Starting TRT - The Dosage seems high?

[alvin]

So apparently they will be starting me at:

• 200 mg Test C (1 x per week)
• HCG (2 x per week, I am not yet sure what the dose will be)

Should I ask them if I can split the test dose in half and take it 2 x per week?

Blood test info:

Age: 36
Total Test: 419
Free Test: 6.8
Estradiol: 10.5
Prolactin: 17.1

[Couchlockd]

So apparently they will be starting me at:

• 200 mg Test C (1 x per week)
• HCG (2 x per week, I am not yet sure what the dose will be)

Should I ask them if I can split the test dose in half and take it 2 x per week?

Blood test info:

Age: 36
Total Test: 419
Free Test: 6.8
Estradiol: 10.5
Prolactin: 17.1

Just let him do what he wants to at first, don't be to "smart" or he may get oddly suspicious.

Yes you split that dose.

[Youthful55guy]

So apparently they will be starting me at:

• 200 mg Test C (1 x per week)
• HCG (2 x per week, I am not yet sure what the dose will be)

Should I ask them if I can split the test dose in half and take it 2 x per week?

Blood test info:

Age: 36
Total Test: 419
Free Test: 6.8
Estradiol: 10.5
Prolactin: 17.1

Yes, that is about double the starting dose that most guys need to get them into the upper end of the Total and Free T range if they have normal levels of SHBG. If SHBG is high, then you may need more. The best approach is to start at around 100 mg per week in at least 2 divided doses and then recheck Free T in 4-6 weeks and adjust from there.


With 200 mg/week T, you'll probably feel great for a week or so until your E goes out of range (it will happen fairly quickly) and then you'll need to layer in E control, which is difficult. You are far better off with a lower weekly dose split into at least 2 injections to keep T within physiological range so that E also stays within physiological range and you will not need E control.

Your DHT will also begin to climb out of range and that will begin to drive hemoglobin production. Within a couple of months, your hemoglobin will go out of range and you'll need regular blood donations to keep it in check. That in itself adds another problem, as you iron level begin to drop. Again, you are far better off with a lower weekly dose split into at least 2 injections to keep T within physiological range so that DHT also stays within physiological range and you will not need DHT control. There's also the added problem of BHP and hair loss from high DHT.

Regarding Couchlocked's comment, I agree. If this is a prescription for T (as opposed to having to make weekly clinic visits), I'd take the scrip and fill it and then lower the dose and split it. You can then do your own dosing experiments by purchasing your own labs and making your own decisions.

[kelkel]

There it is ^^^^

[DeathDefier]

No it’s not high. 2 Drs I went to both wanted to start at 250 a week. It’s better to talk to an actual athlete TRT Dr which understands more.


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[Youthful55guy]

No it’s not high. 2 Drs I went to both wanted to start at 250 a week. It’s better to talk to an actual athlete TRT Dr which understands more.


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"Athlete TRT Dr"?

TRT dosages should be based on the individual needs to bring hormone levels (particularly Free T) to within their normal ranges. Some, myself included, argue that we should not be tied to the typical age ranges provided with the labs, but rather those of a more youthful male. I personally subscribe to the philosophy of the Life Extension Organization (LFO) that the target for Free T levels should be within the upper 33% of a 21-26 year old, which is around 20-27 pg/mL using the LabCorp test. Total T is not a useful test for adjusting T levels because it is skewed by both low and high SHBG levels.

Therefore, rather than questioning whether a particular dosage is low or high, one should ask what is you Free T 4-6 weeks after your starting dose? If it is not yet in range with a 100 mg weekly dose (split in at least 2 injections), then adjust it and retest in another 4-6 weeks. This approach will help to minimize a lifetime of fighting side-effects of an overly aggressive starting dose.

[JdFlex]

No it’s not high. 2 Drs I went to both wanted to start at 250 a week. It’s better to talk to an actual athlete TRT Dr which understands more.


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Yes it is high.

[kelkel]

No it’s not high. 2 Drs I went to both wanted to start at 250 a week. It’s better to talk to an actual athlete TRT Dr which understands more.


