New to TRT- Dosing Questions

[crb123]

My doc has prescribed me 250mg test weekly and HCG 350 IU 3 times weekly. What is the optimal way administer this dosage? Should I pin test and HCG on the same day or should I do it on different days? Should I pin the test 2x/week or 1x/week?

[crb123]

PRE TRT BW

6'1" 215lbs 27 years old

Total Test- 183 ng/dL

Free Test- 10.2 pg/mL

Estradoil- 23 pg/mL

FSH- 5.2 mIU/mL

LH- 3.6 mIU/mL

DHEA SULFATE- 322 mcg/dL

TSH- 2.02 mIU/mL

T3 UPTAKE- 35% (range is 22.35%)

T4 (THYROXINE), TOTAL- 4.8 mcg/dL

FREE T4 INDEX (T7)- 1.7

PSA, TOTAL- 0.1

CBC- ALL IN RANGE

TOTAL CHOLESTEROL- 218 mg/dL

HDL CHOLESTEROL- 42 mg/dL

TRIGLYCERIDES- 276 mg/dL

LDL CHOLESTEROL- 121 mg/dL

CHOL/HDLC RATIO- 5.2

NON HDL CHOLESTEROL- 176 mg/dL

Comprehensive Metabolic Panel- all in range but glucose at the top of the range at 95 mg/dL

[APIs]

That's a high amount of test for TRT. Did your Doc explain why your dosing is so high? To answer your question, many here pin 1/2 the dose every 3.5 to 4 days. There are others that pin once per week and they swear it works fine. As for HCG , a typical dose is 250 IUs 2 x per week, but others do more. There are various thoughts on when to actually pin the HCG. I've tried various times & felt no difference so I pin it on Tues & Thurs...

[Beethoven]

Agree with APIs, also when posting blood work post the ranges.

[kelkel]

I hope you haven't started this protocol yet. I also hope you and your doc found the reason for your low T. Was any effort made or did the doc just see the low T and write you that script, which is a ridiculous starting dosage btw.

[2Sox]

I agree with Kel's comments and question above. They are central. Take things slow.

[crb123]

kelkel,
I have not started my protocol yet. I am supposed to get my gear in the mail tomorrow. My doctor said my LH and FSH looked good so she diagnosed me with primary hypogonadism or testicular in nature. I have had some testicular trauma in the past because I grew up playing baseball and was a catcher. She basically gave me four options for TRT; cream, patch, gel or injections. She also emphasized that injections were generally the most effective treatment but my particular insurance would not cover the injections. I decided to choose injections anyways because my test (183 ng/dL) was extremely low for my age (27). Since my insurance will not cover my injections I decided to become a member of lowtestosterone . com because there is a clinic within an hour drive of where I live. This was the script that I was given to me based on my BW by my LowT doc, she said that she likes her patients to be in the upper range, ideally the 800s & 900s so that why Im guessing the starting dosage is so high. Ive been lurking around this forum for a week or so trying to research a bit because I'm in the dark when it comes to TRT and hormones. I know you are very knowledgable and have very thorough responses kelkel so please help! I just know that for the last 2 years I have been suffering from insomnia, depression, moodiness/irritability, lack of motivation, focusing and concentrating, low libido and soft erections. I have visited the Finding a TRT Physician Thread but don't have all of the BW listed on that thread. What steps would you advise me to take from this point on? Thanks

[kelkel]

Interesting. The only thing I would have considered is an ultrasound of your testicals to check for varicoceles, which can be corrected. But as you stated you've suffered testicular trauma in the past, which can cause primary failure.

When it comes to your starting dose I still feel it's a bit high. Always best to start low and titrate up, less side effects this way. Doesn't matter what your starting T level is as this point as the exogenous T is going to shut you down and you'll be starting from zero. Only caveat is that some docs do, in fact, like to front-load the initial injection which is just a preference and there's nothing wrong with it. Regardless, you'll have BW in 6-8 weeks and will be adjusting at that point.

Your doc's idea of keeping you in the 8-900's is great but know that the main number to watch is your Free T. Total T really is irrelevant. I would have faith in your Low T doc at this point and am very interested in how you make out so keep us informed on this thread please.

