T Nation

TRT Optimization

I’m 37y old and on TRT since 6 months. Effects have been excellent but I wanted to ask if you could comment on my protocol. I use 200mg Testosterone Enanthate / week, splitted in 2 doses via s.c. injection.
My lab values on the second day after injection are: Testo 10.6 ug/l (3.0-10.0), SHBG 22.4 (18-54) nmol/l, E2 29.7 ng/l (27-52), Prolactin 9.16 ug/l (4-15).

Is there room for improvement? Anything I should consider?

Include the ranges as well.

Ranges are included now

Looks fine to me. If you feel fine then I’d just keep on with it.

1 Like

Your levels look great across the board, but I would test free testosterone next time. Your TT and SHBG levels would likely put your free testosterone beyond the reference ranges.

Looks good aside for E2, why is E2 so low

E2 was always quite low. At the beginning I took an AI (1 mg anastrozole/week, because I gained a large amount of weight; 84 --> 92 kg in 2 months - most likely water weight - but developed side effects like joint pain so I stopped.

I aromatized more on SQ injection, less on IM.

Adipose tissue contains aromatase, injecting directly into fat tissue will expectedly induce a higher rate of aromatisation

Also regarding TRT optimisation, Dr Sir is back with @dbossa

They’ll be conducting an interview with one another. The video will be streamed live on YouTube with Q@A

Wow… I’m great… free advertising for the win

Seriously though, if you’ve got a question this would be a pretty good place to ask (when the interview is streaming that is)

@systemlord @NH_Watts @charlie12 @vonko1988


So you would recommend to switch to i.m. injections??

Only if still having problems with estrogen.

Depends, if you’re legitimately aromatising at a disproportionate rate AND you have associated symptoms (most bloating and fatigue isn’t E2 btw, it’s effect on adrenals/thyroid) then sure

WHAT!? When worlds collide! This is amazing news.

1 Like

99% of men who claim to be aromatising at that rate aren’t… It’s significantly more rare than people realize.

I was started on 1mg Anastrozole per week because my e2 was 110 after 6 months. Last blood test it was 28. Free test was 26. Been on 200mg test per week for 2 years. Ive decided to start injecting twice a week instead of once, so I suppose I should take half Anastrozole after every injection?
Im injecting into my thighs. Cant reach around to my glutes or I would do that as some thigh injections hurt like a bitch.

You took arimidex because of a number or because of the way you felt? There is a difference. I know plenty with E2 at 110 and feel better than they’ve ever felt in their lives. A number on its own doesn’t mean much in this case.

I inject daily to avoid the AI because any mount equals low estrogen. The .5 anastrozole is still too much.

Well there is a ratio of acceptability

Say he has a TT of 400 on this dose but an E2 of 110… then there’s an issue

It’d be interested to know whether any history of hepatic impairment exists (familial or otherwise) + bf%, his lifestyle (does he drink a lot of beer?)

Furthermore a rare genetic disorder (aromatase excess syndrome) does exist, those who have this actually do require an AI or otherwise typally are given HRT but with a nonaromatisable androgen instead (e.g mestanolone, esterified dihydrotestosterone… but with both having affinity for 3-hsd they can’t preserve skeletal muscle adequately :frowning: otherwise drostanolone (still fda approved, could theoretically be compounded), methenolone, fluoxymesterone etc

Fluoxymesterone is c17aa and thus hepatotoxic (and fairly toxic at that, being able to induce BSP retention at 3x less of a dose comparative to oxandrolone) but it IS a still FDA approved to treat hypogonadism and is still manufactured

Agreed… But how many men have you met with total T of 400 on 200mg a week? It’s an extremely rare occurance.

I dealt with one guy like this who was injecting Sub-Q. Couldn’t figure out why he was getting such low levels. Then it turned out he had a skin disease (forget which one). Had him switch to IM and bingo!

I avg around 700 total. No liver issues and normal CBC. I did not feel right at 110. Always felt like my head was in a fog, and the libido was way off.