Unique TRT Situation

Minor update:

I’ve been injecting 70mg test cyp twice a week and taking a full 2mg of adex per week (split in 4 doses…0.5mg on the day of and after each injection).

So this is a slight decrease in my original T prescription but split into twice weekly. And a doubling of adex, split 4 times weekly.

I’m purposely aiming high with the adex to see where it puts my E2. I will be drawing for labs on 10/1/16.

I will adjust the adex accordingly after that (likely down obviously, probably to 1.5mg). In the meantime, the acne has definitely settled down. No new acne, and the old ones have relaxed but haven’t disappeared or healed completely yet.

I don’t know if this is because of the increased adex or the split doses of the T…or maybe a little of both. Normal libido has returned though (thank God!), and even orgasm has normalized (as opposed to what I complained about in an above post). I’m thinking this is more likely because of the increased adex.

Okay, appointment and lab results update:

…and regarding what I posted just above, I made a slight change 3 weeks before drawing for these latest labs. Here’s what I was and am currently doing…

  • 70mg test cyp, twice weekly for a total of 140mg (sunday morning, wednesday evening)

  • 0.5mg arimidex 3 times weekly for a total of 1.5mg/week

Results:

Total testosterone 1601 ng/dl (250-1100)

Free testosterone 333.8 pg/ml (35-155)

Estradiol 21 pg/ml (<61)

Hemoglobin 17 g/dl (13.7-17.5)

Hematocrit 49.8% (40.1-51%)

labs drawn on a Wednesday before that day’s injection

So these numbers are better than I was expecting (free T 333!), not to mention that all of the problems I had been experiencing have been virtually eliminated. I’ve also almost hit the apparent E2 sweet spot with my result of 21.

I owe it all to you very knowledgeable and helpful bastards.

I did bring up one other thing with the doc today though. That of shrinking testes and my not incorporating HCG. Now apparently he generally does HCG in huge doses for a short period of time, and then repeats it every 3 months, as opposed to most here on the forum that seem to take a lower dose constantly.

I asked him what he thought of me trying his intermittent restart method with clomid instead of HCG (because I pay cash and don’t go through my insurance, and clomid is cheaper). He said that sounded reasonable and wrote me a script for clomid, 50mg/day for ten days.

From what little I know, 50mg sounds high. What do you guys think about it overall, and does clomid have any side effects I should look out for?

I should also mention (out of general interest) that I brought up the topic of sub-Q vs intramuscular injections with my doc yesterday (I even mentioned Dr. Crisler).He explained that the reason he prefers the love handles is because it’s intramuscular yet surrounded by lots of fat. Apparently that makes for the best site…as opposed to a site where it’s solid muscle and very little fat, or sub-Q where it’s all fat.

I wanted to ask him to explain the mechanics or kinetics behind that, but we had gone far over my appointment time already. But I thought that was an interesting answer.

@KSman and @Nashtide

So I picked up the clomid (prescription 50mg/day for 10 days) and took the first pill yesterday. After my mouth going numb, getting a headache and heart arrhythmia, I had second thoughts. No way I’m taking another 50mg today.

I know you guys don’t recommend clomid but it is all I can get at this point. I also know that you recommend lower doses like 25mg EOD, is this correct? If so, should this go longer than the normal ten days?

To be clear, the reason for this is just to give my testes a periodic boost so as to minimize atrophy. I am still continuing the TRT protocol as described just above.

I have no personal experience with clomid. What I do know is lots of guys hate it. Causes all kinds of problems from headaches to vision problems to just feeling shitty. I’d stay away if I had the side effects you had yesterday.

Clomid 50mg is insane. Try 25mg twice a week,

If you feel terrible, that is not uncommon, get nolvadex and try 10mg ED or 20 EOD.
There is a lot more in the stickies, you should have known to never take 50mg.

Just do SC any way you want, its your gig.

Your labs were great.

If you get too much LH/FSH from the SERM, you could get very high E2 and spoil the party. The high induced T–>E2 inside the testes cannot be controlled by anastrozole.

Please read the stickies found here: About the T Replacement Category - #2 by KSman

  • advice for new guys
  • things that damage your hormones*
  • protocol for injections
  • finding a TRT doc

Thank you very much guys. And @KSman, yes, since my labs are on target and I’ve been feeling so great, I don’t necessarily want to mess them up with clomid. It makes me wonder how necessary any testes boost even is?

