Week 3 on TRT and Already Time to Tweak the Protocol

The correct answer is that you should always base it on bloodwork. That being said, I still use bloodwork and a very regimented system, but I’m to the point that symptoms of either low T or low or high E are very obvious and I can adjust accordingly. That is after more blood work than I care to admit.

As a clarifier, I’m also just getting back into injections after giving pellets and then Clomid a try, but those were both disasters and I am back to a regiment of SubQ T and HCG with an AI on hand. So far, I haven’t needed the AI and my E seems to stay around 30, but that is what really works well for me. Being a slightly larger guy, 6’4, 285, most people have said that I should definitely be on an AI regiment, but I end up crashing my E whenever I take even small doses.

Therefore, I wait until I either get a report that my E is high or I feel certain things, before taking a small does. But for me, it is an as needed basis and I am getting really good at figuring out what causes my E to rise…stress, lac of sleep and sickness seem to do it for me…not TRT like most people.

Therefore, my lesson is that you need to learn your protocol and do blood work constantly, but realize that everyone is not the same and what may work for 99.9% of people, may not work for you. Heck, when I started TRT it was never acceptable to do SubQ injections because it was believed to raise E through aromatization. That has been proven wrong now. Doctors and even the incredible people on this forum will tell you certain things, but ultimately, you need to own your protocol and use a system of A/B testing to figure out what works best. It is tedious, but it is the only way.

Take care and I hope this provides some sort of help.

Thanks @longjourney! Very helpful comment. I’m doing blood work every two weeks until I get things dialed. I enjoy tracking and doing blood work and correlating how I feel/felt when I got blood drawn. If I could do daily labs I would!

I will chime in as well here bc I think your doing what I did when I first started. Don’t play around with your doses until you get blood work done. How would you know where to go if you don’t know where you’ve been. You will be on a roller coaster ride constantly changing protocol before looking at labs. I don’t agree with automatically starting anastrozole if you don’t know how your body responds to it. You may be crashing ur e2 and that will make you feel like crap as well. I think you should Start with 100mg twice a week and no AI. get blood work done after 4 weeks and adjust from there. That will make getting dialed in much easier. Just my 2 cents

Thanks for the input @joeyl41 - I agree with you!

The past week was a big improvement, and today I got my labs back from this past Thursday 1/19. The labs show that my E2 has bounced back from 7.6 and is now 27.9. These labs are 6 days old so maybe E2 levels have stabilized or perhaps they’re higher. I’m still on the lookout for high E2 symptoms and so far do not notice any. I would much rather E2 be high than have it crash again, so I’m going to be conservative on when I add back in AI. Hopefully I won’t have to use AI, but if I do, that’s fine. I have my anastrozole liquified in vodka and I’m ready for it if needed.

Labs

Historical Labs

Testosterone levels seems to have stabilized after I reduced my dose from 210 to 105mg, but I’m not that happy with it only being in the 700’s. Not based purely on the numbers - my symptoms aren’t that much better yet. I feel better in many ways, but still feel pretty tired throughout the day - especially upon waking.

I want to adjust my T dosage to get my TT up a little, but obviously that will affect my E2 levels as well. Which begs the question - what do we try and get dialed in first? T or E2? I would think we want to get T levels stable first, but not sure.

One concern is that my doctor is going to see TT in the 700’s and bump up my dose even more. 210MG/week is only getting you to the 700’s, let’s do 300MG/week…

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

What do you guys think? Bump up T dosage or not? @KSman ?

Cortisol
Also - AM cortisol came back at 7.6. Any feedback on that? I did take a saliva cortisol test that took 4 measurements throughout the day, which revealed that my levels were low but the curve was correct. i.e. My cortisol production throughout the day looked normal, from what I know.

I’ve done the math and I’m considering going from 105MG/week to 126MG/week in divided doses. This is going from .25ml twice per week to .30ml twice a week.

I might just stay the course and see what the labs say next week.

Thoughts?

Well, absent of anyone’s input, I am going to increase my dose to 126MG. Could not find any information about how to adjust one’s dose. i.e. increments to change it, so I’m going with the lowest increment that’s easy on my syringe.

Labs again next week, after 1 week on new dose.

@KSman - any thoughts?

