. Doc ordered me to check the levels couple weeks after the 1st shot. No new tests ever since and it's been like 4-5 months now atleast.

I'm on my way to do a comprehensive tests soon when my local public healthcare opens up from their summer vacation, private doc is just too expensive for me atm since one test alone costs nearly 70 euros so you do the math... So unfortunately i cannot tell you any lab work that would reflect reality at the moment.

Also i get really heavy night sweats, the pillow is soakin wet in the morning and sometimes it's hard to sleep because i sweat so much.
Sex drive is not good either, very mediocre at best. Or then it's the fact that i've had same woman for 15 years. :slightly_smiling:

Without labwork it's just speculation atm, but could my trt dosage be too high for me? Nightsweat really makes me wonder, also are sore nipples possible at this supposedly "low" dosage? Don't have lumps or such, just curious.

Thanks in advance.


#2

Your E2 levels are too high from T–>E2 aromatization.

You need these labs at a minimum: We need lab results and lab ranges in list format.
TT
FT
E2
LH/FSH = should have been done before starting TRT, too late now
prolactin if younger
AST/ALT
CBC
hematocrit
PSA if >45

You should be self injecting twice a week to avoid T levels peaking very high.
You can inject with #29 0.5ml 12mm insulin needles which you can preload.
Might be a problem getting T loaded to those from a small single dose amp.

T has increased your metabolism. It may take time to settle down. You may also loose fat. Sleep with less bed coverings!

You need to do a lot of reading because the doctors are mostly useless at TRT.
Please read these stickies:

  • advice for new guys - and note the first paragraph !!!
  • things that damage your hormones
  • protocol for injections
  • finding a TRT doc

Can you self inject testosterone ethanate in your country?

Ideal would be: T+AI+hCG
50mg T ethanate twice per week
250iu hCG SD EOD
1/2mg Arimidex/anastrozole at time of T injection


#3

[quote]KSman wrote:
Your E2 levels are too high from T–>E2 aromatization.

You need these labs at a minimum: We need lab results and lab ranges in list format.
TT
FT
E2
LH/FSH = should have been done before starting TRT, too late now
prolactin if younger
AST/ALT
CBC
hematocrit
PSA if >45

You should be self injecting twice a week to avoid T levels peaking very high.
You can inject with #29 0.5ml 12mm insulin needles which you can preload.
Might be a problem getting T loaded to those from a small single dose amp.

T has increased your metabolism. It may take time to settle down. You may also loose fat. Sleep with less bed coverings!

You need to do a lot of reading because the doctors are mostly useless at TRT.
Please read these stickies:

  • advice for new guys - and note the first paragraph !!!
  • things that damage your hormones
  • protocol for injections
  • finding a TRT doc

Can you self inject testosterone ethanate in your country?

Ideal would be: T+AI+hCG
50mg T ethanate twice per week
250iu hCG SD EOD
1/2mg Arimidex/anastrozole at time of T injection
[/quote]

Thanks for your great answer KSman.

I’ve began to suspect the E2 aswell.

Prolactin and LH were both in normal levels before starting TRT, the doctor made me to take some bloodwork before ordering the trt. Their current state is unknown though. PSA was 1.1 couple months ago ( i’m 34 years old though ) and i forgot the measurement unit, just remember the number.

I don’t have access to ethanate.
Only sustanon and nebido are available through pharmacy in my country.
Other types are either Gel which my skin/body didn’t absorp, or an oral which i don’t have much trust towards either. Doc first wanted me to use Nebido but i asked for sustanon because at the time i didn’t have couple hundred euros to pay for the nebido, compared to cheap price of sustanon 7 euros per ampoule.

I will read the stickies :slight_smile:

I will order the labs you mentioned and get back to you with the results. It’ll take couple weeks though or so.

Thanks again for the info bro!


#4

[quote]KSman wrote:
Your E2 levels are too high from T–>E2 aromatization.

You need these labs at a minimum: We need lab results and lab ranges in list format.
TT
FT
E2
LH/FSH = should have been done before starting TRT, too late now
prolactin if younger
AST/ALT
CBC
hematocrit
PSA if >45

You should be self injecting twice a week to avoid T levels peaking very high.
You can inject with #29 0.5ml 12mm insulin needles which you can preload.
Might be a problem getting T loaded to those from a small single dose amp.

