TRT Protocol Advice, Post Accutane Syndrome

So i am going to try TRT in order to upregulate or heal my damaged Androgen Receptors, i have Post Accutane Syndrome. In general:

My TT hovers around 500 ng/dL
My free T is 20- 22.
E2- 30

I need to be sure if my disease is related to androgens or not and to see if TRT can fix it.
My goals:

Increase my TT level around 1000- 1200ng/dL
Keep my E2 at 30 or lower.

Can someone recommend me a dosage for TRT? And an AI dosage to keep my E2 low?
I am going to shoot Nebido, subQ, not intramuscular.

Of course i will use HCG with it too, so, HCG+ TRT can really increase my E2, should i try it natural or use an AI with it? What will happen when i come off from all of this? Is AI’s really dangerous and risky? @iron_yuppie

My own guessings:

With 250iu 3x a week HCG,

-150mg Nebido once a week or
-50mg nebideo 3x a week

Which one is better? Is splitting your TRT dose to thirds are better so you don’t ride on abrupt waves of T?

Thanks all. I will also be using HGH 4IU eod with this protocol or Mk677 25mg daily.

@lordgains I can’t stop myself from tagging you brother :slight_smile: I will try this before Mifepristone and Bicalutamide.

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No problem, I’ll get back to your other post very soon. I just don’t have the time to post here much right now.

I think you’ll get some flak for suggesting you are doing temporary TRT, because that is nearly per definition not TRT.

Mifepristone is a very interesting compound, still the only (non-selective in that) GCR antagonist we have. But know that it is a strong progesterone antagonist too.

I think trying mifepristone would be easier and of shorter duration than TRT but the chances of it helping your case, I don’t know. I’ll have to read your posts and get back to you.

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If you don’t take too much? I’d argue no, not at the small doses we are using on TRT

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And what would those small doses be?

Im not entirely sure. But i think the ideal is to keep it around 20- 30, and experience a clear “high” from Testosterone instead of a fuzzy mixture of high E2 symptoms with it.


FYI, I have read some of your posts and you’re on the fringe, meaning you have a complicated case with the possibility that no resolution to your issues is possible at least with current medical treatments no matter what.

In these cases I would recommend everyone at, least periodically, talk to a therapist, psychologist, etc to help dealing with the stress and moving forward with a good mind set while treatment is searched for.

Doing a trial of trt for a period of time is fine to see if it helps. Even if it does though, doesn’t mean that you can stop later, your symptoms may return.

With Nebido, I don’t think splitting the dose is necessary, but it won’t hurt anything. I’d recommend Test C or E, but you work with what you can get.

The dose, if it was test C is fine, I’m not sure about nebido. A larger portion of the molecule is the ester, so the actual amount of test receive wI’ll be a bit lower than C or E, will it matter much, who knows. Really for all of them you kinda have to pick a dose and run with it for 6 weeks then test your levels and adjust. You’ll be using HCG, I understand why, which will bump the number up. Essentially, I think you picked as good as starting point as any. Run with it, if you decide to, for probably 2-3 months, then test your levels, once you get to the levels for your “attempt” I’d probably give it 6-12 months to see if you’re getting improvement. Repair takes a long time and you may not see improvement for a while.
A diary or log may be useful to document things if your not already doing that, since improvements may be small and incremental they can be difficult to track if not written down. Even going from feeling good 2 days a week to 3 can be a meaningful improvement.

HCG dose is probably fine, I’ve seen up to 500iu x 3 week as part of a fairly normal trt protocol.

I’m not familiar enough with HGH to really know about it, that doesn’t seem like a crazy dose.

No clue on the mk677.

Given what I’ve read in some of your other posts, you’re in a tuff spot, I can’t say I wouldn’t be as or more frustrated if I had half the issues you’re experiencing. For example, I have some persistent ED, but I can largely deal with it with cialis and viagra, sure sometimes max dose of each at the same time, but I can git 'er done.

I was one of the first people prescribed Accutane, after it was approved, back in the 80’s. I’ve had no negative side effects, that I can tell, I’m in my 50’s now.

I do strongly recommend talking to a therapist even if you’re supremely optimistic that a “cure” is to be found. Help navigating the emotions of the search and treatments can be exhausting and frustrating and having someone familiar with your case to talk to about things, is very helpful. All treatments for complicated cases are multifaceted, and working with a professional for each aspect is important.

Good luck

Edit: I skipped your ai question, I take an ai, .75ml/wk, I’ve not noticed any side effects.

As usual, just my opinion, not medical advice, etc. etc.

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For me AI’s are going to degrade my health very quickly as I am an over-responder to all medications to the point where my doctors are never suggesting normal dosages of anything anymore.

I even tried 1/10th of a 0.050 anastrozole and a few days later knees and hips are hurting, very loose and feels like joints are dislocating with any movement.

My point is there must be someone at the other end of the spectrum where they need to take a lot and get the intended effect without risking long term health.