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I know what you're trying to say but there really isn't an Athlete TRT, it's just TRT like Youthful respectfully explained. Goal is to maintain healthy levels of Free T with minimal to no ancillaries needed other than HCG . Once settled on a protol that keeps you healthy for the long haul many guys here will routinely ramp up their doses to achieve personal goals.

[DeathDefier]

There are Drs that are also athletes that specialize in TRT. They see things differently, and build optimal levels for a person who pounds their body. That’s different than just a “Normal” Test level goal. Think of it like protein requirements. For a regular, undermuscled, high bodyfat lazy American versus the needs of a guy with large amounts of muscle and continuous breakdown.


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[kelkel]

There are Drs that are also athletes that specialize in TRT. They see things differently, and build optimal levels for a person who pounds their body. That’s different than just a “Normal” Test level goal. Think of it like protein requirements. For a regular, undermuscled, high bodyfat lazy American versus the needs of a guy with large amounts of muscle and continuous breakdown.


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Oh I totally understand what you're saying but that is not really TRT. Moreso a low dose cycle like many clinics do. You'll find a lot of the docs that prescribe like this also sell their own products. Company store type philosophy. When it comes to the docs in question that routinely over-prescribe they are just an FDA audit away from losing their license.

I've been in this for decades and a BB'er forever so know that I'm not condemming what you're saying. Just that eventually you have to separate the two (cycling and HRT) for long term health and wellbeing.

[DeathDefier]

Just inject Subq divided between a few doses which helps with estrogen conversion.

[MuscleScience]

Who is your doc? Asking for a friend...

[kelkel]

Who is you doc? Asking for a friend...

I have some extra scripts.........$$$$$

[Youthful55guy]

So apparently they will be starting me at:

• 200 mg Test C (1 x per week)
• HCG (2 x per week, I am not yet sure what the dose will be)

Should I ask them if I can split the test dose in half and take it 2 x per week?

Blood test info:

Age: 36
Total Test: 419
Free Test: 6.8
Estradiol: 10.5
Prolactin: 17.1

You've heard opinions both ways, now you need to come to your own decision on whether or not your doctor is competent or has some other motives in mind. I think we are all in agreement that your original labs indicate that you a candidate for TRT. However, before I'd dive head first into a LIFELONG treatment at your age, I'd want to know more about why I was low on T. What's preventing normal production? Are you primary or secondary? Is it correctable by other treatments? All good questions to be answered.

I also suggest you read the sticky on the first page of the forum called "Best Practices in TRT". There I lay out with a lot more discussion what I believe to a good starting dose, labs, follow up labs, and ancillaries that are important for pursuing a successful and SUSTAINABLE TRT protocol. My personal belief is that your doc is approaching it the wrong way and that over the long term, you will be battling unnecessary side-effects. You posted in this TRT/anti-aging forum, so I am assuming your goal is to restore a healthful and more youthful feeling, not to make you into a bodybuilder. There are other forums for that.

[bethdoth]

My Doc started me at 200mg CYP a week. I just took the script and started my own protocol doing frequent labs. I do 70mg subq every 3.5 days. I mark the calendar when my 10 weeks is up and I can refill my script. Then once I get an extra vial I use the extra test with a cycle. You can see in the lab results that I have tested it while on cycle (at 200mg a week I am pushing the 1100). You can see it took me a long time to get dialed in. The first year when it was around 300, they tried androgel and the patch. Once I started injections you can see it go up. I'm still not 100% dialed in, because I do labs often and I may be coming off a cycle. I do my injections on Sunday morning and Wednesday evening. All labs were drawn about 8AM on Wednesday mornings. My goal is to stay right around 800 total test when just doing TRT.

Like others have said it's a vicious cycle. Test goes up, estrodial goes up, hemoglobin goes up. I do take 12.5mg exemestane daily, 250IU HCG twice a week, NAC, and give blood every 10 weeks. When I first started TRT it was because I was low and just wanted to feel good and keep my build that I had made the natural way. But, then I decided to try a low dose tren cycle and bammm I was hooked. Well, after recent experience I got unhooked. Like Youthful55 said if you just want to feel good and be healthy TRT can do that, but it is a lot of work and takes a lot of dedication to follow through.

