Having tough time with Dr

Hello new to forum, Been on TRT for one year under Urologist that I've come to realize does not know what he is doing as regard to hormone replacement therapy. At a year my labs are 197 test. Tell the dr I'm not feeling good do not have energy, no interests and all of the other symptoms of low T. He's not concerned about my low numbers says he sees no reason to change anything that I'm on a pretty large dose (I'm only on .7ml a week). Went to my GP and he said lets check estrogen levels since Urologist did not, and they came back ok. Not sure where to go from here. In the small town I live in there are limited Drs and zero endos.

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Originally Posted by tkdan63

Hello new to forum, Been on TRT for one year under Urologist that I've come to realize does not know what he is doing as regard to hormone replacement therapy. At a year my labs are 197 test. Tell the dr I'm not feeling good do not have energy, no interests and all of the other symptoms of low T. He's not concerned about my low numbers says he sees no reason to change anything that I'm on a pretty large dose (I'm only on .7ml a week). Went to my GP and he said lets check estrogen levels since Urologist did not, and they came back ok. Not sure where to go from here. In the small town I live in there are limited Drs and zero endos.

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Is that 0.7 mL of a 100 or 200 mg per mL. Most are 200, but 100 exists. Makes a big difference. Assuming it's 200 mg/ml, My suggestion is to ask the doctor to break the dose in half and axminster Twice weekly. This will give much more stable levels all week long.

When was BW pulled relative to your last injection?

It is 200mg per ml
It was on the day of injection before injection.

If you're already on trt and have exhausted all options to find a doctor just buy online. Take 100-150 mg a week depending on if it's underdosed coming from another source not pharmaceutical. You can already get needles at your pharmacy so inject twice a week. At that dose you shouldn't need an Ai but check bloodwork on your own and buy arimidex online if need be.

I've done a lot off looking online but I'm afraid of getting ripped off. I have pretty much accepted the fact that in order to have levels so that I feel like I should on trt I'll have to self dose.

I guess I should add that I've been doing HCG 200iu 2xweek. This is not under Dr supervision it is just something I felt I should do from everything I had read. I was worried that my body's ability to produce test on it's own would be lost once I started trt. I was concerned that if I ever had to discontinue treatment I would be in really bad shape.
Also I'm 53 with very little BF, and do workout 5+ days a week. I eat fairly healthy other than an occasional cheat day.

I would follow YG55's advice and split your current dose. It can make a big difference. Continuing to take the HCG is a smart move as well. Now, if you choose to continue your current protocol then inject your HCG both 1 and 2 days before your injection day. It's old school but the point is that it will bump up your T levels and the end of the week when they are waning.

Thanks for all of the advise.
Thanks kelkel I did not know exactly when to inject HCG I had been just doing it right in the middle between doses but your suggestion makes more since. I guess .35 ml of test could be injected in pretty much in any muscle group?

Solid advice, however, other than maybe stabilizing your T I don't know that twice a week protocol is gonna do much. I pin once a week and fall down to 3-400 on day 7. Doesn't matter to. Me because I can't feel one bit of difference from day 2 to day 7. I pin 1 full ML most of the time, sometimes I drop to 150 for several months but still feel the same.
Weareyou having your symptoms?? Must be day 6 and 7? If it's all week long then it's not from T it's something else. You may want. To get BW on day 2 or 3 and see where your level is at. I would be surprised if it were 7-800 if you are falling below 200 on day 7? Also, we are all discussing something somewhat irrelevant, your free is what matters and where titration up or down should be made. Of course your urologist probably never checked free if he doesn't know hormones.
Also for what it's worth I do not feel you are on a "large" dose, I would personally call it average or standard. Some people do legitimately need more than 140 per week.

Sorry for all the typos, I'm tired. My point is not to bash twice a week pins, nothing wrong there. I'm just a little leery that will fix things if you are having symptoms??
You really should find out what your free is and may legitimately need to titration up a bit.

Bullshark99
As far as my dose it's.7 ml once a week. It is around day 6-7 that the symptoms start. I actually feel fine before then have energy can push extra hard in the gym by day six which is Friday I can't push as hard and I do not have the motivation or energy to even get out and go to the gym on the weekend. Saturday I pin and by Sunday evening I'm feeling energetic and more upbeat and the week cycle starts again.

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Originally Posted by tkdan63

Hello new to forum, Been on TRT for one year under Urologist that I've come to realize does not know what he is doing as regard to hormone replacement therapy. At a year my labs are 197 test. Tell the dr I'm not feeling good do not have energy, no interests and all of the other symptoms of low T. He's not concerned about my low numbers says he sees no reason to change anything that I'm on a pretty large dose (I'm only on .7ml a week). Went to my GP and he said lets check estrogen levels since Urologist did not, and they came back ok. Not sure where to go from here. In the small town I live in there are limited Drs and zero endos.

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I would feel like shite too at 197. 300 is the cutoff for insurance and my doc runs me around 1100 on pellets with peak likely 1300. I would get with a knowledgeable vet here and work out a home protocol if it were me. Low test and/or abnormal e2 wreck my life in a huge way. Likely cost me a marriage before I got it corrected, or at least contributed. Not sure how you feel, but for me maintaining test levels is of paramount importance for quality of life.