When it comes to the side's you've been suffering with they all "can" be attributed to the lack of testosterone . I'm willing to bet you'll feel like a new man in the future. Just be patient as getting dialed in and finding homeostasis does not happen over night.

kel

[crb123]

I appreciate your help and advice greatly, like I said before I have been lurking for a week so I know I am in good hands with this forum. I will keep y'all informed and updated with my progress. I am glad to be a part of the forum. Thanks again for all of your help.

[kelkel]

Glad to help crb. Great place to learn!

[crb123]

Ok, I got my gear in today. I decided that I'm going to pin my test cyp 2x/week. I had a lot of trouble drawing test out with 25G needle. What needle gauge is ideal for drawing? With me pinning test every 3.5 days, what is the best way to incorporate my 350 IU of HCG 3x/week? Also i didn't mention my doc prescribing me .25 mg anastrozole 2x/week, should i start taking my AI right off the bat? I believe I read in another thread that the best time to take my AI is the day after my test injections...

[Brett N]

I usually take ai the day after injection of test.

Test will draw better if warmed. Usually my hand wrapped around the bottle is enough. If you are drawing .5cc make sure you inject .5cc of air to create a little pressure. Don't do more than you draw though, I have had bottles leak from too much pressure. I draw with a 27g.

3x a week forr HCG isn't really a normal protocol. But, I would try to just space it out. Keep it simple. M -W - F

Here is how I would do it if your protocol was mine.

Test - Monday morning and Thursday Afternoon (about same time as monday am but in pm) 6am or 6pm
Ai - Tuesday, Saturday
HCG - M,W,F (personally I think I would ask your doctor but I would want to switch it to 500iu 2x per week on Tues and Sat (same as ai)

Just curious.... are you injecting subq or im with test. A longer needle for im draws slower also (subq is 1/2")

[kelkel]

I draw with an 18 ga pin and then switch tips to whatever you choose to inject with. I prefer a 27 ga 1/2 inch for TRT.
Just put your HCG in the same syringe as your test and go twice per week with it. Keep it simple.
Remember, the amount of test you're prescribed is unusually high for TRT. Normally I'd suggest no AI until BW shows the need but with that dose I would use the AI as directed. Take it when it's easy for you. Day of injection or day after, both work and will cover the peak of the Test.

Keep it simple.

[crb123]

i was supplied with 1" 25G for my IM test injections and 5/16" 30G for my sub-q HCG injections. so kelkel, you are suggesting that i do my HCG IM too?

[Roger11]

sooner or later your going to feel like utter crap on that dose for prolonged periods of time, id drop it down half of that !.

[kelkel]

i was supplied with 1" 25G for my IM test injections and 5/16" 30G for my sub-q HCG injections. so kelkel, you are suggesting that i do my HCG IM too?

Sure. Less pins is a good goal. HCG is just as effective IM or SQ. Problem is without loading pins you're dulling the needle the more you push it through stoppers.

[crb123]

Thought I would update my thread and inform everyone that I'm going to change my protocol to 60mg test every 3.5 days, and 250 IU HCG every 3.5 days. This basically cuts my original dosage in half. Just taking the advice from the majority of you guys feedback, I also agree with kelkel that it is better to start low and titrate up rather than starting at a high dose and titrate down.

[kelkel]

Update this thread when you get BW please.

[Simon1972]

ive settled on a tuesday night and saturday morning SUB q injection protocol also using 63mg of test E every 3.5 days.

prevents me having to rush in the morning on a weekday when i have to get to work and i find it works fine as i dont work weekends. Best of luck

[crb123]

Hey guys just about to finish up my third week of TRT. I have noticed low semen volume and weak ejaculations/orgasms. I am currently dosing 250IU HCG 2x a week. Since I'm on a 2x week protocol with my test cyp, should I be injecting HCG more frequently? Like say M-W-F or EOD. Just asking because this is what I read on the HCG sticky based on a 2x week test injection protocol.

[hawk14dl]

I'd say it's in your head.

I've stopped taking hcg completely, no difference in ejac's.

Interestingly, you and i share many similarities. I was also a catcher, diagnosed primary at 27 and went through low t.

My starting dose was 50mg 2x wk. 350iu 2x wk. No ai to start.

I'm really surprised at the dosing, considering you're using a low t . Com dr. They're typically very well educated and well versed in treatments.

Anyways, i feel best at about 120mg weekly (60x2). There's no need for an ai at that dose (for me) and my numbers are at the top of the range.

