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Thread: Need advice 29 y/o low T and E2

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    fossilk1 is offline Junior Member
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    Need advice 29 y/o low T and E2

    Hello,

    I recently just had some blood work and a 24 hour urone analysis. I am 29 y/o, weigh 207.6lb with from what my under armour scale says 27% body fat, BP is 110/67/55 As of right now my symptoms are frequent urination, low libido, sleep issues (can’t really stay asleep too long) and anxiety. Currently I am not taking any hormone medication, but in the past was prescribed 50mg Clomid to be taken 25mg everyday. With the Clomid taken for 3 months my FSH & LH was around 4-5, and my TT was 400’s. Then I came off a few months ago and just had lab work done again and wanted to see what everyone thought. The doctor may order an MRI of the pituitary, and took I had a 24 hour urine analysis for the frequent urination which I am waiting on the results.

    Thanks ahead for any advise.
    Attached Thumbnails Attached Thumbnails Need advice 29 y/o low T and E2-0aa6f6f1-64e4-404b-82a2-a0522eb6ad54.jpeg   Need advice 29 y/o low T and E2-b20b61c8-fda6-4083-b941-033d6d69fcfc.jpeg   Need advice 29 y/o low T and E2-f39ee789-78c0-4b56-b3d0-c3ef80b2c449.jpeg   Need advice 29 y/o low T and E2-a4e6bd53-c646-4573-b825-e65e68c680db.jpeg  
    Last edited by fossilk1; 03-09-2018 at 01:18 PM.

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    Youthful55guy is offline Knowledgeable Member
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    First off, I am not a believer in Clomid as a long term therapy. It may be somewhat effective in boosting T, but it has too many side-effects for long term therapy. It's best used as a short term component in a HPTA restart protocol (steroid guys call this PCT).

    Your labs look abysmal for a guy your age. LH, E, and T are all too low. Also, Vit D is borderline low and Reverse T3 is high.

    I concur with your doctor that you should have an MRI. Fortunately Prolactin is normal, but that still does not rule out a pituitary tumor. You should get a definitive diagnosis. Something is preventing the GnRH signal from getting from the brain to the pituitary, or preventing the pituitary from responding. Since Clomid seems to help restore normal T levels, I suspect it's not a pituitary tumor but rather some sort of hypothalamus dysfunction in the production of GnRH.

    I'd follow your doc's advice and get whatever tests are necessary to nail down a diagnosis before starting TRT, but in the end, you may have to go down that road.

    I'd boost your Vitamin D3 intake to about 4000 to 5000 IU per day to bring those levels up.

    Regarding Reverse T3, it often happens when the body is under stress. Frequently it happens during highly restrictive caloric intake (starvation dieting) and/or excessive exercise. In your case, it could be the anxiety causing and/or contributing to it. Reverse T3 binds competitively to T3 receptor sites but has no T3 activity. Thereby, preventing the action of T3 in the body. The best treatment is to get to the root of the problem with lifestyle changes. However, it may also require thyroid hormone supplementation to overcome the suppressive effects. I'd thoroughly exhaust the lifestyle changes and/or the T issue before I much with thyroid hormones.

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    fossilk1 is offline Junior Member
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    Quote Originally Posted by Youthful55guy View Post
    First off, I am not a believer in Clomid as a long term therapy. It may be somewhat effective in boosting T, but it has too many side-effects for long term therapy. It's best used as a short term component in a HPTA restart protocol (steroid guys call this PCT).

    Your labs look abysmal for a guy your age. LH, E, and T are all too low. Also, Vit D is borderline low and Reverse T3 is high.

    I concur with your doctor that you should have an MRI. Fortunately Prolactin is normal, but that still does not rule out a pituitary tumor. You should get a definitive diagnosis. Something is preventing the GnRH signal from getting from the brain to the pituitary, or preventing the pituitary from responding. Since Clomid seems to help restore normal T levels, I suspect it's not a pituitary tumor but rather some sort of hypothalamus dysfunction in the production of GnRH.

    I'd follow your doc's advice and get whatever tests are necessary to nail down a diagnosis before starting TRT, but in the end, you may have to go down that road.

    I'd boost your Vitamin D3 intake to about 4000 to 5000 IU per day to bring those levels up.

    Regarding Reverse T3, it often happens when the body is under stress. Frequently it happens during highly restrictive caloric intake (starvation dieting) and/or excessive exercise. In your case, it could be the anxiety causing and/or contributing to it. Reverse T3 binds competitively to T3 receptor sites but has no T3 activity. Thereby, preventing the action of T3 in the body. The best treatment is to get to the root of the problem with lifestyle changes. However, it may also require thyroid hormone supplementation to overcome the suppressive effects. I'd thoroughly exhaust the lifestyle changes and/or the T issue before I much with thyroid hormones.
    You response is very spot on. I have been eating a lot less and starving myself to lose weight. Not a smart idea but it has been working. This would explain the reverse T3, makes sense.