In general AI’s are causing damage to most, how much is very individual.

Thanks for the advice and interest sir.

You were lucky to get away with that Accutane usage, or im just so unlucky.

May i ask did you grow after Accutane? Height, clavicle bones (they ossify at 25) facial masculinisation, jaw growth, widening etc.

Oh and no i won’t going to try Testosterone for months. I don’t want to damage my natural production.

Im gonna try Test. just for 6 weeks. And my main concern is usually about muscoskeletal development, i am not sure if this disease is systemic or tissue spesific. Because i believe i can fully recover my sexual health, somehow i will find a way!

Some Post Accutane victims i closely know have fairly masculine faces, beard, brow ridges etc. So i assume this must be tissue spesific. I just wish the ARs in my bones didn’t have any damage. Because other things are totally fixable as im still young. Besides, i don’t think androgens are the main agents of bone remodelling and growth. There was a guy with Kallman’s Syndrome, Brandon Westfall and he is 6’4. Wide shoulders etc. without medically hitting puberty, so almost zero Testosterone and DHT in his system.

What damage are you saying that accutane caused? I’ve suspected that my taking accutane twice as a teen, played a part in my low t, but I don’t know if there’s actually any way to prove it.

Allow your e2 to run as high as it can get without causing you side effects. For you maybe that’s 32. For me it’s in the 50’s. You’ll have to monitor it and make notes about when you feel good and then link that with blood work. It’ll be annoying but worth it.

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I didn’t see any ranges for your results, so it’s hard to comment.

I personally wouldn’t try for anything under then 3 months, assuming you get your doses right the first time, which isn’t a good bet.

If you actually have a 5ar inhibitor related issue, trt seems to be the only thing that I’ve seen that helps people. I’d be open to being on longer, or forever.

Don’t mess with an AI unless you absolutely have to.

I don’t know your shbg so I can’t comment on dosage.

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Yes , I developed normally after taking accutane, no issues or side effects, other than maybe dry skin while on it, it was 35 years ago so hard to recall. My experience was nothing but positive.

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Thanks, so i can buy either Test C or Test P.

I have read Test P is better for shorter cycles due to half life etc.

Im thinking to do 3x a week 50mg Test P injections SubQ. (With 3x HCG.)

What should i do? Test P seems useful for me? Thanks.

And anyone here knows if Testosterone injections can upregulate the expression of some Androgen Receptors?

General consensus says the otherwise, that external androgen intake will downregulate the androgens, so that’s why i was going to take the strong AR antagonist Bicalutamide, to upregulate my AR as i tend to believe Post Accutane Syndrome is the opposite of Post Fin, and has downregulated AR instead of Upregulated AR.

Can Test. injections fix my problems via AR regulations?

When i took Tamoxifen it was on 62. And i didn’t experience any side effects from that E2. So this protocol must be safe for me as Tamoxifen increases E2 more? Hm.

no point in trying trt for 6 weeks when maximal improvement and improvement in eq comes on the 6’th month mark. Also, your free t is 20-22? In what units? Do you have SHBG test?

So guys, i injected 50mg of Test Prop. into my belly fat. @iron_yuppie

And now i have a red swelling there. And i can feel the lump on the injection site. Is this normal with Subq?

The package said: ‘‘I.M use only’’ but i guess thats due to warning for oral use and that the labs are outdated and didn’t also state SubQ use is also doable?

It is oil based so maybe needs more time? Funny thing is, i didn’t have the lump or swelling when i first injected to my belly. The injection side had no lumps and it was clear looking. But today i woke up and there is that red lump, it is not so huge and so red but it hurts when i move.

Did i just trapped the Intramuscular oil inside my fat tissue for eternity lmao?

FSH 1,68 - 1,5 - 12,4 IU/L
LH 4,24 1,7 - 8,6 IU/L
Estradiol 30,96 pg/ml 11,3 - 43,2
Prolaktin 12,1 ng/ml 4,04 - 15,2
Testosteron, Total 4,66 ng/ml 2,49 - 8,36
PSA, Total 0,937 ng/ml 0 - 2,5
Progesteron 1,09 ng/mL 0,14 - 2,06
DHEA-S (Dehidroepiandrosteron Sülfat) 508,4 ug/dl 85 - 690
(Growth Hormon) 0,784 ng/mL 0 - 0 <5,0
Testosteron, Free 22,55 pg/mL 4,5 - 42
Dihidrotestosteron (DHT) 800,72 pg/mL 250 - 990
(SHBG) 23 nmol/L 10 - 57
Somatomedin C 212,1 ng/mL 116 - 358


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Do those lumps indicate that the Test oil still didn’t get absorbed?

Or that it gets absorbed within minutes but leaves a scar like swelling or something?

Otherwise this very slow absorbtion is going to throw off my schedule. Thanks.

Guessing just slower. There’s a reason the vials say IM for oils. IMO when it’s time to get the meds in you, you want the fasted route. Let the ester control the release schedule