So then, if nolvadex is out of my reach for the time being, and assuming I did 25mg clomid twice a week, how long would I take it for? I assume it’s longer than the 10 days?

There is a need to prevent damage to the testes for various reasons. You can use hCG or a SERM. The intent is to not create a lot of T, the injections are most cost effective measure for that. So testicular stimulation should be at a lower level. SERMs are foreign chemicals. hCG is a natural hormone and you were swimming in it for a few months before birth. Less is more.

So I never took another clomid. It took a good 8 days for the side effects to clear just from the one pill, including massive acne again, so I assume it significantly raised my E2.

I will wait for the next doc visit and ask about getting nolvadex instead. Does anyone know a ballpark figure on the cost of nolvadex when paying cash?

@KSman and others,

I’m not sure why my levels don’t seem to remain stable. Currently I’m doing everything identical to just above where I got great numbers and results, but a couple weeks ago I started getting unusual and painful acne again, and the morning wood and libido has dropped off again. I suspected that maybe E2 was creeping back up, so I went from 1.5mg/week of arimidex to 2mg.

The acne has subsided, but the morning wood and libido hasn’t returned…so I’m not sure what to make of that, and I don’t want to get my E2 too low (in case I’ve passed through the sweet spot)…however the acne has continued to improve.

What do you make of this?

When I was taking too much AI, my FT spiked and E2 crashed. Backne was a problem. Could be too much AI, caused a crash, Acne and loss of morning wood would be a good sign… Your FT was almost double the legal limit in your last test, which is great if you feel good, but keep a close eye on Hemocrit level. If you took too much AI at some point it could have crashed E2 into single digits. I had a lot of issues with symptoms when I took an AI, turned out I really didn’t need it. I finally just reduced my T dose enough to get off the AI, and so all I take now is a lower dose of T. My T>E2 conversion is normal. TT, FT, E2 are all midrange/normal. I’ve never been estrogen dominant, so this works for me. My advice is to reduce your protocol based on how you feel. I don’t feel better with TT and FT above normal, so I reduced mine enough to get off AI entirely.

When I first went on TRT I was terrified of high E2, so I took too much AI and crashed E2 for months. Had all kinds of problems, ance, BO, limp dick, libido, thick blood, etc. Now I keep TT/FT in the normal range and doing great, with no AI and less meds to balance…

Interesting @Jdeck

When my E2 was too high I had three symptoms…low libido (and lack of morning wood), acne, and prostate inflammation. Currently, I have 2 of the 3 symptoms. My prostate is fine. I suppose it’s possible that low E2 is mimicking high E2 minus the prostate problem?

The odd part is, everything was running tip-top at my last labs and at 1.5mg arimidex a week. When things deteriorated I upped the arimidex to 2mg. If I cut back to 1.5 again, I’ll be right back where I started. And I know for sure that 1mg is not enough.

As far as your numbers and what you felt good at, can I ask how old you are? …because my doc told me that guys my age don’t feel any improvement until their FT is at least 200 pg/ml (35-155) (I’m just turning 53).

@KSman

Okay after giving it some thought, here is my working theory…let me know what you guys think.

My first cascade of problems was caused by high E2. Increased adex lowered my E2 and the problems went away. However, knocking back the E2 conversion caused a significant increase in FT, and it is this current high FT level that is causing the current problems (acne, lack of libido).

I guess a good question would be, can high FT cause low libido (having gone from 210 to 333 FT)?

I’m 41 (answering your previous question).

I’m not sure if just high FT alone will cause low libido, but my experiments over the last few years have taught me the lab ranges are important. If you are double the high mark on FT, its likely you will introduce problems long term, such as thick blood (hemocrit) can cause stroke/heart attack, high/immature RBC also. The thick blood can cause blood flow issues to the penis, as well as elevated risk of heart attack and stroke. Your elevated Test causes elevated E2, then too much Adex crashes E2. E2 being high or low causes more sexual problems than T being high/low. To feel optimal, with optimal health you probably want to get your T into range, and you may not need an AI if your T>E2 conversion is working properly. Some people may have had different experience with TRT. Just for your reference I take roughly half your T dose, and no AI. 70-100mg week, I fluctuate a little just for fun. I discovered some fluxuation to be helpful in the bedroom. My TT is normally 7-800 and E2 around 20. FT is usually at the top of norm, and sometimes a couple ticks above range… FT and E2 are the most important numbers to watch.

