T Nation

Week 3 on TRT and Already Time to Tweak the Protocol


#1

Here’s my current protocol, as prescribed by my doc at a men’s clinic.

210mg Test Cyp. 1 x week IM
1MG Anastrazole 1 x week
500IU HCG 2 x week

Within 2 days of my first shot I noticed a difference. Morning woods have been consistent every day, I wake up feeling rested, mental clarity has improved, energy level much better, mood better. The only thing I haven’t noticed an improvement in is libido, but otherwise, I noticed a big difference. I’m hungry all the time, and despite having a very clean diet, my scale weight it going up. However, I don’t look like I’ve gained weight and my clothes fit about the same.

I inject T on Mondays. HCG is injected Mondays and Thursdays.

Now here’s the problem - I feel like garbage on Mondays and Tuesdays. Mental focus and clarity sucks on these days. Basic math, problem solving is difficult on these days. I also wake up feel worst, and I’m in a worse mood overall.

I track daily so while it’s only been twice now that I’ve experienced this crash, I believe it is due to the once a week injections.

I called my clinic and they said something like, “things will even out - stay the course”. But they also told me that if I wanted to supply my own needles that twice a week is OK with them.

My does of T Cyp. (210/week) is high, from what I’ve been reading, but I don’t want to alter it for now without my doc’s permission. I also don’t want to alter the HCG routine just yet, but may look at that in the future.

But what I am going to do is to split my 210mg/week into 2 doses using 29g .5" 1/2CC insulin syringes. I plan on Monday and Thursday, to follow my HCG injection schedule, and will switch from IM to sub q.

Also - I will split my anastrazole pill in half and take .5MG on Monday and Thursdays.

It seems ridiculous to already tweak, but I know how I feel and it’s like going backwards - maybe even worse. I wanted to do exactly what my doctor said, but I also feel like educating myself and deciding for myself is what’s best for me.

So I’m only changing three things:

  • Test cyp. Injection frequency - changing to twice weekly
  • Test cyp. Injection type - changing from IM to sub q
  • Splitting anastrazole does in two - changing from 1x week to twice a week

Does anyone have any feedback on my plan?


Diagnosed with Low T at 30 & Need Overall Guidance
#2

Looks like a step in the right direction. Get follow up labs done in a month to see where you’re at.


#3

Can you believe my doc wants to wait 13 weeks??? I’ll do my own at 8 weeks, I think.


#4

Looks like a good change.
But T dose easily excessive.

Some would need 2mg anastrozole per week to manage 200mg T per week.
So you are probably suffering from surges of E2.

Refer to:

Please read the stickies found here: About the T Replacement Category

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

You need to know your stuff and not be passive with the docs and clinics as they often fail.


#5

KSman - thanks for the input! That’s a great point about needing more anastrazole to manage that level of T.

I was trying not to modify the doctor’s dosage, but from everything I’ve read, it is excessive, and that you recommend starting at 100MG per week. If I modify his dose I guess I’m either going to have to tell him or choose not to tell him…

Thanks again. I will think about it, for sure!


#6

Many have great results on 100mg/week. If years later you need to kick it up because of age, you still have some head room left. We have seen some guys never get things right on 200mg/week. Now we have more and more T-clinics blinding starting guys on 200mg/week. But that is what many are now seeking…

Hematocrit needs to be watched. Some guys get in trouble on 100mg/week and 200mg/week would then be dangerous.

If one’s thyroid function or adrenals are not in good shape, the increased/restored metabolic demands from TRT can run out of gas against those other issues. 200mg/week would then crash harder.

Any labs to post?


#7

you’re probably crashing on Mondays – and it takes a day or so after that injection to ramp up your levels again - so the 2x/week pin should help even things out. The fact that you were taking 200 mg per week – which is a very high dose by the way – may have exacerbated the crash as you come down hard after seven days. As noted above – try a lower dose two times a week and you should be good to go.


#8

Why the hell would the doc prescribe such a high dose? Ugh. I guess I am going to have to cut his dose in half see how it goes.

