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Thread: 48 years young and starting HRT (feedback?)

  1. #1
    Motardpdx's Avatar
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    48 years young and starting HRT (feedback?)

    After 30 years of working out, living an active and healthy lifestyle plus reading 1,000+ posts on this forum, I’m starting my HRT program but keeping it simple.
    I believe this is a “primary” cause due to my age and my natural Test levels based on my last 3 blood tests, all fell below 300/free T.
    My BF is 15-17%, 6’4, 195lbs, resting heart rate 45 BPM, target heart rate 170+BPM, TDEE/3,000 per day
    Furthermore, I had all the natural symptoms of low T, low libido, low energy, depression, slow recovery, sleep pattern off, low concentration.
    My HRT program will be @50mg every 3.5 days instead of 100mg once per week, will increase dose after I evaluate my energy levels, mood, sleep pattern, libido. I understand the more you take the more you manage, like estrogen, RBC's, etc. Less is more on HRT and you should always start at a lower dose and increase if needed based not only on your blood work but your overall self awareness. I have decided to inject the Test, sub-Q once per week, splitting the dose and the second injection will be in the arse. In addition, inject 100IU sub-Q of HCG prior to the next T injection. I have read that after introducing exogenous T into your body, it stops natural T due to HPTA suppression. So, I plan on including either the HCG or independently supplementing Pregnenolone/DHEA into my HRT program but again not until I had time to elevate my “NEW” hormone levels and overall self being.

    My next blood panel will include the following:

    • Total Testosterone
    • Bioavailable testosterone (aka Free and Loosely Bound)
    • Free Testosterone
    • SHBG
    • DHT (gel users especially pay attention to this)
    • Estradiol (specify “sensitive” assay for males)
    • LH
    • FSH
    • Prolactin
    • Cortisol
    • Thyroid Panel (complete)
    • CBC
    • Comprehensive Metabolic Panel
    • Lipid Panel
    • PSA (age dependent)
    • IGF-1, IGFBP-3 (if HGH therapy is being considered)
    • Vitamin D

    I hope to increase my endurance, sex drive, mood, over all well being, strength, muscle mass and enjoy life again. I’m not sure how much testosterone will make me feel the “best” or “normal” again but hope to eventually land between 600-800 on my blood work, starting out slow and steady.

  2. #2
    Ephemeral is offline Associate Member
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    Seems like you've done your homework! A couple of things I can recommend though:

    1. It's not clear to me whether you're injecting once subq (into the belly?) and once subq into arse or if the second one is IM. I think it's best to use only one injection site in the beginning, because subq absorption rates may vary in different areas of the body (and it's also different from IM), so you know what works for you and what doesn't.

    2. I wouldn't add HCG from the start, it's better to see what T alone can do for you.

    3. Once you add HCG, 2*100 IU will not be enough, you need 500 per week at least (some say you need more) for your testes to function fully. I use 250 EOD (875 per week) to err on the safe side.

    4. When you're on TRT, LH and FSH are close to zero, so there's no point in testing them. I guess you can do it once just to make sure.

    Good luck!
    Last edited by Ephemeral; 05-16-2018 at 06:05 PM.

  3. #3
    Youthful55guy is offline Knowledgeable Member
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    Quote Originally Posted by Ephemeral View Post
    Seems like you've done your homework! A couple of things I can recommend though:

    1. It's not clear to me whether you're injecting once subq (into the belly?) and once subq into arse or if the second one is IM. I think it's best to use only one injection site in the beginning, because subq absorption rates may vary in different areas of the body (and it's also different from IM), so you know what works for you and what doesn't.

    2. I wouldn't add HCG from the start, it's better to see what T alone can do for you.

    3. Once you add HCG, 2*100 IU will not be enough, you need 500 per week at least (some say you need more) for your testes to function fully. I use 250 EOD (875 per week) to err on the safe side.

    4. When you're on TRT, LH and FSH are close to zero, so there's no point in testing them. I guess you can do it once just to make sure.

    Good luck!
    Pretty much the same points I was going to make.

    I'd keep the injections simple. Most guys do subcutaneous in the belly. I posted a video like in 'Best practices' post with Dr. Crisler (a well known expert in TRT) demonstrating the technique. Personally, I always bruise with SC and prefer a more simple straight into the quadriceps with an insulin needle approach, but I don't think any method is better or worse. Whatever works best for you. Time and experience will show you the way.

    I tend to agree with both HCG comments. I usually suggest dialing in T first and then layering in HCG, but it's not a hard and fast rule. Also, 200 IU per week is a low dose. I'd at least double that. I do 1050 IU per week, but then again, I'm not price sensitive and the stuff is expensive without insurance coverage.

    Once you start TRT, there's no reason at all to test for LH or FSH. It will be zero, guaranteed.

    You don't need both Free T and Bioavailable. One or the other is fine. My experience is that they parallel each other nicely.

    Best of luck with your protocol. Ask questions. Be happy to help.