Edit: This info is for people in cold climates! In the lab results you can see in January of this year I was up around 1100. These were pre-cycle labs and my test should have been around 800. Well, long story short. Your test needs to be stored in temps 68-78. It's winter and our master bathroom is always cold 64 degrees. My test was separated and looked like it had little hairs running through it. So this told me when my test is separated it is more concentrated ... maybe 250-275mg per ml vise 200mg per ml.

[Youthful55guy]

I commend you on your record keeping a strongly recommend others to do the same. After a while, it becomes difficult to remember all of the labs and time consuming to go through reports to compare one to another. Then there's the topic you also hit on, which is that protocols change and they are reflective in the lab results, so when you make changes, you need a method to record the protocol in use at the time.

To this end, I've developed an Excel spreadsheet with dates in the columns and standard labs in the rows. As I complete a new lab draw test (the date), I fill in the rows with the lab results. In the Date field at the top of the column, I insert: 1)A standardized protocol summary of what I was doing for that lab, 2) Notes on why I'm conducting the test (e.g., objectives), and 3) A summary of interpretation of the results.

Using this method, I can see at a glance what has been done and be able to quickly post comments about my labs/results in this forum.

[Ashop]

Yes it is high.

Most men for TRT will find that they don't that much.
I've seen guys, myself included, get into perfect range with 100-125mg wk.
I don't think its a bad idea to start out with 200mg week, but you can adjust accordingly
later after you do blood labs again.

[Couchlockd]

Most men for TRT will find that they don't that much.
I've seen guys, myself included, get into perfect range with 100-125mg wk.
I don't think its a bad idea to start out with 200mg week, but you can adjust accordingly
later after you do blood labs again.

What's the perfect range?

In my mind it's 900-916. Extreme top end

[Youthful55guy]

What's the perfect range?

In my mind it's 900-916. Extreme top end

We should focus on Free T not Total T. I personally buy into the Life Extension Organization recommendation that we target the upper 33% of the range for a male in the mid to late 20's. Keep in mind that Free T (unlike total T) isis usually given in age-adjusted ranges because SHBG typically increases with age. By my calculations, the upper 33% of the target range for Free T is around 21 to 26 pg/mL using LabCorp's test. This is the target I use to adjust my T-cyp dose.

I do feel the need to respectfully disagree with Ashop that it's OK to start high and adjust with labs. It's more difficult to adjust down than it is up. Starting high can make you feel real good for a while (until you start chasing side-effects). You recover much faster and just plain feel better, but it's not sustainable. This is a life-time medication, so we need to approach it from a sustainability standpoint. A higher than needed dose can also through off the balance of many other endocrine and neuroendocrine factors (E and DHT are the two biggest). It makes it more difficult to find an optimal dose when you feel bad from side-effects. I recommend starting at the low end and adjusting upward until you hit the target range. That way, the side-effects are minimized.

[Slick88]

Curious what your guys thoughts are on 150 every 2 weeks (I’m splitting that into 75 a week). I was on androgel for 2 months and actually saw my t levels drop even lower (258 with a range of 290-800). My doc then put me on injections and this is my 3rd week. Is a cautious smaller dose the sign of a bad doc?

[Youthful55guy]

Curious what your guys thoughts are on 150 every 2 weeks (I’m splitting that into 75 a week). I was on androgel for 2 months and actually saw my t levels drop even lower (258 with a range of 290-800). My doc then put me on injections and this is my 3rd week. Is a cautious smaller dose the sign of a bad doc?

It's a sign of a doc that doesn't know what he's doing.

First off, every 2 week dosing is from the stone ages of medicine. It's just plain a bad idea. Keep in mind that the average male produces about 8-10 mg of T per day. Also when you start exogenous T supplementation, you shut down endogenous production and it take many weeks to recover (some never do), so that means you are dependent on the daily T being released from the T-ester (cypionate in your case).