My hematocrit was already to within a few points of the upper limit - probably because of snoring. I donated blood the first week and plan on doing so every two months.

As for thyroid function, I’m checked my temperature today and it’s low. 96.3 upon waking, 96.6 3 hours later, and 96.8 6 hours after waking and also 9 hours after waking (3:30pm). I’ll be doing this for the next few days as well.


So my new, tweaked protocol is going to be:

  • Test cyp 105MG per week split even in two doses, Mon and Thursdays injected sub q
  • 1MG per week of anastrazole split into two doses - taken on injection days
  • 500IU HCG twice per week - same days as T

My labs pre-medication were:
Total T: 414
Free T: 4.7
LH: 2.4
Estradiol: 17.5

Today is Wednesday and I’m super tired…think I got a good night of sleep but man do I feel tired.

Off to do more reading! Thanks, guys!


#9

200 mg/week T would be a problem with your hematocrit.

Low body temperatures:
Have you been using iodized salt to support thyroid hormone production?
Are outer eyebrows sparse?

Labs:
TSH
fT3
fT4 [please not T3, T4]
AM cortisol at 8AM

Fatigue can be thyroid and/or cortisol[adrenal]

Waiting on more info about you, see the first sticky.


#10

Thanks for the response. I ordered new labs last night - did them this morning before seeing your post, but I did get all of those except for cortisol. I also got free and total T, along with sensitive E2 and a CBC.

Tired again today. Also reminded myself that I have been having mild headaches almost every day, which is rare for me - I never get headaches.

As for the iodized salt, not yet. I just ordered some that will be here tomorrow, and I will continue to take my temp a few times a day at the same time to get some consistent data.

Blood pressure today midday was slightly elevated.

I took .25MG of anastrazole last night before going to bed to see if it would make me feel any better today. It may have worked a little. Lab work will tell.

Again, thanks for the response!


#11

Why were you not using iodized salt?

Symptom: Are outer eyebrows sparse?


#12

Just read about iodized salt and the thyroid yesterday.

Eyebrows - haven’t looked at them for a long time but they seem thinner than they used to be.


#13

Quick update.

Rough past week, but hopefully things will be looking up with new protocol.

Today was medication day, so I just administered my first modified dosage, consisting of:

  • .5mg anastrazole
  • 52.5mg Test Cyp
  • 500 IU HCG

Notes:

  • HCG still stings like a bitch, despite numerous injection sites
  • New 29 gauge needles for sub c test was painless. Drawing the T took a while but thankfully my test is 210mg/ml so I only have to draw .25ml :smile:
  • using the pill cutter on the anastrazole seems imprecise, but it’ll probably do the trick

I expect lab work soon, which will be interesting to correlate how I felt last week on original 210mg/week dosage.

Thyroid/Body Temp

  • I have been monitoring my temperature for the past 6 days and every day my waking temp has been below 97.3 degrees. Only one day my temp has gotten anywhere close to 98.6 at 3pm. Iodoral arrives tomorrow.

#14

Update:

The past 8 days have been much better. And it has only been 8 days (3 times administering meds) since I modified my dose from 210mg to 105mg and split my dose of anastrazole. I feel tired, foggy, and unmotivated today, but maybe that’s just because I didn’t sleep that well last night.

Lab work from 12/22 finally came in. I got this lab work done 3 days after my 210mg dose of T and 1mg anastrazole the preceding Monday and .25mg anastrazole Wed evening. I felt like shit and suspected that my E2 might be off the charts. It WAS off the charts, but at the other end of the spectrum…

Results:

Notes from the results:

  • Total and Free T were off the charts high
  • E2, at 8.4 was almost out of range on the low end
  • Hematocrit well within ref. range
  • Have to read about interpreting my thyroid tests. i.e. TSH, fT4 and fT3

I am really glad I listened to you guys regarding the 210mg per week dose. Obviously that was just “off-the-charts” stupid. So thank you @KSman and others.

Surprised that my E2 was so low after 210mg of T, and 1.25mg of anastrazole.

