Sound right to you?

**Tbound** · 06-04-2011, 09:33 AM

Recently, I had my initial blood work to see if I was a candidate for TRT. Results showed me being at 221 total. Received first shot(1cc/200mgTestCyp) and 6 days later had blood workup. Having seen zero results, I figured my next dose would be on day 7. Office calls and says "great news, your Total T is up to 550 and we'll see you back to start receiving your maintenance shot in a week"....So my question to all is? Does this sound correct or are they just wanting to dish out the minimal amount and receive the $230 a month while keeping their liability down?

**GotNoBlueMilk** · 06-04-2011, 10:23 AM

Test Cyp has a half life of about 8 days.

So you take shot 1 on week 1. 7 days later you still have about half of shot 1 in your body, and you add shot 2. 7 days later you still have 1/4 of shot 1 and 1/2 of shot 2 in your body, and you add shot 3. This keeps going on and on.

This means it takes well over a month to get your blood T levels to their new level. I have no clue why they even bothered testing your T level after one shot, or even after 2 shots. They really should have waited 2 months minimum.

Your T levels will keep going up for the next 6 weeks at least. Sometime after 6-10 weeks they will hit max and level off; however, you will get close to your peak after about 4 weeks.

**steroid.com 1** · 06-04-2011, 10:36 AM

God how many time have we seen this? Another Doc who doesn't understand correct TRT protocols. Testing after 1 week? Really?

T - Did your Doc talk to you about HCG and why you will need it on a TRT program? If not, do your research and see why and then discuss with him if he hasn't already.

Also, what were your E2 levels before the start of your shots? Make sure he tests for E2 as you don't really want anything above 30.

**Tbound** · 06-04-2011, 10:45 AM

Yep, from the massive amount of threads your scheduling would be perfect bro and I appreciate your reply. But the thing is this facility I'm going to has just started this type of therapy and they don't have a full grasp as to what they are doing just yet and there's not a chance of them getting away from their most basic MO....don't get me wrong most of what I know is from you guys and this site. Case in point....when I asked what type of testosterone will I be getting she had to check through several emails to find out it was Cyp....and still then she couldn't even pronounce it....had to write it out. So it is set in stone that these shots will be 2 weeks apart and asking for or about estrogen blockers or any other add ons is out of the question. So I'll have to make the best of what I have for now.....I'm new to this and exploring other docs and treatments is most definitely in my future. For now due you think this is even going to benefit me??? Or will I just be on a roller coaster of hormonal hope?

**Tbound** · 06-04-2011, 10:50 AM

Gdevine.....my message I just wrote answers some of your questions and sheds light on my situation. From your response maybe it's best to move on to another doc?...E2 was NEVER discussed.

Originally Posted by gdevine

God how many time have we seen this? Another Doc who doesn't understand correct TRT protocols. Testing after 1 week? Really?

T - Did your Doc talk to you about HCG and why you will need it on a TRT program? If not, do your research and see why and then discuss with him if he hasn't already.

Also, what were your E2 levels before the start of your shots? Make sure he tests for E2 as you don't really want anything above 30.

**GotNoBlueMilk** · 06-04-2011, 10:55 AM

If they are giving you 200mg of T a week, you definately need to watch the E2 levels. Your E2 may be ok on that amount, but typically people on that amount end up doing an AI.

**Tbound** · 06-04-2011, 10:59 AM

No....200 every 2 weeks. In your opinion will this even be a therapeutic dosing schedule?

Originally Posted by GotNoBlueMilk

If they are giving you 200mg of T a week, you definately need to watch the E2 levels. Your E2 may be ok on that amount, but typically people on that amount end up doing an AI.

**THE-DET-OAK** · 06-04-2011, 11:10 AM

IMO that schedule will mess up your E2, tell your doc i said he is an idiot.

**GotNoBlueMilk** · 06-04-2011, 11:21 AM

Originally Posted by Tbound

No....200 every 2 weeks. In your opinion will this even be a therapeutic dosing schedule?