Best of luck

[lovbyts]

Thought I would update my thread and inform everyone that I'm going to change my protocol to 60mg test every 3.5 days, and 250 IU HCG every 3.5 days. This basically cuts my original dosage in half. Just taking the advice from the majority of you guys feedback, I also agree with kelkel that it is better to start low and titrate up rather than starting at a high dose and titrate down.

I like that idea because it does not take long to get a good little stock pile of RX test you may want to use for a blast in the future.

Are you using an AI at all? HCG has a tendancy to increase your E2 so it would be a good idea to get a sensitive E2 test done to be sure, this also would effect your libido and possibly volume issue.

[Thc Sargon]

I draw with an 18 ga pin and then switch tips to whatever you choose to inject with. I prefer a 27 ga 1/2 inch for TRT.
Just put your HCG in the same syringe as your test and go twice per week with it. Keep it simple.
Remember, the amount of test you're prescribed is unusually high for TRT. Normally I'd suggest no AI until BW shows the need but with that dose I would use the AI as directed. Take it when it's easy for you. Day of injection or day after, both work and will cover the peak of the Test.

Keep it simple.

Kel, just had a question regarding your 1/2 needle, from my understanding 1/2 would be too short to reach the muscle, is this true? I was using a minimum of 1 inch but 1 inch for me is tough to come by and 1/2 is easier to retrieve.

[kelkel]

Kel, just had a question regarding your 1/2 needle, from my understanding 1/2 would be too short to reach the muscle, is this true? I was using a minimum of 1 inch but 1 inch for me is tough to come by and 1/2 is easier to retrieve.

Depends on where you inject. Glutes yes, delts maybe not as it depends on how lean you are (or aren't.) Remember, we're talking low volume TRT injections. It doesn't matter whether it's IM, SQ or a combination of the two. It all works and will be fine.

[crb123]

I like that idea because it does not take long to get a good little stock pile of RX test you may want to use for a blast in the future.

Are you using an AI at all? HCG has a tendancy to increase your E2 so it would be a good idea to get a sensitive E2 test done to be sure, this also would effect your libido and possibly volume issue.

Im not currently on an AI. My doc and I are waiting until 6wk BW to see what my e2 is and then I will take my AI if needed. When would be the optimal time to have blood drawn for my 6wk BW? I pin on Mondays at 7pm and on Fridays at 7am.

[crb123]

When would be the optimal time to have blood drawn for my 6wk BW if pin on Mondays at 7pm and on Fridays at 7am?

[hawk14dl]

Monday morning

[crb123]

6 WEEK BW UPDATE
6'1" 205lbs 27 years old



Total Test- 1239 ng/dL Range 348 -1197

Free Test (Direct)- 43.9 pg/mL Range 9.3-26.5

Estradoil, Sensitive- 41.5 pg/mL Range 8.0-35

Hematocrit increased from my initial 47.4 to 50.4 Range 37.5-51.0

My protocol during this 6 wk period was 60mg test every 3.5 days, and 250 IU HCG every 3.5 days, no AI.
What changes should I make to my protocol and should i be concerned about my hematocrit being at the top of the range? Maybe donate blood soon?

[Far from massive]

Did you do any test dosing with the original 350 a week?

A couple of wks of that would throw off your readings. If not then a lower dosage would be in order probably 45-50 a week would be a good move. As far as the estradiol what is your bodyfat% ? Since test is converted to estrogen in the fat tissue if you start eating clean and working out a little more its likely that the drop in test and the change in BF could be plenty to get your Estradoil back to normal..this would be a lot better way to control that number than using AI's if you can do it.

As far as the Hematocrit same deal with the initial dosage, however I would go ahead and give blood now to knock the edge off it and then see what happens with your new dosage of test and see if you need to address it on a continuing basis. If you do there are some other things in addition to donating blood that may also work.

[crb123]

My original dosage prescribed was 250mg/wk test cyp. I started at 60mg/2x week from the very first pin. I have 25% body fat. My diet has been clean for the last 5 wks just need to start working out more.

[Simon1972]

My original dosage prescribed was 250mg/wk test cyp. I started at 60mg/2x week from the very first pin. I have 25% body fat. My diet has been clean for the last 5 wks just need to start working out more.

