T Nation

TRT in Japan Not Ideal

I am a very fit 49 year old who is struggling to stay fit and have a lower sex drive than I would like so I scoured the earth to find someone in Japan, where I live, that did some sort of TRT treatment. I found a doctor and went in to do my blood work. My free testosterone was 6.6 and he said it was abnormally low. I do not understand very well, but it appeared to be quite low. He put me on 125 mg. testosterone injection along with HCG injection every two weeks.

From what I can gather, it is standard protocol for people seeking TRT in Japan and the Japanese are very rigid so can’t expect that to change. At any rate, I was thinking that if I am taking the HCG then at least my normal testosterone will remain the same and the 125 mg. every two weeks will just be a bonus?

You all are so much more knowledgeable than I and I would appreciate what you think. Anything I guess seems better than status quo without the injections? But maybe not, here for your wisdom.

You need to start taking that dose weekly and split it at least in two injections

The protocol this doctor has put you is terrible and very likely you will be worse than before

What kind of ester does he use?. How much HCG?

I guess he thinks that HCG will keep your current test production and he is adding a little bit more on top of that. The problem is that ONE hcg injection every 2 weeks will probably have no effect on the second week (please HCG users and/or MD correct me if wrong). HCG is not like a Test ester that is released along several days. So as your own pulsatile test secretion will be supressed with the hormone replacement, your testosterone levels will be very bad on the second week as they will be based only on less than 62mg.

Follow @vonko1988 advice and claim for AT LEAST one injection /week. And much better 2 injections per week (both T and hcg), to keep stable levels on blood. Same total dosage, but divided along more injections. Then, you will have to assess whether the dosage is enough. Maybe the HCG dosage is enough high and those 125 mg could make sense… or not.

If you want a greater level of advice you will have to upload the full hormone blood panel, and details on the ester and HCG dosage. Excuse my english. Greetings from Spain.

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The half-life of HCG is 2 days so it makes no sense to space it out to every 2 weeks because it will wash out of your system by 4 days. As far as every 2 week T injections, the odds are you’re not going to show much benefit.

It’s like doctors are oblivious to half-lives and is a failure on the most basic level.

Hormone profiles after intramuscular injection of 200mg enanthate every 2 weeks in patients with hypogonadism

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.

WTF, this “japanese study” came out 15 years ago!

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Really useful @systemlord . @japan now you have an official paper for your doctor.

@systemlord giveth and @systemlord taketh.

Every two weeks is horrible.

If the paper above won’t get him to bend, I’d consider proposing that he let you try 1-2 months of injections 2+ times a week, to see how you feel. Just a little negotiating/social engineering.

Slide him some yen… ya know.

You’ve gotten some good advice. Not much more to add other than to summarize:

  • List item125mg once per 2 weeks will probably do more harm than good. It will interfere with normal production but will only keep you in an effective range for about 4-5 days after the injection and then it’s going to be hell for the next 9-10 days.

  • List itemHCG has a relatively short half-life and needs to be administered at least 3 times per week. You did not mention the dose. i suggest starting at 200 IU 3 times per week.

  • List itemA dose of 125mg per week (not 2 weeks) is pretty much what I’m zeroing in on as an optimal dose for me. The caveat being that the dose is broken up into at least 2 injections per week. This will help to prevent the peak levels from going way out of the normal range. I much prefer every 3 day (E3D) dosing .

  • List itemPerhaps you could negotiate with the doctor. Establish a target Free T level that you both can agree on (I suggest between 20-25 pg/mL) which will put you in the upper 75th percentile of the normal range of a 20-50 year old man. It’s a reasonable level to which he might agree. Then do a series of sequentially higher doses until you establish the dose that will put you in that range. Something like 50mg twice per week for 6 weeks and then retest. Then if not enough, 60mg twice per week, etc. This might get him more comfortable with the dosing if he has proof that you are well within the normal range for a guy your age.