  4. #4
    Motardpdx's Avatar
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    Thanks for the feedback. It’s interesting about HCG and amounts needed for proper function while on TRT, I’m concerned about estrogen levels to high if I dose too high but not enough won’t really serve a purpose. I’m planning on not incorporating HCG until my Test is dialed in and I’ll do blood work. I planned on pinning sub-Q because 500 pins in the muscle per year is gonna add up over time. I was thinking Test levels remain more consistent with sub-Q but will experiment with what works best for my levels. Dr. Crisler has great insights and his videos teach you a lot about proper techniques. I’ll remove LH, FSH from my labwork, thanks for pointing this out.

  5. #5
    Youthful55guy is offline Knowledgeable Member
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    Quote Originally Posted by Motardpdx View Post
    Thanks for the feedback. It’s interesting about HCG and amounts needed for proper function while on TRT, I’m concerned about estrogen levels to high if I dose too high but not enough won’t really serve a purpose. I’m planning on not incorporating HCG until my Test is dialed in and I’ll do blood work. I planned on pinning sub-Q because 500 pins in the muscle per year is gonna add up over time. I was thinking Test levels remain more consistent with sub-Q but will experiment with what works best for my levels. Dr. Crisler has great insights and his videos teach you a lot about proper techniques. I’ll remove LH, FSH from my labwork, thanks for pointing this out.
    My experience is that HCG does not impact on E to a significant amount. I hear theories to the contrary that it does, and in fact, I've repeated them in much earlier posts. But experience (and many labs) has shown that it's not significant (if at all). Even if your E does go up a small amount, it can be controlled with proper dosing of anastrozole as dictated by labs. For this, please see my post on dosing anastrozole using the Eye Dropper method: https://forums.steroid.com/hormone-r...astrozole.html

    I hear the "holes in the muscle" argument a lot, and even Dr. C reiterates it in his video, but I take a contrarian view.

    1) I inject E3D which is slightly more frequent than 2X per week. That makes 52 (weeks/year) X (7/3) = 121 injections per year.

    2) Most guys think of TRT in terms of the harpoons that most docs set them up with and are often discussed in the steroid forums. This HUGE needles are necessary for old school thinking because they are injecting 1-2 mL of a thick oil based substance, which would take forever if you used a smaller needle. I inject at most 0.25 mL, which allows me to use a very small 28G 1/2 inch long insulin syringe. The needle barely enters the muscle and leaves behind an almost unperceivably small track. The damage caused by these small needles is negligible compared to the old school methods. Also, think about it, diabetics do this anywhere from 4 to 6 times per day most of their life. If it were all that damaging, there'd ne something written in the medical literature by now.

    3) Studies have shown that the absorption kinetics are not different between SC and IM, so stability of the T profile is not a benefit to either method. You simply go with what works for you.

    4) I strongly suggest you do explore SC injection. I have and I came back to shallow IM with a small insulin syringe because I ALWAYS begin to bruise and occasionally develop injection site lumps with SC. Dr. C claims that hydraulics of a smaller needle are to blame for the lumps. With all due respect to him (and I REALLY DO respect him), I think he's wrong. I simply can't wrap my head around there being less subcutaneous damage from a 25G than a 28G needle. Perhaps I'm wrong, but there's still the bruising issue, which always drives me back to shallow IM.

  6. #6
    Ephemeral is offline Associate Member
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    Quote Originally Posted by Youthful55guy View Post

    3) Studies have shown that the absorption kinetics are not different between SC and IM, so stability of the T profile is not a benefit to either method. You simply go with what works for you.
    Do you happen to have those studies at hand? There's a thread here which kinda contradicts this, limited sample obviously but it's an interesting read:

    https://forums.steroid.com/hormone-r...m-labwork.html

  7. #7
    Youthful55guy is offline Knowledgeable Member
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    Quote Originally Posted by Ephemeral View Post
    Do you happen to have those studies at hand? There's a thread here which kinda contradicts this, limited sample obviously but it's an interesting read:

    https://forums.steroid.com/hormone-r...m-labwork.html
    I provided links in the post for best practices. You should be able to find them easily.

  8. #8
    Motardpdx's Avatar
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    I really appreciate the feedback on this and after doing some more reading about the subject (you suggesting IM) it makes good sense. I was hesitating because of the “scare tissue” but discovering my amounts of test will be so small plus the needle size @28g 1/2 inch will be fine with me. Also, your correct on the total amount of injections per year, I was estimating both the HCG weekly plus test x2 per week.
    I read up on the eye drop method of Anastrozole, I feel really comfortable about my low TRT dose and hope I don’t need to incorporate using this into my program. I have 17% BF and eat super clean too, this might help with keeping my estrogen levels low.
    I’ll start with the shallow IM injections and see how my Test levels do over the weeks dosing 2x per week, if I can maintain a nice “sawtooth” level and no valleys, great!

  9. #9
    Motardpdx's Avatar
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    I’m thinking about the weekly amounts of injections and will include both the Test/HCG together in a single shot using IM with a 27g, 1/2 inch, 2x per week. So the protocol will be .25ml of Test and .25ml of HCG. If this is the right dose or not I’ll adjust above or below @ 500IU starting total per week. The compounds will not mix together in the syringe one is water based/oil based so not sure if that matters when injectioning. I’ll base HCG dosing amounts on my overall well-being after a few weeks and adjust the protocol accordingly.