Results look good, estradiol may be a little high, some say to keep it in ratio others say keep it optimal (low). How are you feeling emotionally on the protocol? Holding back tears at certain moments?

What are your energy levels like? Personally estradiol scares me as I have prostate concerns in my family, and I'm worried about possible gyno.estradiol can make you tired

[crb123]

Emotionally and mentally I have been feeling great. I am performing better than I ever have in school, I'm the top student in my chem II class for majors out of 60 people. This is a class that I barely failed when my t levels where in the shitter. As for holding back the tears, I feel like I'm trending more in that direction. My energy and motivation have been great until towards the end of my protocol before BW. Latley I have noticed a little more fatigue/lethargy and I have also noticed being more emotional/irritable towards the end of my protocol as well.

[crb123]

Did you do any test dosing with the original 350 a week?

A couple of wks of that would throw off your readings. If not then a lower dosage would be in order probably 45-50 a week would be a good move.

Just curious as I am fairly new to TRT. Why are you suggesting I cut my dosage by 60%?

[Brett N]

He is suggesting lowering it a little because your free test is above the high end of range. Not necessarily a bad thing but estrogen follows test and your e2 is a little high too. It would be better for you if you could lower e2 without an ai.

That's why.

I don't think lowering test a little would be a bad thing but I would also talk to the doc about it to see what he thinks. If you are at 60x2 per week right now, 50mgX2 may bring you down to a great number and still feel good.

I am no hrt expert by any means, I personally would trust anything that kelkel suggested though. His comments in the past have helped me and he has said stuff that's doc agreed with when I brought it up or him. Maybe wait and see what kelkel thinks.

[crb123]

Maybe Massive meant 45-50 mg 2x/week. If that's the case, I totally agree with lowering my dose to 90-100mg/wk. The post I was replying to said "45-50 a week". I am also interested in what kelkel thinks I should do!

[kelkel]

FFM's and Brett's posts are on point. FFM means lowering your dose to 45 - 50 mgs twice per week.
You have plenty of room with your free T to do so and not really notice any negative difference. The positives will be less conversion to E and better control of your hematocrit. Yes to giving blood. And this does not mean you'll have to donate all the time. There are more people on TRT that do not have to donate than there are that do. Be sure to hydrate well as this will help you.

Your fatigue / lethargy may very well relate to this (hematocrit) as well. Just because your level is not "over" scale does not mean there's no impact. Do a quick google search to the side effects of polycythemia.

IMHO, I'd consider reducing your dosage by 10 mgs per injection for now and retest in a month. Increases or reductions in doses to not result in linear changes in levels. Sometimes small changes can make a big difference.

With your changes in diet along with a reduction in your dose should make a nice improvement in your E2 level. Consider supplementing with zinc as this will help a bit as well.

[crb123]

What dosage of zinc do you recommend? examine . com states "Zinc has two standard dosages. The low dosage is 5-10mg, while the high dosage is 25-45mg" Or do you recommend a different dosage?

[kelkel]

Glad you go to Examine. Best vitamin site out there, hands down.
For our purposes most use 50 mgs per day.

[Far from massive]

FFM's and Brett's posts are on point. FFM means lowering your dose to 45 - 50 mgs twice per week.
You have plenty of room with your free T to do so and not really notice any negative difference. The positives will be less conversion to E and better control of your hematocrit. Yes to giving blood. And this does not mean you'll have to donate all the time. There are more people on TRT that do not have to donate than there are that do. Be sure to hydrate well as this will help you.

Your fatigue / lethargy may very well relate to this (hematocrit) as well. Just because your level is not "over" scale does not mean there's no impact. Do a quick google search to the side effects of polycythemia.

IMHO, I'd consider reducing your dosage by 10 mgs per injection for now and retest in a month. Increases or reductions in doses to not result in linear changes in levels. Sometimes small changes can make a big difference.

With your changes in diet along with a reduction in your dose should make a nice improvement in your E2 level. Consider supplementing with zinc as this will help a bit as well.

Kelkel, and crb123, yes that is what I meant. Thanks for clearing up my totally typo-ed post. I will try to avoid posting while talking on the phone as on a thread such as this with new users reading it multiple typo's in one post is really not a good thing. Again thanks for clearing it up.

[Brett N]

Phones suck, I can relate. I have to double check my spellcheck and even then it somehow gets changed.