T has increased your metabolism. It may take time to settle down. You may also loose fat. Sleep with less bed coverings!

You need to do a lot of reading because the doctors are mostly useless at TRT.
Please read these stickies:

  • advice for new guys - and note the first paragraph !!!
  • things that damage your hormones
  • protocol for injections
  • finding a TRT doc

Can you self inject testosterone ethanate in your country?

Ideal would be: T+AI+hCG
50mg T ethanate twice per week
250iu hCG SD EOD
1/2mg Arimidex/anastrozole at time of T injection
[/quote]

Partial update, waiting for all the results.

Using 1cc sustanon 250mg/ml every 10th day.
Blood drawn on 8th day after injection, 2 days before new shot.

  • Estradiol 0.18 nmol/l. High imo.
  • Prolactin 214 mU/l. Normal. ref range 50-300.
  • Waiting for TT
  • Waiting for FT

Doctor didn’t order CBC which i specificly asked also. lol surprise.
I didn’t ask for LH/Fsh, they were good before trt.

Didn’t see conversion rate hastily in google to convert nmol/l to pg/ml. To be frankly i did see some calculation formula but wasn’t sure if i did right math with it. I’m ashamed to ask but what’s 0.18 nmol/l in pg/ml?
Easier to wrap my mind around the units used more often in this forum.

Interestingly and unfortunately in my country, depending on laboratory, the ref ranges for male estradiol level varies hugely. Didn’t think there’s that much difference. I’ve now seen top ranges to be everything from <0.13 to <0.23 nmol/l. That’s insanely huge window in my opinion.

I get testosterone results in Monday.
Also made an appointment with my urologist for that day, to discuss results and going to ask him to give me an Ai, i think it’ll come in handy. Could ask why the hell he didn’t order one in the 1st place but hmm…


#5

On TRT, do not test LH/FSH as these go to zero. TRT does not change prolactin levels.

http://www.globalrph.com/conv_si.htm

80 pmol/L is a good E2 target

Try loading 125mg into two syringes and inject every 5 days.


#6

[quote]KSman wrote:
On TRT, do not test LH/FSH as these go to zero. TRT does not change prolactin levels.

http://www.globalrph.com/conv_si.htm

80 pmol/L is a good E2 target

Try loading 125mg into two syringes and inject every 5 days.[/quote]

I remember you saying as much from LH so that’s why i didn’t test it.
Ok good to know about prolactin.

E2 Conversion.

I “only” had 180 pmol/l and converted to pg/ml it’s roughly 48.
How about it!! :slight_smile: Heh.

I haven’t been self injecting my sustanon. I live so nearby ( 100 meters ) away from my public healtcare service so i just walk in and let nurse inject it to my bum or what ever muscle it is, doesn’t cost anything.

I can get syringes from local pharmacy nearby when i go to purchase the trt doses. Could let my wife to inject as she has done IM injections to some fellows when she was studying to be a nurse.

I’m too much of a baby to self inject unless totally necessary.

No wonder i can feel little tiny bit of soreness in my nipples and libido is shit. Mentally i’m fine though.

Sustanon comes with 250mg/1ml ampoules.
Only other option is Nebido which is seriously long acting.

Let’s see what my doc says, might keep things as it is and take 1mg arimidex at time of injection, take controls and see how it goes.
Don’t think it’s too high dosage but i cannot afford even remotely to crash my e2 since one of my jobs requires me to be mentally very aware.


#7

You can inject 0.5ml with a #29 12mm “50iu” 0.5 ml insulin syringe. Slow to fill, injection time is OK.

With every 10 days, 1mg anastrozole is too much then after 5 days its basically gone.


#8

Sustanon also has pretty long half life due to many esters.
If i don’t recall wrong HL for sustanon is approx 14 days.

I quote your earlier post.
You recommend following prodecure.

Total of 100mg T Ethanate per week, 2 shots.
Total of 1mg Arimidex per week at time of injection days.