  10. #10
    kelkel's Avatar
    kelkel is offline HRT Specialist ~ AR-Platinum Elite-Hall of Famer ~ No Source Checks
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    Quote Originally Posted by Youthful55guy View Post
    My experience is that HCG does not impact on E to a significant amount.

    Exactly. Guys blow this all out of proportion.
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  11. #11
    Youthful55guy is offline Knowledgeable Member
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    Quote Originally Posted by Motardpdx View Post
    I’m thinking about the weekly amounts of injections and will include both the Test/HCG together in a single shot using IM with a 27g, 1/2 inch, 2x per week. So the protocol will be .25ml of Test and .25ml of HCG. If this is the right dose or not I’ll adjust above or below @ 500IU starting total per week. The compounds will not mix together in the syringe one is water based/oil based so not sure if that matters when injectioning. I’ll base HCG dosing amounts on my overall well-being after a few weeks and adjust the protocol accordingly.
    I have yet to hear of anyone mixing T with HCG into the same syringe. Personally, I'd rather use two syringes since I can go way down to a 31G 3/8 inch needle with HCG. I also use GH releasing peptides in my protocol and HCG makes for a good vehicle with them.

    If you are going to proceed with mixing the two, I would suggest drawing up the T first. Since it is much more difficult to pull up into a small needle, you have to pull the plunger way back and hold it for a minute or so. This means you will almost always overshoot the mark, but that's good because there will also be significant air bubbles in the syringe. When you slowly push the T back into the vial, the air bubbles coalesce and raise to the top and get injected back into the vial.

    After doing this, you can withdraw the needle and swab it down with alcohol to remove any residual T oil and then inert it into the HCG bottle and slowly pull up your dose until you are exactly on the mark. I would not attempt to push any back in for fear of contaminating the HCG vial with T oil. Over time a vacuum will form in the HCG vial that you'll need to relive.

    You're inventing something new, so not much more guidance I can give.
    almostgone likes this.

  12. #12
    Motardpdx's Avatar
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    Thanks for the feedback..Just trying to simplify the injections and limit the time/needles/syringes.
    I’m sure this will be a contentious leaning experience for me and will share what works and what doesn’t.

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    Update.. I decided to get my blood work done one last time at 8am before starting HRT and my free T came back higher than my last panel ( 6 months ago/ T 400). I made no changes to my diet or routine but did drink 6-8 beers the night before, I had no food after 12am and only 1/4 cup of flax seed and a sip of green tea before the test. If this is a primary issue (not secondary) could my free T jump up 196 points? It’s just confusing to have it higher and not lower. 48 years young and starting HRT (feedback?)-7e20eae9-67c7-4bbc-b723-f1bcac738c26.jpg
    48 years young and starting HRT (feedback?)-d7d5bff3-12c6-404f-a039-332f6363ff98.jpg
    48 years young and starting HRT (feedback?)-4db3973a-9e6c-4d5d-b35b-069d92e913ab.jpeg

  14. #14
    Windex is offline Staff ~ HRT Optimization Specialist
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    For the sake of comparing apples to apples, have you been getting your bloodwork at the same intervals ? For example, always in the morning, or evening, same day of week, etc.

    As previously said you have the option of subQ and IM. I personally do IM as it works better for me and it's easy to rotate for example it may look something like

    Mon AM Left outer quad
    Thurs PM Right outer quad
    Mon AM Left inner quad
    Thurs PM Right inner quad
    repeat


    Have you also considered getting your diet checked ? We have an exhaustive diet and nutrition section full of good info to help you along the way of TRT.
    Last edited by Windex; 06-10-2018 at 12:56 PM.

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    Quote Originally Posted by Windex View Post
    For the sake of comparing apples to apples, have you been getting your bloodwork at the same intervals ? For example, always in the morning, or evening, same day of week, etc.

    As previously said you have the option of subQ and IM. I personally do IM as it works better for me and it's easy to rotate for example it may look something like

    Mon AM Left outer quad
    Thurs PM Right outer quad
    Mon AM Left inner quad
    Thurs PM Right inner quad
    repeat


    Have you also considered getting your diet checked ? We have an exhaustive diet and nutrition section full of good info to help you along the way of TRT.
    Hey Windex , you ever pin your delts?
    I usually do left quad , right quad , left delt , right delt and then repeat but I notice no matter what needle I use , I get more pip in my delts

  16. #16
    Windex is offline Staff ~ HRT Optimization Specialist
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    Quote Originally Posted by Chrisp83TRT View Post
    Hey Windex , you ever pin your delts?
    I usually do left quad , right quad , left delt , right delt and then repeat but I notice no matter what needle I use , I get more pip in my delts
    I have not - mostly because I've spent the last few years completeling a half sleeve on one shoulder/arm and big tattoo on the other so avoided pinning there to avoid complications.

    I have tried glutes but too much of a hassle and too wide to do it solo. Tried calves once, never again.
    Motardpdx likes this.

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