The following graph show what your T levels released daily from a 150 mg dose administered every 2 weeks. As you can see, you spend most of the second week BELOW normal levels, and that's a recipe for feeling like $#^! all the time.


Here's what your T release graphs will look like with your current protocol. As you can see, you'll have more stable levels, but again, you are spending about half of the time below normal.


I discuss what I consider best practices in TRT in a sticky post on the first page of this forum. I Strongly suggest you read it and tell your dinosaur doc that he needs to educate himself on modern TRT protocols (well maybe be a little more diplomatic). I suggest you start with 100 mg of T-cyp administered in divided doses of at least 2X per week. I much prefer the E3Dday protocol for several reasons. Then after 6 weeks, retest (and be sure to include Free T or bioavailable T) and then adjust the dose accordingly. You might need to bump it up to 120 mg, but few people need to go higher than that.

[alvin]

You've heard opinions both ways, now you need to come to your own decision on whether or not your doctor is competent or has some other motives in mind. I think we are all in agreement that your original labs indicate that you a candidate for TRT. However, before I'd dive head first into a LIFELONG treatment at your age, I'd want to know more about why I was low on T. What's preventing normal production? Are you primary or secondary? Is it correctable by other treatments? All good questions to be answered.

I also suggest you read the sticky on the first page of the forum called "Best Practices in TRT". There I lay out with a lot more discussion what I believe to a good starting dose, labs, follow up labs, and ancillaries that are important for pursuing a successful and SUSTAINABLE TRT protocol. My personal belief is that your doc is approaching it the wrong way and that over the long term, you will be battling unnecessary side-effects. You posted in this TRT/anti-aging forum, so I am assuming your goal is to restore a healthful and more youthful feeling, not to make you into a bodybuilder. There are other forums for that.

After my latest blood test, he is already dropping me from 200 mg per week to 160 mg per week. I did not expect my numbers to jump so quickly, and my friends at the gym could tell I was on something. He agrees that switching to a twice per week dose will be better than the once per week.

So I am going to do:
80 mg on Sundays
80 mg on Wednesdays

My HCG dosage is still twice a week; would you suggest doing them exactly in the middle of the Test days (so Monday night and Friday)?

Your sticky is great. I might switch to E3D here soon and order some smaller syringes than what I have been using!

[Youthful55guy]

After my latest blood test, he is already dropping me from 200 mg per week to 160 mg per week. I did not expect my numbers to jump so quickly, and my friends at the gym could tell I was on something. He agrees that switching to a twice per week dose will be better than the once per week.

So I am going to do:
80 mg on Sundays
80 mg on Wednesdays

My HCG dosage is still twice a week; would you suggest doing them exactly in the middle of the Test days (so Monday night and Friday)?

Your sticky is great. I might switch to E3D here soon and order some smaller syringes than what I have been using!

I still believe that 160mg is more than you need if your SHBG is in the normal range, but it is better that 200mg. He should never have started you out there. You are going to find it more difficult to cut, but it's for the best. I suspect your optimal dose is going to be close to 120mg. I suspect that at your next labs, you'll be high once again.

I don't think it matters all that much when you dose with HCG. Some people dose toward the end of the injection cycle thinking that the HCG will give them a boost. However at 160mg per week, you are not going to feel any very slight boost in comparison to that which you are getting from the T-cyp. I suggest you do it on a day that convenient for you and space the HCG injections out as evenly as possible. I currently mix it with my peptides, so I get a low dose twice a day. However, before that, I was injecting about 350 IU Monday, Wednesday, and Friday.

I like E3D because I can program it into my computer calendar and a flag comes up every injection day to remind me. With E3D, it doesn't matter which injection day you do your lab draws because the injections are all spaced evenly apart. With 2X per week dosing, the interval is either 3 or 4 days. One day can make a big difference in labs, so that means you have to draw on the exact same day of the week for all of your labs in order to compare one lab to another. E3D takes that hassle out of the equation.

I like 28G needles. It's a reasonable draw up time and a very comfortable injection. I've tried 25G and that works too. Faster draw up time but not quite as comfortable on the stick. 30G is a too slow of a draw up time for me.