Luckily Arimidex is sold in 1mg pills so it’s easy to cut half i’d imagine.
Not sure if i’m missing your point regarding the ai use.
I don’t know enough how testosterone and aromataze entsyme works in time frames. I understand spike with fresh injection, but after that i have no real clue.

Perhaps you are trying to teach me here that the short half life of arimidex vs the long half life of sustanon combined with how aromataze works isn’t good combo in general. Also i don’t know how potent Arimidex is but apparently it’s pretty effective.

I’m ok with bit fluctuating hormone levels as long as i can predict them in the future to a degree, and changes wouldn’t be extreme.

Have to think something.
The self injecting is last of the options ( for many reasons but is also related to junkie parents and a child whom we gave a home, you can guess the rest ).


#9

Regarding my current every 10d sustanon trt cycle and hightened E2 levels.
E2 was 180 pmol/l,

I wonder if i should just:

Use approx 0.25mg/arimidex @ day of injection,
0.25mg every 5th day followed by new injection day’s 0.25mg.
This roughly equals 0.5mg weekly, and apparently if research is right could lower estradiol around 50%, moving me much closer to sweet spot.

Alternatively, 0.5mg on injection days and 0.25mg 5th day followed by 0.5mg on new injection day. ( roughly 0.75mg per week ).

Could this possibly cause too much fluctuation?
Does anyone see a lot of flaws and brain farts in my current thoughts?
Feel free to let me know and comment.

The more i know and can reason before Mondays urologist appointment is always the better. Somehow i don’t trust doctors anymore so much.

Not sure if Aromasin would be better choice but i doubt it.

Thank you!


#10

Udate:

I went to see my doc today.

Last lab results were:

E2: 0.18 nmol/l *Reference range high limit is 0.15.
My value roughly 48-49 pg/ml.

TT: 19 nmol/l *This is okay, nothing stellar and not bad considering.
FT: 279 pmol/l *Okay, nothing stellar and not bad either.

Lab results taken on 8th day of every 10d cycle.

I told my doctor that i’m happy with rest of the results, but i’d want to control the estradiol. He thought my estradiol value was totally fine.
He asked me what level i thought would be good? I told him i’d like to see atleast half of the current value gone. He told me he had just been on seminar in states where research had been done that found no evidence of decreased libido or ed linked to higher estradiol levels, but if they were too low there was a link. I disagreed with the high estradiol being totally ok. I told him i’ve seen alot of evidence from fellows in “our discussion forum” which is dedicated to TRT treatment etc.

So, he perscribed me anasztrozol ( arimidex, but it’s now gone from market with that shop name, it’s anastrozol stada in our country now ).

I asked about dosage, he told me to take 1mg every day.
I said that’s gonna kill my Estrogen completely, he then asked how much i think i should take it? I said that total max in my case could be that 1mg per week ( i didn’t tell him that it’s propably too high also ).
I said i figure out something.

We agreed i test how things goes with anastrozol and now i have perscription for it. If i cannot make it work, i switch to Nebido. I think it’s fair as i don’t need huge spikes anyway to my testosterone levels and there’s only two options, either sustanon or nebido in my country ( from injectables ). My doctor hates polypharmacy and wrote it to papers that we’re heading towards that with this protocol. I can understand that well.

So, how do you like my doctor? :slight_smile:

Still need to figure out what would be best total dosage of anastrozole per week, and what days, or to say better the dosage for 10 day cycle with trt shot. Less is more in this case.

Edit: Planning to start anastrozol either 0.25mg e2d or e3d, or around 0.12 ed or e2d. Propably the 1st option. Do lab controls often ( weekly ) to see effects as well as go by general feeling.


#11

You can dissolve anastrozole in vodka, 1mg/ml and dispense by the drop after finding drops per ml.

Your 10 day cycle has T and E2 levels changing a lot. Serum anastrozole needs to match serum T levels. So you will not have a perfect result.


#12

[quote]KSman wrote:
You can dissolve anastrozole in vodka, 1mg/ml and dispense by the drop after finding drops per ml.

Your 10 day cycle has T and E2 levels changing a lot. Serum anastrozole needs to match serum T levels. So you will not have a perfect result.[/quote]

Thank you for the info.

Yes i’m afraid it’ll be issue with the fluctuating levels.

