T Nation

What Do You Think About My New Protocol?


#1

35 year old male. Diagnosed with low T 5 years ago. Been on just 100mg/week (IM shot twice a week) of test . cyp. for 3 years.
Recently been wanting to have kids again and just started on the following:

Right before I went on regime below, my lab results were 1000 ng/dl of total test, 44 pg/ml of E2; HOWEVER, this was the day after my test. cyp. shot.

  • 60mg Test. Cyp. every Wednesday and Saturday
  • 1mg of anastrozole every Saturday
  • 400iu of HCG every Monday and Thursday (read this will prevent too high of Test. levels spike since I am also taking Test. Cyp.)

This is what I felt thus far after starting this past saturday:

  • Monday: Libido: high. Mood: good. Energy: good
  • Tuesday: Libido: normal-high. Mood: good. Energy: OK
  • Wednesday: Libido: normal. Mood: Feel numb. Energy: Low

Do you guys think I need to adjust? Do you think my E2 is getting too low towards the end? my doc told me that injecting test. cyp. twice a week is not recommended due to toxicity level and recommends once per week?? I have my next labs drawing in four weeks.

Thanks


#2

60mg T twice a week
0.5mg anastrozole at time of injections
250iu hCG SC EOD

So no hCG for 3 years?
How much did testes shrink?

With E2=44, you were not using any anastrozole?

With 120mg T per week, 1.2 mg/week anastrozole may be required to get near E2=22 pg/m;

With E2=44, you may have had some problems with sexual performance, libido, mood, gyno and fat loss/patterns.

I gave you good advice 2.5 years ago: Decrease then Increase Dose Causing Issues?


#3

Yes, thanks for the advice. My tests shrunk about 30%.

Ive been on this protocol for about 1.5 weeks and I feel tired all the time. I lost a lot of strength at the gym. Don’t feel like going to the gym anymore. My libido is very high though. Also feel nauseated. Could this be high or low E2? My lab is in 3 weeks. Should I stop taking AI and see what that does?


#4

Your libido does not clearly indicate that E2 is too high or too low.
Mood?
Energy is low, can be high or low.
Feel crashed, that could be too low.

You know about anastrozole over-responders?

You were not feeling tired before this protocol?

Never take anastrozole 1mg at once.
Are you doing as I suggested?


#5

Yes I just started doing as you suggested. I feel low energy and crash. I never used to be able to take a nap before, but now no problem.
I had moderate amount of energy before.


#6

If you reduced AI dose by a factor of 4, you can see if you feel better as an over-responder. You should stop AI for 4-5 days then resume at reduced dose if you choose to do this. But you need to be on a stable dose for your labs do get value from the E2 report. Or ask doc to do E2 right a way and have some data to act on. This is covered in some of the stickies too.


#7

KSman:

Followed your protocol of 60mg T twice a week, 250iu HCG EOD and 0.5mg of Anastrozole for the last 4 weeks. Here are my latest lab results:

The blood was drawn the day before my next T shot.
Testosterone: 1254 ng/dl
E2: 50 pg/ml

Again, before taking HCG and AI, I was just on 100mg of Test Cyp. injected twice a week and my lab the day after was 1000 ng/dl.

What’s shocking is that even at 0.5mg of AI (0.25mg twice per week), i have had joint pains, chapped lips and EXTREME fatigue. However, this past week, I reduced the dose to 0.25 mg of AI once per week and the first two days I am tired, but thereafter, I feel fine. Should I split the dose even further to 1/8 the pill and take it when I inject HCG(EOD)?) Is there really a E2 to Testosterone ratio we need to target vs. independent numbers? My testes did grow a bit, so definitely know HCG is working. Also, my wife missed her period for over a week. Pregnancy test showed negative but will schedule an appointment.

My doc told me that my E2 is still high because my Test Cyp. half life is overlapping and he recommended doing 1 a week injections. He will check with the compound pharmacy to get me a different type of AI. I told my doc about my joints popping and he said that a high E2 would even cause that.

Any help would be appreciated!


#8

That is exactly the point and goal. If you inject once a week and get higher peaks, E2 will be worse. Steadier levels are best.

With E2=50 and target E2=22pg/ml, I would normally advise to double anastrozole dose. Try ~10mg Aromasin EOD and see how you feel after a week. You will have to test E2 and try adjusting to get near E2=22pg/ml and then eval again.

Note that a few drive a lot of T–>E2 inside the testes with normal low-dose hCG and anastrozole cannot manage that. And then perhaps anastrozole then is lowering T–>E2 inside the brain where E2 might then be too low. It is not easy working through all of these hypotheticals.


#9

So the doc dropped shipped me Letrozole and advises me to take 2.5mg once a week. Is this still too high of a dose? I told him about Aromasin but he contacted the compound pharmacy and recommended Letro.

How much should I take and how often?


#10

Anyone taking Letrozole and how much? given my previous results and protocol.


#11

Horrible advice. Letro is often more harsh than anastrozole and its dose/response is not predicable.

Have you started injecting twice a week?
Do that and try letro 0.25mg at time of injections. Start small. It will take a week of constant dosing to reach steady state, for better or worse. If you feel OK, take a small amount more and let things develop for a week. To get arbitrarily small doses, dissolve 1mg/ml in vodka and dispense by volume or by the drop.


#12

Yes I’ve always injected test cup twice a week. Along with my injection, this morning I just took 1/4 of Letro, so about .6mg. Should I wait a week before another dose?


#13

So i got my lab results back and my Estrogen has tanked since switching to Letrozole due to being very drowsy on Anastrozole. My protocol has been:

50mg T twice a week
0.6mg Letrozole at time of injections
300iu hCG SC EOD

I have since stopped taking Letrozole but I am still feeling the symptoms of very low libidio, foggy mind, anxiety, depression. The last time I took it was 6 days ago. Does letrozole stay in the system that long? I feel like its gotten worse. I’ve been on Letrozole for about 3-4 weeks now. I’m thinking about taking 0.6mg of Letrozole once every week instead of twice every week. Should I wait another week before I go to this protocol?

TESTOSTERONE, FREE,BIO SLI
AND TOTAL, LC/MS/MS
TESTOSTERONE, TOTAL,
LC/MS/MS 929 250-1100 ng/dL
TESTOSTERONE, FREE 195.2 46.0-224.0 pg/mL
TESTOSTERONE,BIOAVAILABLE 393.0 110.0-575.0 ng/dL
SEX HORMONE BINDING GLOBULIN 23 10-50 nmol/L
ALBUMIN,SERUM 4.4 3.6-5.1 g/dL
ESTRADIOL (2243-4) <15 Reference Range: < OR = 39 (pg/mL)
T3, FREE (3051-0) 3.0 Reference Range: 2.3-4.2 (pg/mL)
PSA, TOTAL (2857-1) 0.7 Reference Range: < OR = 4.0 (ng/mL)