If you want to increase t then do it, your decision. Since your e2 was 27 while not on an ai and your raising the t now, I would start with .1 mg of anastrozole at time of injection, .2 mg total per week. I get .1mg trochees at a compounding pharmacy. If at the time of your next blood work and your e2 is a little elevated just increase by .1mg of anastrozole. I am an over responder of anastrozole like you and doing this got me dialed in.

Get blood work every 3-4 weeks

Thanks for the reply, @joeyl41 I’m not going to start AI until I noticed symptoms of high E2. Ideally I can do without AI, but I’m prepared to start it if E2 gets out of range or symptoms appear.

Bad idea. Just do the lab work.

I do lab work every 2 weeks, which is why I stated “if E2 gets out of range or symptoms appear”

Thanks for reminding me of that.

Weak boners, weak morning wood, and no midnight boners the past few days has me feeling like E2 is too high. It has been 1 month without AI, and the last lab about two weeks ago had my E2 at 27.9, and I have since slightly increased my week T dose from 105MG to 126MG, so I’m not surprised that my E2 might be out of range.

Lab work tomorrow, and if my wood is weak tomorrow then I will likely start AI. Or maybe I’ll wait a week and see what the lab results say.

Update:

I did start anastrozole .05mg on the hunch that E2 was out of range. Lab results show that E2 was NOT out of range, but it was 26.1 - went down almost two points even though I increased T dosage. My baseline with no TRT was 21.6.

Latest labs:
Total T: 953 - up from 768 on new dose -went from 105MG to 126MG
Free T: 18.8 - up from 15.5
E2: 26.1

I am considering increasing my T dose to 147MG to see if that gets me to the top of the T ranges, but I might wait and see what the AI does to my E2 first.

I have been feeling pretty good lately and have resumed working out and have been fairly active. Have gained 10 lbs since starting TRT 9 weeks ago. Pants are tighter but still fit. Tailored dress shirts barely fit me now. Ring tight. Watch tight. Shooting for lower E2.

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Update:

So I did up my T dose to 147mg, which put me at:
TT: 1339 [348 - 1197]
Free T: 25.3 [6.8 - 21.5]
E2: 40.3 [8.0 - 35]

TT is a little high so I will back my dose off by .02ml to 69.3 twice a week = 138.6mg/week

Also doubled my anastrozole dose to .10mg twice a week for a total dosage of .20mg/week

Symptoms:
Feeling good to great most days. Getting back into the swing of things. Libido has improved a lot. Wood during sex is great and no problems getting it up quickly or keeping it up.

Feel like I just need to dial in E2 and I’ll be good to go.

Will continue to do lab work every 2 weeks until I stop tweaking and until my numbers are stable.

If you are basing these adjustments purely on numbers game it seems you are doing fine. You are not giving yourself enough time to feel the difference between protocols however. Just keep that in mind as it takes more than two weeks to feel the difference in an adjustment.

Thanks for the input. I do realize that things won’t stabilize until I leave the dose alone for a while and I look forward to when that time comes. I’m just super happy that I’m making steps in the right direction and my overall quality of life is improving. Biggest thing for me is to make sure my E2 doesn’t crash again. It has been a little high for the past week or so and the sides haven’t bothered me enough to make a difference, although I am working to bring it down.

Update - 13 weeks in.

Lowered my T dose to 134.4MG per week
Doubled my anastrozole dose to .20mg per week

resulting in the following labs:

TT: 1247 [348 - 1197]
Free T: 24.4 [6.8 - 21.5]
E2: 19

The numbers are almost perfect so I’m not gonna mess with anything for now.

Symptoms:

Feeling much better. Still some brain fog every now and then, but for the most part I’m doing really well in all areas.

Read the entire post. I was scared to get on “legal” TRT as I’d be around 400-500 TT at 100mg. This gives me hope that I can hit 800+ on 100mg. My new dr yesterday stated that she doesn’t usually go over 100mg test per week for clients. I do go in and talk to her Friday about dosages and etc.

Do you know/feel that HCG updated your TT and you mood? I’m REALLY interested in HCG for memory and mood. My father died from Alzheimer’s and from what I’ve read HCG helps with that.

I’ll keep waiting for any updates on here!