One shot every 2 weeks sucks! You will feel like crap days 10-14. With that being said, lots of people do 100mg/week. My total T was 750 on just 80mg/week. 100mg/week isn't a bad place to start at. But you have to get off the every 2 weeks schedule. See if you can do your own injections. Everyone here does it that way.

**Tbound** · 06-04-2011, 11:35 AM

Bingo....today is day 10 and going down hill.

Originally Posted by GotNoBlueMilk

One shot every 2 weeks sucks! You will feel like crap days 10-14. With that being said, lots of people do 100mg/week. My total T was 750 on just 80mg/week. 100mg/week isn't a bad place to start at. But you have to get off the every 2 weeks schedule. See if you can do your own injections. Everyone here does it that way.

**zaggahamma** · 06-04-2011, 12:13 PM

if i had no test at all id do cartwheels for 200 every 2 weeks although like the others said every week is better.....

do what you can to bring the vial home then nuff said

seriously though....really that shitty days 10-14?

**Tbound** · 06-04-2011, 12:23 PM

Not gonna lie bro.....when I heard that I was going to be getting the 200 every 2 I was happy as hell!!! But after reading through many threads started to worry about bi weekly shots.....and yes the down-slide started actually on day 8....I think it's more of just an emotional thing tho.

Originally Posted by jpkman

if i had no test at all id do cartwheels for 200 every 2 weeks although like the others said every week is better.....

do what you can to bring the vial home then nuff said

seriously though....really that shitty days 10-14?

**zaggahamma** · 06-04-2011, 12:28 PM

Originally Posted by Tbound

Not gonna lie bro.....when I heard that I was going to be getting the 200 every 2 I was happy as hell!!! But after reading through many threads started to worry about bi weekly shots.....and yes the down-slide started actually on day 8....I think it's more of just an emotional thing tho.

thats wut i'm sayin would you trade back to not running any and having your 200 level??????????

**Tbound** · 06-04-2011, 12:50 PM

Not a chance.....it's just easy getting caught up in reading the "perfect regimens" others right about....I just need to focus on what I have access to and be thankful I guess. I'm nursing a serious spinal injury that shut my working out down for some time now and I'm antsy to get what I had back.

Originally Posted by jpkman

thats wut i'm sayin would you trade back to not running any and having your 200 level??????????

**steroid.com 1** · 06-04-2011, 01:19 PM

IF your E2 levels increase with your protocol then all the injected T in the world won't do you a hill of beans good and in fact the negative sides do to the high E2 levels will make you feel even worse (weight gain, manboobs, bad moods...) You need to have your E2 levels checked...period. If your Doc does not understand the mechanisms associated with aroamatase enzymes and conversion from T to E2...find another Doc. When you balls start to hurt and get smaller that may motivate you to find one right quick. ;-)

Honestly, I know that you are happy that you're receiving 200 mg E2W but if it is converting to E2 you could end up in a much worse place. At 200 mg E2W your E2 levels will be going through peaks and valleys along with your T levels...not a real good scenario in any respect. Always remember the E2 follows T. Unless you are blessed with a great liver and can metabolize E2 better then most men you will need an AI at some point...soon.

**zaggahamma** · 06-04-2011, 01:42 PM

gevine makes a good point as always but e2 is an easy fix as AI(e2 control meds) are easy to find and e2 fairly easy to correct

**Tbound** · 06-04-2011, 01:48 PM

I'm going to their office and getting all of my reports and will check back. But my options are limited in my area so moving from doc to doc will probably be out of the question can you direct me on how to find other physicians that treat with TRT? I live in West TN and being on the cutting edge of things like this would be far to out of touch with reality. I do web searches but always come back with a trillion things mostly about bs "natural test boosters".