    I have been taking D3 5000iu a day with a meal which seems a lot better. From what my numbers were in the past.

    For the hypothalamus and GnRH, I am sort of confused there. What would I expect if that was the case? That is if the pituitary is normal (no tumor). Something like Kallmann syndrome? This almost make me want to take Triptorelin as a small dose lol. What would be the worst that could happen.... looks like i’m gonna have to start TRt regardless. I just have to make my doctor happy with these tests.

    Or more along the lines of Hypothalamic diseases like Hypogonadotropic hypogonadism?
    Last edited by fossilk1; 03-10-2018 at 06:38 PM.

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    Youthful55guy is offline Knowledgeable Member
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    Quote Originally Posted by fossilk1 View Post
    For the hypothalamus and GnRH, I am sort of confused there. What would I expect if that was the case? That is if the pituitary is normal (no tumor). Something like Kallmann syndrome? This almost make me want to take Triptorelin as a small dose lol. What would be the worst that could happen.... looks like i’m gonna have to start TRt regardless. I just have to make my doctor happy with these tests.
    No, do not use Triptorelin. It will completely desensitize the pituitary and take months to recover. It is a long lasting analog of GnRH used to hormonally castrate men. The Pituitary must receive GnRH in a pulsatile fashion. When it is constantly infused, or a long-lasting analog is used, it will cause very rapid down regulation of GnRH receptors.

    Given that clomid seemed to help, it is probably some sort of hyper negative feedback of E on the brain. Why? I have no idea. Your E levels were on the low side to begin with, so it is not a case of excessive E. At this point, I think you need to press for the MRI and then put your condition in the hands of an endocrinologist for a more definitive diagnosis. I would suggest that you not muck around with long-term clomid therapy. It is simply not a good substitute for TRT when TRT is indicated. Way too many side-effects.
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    Outstanding responses Y55G!
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    fossilk1 is offline Junior Member
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    Quote Originally Posted by Youthful55guy View Post
    No, do not use Triptorelin. It will completely desensitize the pituitary and take months to recover. It is a long lasting analog of GnRH used to hormonally castrate men. The Pituitary must receive GnRH in a pulsatile fashion. When it is constantly infused, or a long-lasting analog is used, it will cause very rapid down regulation of GnRH receptors.

    Given that clomid seemed to help, it is probably some sort of hyper negative feedback of E on the brain. Why? I have no idea. Your E levels were on the low side to begin with, so it is not a case of excessive E. At this point, I think you need to press for the MRI and then put your condition in the hands of an endocrinologist for a more definitive diagnosis. I would suggest that you not muck around with long-term clomid therapy. It is simply not a good substitute for TRT when TRT is indicated. Way too many side-effects.
    Thank you again for your responses, you are very knowledgeable with this criteria... so basically, the MRI would be nice to have to make sure nothing is serious. And if I am understanding you correctly, what ever diagnosis the endocrinologist gives me, TRT will be a must, in this case Cypinate. I just wanted to see if I can recover naturally since I am young, but seems this is not the case anymore. Whatever happen to my HPTA, it seem to be at the communication with the hypothalamus to the Pituitary, assumingy pituitary is normal from the MRI. More than likely it will be since I don’t show high Prolactin, Cortisol, thyroid and physical symptoms like tunnel vision and loss of sight which would point to the pituitary.
    Last edited by fossilk1; 03-12-2018 at 01:59 PM.

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    Maybe I missed it but has there been any head trauma in your past?
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    fossilk1 is offline Junior Member
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    Quote Originally Posted by kelkel View Post
    Maybe I missed it but has there been any head trauma in your past?
    Crashed into a tree on my dirt bike when I was a kid, luckily I had my helmet on. CT scan showed nothing back then... I mean I have always been in accidents when I was a kid but nothing serious... snow boarding landing on my head. When I was a kid I never really recognized it as anything serious. When I was 21 prior to steroids I had gyno on my right side which was really strange and it went away eventually. I mean during college when I was 21 I smoked a lot of weed. I was like a chimney. I know weed can fluctuate hormones so that might have been the gyno issue.

    I guess we won’t know until the MRI kelkel, you have been helping me since last year when this all started. I just hope my insurance does not reject me again this time.

    Shit is depressing, was benching 500lb, weighed in at 245lb, 22% body fat.... now i’m 206.8lb with 25-27%
    Last edited by fossilk1; 03-12-2018 at 04:41 PM.

