TRT: Protocol for Injections

I would be interested in knowing how to split up the 100mg dose on the insulin IU’s. Also if its no biggie to move between shoulder and quad

I’ve been prescribed 3 testogel 50mg per day for long term supplementation of my Test Levels. I’m 40 years old, no steroid background. The Testogel I’m using now for more then a year. On my new location I do not have access to testogel anymore and heat and training makes it not an ideal way to get Test Levels up.

Now I still have 4 Boxes of Testogel, Andriol is available in any pharmacy without prescription. So I switched now to 1 Testogel + 160mg Andriol daily + 1mg Finasterid to protect my hair. I also take Resveratrol morning and evening as well as 30mg Zinc. Besides Andriol, Test Depot(enantat) is also easily available for me. An Injection every 5 day of T Enantat would be the easiest way for me to get my test. On the other hand I worry to completely shut down my natural production, which now is still working but just a bit low. I don’t know if that applies to the other guys in this thread or if they are near to complete shutdown. What protocol do you suggest for me for longtime therapy? Not sure if I can get HCG.

the handling of hcg is a bit much, and is it safe for longterm use?
would it make sense to apply it at 250iu only once a week? or use it on/off like 6months no hcg following a 6week period with hcg eod?

I’ve been struggling with low test for years- I suffered a severe eating disorder from the age of 17 and didn’t start to recover until I was 21. I’m 24 now, recovered from my illness, and over the past several years have received different types of treatment to address the low test I developed as a result of it. Initially I was treated with gels, and for the past 1-2 years with a testosterone undecanoate injection (Nebido) which I receive every 12 weeks. However, my levels have never reached within ‘normal’ levels. I have tried halting treatment and attempting to naturally restore test levels (through diet, supplements, etc.) but with no success. My endocrinologist insists that there are no alternative protocols (or at least none which he is willing to prescribe for me) and cannot determine a specific reason as to why my levels are low. Looking through the protocol which was suggested in this thread, it seems like a preferable approach, or at least one which I would be willing to try.

However, because I live in the UK, it will likely be difficult to get hold of what’s recommended (or so I’ve been told.) As I’m currently working in a gym, there’s obviously ways and means of possibly getting hold of what’s suggested here, but I’m sceptical of the quality/safety of what I could be getting. As I said, I’m willing to try this protocol, as I’m frustrated that my doc is not willing to look down an alternative path and maintains that my current treatment (which isn’t working) is the best for me. Should I go ahead and take the risk, or does anyone have any other advice??

Apologies, have just read further into the thread and realized that I was not supposed to make a personal post. Please delete my previous post.

Any ideas on how to get an ordinary doctor to agree to this? He talks about gels and about once/week dosing in-office.

.65 ml is 650 iu ONLY IF the mix is 1000iu/ml. Many mix to 2000iu/ml and inject smaller volumes.

So you are asking how to inject hCG if injecting T twice a week? hCG does not have a half life that supports injecting every 3.5 days. Still recommending injecting hCG 250iu EOD. If you must inject hCG twice a week, you may find that injecting T and hCG at the same time will feel
OK and this is a simple routine.

Injecting 650iu for two days, 1300iu total before a weekly T injection does not make any sense at all.

If you cannot reason with your doc, it is a relationship based on one way flawed communication; you need a new doctor and there is a sticky for that. Finding a good doc is the biggest problem with TRT.

KSman,

While on TRT, would it be possible to use Clomiphene Citrate (say at a dose of 12.5mg per day) instead of HCG?

Even with 250iu of HCG EOD and Arimidex 0.25mg EOD, I still tend to hold a little water in my face which is noticeable. I have tried increasing the Arimidex dose but it did not stop the face bloat.

Thanks.

[quote]Luke2000 wrote:
KSman,

While on TRT, would it be possible to use Clomiphene Citrate (say at a dose of 12.5mg per day) instead of HCG?

Even with 250iu of HCG EOD and Arimidex 0.25mg EOD, I still tend to hold a little water in my face which is noticeable. I have tried increasing the Arimidex dose but it did not stop the face bloat.

Thanks. [/quote]

In theory, yes. However, many feel crappy with clomid as it acts as an estrogen for them. Suggest Nolvadex to avoid that. hCG is a natural substance in humans. SERM’s are drugs. So you can see why SERM’s are not widely used for this purpose. You need E2 lab data. Please keep these case specific posts in your own thread, not in any stickies.

[quote]KSman wrote:

[quote]Luke2000 wrote:
KSman,

While on TRT, would it be possible to use Clomiphene Citrate (say at a dose of 12.5mg per day) instead of HCG?

Even with 250iu of HCG EOD and Arimidex 0.25mg EOD, I still tend to hold a little water in my face which is noticeable. I have tried increasing the Arimidex dose but it did not stop the face bloat.

Thanks. [/quote]

In theory, yes. However, many feel crappy with clomid as it acts as an estrogen for them. Suggest Nolvadex to avoid that. hCG is a natural substance in humans. SERM’s are drugs. So you can see why SERM’s are not widely used for this purpose. You need E2 lab data. Please keep these case specific posts in your own thread, not in any stickies.
[/quote]

Yes, what you said makes sense. Since hCG has a half-life of 23 hours, if someone was willing to inject every day, do you think 125iu of hCG daily would be an ideal way to go?

