Hi everyone 54yr male here. My natural levels of T are hovering around 107 due to a pituitary tumor that I’m having removed next month. Endo has prescribed me TRT to get me going before the surgery. Looks like I’ll totally lose my pituitary, if it’s not a goner already.
She prescribed me 100 mg/ml Cypionate to inject 1.5 mls every two weeks. Any thoughts on this dosage to get me started in the world of TRT? From an initial calculation it seems like a low dose. Thanks for your input.
You will not want to go longer than one week between doses and I think you should start with at least 150mg par week.
These every other week protocols create estrogen dominance in men and also return you to a state of hypogonadism in the second week according to a 2005 clinical study of men injected with 200mg every 2 weeks. You’re prescribed 150mg and will reach a state of hypogonadism much sooner.
Don’t expect your endo to be able to help you managed side effects if encountered, most are not trained in replacing testosterone and blindly follow guidelines which are available for those doctors that are not sure what to do.
This 150mg every 2 weeks is no better than the disease, you will feel as bad or worse than you do now. You will need a minimum 100mg injection per week, however if SHBG is on the lower end more frequent dosing may be necessary.
If your SHBG is on the higher end you will need quite a bit more testosterone and will most certainly be fighting with your doctor on that one. It makes sense to seek care outside of the sick care system which has ignored TRT for seven decades and knowledgeable doctors are in short supply.
My endo also wanted 150mg every two weeks, I had other plans and I inject 7mg every day because I have low SHBG.
When I finally told my endo what I was doing he was shocked and though my hematocrit would be out of control, in fact my hematocrit had never been lower, -4% (50–>46%) of previous levels. He doesn’t have a problem with it since he knows my hematocrit was high on his protocol where I was having so many problems.
In fact, the present study confirmed serum levels of T which were lower than pre-ART value levels on day 14 after administration. Therefore the further decrease in serum T levels on day 14 after administration is considered to relapse of hypogonadal symptoms and to reduce the patients quality of life.
I’ve run 250 every two weeks in the past with no issues if you don’t wanna inject every week.
My endo started me at 100 every two weeks. I ignored that and went straight to 200 every week. Never followed the endo prescription.
Your are 1 in million, definitely not a typical case we see on T-Nation. If fact you may be the second or third guy in 3 years spending everyday helping out across three different TRT boards have ever encountered that did fine on every 2 week dosing.
I only remember the total test numbers in two blood tests for that protocol.
First test blood taken 3 days into injection total test was 1011 ir so.
Second test blood taken last day of two weeks before injection and total test was 450-460.
No sides or roller coaster ride. So while it goes down I still stay in the normal range and felt good.
I need to get bloods done again. Stopped low dose tren 2 weeks ago and currently running 200mg test e per week. Letting things stablize for 2 more weeks to get a better idea of where I am.
I often wondered if the higher dosage allowed me to stay in the normal range longer but I suppose some may run into estrogen problems.
I’m hoping that my Endo is being conservative and putting me on a very light dose as a lead up to surgery. Im sure my hormones are going to bounce around after surgery so perhaps this is just the beginning of my journey. It’s good to know, however, that the general consensus is that this regimen appears to be low.
It’s not conservative, is it inexperience. The clinical study shows levels are outside the therapeutic range on day 5, day 6 levels are at pre-TRT levels and symptoms present. Now you have to feel like this for 8 more days until your next injection.
This is the wrong way to do TRT, your estrogen will be higher in relation to testosterone making you feel worse than you do now. Most either quit TRT altogether, figure it out on their own or seek private care.
My endo seems top notch, so I’m sure there’s room for working with her. She’s a top doc on staff at a major hospital in NYC. She’s pretty cool and I’m sure we can work something out in the coming weeks. Not sure what the protocol is with a run up to surgery. We discussed a theoretical possibility of TRT actually making the tumor grow before it’s removed - and I stress it’s just a theory, but she’s very cerebral about her decision making process. I see her on Tuesday to get a run down on self injection so I’ll ask her about her thought process. Thanks so much for your help and replies
Am curious as to what other hormones she will supplement with your condition.
You can state the Dr’s name in here it is helpful to others. Am in the NYC area too.
If u have issues down the road with her trt protocol, I can tell you who I see
Being affiliated with a top hospital is a good sign but that means shit
Thanks Charlie for the reply. I’d love to hear who your doc is just in case mine doesn’t work out. I’ll probably have to supplement cortisol at the very least. Not sure about the other drugs just yet, but I will, no doubt, have to have supplement my other missing hormones.