I’m having a lot of second thoughts about using AI in my current cycle for the reasons you mentioned aswell, i understood it myself too.
I did not pick up Anastrozole and prolly won’t.

I’m thinking about quitting Sustanon and giving the other option, Nebido a go. It’s very slow releasing ( 1000mg/4ml ampoule ). It’d be small miracle if i’d have to worry about excess estrogens with that.


#13

This reply is mainly for myself to keep track of stuff.

So I tested Nebido.

Nurse injected me the 4ml ampoule ( huge amount ) around 8 weeks ago.
Prior to nebido injection, i had used sustanon 250 every 10 days, but due to travelling work and super busy period in life i hadn’t taken sustanon injection for atleast 3 weeks so my testosterone levels were low almost certainly.

Nebido injection wasn’t too nice experience tbh.
Pressure was high in the muscle because the dosage is 1000mg/4ml big and it’s injected at the same time. Also it took atleast a minute straight to inject it, time felt slow.

Well, not long after the Nebido injection, i started to experience heavy agression. I realised my levels were low but it still caught me by surprise, because i hadn’t ever experienced anything like that from sustanon and because Nebido should be really slow releasing, i wasn’t expecting to see much of a difference. Oh boy was i wrong.

I wanted to break up a chair as an example and throw it through the window. Don’t get me wrong, i didn’t go raging and doing stupid things, but that is how i felt. I have kids and i had to count to “10” all the time not to shout at them from the slightest fight they had. In the night i couldn’t get sleep well, i felt so agressive that i just had to punch a wall and i was wondering that holy hell with the agression, this is not how i want to feel like.

This lasted about 2-3 days straight. It was shit, and horrible.
God knows what kinds of amounts the injection in reality released testosterone in to my body, and at what time interval, but i didn’t want to test it never again.

I didn’t take labs 'cause i knew pretty soon that i go back to sustanon in a heartbeat. Around 6 weeks after the Nebido injection i started sustanon again and quality of life is alot better, no agression, on the contrary.

I’m gonna check up some lab works and start to experiment with Adex which i still have prescription for, but haven’t pick it up.

Will post follow ups in a month or so.


#14

Crazy aggression experience that I’ve gone through as well. I’ve done a little investigating about test and aggression and what I’ve come up with is that aggression of that magnitude is typically associated when high T is also combined with high E.

Hard to believe that was the case with you since it doesn’t seem there should have been enough time for T -> E aromatization.

The other theory I’ve read is aggression occurs when high T is accompanied with low serotonin levels.

Either way, most of it is speculation and I have 3 children as well, so I know how awful it feels to walk around like a rage monster, consistently having to pump your brakes and tell yourself to calm down.

Are you not able to get your hands on some test cyp and inject twice per week or EOD?


#15

Sorry, I just reread and saw that you only have access to sustanon and nebido for injection.


#16

[quote]Davinci.v2 wrote:
Crazy aggression experience that I’ve gone through as well. I’ve done a little investigating about test and aggression and what I’ve come up with is that aggression of that magnitude is typically associated when high T is also combined with high E.

Hard to believe that was the case with you since it doesn’t seem there should have been enough time for T -> E aromatization.

The other theory I’ve read is aggression occurs when high T is accompanied with low serotonin levels.

Either way, most of it is speculation and I have 3 children as well, so I know how awful it feels to walk around like a rage monster, consistently having to pump your brakes and tell yourself to calm down.

Are you not able to get your hands on some test cyp and inject twice per week or EOD?[/quote]

Hi bro and thanks from the input.

I haven’t ever studied how long estrogens can be elevated from prior injections even after your T levels have already fallen down. Last time i did check E2 during sustanon trt use, it was too high.
I’d suspect that E2 wasn’t the case with me.

Serotonin on the other hand very well might have been an issue.
I don’t feel depressed but there are plenty of reasons in my life why my serotonin levels could be low. This is true even from our weather alone. I wish we wouldn’t have these dark winters without much of a sun light at all ( sun shines really rarely and goes down really early ), it really affects your serotonin levels too and i notice it heavily. This might suggest that my personal levels are low.

Yes these two injectables are the only options available legally in my country, either Nebido or Sustanon and that’s it.