T Nation

Why You Need to Manage Labs This Way


#1

Most guys here have a TRT-doctor process that is very flawed. Please see below and see what you can borrow to enhance your TRT procedures.

Business as usual [BAU]:

  • You inject once a week, TT, fT and E2 levels change every day, on one single lab is representative or very useful, you probably are feeling like crap on day 7.
  • You get labs at doctor visit on day 7
  • While there you talk about anything except lab data, do not have.
  • Later on you get a call from a brain dead office assistant/nurse who says:
    . “Your E2 is a little high, but that is OK”
    . FT is midrange
    . keep doing what you are doing
    . does not provide you with lab results - you are blind
    . cannot discuss or answer any questions
    . end of phone call

Take Control [TC]:

  • Inject T twice a week and take AI at that time, this will make make hormone labs steady and lab results meaningful.
  • press for the labs that you need and get a lab order in hand
  • do labs at doctors office or lab draw station 10-14 days before appointments with doctor
  • do labs always halfway between injections to eliminate lab timing changes to lab results
  • get lab data in hand before appointment, get opinions here and write down what you want changes and document how you have or have not been doing in terms of libido, sexual function, energy, fat loss, strength, mood etc
  • in appointment with doctor, with two copies of your write up, drive conversation and keep doctor on points. Write up needs to be concise and to the point. If rambling doc will not read it.
  • leave doctors office with agreed upon changes to protocol and next set of labs with lab order in hand
  • prepaid labs are an option that might be of some advantage in your situation
  • you could, in some USA States, get the labs on your own and supply to doctor if that saves you money.

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#2

Awesome information as always KSman. I have been going rogue and doing just that. Question on my protocol. Have been prescribed HCG Compounded 1000 Units/ML Vial I am to inject .25ml (250 units) subq weekly. T-Cyp 200 MG/ML Vial Inject .7ml IM once weekly. Anastrozole 1mg Tablet take 1/2 tablet .5 mg once weekly.

I have been injecting .35ml IM Sunday/Wednesday, Injecting .125ml SUBQ Sunday/Wednesday, and taking 1/4 tablet .25 mg with injections.
KSman has suggested I do .5ml IM Sunday/Wednesday, Injecting .25 SUBQ EOD of HCG, and have not got an answer on how much Anastrozole. I do get 10 tablets per order. Any help suggestions would help.


#3

To get near E2=22pg/ml territory, most guys need 1mg anastrozole for every 100mg T ester [cyp, eth]. The based on subsequent E2 lab results adjust as needed.

You are injecting 140mg T per week, close to 150, so you might need 1/2mg three times per week. 1/2mg once a week is insane.

Anastrozole needs to match serum T levels and once a week does not match anything. You need steadier levels of T and anastrozole. However when injecting twice a week, anastrozole when doses then tracks changes of T and they rise and fall in the same direction and that works. You could try 1/2mg at time of injections and see where the labs go. You also need to get doc on board with changes so your Rx does not run out.

Example: lab result E2=30pg/ml, new dose = old dose X 30/22

This method will also down calculate anastrozole dose as well.

Fine E2 management requires arbitrary anastrozole doses that may not work splitting pills. You can dissolve 1mg/ml in vodka and dispense by the drop or by volume.

250iu hCG SC EOD was shown to be a good replacement dose for youthful LH receptor stimulation. There was a really good piece of research backing that up. So the question is your dose adequate. If your testes are OK physically and fertility is not a concern the smaller dose is OK. If fertility is a concern you do not want to be low dose science experiment.


#4

KSman wanted you to know I had my 4 week blood draw this morning. I actually visited with the Dr. and told him I had been splitting my doses like I mentioned above. HE was totally cool with it, and I also talked about more anastrozole and HCG…and I thought I should be closer to 50mg of T-Cyp on the Sunday/Wednesday routine. He said lets get results back and see where we are. I was glad I took your advice and took some ownership of my health.


#5

Nice to see that the road to your doctor is a two way street.