T Nation

TRT: Protocol for Injections

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This post was flagged by the community and is temporarily hidden.

[quote]Headhunter wrote:
No doctor I’ve ever met will prescribe the ideal protocol listed above, unless you can fly to Florida or Vegas and set it up at one of the anti-aging clinics. Expect to pay thousands for this.

IMHO, if someone’s got that kind of cash, they should try the ideal protocol laid out at the top, for a couple of months (didn’t work for me). Unless you feel significantly better subjectively, its better to simply give up and accept fate.
[/quote]

There is a guy near me that prescribes the T+AI+hcg (+optional hgh): http://www.agemanagementcenter.com/

[quote]bushidobadboy wrote:
FFB WannaB wrote:
BBB
If I read you correct, you fill your “tubes” up from the back(keeping the needle sterile) ahead of time. Is this sanitary enough? How many ahead? I am relatively new to injections, so don’t come down to hard on me!
Also, how do you load up when injecting more than one “medicine” at a time?

Thanks

Yes it is sanitary. You don’t even need to keep your needles in a fridge. I use a filing cabinet with a tupperware box to store up to 40 pre-filled insulin pins at a time.

Keep your oil and your water-based injections seperate. Keep your water-based stuff in the fridge though as peptides degrade unless chilled, plus water is a more favourable medium for bacterial growth, compared to oil.

BBB[/quote]

I load mine for a month at a time but drawing up 40 or so would make it even easier…

Guys
Thanks for the info on the oil based vs. water based solutions. Now to get HCG rx and I am set! Maybe? I have been on TRT for almost 2 years. Anyone know what the odds of my shrunken, disappearing and achy testicles coming back to life is?

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I had my doctor call in my Prescription for hCG to Universety compounding pharmacy
1875 Bird ave
San Diego 92101
Phone 619-683-2005
They are shipping it to me.Its to far for me to go to get.Just have you doc call in Prescription and they will take your info over the phone and ship it to you after your doc calls it in. Like I said mine did then I received a call from them asking for my info.Hope this helps those that are looking for hCG that can not find it.

Thank you KSman for such an informative form. I was really happy to read that the androgel is not a suitable choice for someone who is a avid trainer.

A couple of months ago I told my doctor that I believed a lot of the gel was rubbing off due to excessive sweating which caused me to have major crashes after the gym. He blew me off and said that he doubt the gel was coming off.

I asked for weekly injections and he responded, “Are you kidding me there is no way I am giving you a bottle of testosterone and needles!” So sadly I am stuck with the androgel until I find another doctor. Thanks again for the information.

Haven’t posted on T-Nation for a long time, I’ve been wasting my time, money and sanity on the medical profession again. Went to Mayo clinic to supposedly one of the “Top Five” docs in the country regarding my urological/endocrine problems.

After a couple days of tests, he sends me on my way saying I had primary testicular failure due to my longstanding varicoceles, and he sent me on my way with Testim (testosterone gel) and said I would be fine. I wasnt. Months later I was worse than ever and I got a bill from Mayo for $8000. Then the doc called me, worried because my LH was very low (.3) at the same time my T was drawn, and the TT level was 105 after being off anything for 3 weeks. WTF.

So I go to another doc in town, did the same two tests, except this time while ON the testim gel. TT 188, LH .3. This is a new hell. I am rushed into an MRI to see what several docs locally now fear will reveal a pituitary tumor. None is found. So I am now diagnosed with “Hypopituitarism”, and asked to stay off my thyroid and testosterone for a month to do more tests to figure out what the hell is wrong with me. I told them to fuck off.

So I am back to where I should have stayed, T-Nation, and I am going to start taking care of myself since the medical profession to which I belong has caused me nothing but misery and added financial burden.
Doc

I hear that doc. It seems like we all end up in the same place which is being our own doc. HGH changed my life completely and I shared that with my family Dr. He’s thrilled that I’m finally fixed but won’t script HGH. He’ll run labs for me all day but I’m on my own regarding the HGH itself. Thanks to congress for making every dr in the country fear of jail time for scripting T or HGH.

Glad to see you’re back Doc! I only swing through here on occasion now that I’m 100%.

[quote]FFB WannaB wrote:
Guys
Thanks for the info on the oil based vs. water based solutions. Now to get HCG rx and I am set! Maybe? I have been on TRT for almost 2 years. Anyone know what the odds of my shrunken, disappearing and achy testicles coming back to life is?[/quote]

Mine quit aching over time. Just once in a great while now.

This thread should be a sticky!

KSMan: Unless I’m misinformed here, I think a man on this protocol is sterile. If this guy found he wanted to make some girl pregnant, would he then just get off the testosterone and continue with the AI + hCG as before?

Good question, but getting off topic for this injection protocol sticky.

Just try it, speculation is useless.

If you want to get a chick pregnant stick with the same protocol and just swap HCG for HMG. That’s assuming you aren’t able to get her pregnant on this protocol. You aren’t sterile on the T+HCG+AI protocol.

Bump.

This thread deserves to be stickied.

KSman is sharing some real pearls of knowledge. We can only hope that he will write a complete manifesto someday. I suspect he knows quite a lot more than he has told us so far, esp. about neurotransmitters.

BUMP for sticky.