Originally Posted by gdevine

IF your E2 levels increase with your protocol then all the injected T in the world won't do you a hill of beans good and in fact the negative sides do to the high E2 levels will make you feel even worse (weight gain, manboobs, bad moods...) You need to have your E2 levels checked...period. If your Doc does not understand the mechanisms associated with aroamatase enzymes and conversion from T to E2...find another Doc. When you balls start to hurt and get smaller that may motivate you to find one right quick. ;-)

Honestly, I know that you are happy that you're receiving 200 mg E2W but if it is converting to E2 you could end up in a much worse place. At 200 mg E2W your E2 levels will be going through peaks and valleys along with your T levels...not a real good scenario in any respect. Always remember the E2 follows T. Unless you are blessed with a great liver and can metabolize E2 better then most men you will need an AI at some point...soon.

**steroid.com 1** · 06-04-2011, 02:11 PM

Search of an Anti Aging clinic in the state of TN. It would be worth a days drive to get on the right protocol. Most AA clinics get it right but just don't have them sell you the kitchen sink along with your TRT protocol!

BTW, jpkman is right; you can find an AI on a number of websites and self administer if you're comfortable with that.

At the very least, go a good vitamin shop and buy DIM and Zinc (take 90 mg of Zinc daily along with a complete multi) as this will help you manage E2 naturally.

**Tbound** · 06-04-2011, 03:43 PM

Thanks for the info.....The one thing the nurse kept repeating, thus making me think that they know they have a quasi-monopoly on TRT in our area, is that "you can discuss this with your primary care physician if you aren't comfortable with the way we are treating this". Well, I can tell you that my primary would just send me away telling me to take a multivitamin and they know this. Also, the fact that she hadn't a clue and was puzzled by my asking what type of testosterone she was injecting painted a clear picture that using this facility probably wasn't the best choice but you take what you can get.

**lovbyts** · 06-05-2011, 04:29 AM

Anti aging clinics are going to be more expensive if you have insurance. Find an Endocrinologist if there are any around. This is what they do, thyroid/hormone stuff. Make sure to have a copy of your blood work. I get a copy of EVERY blood test I get done, even when I started at teh anti aging clinic. My endo took one look and said yes you need HRT, wrote a scrpt, gave me one test and said Ill see you again in 6 months. 6 months later another test, another script for 6 refills and an appointment in 6 months. Last time he said OK see you in 1 year.

http://www.wellness.com/find/endocrinologist/tn

**lifter65** · 06-05-2011, 08:53 AM

Originally Posted by lovbyts

Anti aging clinics are going to be more expensive if you have insurance. Find an Endocrinologist if there are any around. This is what they do, thyroid/hormone stuff. Make sure to have a copy of your blood work. I get a copy of EVERY blood test I get done, even when I started at teh anti aging clinic. My endo took one look and said yes you need HRT, wrote a scrpt, gave me one test and said Ill see you again in 6 months. 6 months later another test, another script for 6 refills and an appointment in 6 months. Last time he said OK see you in 1 year.

http://www.wellness.com/find/endocrinologist/tn

you must have gotten lucky, ive been to a couple different docs and the didnt have a clue how to treat trt

**Tbound** · 06-05-2011, 09:09 AM

All I can say is wow......What a phenomenal doc to have, bro. Thanks for the info.....but why in the hell is it more expensive at an anti-aging clinic IF you have insurance??....and since you're going through an Endo I would guess that your insurance carrier IS picking up the tab on your treatment, right?

Originally Posted by lovbyts

Anti aging clinics are going to be more expensive if you have insurance. Find an Endocrinologist if there are any around. This is what they do, thyroid/hormone stuff. Make sure to have a copy of your blood work. I get a copy of EVERY blood test I get done, even when I started at teh anti aging clinic. My endo took one look and said yes you need HRT, wrote a scrpt, gave me one test and said Ill see you again in 6 months. 6 months later another test, another script for 6 refills and an appointment in 6 months. Last time he said OK see you in 1 year.

http://www.wellness.com/find/endocrinologist/tn

**Bigfoot66** · 06-05-2011, 09:59 AM

Probably depends on diagnosis and whether the AAC is a provider for that insurance. My PCP took over my treatment plan from my urologist after about a year of talking to him through a nurse. PCP switched me to shots, got me leveled, and now we do BW every 6 months..if all ok he issues script for next 6 mos. All done for a 15 copayment plus prescription cost.