Thank you Jdeck.

So with your FT at the top of norm, do you feel very positive effects of your TRT?

I ask because My doc said that guys my age (52) don’t feel any improvement until their FT is over 200 pg/ml.

Either way, I suppose I could continue to lower my dose until I get back to 200 FT. My next lab draw date is Jan 4th, so it’s a good time to lock in a revised dosage.

It’s just weird though, because initially my FT was 210, but it was the increase in AI that shot my FT up into the 300 range. So if I simply cut back on the AI I should get back to the 200 range, but then I’ll end up with the original problem of acne caused by too high E2. So I will cut back on both the testosterone and the AI and see where I end up.

Get some research chem liquid AI, its easier to dial in dosage with a dropper than cutting pills. I definitely feel better than I used to(pre-TRT). I’ve had my TT/FT above range for some period of time and didn’t feel any better. I had an issue with overresponding to AI and having low E2. I’ve never had a test come back higher than 21, even without any AI. When I took regular dosing of AI my FT would go above range and E2 would crash quickly down to 10 or 12… The lower E2 caused my sexual problems, and hemocrit above range too. I quit taking an AI regularly about a year ago and haven’t noticed any high E2 symptoms, but again I only take 70-100mg weekly of Cyp. I had a blood test shortly after I quit and E2 was 20. It’s been almost a year since I had labs now. I take a few drops of AI every two weeks or so, and I usually get a short term erection quality boost as E2 falls through the sweep spot. and then comes back up a little. But if I take AI regularly it will crash me E2. Its powerful stuff.

My experience may not reflect everyones. I’d be curious if anyone else would weigh in on that question about feeling better with FT over range…

One other point. E2 slightly on the higher side seems to be less problemsome than low E2(below 20). I’ve seen many guys post on here they do fine with no apparent symptoms with E2 at 30-50. Everybody is different which is why you need to dose based on symptoms and labs, rather than trying to hit that E2=22 mark on the dot.

Also I think everybody has a few months of acne when their body is adjusting to higher T level. I know I did, but its gotten much better and almost gone since I’ve quit messing around with my dosages and got my labs in range.

Thanks again @Jdeck,

I have a pill cutter that is very good and I can cut my pills into 4 pieces if necessary (0.25mg). But in the meantime I’m going to cut my test cyp dosage back a little more and go down to 1mg AI total for the week.

Also, my new syringes arrived today…25G 5/8" 1cc tuberculin needles, so I’m officially in the SQ club now. I’m gonna shoot straight into my love handles like before except just in the fat layer…I hope that fat works as well as upper thigh etc.

So between the lower dose and SQ administration, I’m hoping going back to 1mg AI will be enough. I have labs coming up in 4 weeks, so I’ll be locking in to this routine right now.

I’ve gone sub-Q myself with insulin pins. It works good. I inject in belly fat near belly button twice weekly. Just remember this is so important. Low E2 is a sex killer. If you are going to error, error on the higher side of E2. Too much Adex will kill a boner fast. I have an old thread on here about that very thing if you’re bored you can read up on it.

I shot sub-Q for the first time on Sunday and it was very nice. I was worried that because it’s so shallow, and that I’m using 25G, there might be leakage. But my skin appreciated the 25G so much (in comparison to my 21G) that there was not even a drop of blood. It was tough to find the exact spot to put my alcohol pad on hahaha.

The other worry I had was that I had read somewhere that shooting into fat with very low vascularity has very poor results compared to fat with a higher metabolism. And since I’m shooting into the love handles, that’s probably got to be the slowest metabolized fat on the whole body. Oh well, we’ll see how it works out.

I definitely hear what you’re saying about low E2 being a boner killer. Even though I’ve cut back to 1mg/week of adex, my body hasn’t had time to adjust yet. I guess for me it’s going to be tough. E2 at 32pg/ml was killing my boners, and yet now it’s too low and killing my boners. The sweet spot will be a careful and narrow range for me.

And yes I’d like to read your thread. What is the title or url?

Thanks!