I do not believe that there would be any tangible benefit. You activate receptors and the half life of that is considerable. Note that you are maintaining the testes and if they had been working well, you would not be here. TRT delivers the T, T from testes+hCG is typically a small effects. Injecting starts to loose its glamor over time and injecting everyday is burden at some point.

Thanks KSman. Your knowledge is impressive. So for guys who want to have children in the future, would you recommend a combination of hCG (since LH stimulates T) and hMG (since FSH stimulates spermatogenesis) 3x per week if their LH and FSH is shut down? If so, what dose of hMG would you recommend along with the 250iu of hCG? Thanks.

I have never recommended hMG. I know that it would work, but it is typically very costly. What you propose seems reasonable.

hMG contains FSH and LH, so hCG not technically required, but combo may be less expensive. You would use less of each. You do not want to have too much LH or LH+hCG because T–>E2 can be very high in the testes and Arimidex/anastrozole is ineffective for treating resultant high serum E2.

One can alternate with hCG and Nolvadex if the pituitary is SERM responsive.

Most will probably remain fertile with hCG.

“You do not want to have too much LH or LH+hCG because T–>E2 can be very high in the testes and Arimidex/anastrozole is ineffective for treating resultant high serum E2.”

  1. I appreciate your response. Just to be clear, does that mean Arimidex is ineffective against any E2 produced from hCG or it is just ineffective against E2 when a high dose of hCG is used?

“One can alternate with hCG and Nolvadex if the pituitary is SERM responsive.”

  1. Say an individual’s pituitary is SERM responsive, how many weeks of hCG would you recommend before switching to Nolvadex and then how many weeks of Nolvadex would you recommend?

  2. What dose of Nolvadex would you recommend?

  1. Anastrozole cannot eliminate any E2, only reduce the source production T–>E2. Anastrozole is a competitive drug and must balance your serum T levels. Intratesticular T levels can be 80-100 times higher than serum, so an anastrozole dose that is effecting in peripheral tissues simply cannot control T–>E2 inside the testes where T levels are so high. Your concept of “[in]effective against E2” is flawed, the concept is ‘effective against T–>E2’. If you have high amounts of E2 created in the testes, anastrozole cannot manage that source. High anastrozole doses are also ineffective in such cases. Doc’s don’t get it.

  2. No good answer, I was thinking that it might be a good occasional tune up. So if an individual has a fertility issue from non-stop hCG, then breaking the pattern might be very useful. When its time to get pregnant, would be a good idea to get on SERM at that time. One could do 4 weeks hCG then two SERM. Might be interesting to note mood changes. Speaking off mood etc, because some feel terrible on clomid, suggest that Nolvadex be used as it does not have that problem.

  3. 12.5 mg ED or 25 EOD. If you feel estrogen effects, dose may be too high for you. But negative effects can take time to build and perhaps nothing shows up in two weeks.

All assumes that:

  1. the top end of the HPTA can make LH/FSH
  2. the testes can respond to LH/FSH [or hCG]

Thank you for your informative response.
Do you think there is a role for Triptorelin (Gonadotropin releasing hormone agonist) in TRT?

It is used as a ‘chemical castration’. Takes LH to zero. TRT does that anyways. What are you thinking?

“By causing constant stimulation of the pituitary, it decreases pituitary secretion of gonadotropins luteinizing hormone (LH) and follicle stimulating hormone (FSH).”

If it could be delivered in small pulses it might work as you are wishing it did. But you cannot do that.

There is someone on another board who claims to be a physician who directly did clinical research with patients using T. Here is a copy and paste of something he wrote:

"I also like to address a proper PCT at least in my opinion. There are many
different ways that a PCT is done and can be done but i think here is one
best way. Recently i have been using Triptorelin for my patients along
with toremifene and clomid. I don’t use or recommend HCG when using
triptorelin cause those two don’t work so well together because the test
spike from HCG by itself can further delay or halt the production of test
that triptorelin is trying to achieve. If triptorelin was not being used
then HCG definitely should come in to play at very low dosages as in
150-200iu three times a week. But assuming you have your triptorelin, tore
and clomid in hand then this is how my PCT should be done:

  1. SubQ injection of triptorelin 100mcg after most of the last and longest
    acting AAS is out of your system. For example, if you are only on tren A
    and test propionate then you can safely inject the triptorelin 4 days after
    the last dose. But if you are on tren, test enanthate and deca then you
    have to wait 3-4 weeks after your last dose to inject triptorelin.
    Injecting triptorelin too early when AAS levels are still high can make its
    use pretty ineffective. Once you have injected the triptorelin, i advise
    my patients for the first two weeks to take 100-120mg of toremifene split
    twice a day along with 50mg of Clomid twice a day. For week three, reduce
    toremifene by half total daily dosage and still split twice a day and
    reduce clomid to 50mg once a day. For the fourth week, reduce the
    toremifene to 25-30mg daily once a day and clomid 50mg once a day to finish
    out the 4th week. This is the best chance to give your body to bring it to
    its natural test production levels. At this point, you need to wait 30
    days before testing your total test levels. Testing right after you come
    off clomid or tore will give false results."

My understanding is that he is saying a single 100mg dose of Triptorelin would better stimulate LH and FSH as compared to hCG. However, the key is to use a single dose to stimulate LH and FSH. Repeated dosing would no longer stimulate LH and FSH, but would rather downgrade the receptors, shut down LH and FSH, and result in chemical castration.

Of course, I am in no way suggesting that anyone should try this, I just wanted your opinion on it.