Originally Posted by Tbound

All I can say is wow......What a phenomenal doc to have, bro. Thanks for the info.....but why in the hell is it more expensive at an anti-aging clinic IF you have insurance??....and since you're going through an Endo I would guess that your insurance carrier IS picking up the tab on your treatment, right?

**zaggahamma** · 06-05-2011, 10:22 AM

the bottom line is MOST (99% I WOULD SAY) insurance wont cover clinics...clinic is out of pocket thats why no reason other than that if you had to pay out of pocket for endocrinologist visits, follow ups, whatever red tape cometh, then it would be apples and oranges...in this sense i defend clinics that they are not gouging per say

just my .o2 and the 99% is based on what i've seen talked about on THIS site....i've seen 1-3 ppl SAY that their insurance was going to cover the clinic treatment(s)

**Tbound** · 06-05-2011, 11:15 AM

All of this info has been very enlightening to say the least and will help in my pursuit for hormonal stability..lol....let's hope....because I'm now on day 11 and damn I'm going down hill. I know it's mostly a mental thing but it's real.....hopefully I can find an endo who follows protocol and these peaks and valleys are put to rest. In the mean time(and I'm new to these forums so I'm not sure if it's ok to talk about monthly expenditures on TRT or not) is $230 a month on 2 shots of Cyp a ridiculous price?

**GotNoBlueMilk** · 06-05-2011, 12:07 PM

Tbound: we don't discuss "actual" prices in open forumns. It's in the rules and apparently very stictly enforced.

4 month of prescriptions for Test, hCG , and AI are less than what you have paid so far for your two injections. I go down to the local pharmacy with my prescriptions, they fill it, including needles and I inject at home twice a week. AI I swallow.

**Tbound** · 06-05-2011, 01:15 PM

10 4.....gotcha....just thought since I'm just speaking of legitimate doctors bills it wouldn't be much of a thing but rules are rules and thanks for giving me a heads up. I've been reading (as a guest) off and on for a while now and since now I was getting into the world of TRT officially thought it would be to my advantage to register and start posting.....glad I did....lots of good quality info on this site. Still need to get my TRT IQ up a bit.......I see from your #'s I need to get to finding other docs just from a dollar figure as well as protocol.

Originally Posted by GotNoBlueMilk

Tbound: we don't discuss "actual" prices in open forumns. It's in the rules and apparently very stictly enforced.

4 month of prescriptions for Test, hCG, and AI are less than what you have paid so far for your two injections. I go down to the local pharmacy with my prescriptions, they fill it, including needles and I inject at home twice a week. AI I swallow.

**DragonRider** · 06-05-2011, 05:12 PM

Originally Posted by gdevine

Honestly, I know that you are happy that you're receiving 200 mg E2W but if it is converting to E2 you could end up in a much worse place. At 200 mg E2W your E2 levels will be going through peaks and valleys along with your T levels...not a real good scenario in any respect. Always remember the E2 follows T. Unless you are blessed with a great liver and can metabolize E2 better then most men you will need an AI at some point...soon.

Frequency of injections can fix that for many men on TRT. Many men will need no AI at all if they are injecting twice a week.

**DragonRider** · 06-05-2011, 05:13 PM

Originally Posted by Tbound

Not gonna lie bro.....when I heard that I was going to be getting the 200 every 2 I was happy as hell!!! But after reading through many threads started to worry about bi weekly shots.....and yes the down-slide started actually on day 8....I think it's more of just an emotional thing tho.