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Originally Posted by TrailRunAZ

I would feel like shite too at 197. 300 is the cutoff for insurance and my doc runs me around 1100 on pellets with peak likely 1300. I would get with a knowledgeable vet here and work out a home protocol if it were me. Low test and/or abnormal e2 wreck my life in a huge way. Likely cost me a marriage before I got it corrected, or at least contributed. Not sure how you feel, but for me maintaining test levels is of paramount importance for quality of life.

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I can relate 100% to "wreck my life in a huge way". The way I feel has put a strain on marriage, and made things difficult at work as well. Since I'm most likely going to be running a self regulated TRT program I will be needing guidance from others with experience in this area. Thanks for advise.

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Originally Posted by dr. Silabolin

U could try DIM to make more of your estrogen to bind to SHGB and raise free test that way.
After studying DIM i will try this one for myself.
But u gotta get the rigth DIM. And it was kind of expensive.

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I actually stated taking DIM recently. I guess I did not do a good job of explaining everything I do relating to my treatment both medically supervised and my own personal touch.

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Originally Posted by tkdan63

Thanks for all of the advise.
Thanks kelkel I did not know exactly when to inject HCG I had been just doing it right in the middle between doses but your suggestion makes more since. I guess .35 ml of test could be injected in pretty much in any muscle group?

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Yes, .35 can be injected literally anywhere. For small amounts I'll use a 27 ga X 1/2" syringe and inject anywhere, delts, glutes are the usual targets for me. At that low amount you can also inject with a slin pin into belly fat as well.

Re HCG again, if you split your T shots then just inject your HCG on the same days and you'll be fine. What I described previously (HCG one and two days before injection) relates only to a once per week protocol.

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Originally Posted by kelkel

Yes, .35 can be injected literally anywhere. For small amounts I'll use a 27 ga X 1/2" syringe and inject anywhere, delts, glutes are the usual targets for me. At that low amount you can also inject with a slin pin into belly fat as well.

Re HCG again, if you split your T shots then just inject your HCG on the same days and you'll be fine. What I described previously (HCG one and two days before injection) relates only to a once per week protocol.

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For right now I'm going to stay with once a week for test but move my HCG to the suggested days and see how that goes first.

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Originally Posted by tkdan63

Bullshark99
As far as my dose it's.7 ml once a week. It is around day 6-7 that the symptoms start. I actually feel fine before then have energy can push extra hard in the gym by day six which is Friday I can't push as hard and I do not have the motivation or energy to even get out and go to the gym on the weekend. Saturday I pin and by Sunday evening I'm feeling energetic and more upbeat and the week cycle starts again.

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Sorry if I missed anything in the prior posts, I'm away from my computer and trying to follow this on my tiny cell phone screen.

Let me summarize what I think I know. 1) You've been on TRT for about a year at 140 mg per week (0.7 mL of 200 mg/mL); 2) You feel good all week but on the last one or two days of your weekly cycle you feel a return of symptoms; 3) You do not know your E2 but your GP is going to test it; 3) You do not know your free To or SHBG levels; 4) You take HCG (can't recall the exact dose) and are contemplating adjusting the day of injection per Kel's advice.

My first thought is that with a Day 7 total T of 197, free T measurement is going to be meaningless, it's going to be very low. It seems though that SHBG would be extremely useful. Low SHBG could account for your symptoms. With low SHBG, the To is metabolized a lot faster. Going up my help, but it may place stress on the liver. From posts I've read from guys with low SHBG, more frequent injection is a better way to go for more stable Free T levels.

I'm thinking that if low SHBG is the problem, then you might actually find your E2 is low too, as it too will be metabolized faster.

A final question. Is there any chance this is a blended To ester product? That is, could there be any fast acting short esters in it like T-prop?

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Originally Posted by Youthful55guy

Sorry if I missed anything in the prior posts, I'm away from my computer and trying to follow this on my tiny cell phone screen.

Let me summarize what I think I know. 1) You've been on TRT for about a year at 140 mg per week (0.7 mL of 200 mg/mL); 2) You feel good all week but on the last one or two days of your weekly cycle you feel a return of symptoms; 3) You do not know your E2 but your GP is going to test it; 3) You do not know your free To or SHBG levels; 4) You take HCG (can't recall the exact dose) and are contemplating adjusting the day of injection per Kel's advice.

My first thought is that with a Day 7 total T of 197, free T measurement is going to be meaningless, it's going to be very low. It seems though that SHBG would be extremely useful. Low SHBG could account for your symptoms. With low SHBG, the To is metabolized a lot faster. Going up my help, but it may place stress on the liver. From posts I've read from guys with low SHBG, more frequent injection is a better way to go for more stable Free T levels.

I'm thinking that if low SHBG is the problem, then you might actually find your E2 is low too, as it too will be metabolized faster.

A final question. Is there any chance this is a blended To ester product? That is, could there be any fast acting short esters in it like T-prop?

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No I'm on .7ml per week.
I'm getting test from Pharmacy, Watson Test cyp 200g.

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Originally Posted by tkdan63

No I'm on .7ml per week.
I'm getting test from Pharmacy, Watson Test cyp 200g.

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Ok. Just wondering. I had similar problems my first 3 months on a very similar protocol. I was getting TRT from one of those low T clinics where they insist on doing the injection. I finally figured out it was a blended T but the wouldn't tell me exactly what it was. I switched to a TRT specialist who got me on my current E3D protocol. Best decision I ever made!