[quote]bushidobadboy wrote:
brentf13 wrote:
Scipio you are shut down shortly after running T. You NEED HCG upon starting TRT. I could go on and on but trust me on this one.

You also need an AI to some degree. From all of the labs that I’ve seen guys post I’m starting to think all men over 30 could use Arimidex at a low dose regardless of if they’re on TRT.

Chrysin is a joke. You need a real AI. TRT in general should not be taken lightly. You really need to understand how your body works before messing with it. It may seem overwhelming at first but it’s really quite simple. Get an understanding of hormones, the various feedback loops, and metabolites before messing with it.

Well he’s 58 so I doubt he’ll be wanting children. Yes he’s worried about testicular shrinkage, but since he’s using only physiological doses, this should not cause shrinkage.

So the use of HCG is not mandatory IMO. Pregnenolone or DHEA should be used though, if not using HCG, to maintain mood.

BBB[/quote]

Not true.

It only takes a minimal amount of exogenous testosterone to shutdown the HTPA.

Once the HTPA is shutdown, the pituitary will cease LH production, and the testes WILL atrophy when not asked to work.

The testes are of utmost importance. They are not just for cosmetic purposes.

We now know that the testes not only make pregnenolone and DHEA, but they also make and regulate SHBG, along with the liver.

Without testical function, SHBG output can be compromised. This will lead to low SHBG, which is the kiss of death when it comes to hormonal management.

There are also LH receptors which are plentiful throughout the body. We need something to activate these receptors.

Many theorize these receptors, when activated ( or lack of activation) can affect mood, memory, sexual feeling, libido, and overall QOL.

Again, this research is all very new.

Thus, if we are shutdown from exogenous T use, it is of utmost importance we have an artificial stimulus of LH. Enter hcG.

Edit it looks like part of this post has mysteriously disappeared.

Hmmmmmmmmmmm

Concerning higher dose hCG or hCG mono therapy HRT:

There are problems when using larger amounts of hCG. The concentration of T inside the testes, intratesticular testosterone [ITT], can be up to 80 time greater than serum [blood] levels. At least that is seen in young health men.

Most aromatase inhibitors are competitive drugs that interfere with testosterone getting reacted by the aromatase enzyme. This means that one needs a concentration of anastrozole that balances testosterone levels. The higher ones T levels, the more anastrozole is needed. This is a linear relationship.

There is a lot of aromatase in the testes. As men age, levels of aromatase increase and there may be an increase of aromatase inside the testes as well. The testes are a small part of the body, but ITT can significantly leverage the affects of aromatization in the testes.

If you have a level of anastrozole that is appropriate for the serum T levels, and if ITT was 80 times higher than serum levels, the anastrozole levels in the testes could be out numbered 80:1. With high doses of hCG, ITT levels could be more than 80 times higher than serum levels. Also note that high doses of hCG risk LH receptor down regulation… a major step backwards.

Anastrozole is not effective in controlling T–>E aromatization in the testes. When guys take larger doses of hCG, E production in the testes can be high. Taking more anastrozole will not reduce that, but one then pushes down T–>E production rates in the peripheral tissues of the body. We have some who have been taking high amounts of anastrozole who cannot get their serum E2 near [optimal] E2=22pg/ml.

High does of anastrozole can be costly and may create some side effects as reduced T–>E aromatization in the brain may have some negative effects as the E levels in the brain may become lower than what is normally associated with serum E2=22pg/ml with normal anastrozole doses. In this case the ratio of anastrozole to testosterone in the brain is too high. One could state that this is true for all of the body except the testes.

If you are using more than 250iu hCG SC EOD and you cannot manage E2 levels with normal doses of anastrozole, consider using less hCG. When doctors use high dose hCG as a mono therapy [high dose], even if they achieve descent serum T levels, E2 may be big problem and high doses of anastrozole may create mental/mood and libido problems. In this case the doctor is optimizing a T response and not looking at or understanding the big picture.

Do not consider hCG to be a source of T. Use lower dose hCG to maintain the health of your testes and change T dosing to achieve target serum T levels. For those who have been stable without hCG who then add hCG later, the amount of increase in T levels with hCG probably is a good measure of how much E is also produced in the testes and a measure of the potential for higher amounts of hCG to create problems.

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I have finally gotten my protocol to match that described in this thread. I am using 120 t cyp in 2 divided doses subcu, 250 HCG 2 x weekly, and .25 arimdex 3x weekly. After three weeks on this protocol, my results had TT at 549 and E2 at 21.94. My doc also has me on 20 mg Danazol m-f, but I am wondering if that is still needed.

Based on this thread, it seems as though I have the E finally managed at .75 weekly, but do wonder if I need to push the T a bit more to get up to the 800 range.

Thoughts?

Drop:

It may be blocking hCG in the testes.

Yes, you should increase T. See if you can get 175mg/week. [That is 50mg EOD.]

Note that changes to T dose and dropping Danazol may shift E2 levels and change anastrozole needs. Suggest that you increase anastrozole by same % as T dose increase [45-50%].

Best to look at FT and get that to top of youthful range.

Some guys bodies eat T, don’t know where it goes, but the liver is probably doing a job too well.

Is your T cyp 200mg/ml?