Originally Posted by Tbound

let's hope....because I'm now on day 11 and damn I'm going down hill. I know it's mostly a mental thing but it's real.....

Absolutely not. This is what we call the "Roller Coaster Effect" and it is very common and very real on bi weekly shots. Bi weekly injections are outdated by at least 10 years. No doctor who knows anything about TRT or cares about his patient still uses this.
The only solution is more frequent injections. Once a week should be the minimum to promote stable test levels and prevent the roller coaster effect.

**bass** · 06-05-2011, 05:32 PM

Originally Posted by gdevine

IF your E2 levels increase with your protocol then all the injected T in the world won't do you a hill of beans good and in fact the negative sides do to the high E2 levels will make you feel even worse (weight gain, manboobs, bad moods...) You need to have your E2 levels checked...period. If your Doc does not understand the mechanisms associated with aroamatase enzymes and conversion from T to E2...find another Doc. When you balls start to hurt and get smaller that may motivate you to find one right quick. ;-)

Honestly, I know that you are happy that you're receiving 200 mg E2W but if it is converting to E2 you could end up in a much worse place. At 200 mg E2W your E2 levels will be going through peaks and valleys along with your T levels...not a real good scenario in any respect. Always remember the E2 follows T. Unless you are blessed with a great liver and can metabolize E2 better then most men you will need an AI at some point...soon.

right on! my stupid endo said not to take AI for 4 weeks to see what happens, like an idiot i followed her suggestion, 4 weeks later my E2 was above 100 and was feeling like shit! i was on 200 mgs test cyp BTW. AI is a must if you taking the 200 mgs at once, it maybe different if you were taking 100 mgs ew! either way you definitely need AI!

**lovbyts** · 06-06-2011, 12:58 AM

Originally Posted by Tbound

All I can say is wow......What a phenomenal doc to have, bro. Thanks for the info.....but why in the hell is it more expensive at an anti-aging clinic IF you have insurance??....and since you're going through an Endo I would guess that your insurance carrier IS picking up the tab on your treatment, right?

The anti aging is more because most wont work through yoru insurance except for the medication and of course HGH is not covered. I think most doctors at anti aging clinics are not MDs but they are nurse or?

My Endo everything is paid for except the $20 co pay for apt. I still need to talk to him about estrogen and hgh but no problems right now.

**GotNoBlueMilk** · 06-06-2011, 06:36 AM

Getting an AI online is cheaper than the co-pay if your doc is writing a prescription for a month or two at a time.

**steroid.com 1** · 06-06-2011, 08:10 AM

Originally Posted by DragonRider

Frequency of injections can fix that for many men on TRT. Many men will need no AI at all if they are injecting twice a week.

Huh?

What are you basing this statement on?

**GotNoBlueMilk** · 06-06-2011, 11:41 AM

Injecting 2x/week vs. 1x/week does not change you E2 levels that much. Somewhere in one of these threads I actually calculated peak T Cyp injecting 1x/week, 2x/week and 3x/week. There was a difference, but it was nowhere big enough to eliminate the need for an AI by going from 1x/week to 2x/week.

If you are doing 1x/week and are on the boarderline of needing an AI, then this would help, but you have to be right on the boarder.

**DragonRider** · 06-06-2011, 11:58 AM

Originally Posted by gdevine

Huh?

What are you basing this statement on?

The experience of men whom are using this method. My estrogen levels fell from 51pg to 37pg just by going from 100mg once a week to 50mg twice a week. Most of us are attempting to do HRT/TRT with the least additional medications possible. In my case I still had problems at 37, so I got a further drop to 15pg/dl by adding DIM.
For example, if one insists on using HCG , you can guarantee they will need an AI also, becuase for whatever reason HCG causes a rise in estrogen in addition to LH. But, if you are willing to forgo the HCG, it is possible for some men to need no AI either.