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    Well with head trauma (TBI, concussions), I don't believe they can predict when the negative effect (hormone disruption, etc) will occur. Meaning it can be sooner or it can be much later, which of course is of no help other than the fact that we know the negative result can be delayed. Couple that with the fact that hormone levels aren't normally tracked at such a young age makes accurately pointing the finger at something difficult.

    Keep pushing. One way or another you'll get back. I know quite well the feeling of extreme low T having had mine at a 59 level due to an adenoma. You will get through this.
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    fossilk1 is offline Junior Member
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    Quote Originally Posted by kelkel View Post
    Well with head trauma (TBI, concussions), I don't believe they can predict when the negative effect (hormone disruption, etc) will occur. Meaning it can be sooner or it can be much later, which of course is of no help other than the fact that we know the negative result can be delayed. Couple that with the fact that hormone levels aren't normally tracked at such a young age makes accurately pointing the finger at something difficult.

    Keep pushing. One way or another you'll get back. I know quite well the feeling of extreme low T having had mine at a 59 level due to an adenoma. You will get through this.
    Thanks man, yeah i’m getting close to 1 year anniversary with T 86 and estradiol crashed due to Arimidex .

    My doctor actually just called me and said my 24 hour urine analysis came back alright. My osmolality came back normal just I was a bit higher on volume but nothing crazy. He said he put the order in for an MRI, so round 2 attempting to have my pituitary looked at. I have a feeling the MRI will come back clean, and he told me if it did he would try Clomid again but 50mg twice a week for I don’t know how long.

    There is a good Anti-Aging doctor in Westchester NY I heard good things about but I may have to pay out of pocket. I have doctors ready to give me Cypinate. Just this anxiety is killing me and more than likely triggering my fight or flight mechanism telling my body to void all fluids to be lighter to run. Just Ativan is starting to not work that well anymore and I don’t want to increase the dosage. Benzo addiction is from what I heard a hell of a drug to beat.

    One positive thing I noticed which may have no correlation to all of this, is I have not been sick with any colds. Nothing... my wife and kid was sick at least three times. In one case, we had to bring my kid to the hospital for a 103į-104į one time, and he was coughing all over me. Strange =\
    Last edited by fossilk1; 03-12-2018 at 06:42 PM.

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    Be curious how the MRI turns out. You should be able to sign up on-line with whatever imaging service performs it and view the actual images as well.
    50 mgs x 2 per week is a crap protocol. Daily or eod at most.
    My guess is that once on a TRT protocol the anxiety will cease. Agree wholeheartedly with Y55 that clomid is not a first choice, imho.
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    Youthful55guy is offline Knowledgeable Member
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    Quote Originally Posted by fossilk1 View Post
    Crashed into a tree on my dirt bike when I was a kid, luckily I had my helmet on. CT scan showed nothing back then... I mean I have always been in accidents when I was a kid but nothing serious... snow boarding landing on my head. When I was a kid I never really recognized it as anything serious. When I was 21 prior to steroids I had gyno on my right side which was really strange and it went away eventually. I mean during college when I was 21 I smoked a lot of weed. I was like a chimney. I know weed can fluctuate hormones so that might have been the gyno issue.

    I guess we won’t know until the MRI kelkel, you have been helping me since last year when this all started. I just hope my insurance does not reject me again this time.

    Shit is depressing, was benching 500lb, weighed in at 245lb, 22% body fat.... now i’m 206.8lb with 25-27%
    OK, a lot of new information here. Yes, head trauma can mess up pituitary hormones. If the trauma is severe enough to the brain, it can cause neuroendocrine problems preventing proper GnRH secretion. Even seemingly mild trauma like whiplash can damage the hypothalamic stem that communicates with the pituitary and prevent the GnRH signal from get to where it's supposed to go.

    Do you have a history of steroid use ? That can really mess up your endocrine system.

    Yes, smoking weed can mess up your hormones. I don't know the exact mechanism, but I do know that it can cause an increase in T conversion to E, hence probably the gynecomastia .

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    Youthful55guy is offline Knowledgeable Member
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    Quote Originally Posted by fossilk1 View Post
    Thanks man, yeah i’m getting close to 1 year anniversary with T 86 and estradiol crashed due to Arimidex.

    he told me if it did he would try Clomid again but 50mg twice a week for I don’t know how long.
    =\
    What is T86?

    Why Arimidex ? Was your E high?

    Don't do the clomid thing. If you need TRT, do it. Clomid is just not a sustainable treatment, and at 50 mg 2X per week, you are going to feel the side-effects.