I’m going to withhold her name at this point. We just started our treatment protocol together. I’ve seen her exactly one time and she put me on TRT immediately. As far as future adjustments to my dosage, I’m sure we’ll start tweaking it as the my post op blood work reveals itself.
She might be a smart person. Then ask her why in the F would you give someone with low t a shot of something every two weeks when the half life shows it is much much less than that. Go to google and send her a link. Stop justifying your doctors a genius and blah blah. Every doctors smart. They all went to med school.
You need a trt doctor to consult this doctor who has no brain.
Google half life of cypionate and tell me again how you are going to do trt with a doctor who prescribes it every 2 weeks?
Especially when you get the gland removed. You will be back here asking “why do I feel like shit. It’s not working. Is it estrogen? Maybe it’s my levels. Should I do daily? Please someone help me. My doctor won’t five me enough TRT. “
List goes on. Go find a real trt doctor and have them consult this person who wants to make your life worse after removing your gland.
Are you low t? Did you start T and cycle? Guanranteed this is not something that makes any sense. There is not one trt doctor in America who specializes in trt that would give a man a single shot every two weeks.
I’m sure if you kept a log you would of realized the difference. We all do. It’s just paying attention. Some just don’t bother as much while others look at every single change and start panicking…
Omggggg 
I haven’t actually met with her yet to discuss the treatment. It very well may change when I go to her office to talk self injection. I just happened to see the prescription on my online chart that is used to track my surgery. I’ll talk with her about a)injecting weekly b) upping the dosage.
It would appear that everyone is getting angry at this doctor and I haven’t even started injecting yet. And yes, I get your points. Very good advice to consider as I move forward
I’ve heard titles like my endo is the “head of endocrinology” at a big well known hospital, it doesn’t mean anything if you understand the culture of TRT within western medicine and how it has been ignored for the past 70 years.
If you were taught in medical school TRT causes prostate cancer, causes strokes and heart attacks, no wonder doctors have stayed clear of TRT, if you bring up TRT to some doctors they will refuse to even talk about and now they want to to leave their office immediately.
I doubt the OP had a complete hormone panel, most endo’s only test TT and are not concerned about the free portion of testosterone and most refuse necessary estrogen testing. I’ve even heard some endo’s state men don’t have estrogen and you realize sex hormones is an area of medicine paid little attention to in medical school.
The OP endo may very well be a really good thyroid and diabetes doctors, but TRT is an area which she knows very little and doesn’t have the time to take off work to be retrained as she graduated medical school long ago.
Doctors always follow guidelines, thyroid treatment protocol for dosing recommendations are up to date and tells doctors how much and how often to dose thyroid medicine TRT guidelines are decades old and this is what they are following for dosing recommendations.
TRT guidelines are basically instructing how to begin hormone deprivation therapy/hormone roller coaster.
Thanks for your input systemlord. My doctor is part of the team that treats patients with pituitary adenomas, so Im guessing that she’s worked with TRT patients quite a bit. She’s part of my team in addition to a Neural Ophthalmologist, an ENT surgeon, a Neurosurgeon, my PCP and all the radiologist that do CT scans and MRI’s. I’m kind of at their mercy right now guiding me through this process. I did, in fact, have a complete hormone panel. We spoke about estrogen and its roll, in addition to all the other hormones that will be (have been) messed with due to this tumor. There are a lot of moving parts to this surgery. I’m hoping I’m in good hands.
If you had trusted your doctor to do what’s best and instead put you on a path to suffering, you’d be upset as well. We see the same thing about to happen to you.
I was prescribed 200mg every 3 weeks on medicine with a half life of 7-8 days, after the first day of my injections my co-workers could see a remarkable difference, 5 days after my injection my co-workers would ask me are you sick.
The protocol your doctor has prescribed after looking over the study I provided indicate your endo has no clue what she is doing. This is the conclusion I would come to if I had actually read the study.
By prescribing 150mg every two weeks, actions speak volumes.
Oh… and when I first met with the Endo she said some patients like to inject weekly. She said that is my call. So… time will tell. Plus now that I have the prescription I can adjust accordingly as the weeks go by and I’m on my own after surgery.
SHBG levels should dictate injection frequencies. As long as your doctor is willing to work with you, that’s great.
Dose looks reasonable given your age but would definitely discuss bi-weekly injections. I don’t see why the doctor would object.