**steroid.com 1** · 06-06-2011, 12:16 PM

Originally Posted by DragonRider

The experience of men whom are using this method. My estrogen levels fell from 51pg to 37pg just by going from 100mg once a week to 50mg twice a week. Most of us are attempting to do HRT/TRT with the least additional medications possible. In my case I still had problems at 37, so I got a further drop to 15pg/dl by adding DIM.
For example, if one insists on using HCG, you can guarantee they will need an AI also, because for whatever reason HCG causes a rise in estrogen in addition to LH. But, if you are willing to forgo the HCG, it is possible for some men to need no AI either.

I don't know where you're getting your information but it's not correct in most cases. I am happy you had such a dramatic shift in E2 by changing to twice weekly but I can tell you that it's not the norm for sure. Please reference GNBM's post above as he's got it right.

The use of hCG can increase E2 both through the natural production of Test and the increase in intra-testicular E2. In the later case an AI is very ineffective in controlling these levels and is the primary reason a man should take low and more frequent doses of hCG to prevent the increase of E2.

**DragonRider** · 06-06-2011, 12:24 PM

Originally Posted by gdevine

I don't know where you're getting your information but it's not correct in most cases. I am happy you had such a dramatic shift in E2 by changing to twice weekly but I can tell you that it's not the norm for sure. Please reference GNBM's post above as he's got it right.

The use of hCG can increase E2 both through the natural production of Test and the increase in intra-testicular E2. In the later case an AI is very ineffective in controlling these levels and is the primary reason a man should take low and more frequent doses of hCG to prevent the increase of E2.

Most of my information comes from my personal use for the last 13 years and talking to men in other health forums to see what works for them. Look at APIs post (#5) in this thread. I'm not the only member here who is aware of this.
http://forums.steroid.com/showthread...er-Than-Normal

**zaggahamma** · 06-06-2011, 05:18 PM

Originally Posted by DragonRider

Most of my information comes from my personal use for the last 13 years and talking to men in other health forums to see what works for them. Look at APIs post (#5) in this thread. I'm not the only member here who is aware of this.
http://forums.steroid.com/showthread...er-Than-Normal

API states that "some" ppl dont need an AI on 100mg of test thats all he said in the link u posted....if i'm reading correctly thats not wut gdevine was debating...

you've made a few posts that seem to jump to conclusions not based on fact

**steroid.com 1** · 06-06-2011, 07:32 PM

Originally Posted by jpkman

API states that "some" ppl dont need an AI on 100mg of test thats all he said in the link u posted....if i'm reading correctly thats not wut gdevine was debating...

you've made a few posts that seem to jump to conclusions not based on fact

Thank you Jman; it's not what i was debating.

We all know that some men with low doses and/or great livers can have normal E2 ranges on a TRT protocol with no AI...no one here willl argue that; but it's not the norm.

I was confused by his post:

"Many men will need no AI at all if they are injecting twice a week."

Well we know this is simply not the case I am perfect example of that!

**steroid.com 1** · 06-06-2011, 08:01 PM

Originally Posted by DragonRider

The experience of men whom are using this method. My estrogen levels fell from 51pg to 37pg just by going from 100mg once a week to 50mg twice a week. Most of us are attempting to do HRT/TRT with the least additional medications possible. In my case I still had problems at 37, so I got a further drop to 15pg/dl by adding DIM.
For example, if one insists on using HCG, you can guarantee they will need an AI also, becuase for whatever reason HCG causes a rise in estrogen in addition to LH. But, if you are willing to forgo the HCG, it is possible for some men to need no AI either.

There are lot of men on mono hCG therapies who don't use an AI...why is it "Guaranteed"???

"For whatever reason HCG causes a rise in estrogen in addition LH" HCG IS a bio-identical form of HCG. When a man is on an exogenous TRT protocol they go into HPTA shutdown meaning the pituitary gland is no longer producing LH so it is replaced with HCG to keep the testicles functioning in absence of natural LH. HCG does not cause the pituitary gland to produce more LH.

I won't even comment on that last sentence...