Questions

  1. I ordered this lab work on Wed evening because I was feeling bad. I suspected it was due to high E2, so on Wed evening I took .25mg of anastrazole. Blood drawn Thursday morning. How much that would have knocked down my E2?
  2. Do I need 1mg/week of anastrazole or is this too much?
  3. Should I get more labs done this week?
  4. Should I stay the course and let things settle down or modify anastrazole dosage?
  5. Any feedback on thyroid labs is appreciated

I really don’t mind getting more labs and I’m wary of altering anything else - want to make sure I give things a solid chance and not change too much.

In other news, have been supplementing with 50mg of iodoral for the past 4 days. Waking temps about the same.


KSman is Here
#15

Tired again today…tired all day yesterday. Joints don’t hurt but I notice them - popping, cracking.

On second thoughts, and after a lot more reading, I think I should skip my AI dose tomorrow.

E2 being reduced to 8.4 after a big dose of T and an undersized dose of AI (in relation to the T dose) combined with how I’ve been feeling the past 2 days most likely means that my E2 is too low and that I am most likely an over-responder.

Any ideas, guys?


#16

Based on advice @KSman gave in another thread, and assuming I’m an over-responder, I’m going to:

Stop anastrozole for 5-6 days for 4 half life washout
Resume at 1/4th the expected dose, 0.25mg a week.
Inject T twice a week and take 0.125mg at time of injections.


#17

Thankfully I feel much better today. Joints still making a lot of noise, but at least I got a great night of sleep and felt better upon waking today.

Did my dose and skipped the AI. Getting blood drawn today. Need to confirm that low E2 reading from 2 weeks ago. Also see how my off-the-charts T levels have come down since switching from 210mg to 105mg per week.


#18

Lab work came in today for the blood drawn on 1/5/17.

This lab work was exactly 2 weeks after I cut my T cyp. dose in half - from 210mg/week to 105mg/week. My previous labs were:

  • TOTAL T: >1500
  • FREE T: 32.8
  • E2: 8.4

Results of latest labs are:

  • TOTAL T: 787
  • FREE T: 13.2
  • E2: 7.6

I expected to see lower free and total T levels, but perhaps not this low. I will get more blood work done this Thursday (another 2 weeks) and see where we stand, but for now I don’t intend to adjust T dosage for a bit until things stabilize.

I also expected that my E2 might be the same or a bit higher, but it was slightly lower. Blood work done this Thursday will be 2 weeks with no AI. Probably be 3 or 4 weeks until I get the damn lab results. In the meantime, I expect that my E2 will rise and I will be on the lookout for high E2 symptoms. Until that point, I will not be taking any more AI.

Current dosage and protocol:
105mg Test. Cyp. divided evenly dosed 2 x per week (Mon and Thurs)
250IU HCG EOD

I did end up making the final tweak to my protocol for now, and that is doing 250IU of HCG EOD as recommended. I figure there’s nothing else to modify at this point.

In other news, I have been supplementing with Iodoral for a little over 2 weeks now. Lost my damn thermometer so can’t check body temps but will get a new one soon.

I feel like my life is slowly coming back after feeling awful with low E2. I actually worked out, did yoga, and went surfing this past weekend. This is a change because nothing got me excited when E2 was low and I had ZERO motivation for working out or doing hobbies that I love.

Now if I can only get used to waking up in the middle of the night with a god damn baseball bat between my legs getting in the way when I try and roll over. It’s like a kick stand on a bicycle.

Thoughts? Comments? Opinions?


#19

Please take all of this with a grain of salt as I’m not an expert.

We have similar situations. Skipping all of my boring details, I finally found a protocol that works for me. I realized that AI really dropped me low on E and I had to learn to be very careful. Rarely take it and feel great around 30 E.

Also, I take .5 cc Hcg with another .5 cc T in the same syringe twice a week SubQ. That works out to 500 IU HCG and 100 mg TC.

This has worked much better than my other protocols and I have tried THEM ALL!

Good luck and make sure you make changes very carefully so you can track what works and what doesn’t. Take care!


#20

Thanks for the reply @longjourney - When do you take AI? What do you base it on?