    At your age too, if you go down the TRT road, I'd make sure you get a script for HCG . Best to use at least 500 - 1000 IU in 3 divided doses per week. 500 IU is about the minimum to keep your testicles from shrinking. 1000 is the optimum dose to restore normal testicular function while on TRT.

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    fossilk1 is offline Junior Member
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    My total test was 86, I was misguided on my PCT protocol and took Arimidex when I was coming off. Also I later realized my PCT was way too short. At this point I acknowledge I did not know that much about PCT and should have done more research. If you are interested, here is my original post last year which if you really want to read into my journey it has been pretty tough so far. I agree with you. Regardless if the doctor says he wants to start Clomid again I am going to press for cypinate. And I already have a son, so I am good enough with one kid lol. No need for HCG unless the doctor feels the need to add it.

    https://forums.steroid.com/anabolic-...el-2120-a.html

    To add I also recently had surgery called Lateral Internal Sphincterotomy in December 2017 for a severe fissure near the scrotal area. The doctors thought the severe fissure (down to the muscle) was possibly causing the urination issues due to nerve damage.

    I greatly appreciate all the feedback and food for thought when I do decide to start my TRT protocol. Should I start at 100mg or 200mg a week? I really want to get back into heavy lifting, I miss it lol.
    Last edited by fossilk1; 03-12-2018 at 08:35 PM.

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    100 mgs split 50 x 2 and titrate after 6 week blood work. No ancillaries until after first BW to fully assess need.
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    Youthful55guy is offline Knowledgeable Member
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    Quote Originally Posted by kelkel View Post
    100 mgs split 50 x 2 and titrate after 6 week blood work. No ancillaries until after first BW to fully assess need.
    Concur, except I'd also consider splitting the weekly dose up into E3D (40 mg = 0.2 mL). Either way will work just fine. Whatever works for you.

    FYI, HCG does more than just preserve fertility. I'd layer it in at least at the minimum 500 IU dose after you optimize the T dose.

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    Todayistomorrow is offline New Member
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    Quote Originally Posted by Youthful55guy View Post
    What is T86?

    Why Arimidex ? Was your E high?

    Don't do the clomid thing. If you need TRT, do it. Clomid is just not a sustainable treatment, and at 50 mg 2X per week, you are going to feel the side-effects.

    At your age too, if you go down the TRT road, I'd make sure you get a script for HCG. Best to use at least 500 - 1000 IU in 3 divided doses per week. 500 IU is about the minimum to keep your testicles from shrinking. 1000 is the optimum dose to restore normal testicular function while on TRT.
    This my main concern with TRT, that and testicle pain. Does HCG help with that as well? Iím trying to get in to see Dr Mark Gordon as this seems so complicated and heís had success treating TBI patients.

    On one of his podcast, he mentioned he doesnít use estrogen blockers at the doses heís doing, and uses Keto7-DHEA along with zinc 50mg2mg copper and thatís enough?

    Iím trying to emmerse myself in this stuff and learn the right questions to ask.

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    Youthful55guy is offline Knowledgeable Member
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    Quote Originally Posted by Todayistomorrow View Post
    This my main concern with TRT, that and testicle pain. Does HCG help with that as well? I’m trying to get in to see Dr Mark Gordon as this seems so complicated and he’s had success treating TBI patients.

    On one of his podcast, he mentioned he doesn’t use estrogen blockers at the doses he’s doing, and uses Keto7-DHEA along with zinc 50mg2mg copper and that’s enough?

    I’m trying to emmerse myself in this stuff and learn the right questions to ask.
    That is correct, he does not like to use AIs or blockers. He believes that zinc/copper is enough. He believes that AIs will decrease GH production.

    I part with him on this advice. I recommend incorporating the zinc/copper into your program and if E labs dictate, then an AI should be used. However, with the strong caveat that it must be supported with labs and they must be the correct E labs. If you do start an AI, be aware that dosing is very difficult if you are borderline high in E. In that case, I recommend the 'Vodka Method". Dissolve 1 mg of anastrozole into 1.5 mL vodka and dispense 5 drops per day in a glass of water. Keep the solution tightly capped and make up no more than 1 mg at a time. It has a short shelf life.

    I've never taken 7-Keto DHEA, so I have no opinion or experience.

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    Ephemeral is online now Junior Member
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    Quote Originally Posted by Youthful55guy View Post
    Concur, except I'd also consider splitting the weekly dose up into E3D (40 mg = 0.2 mL). Either way will work just fine. Whatever works for you.

    FYI, HCG does more than just preserve fertility. I'd layer it in at least at the minimum 500 IU dose after you optimize the T dose.
    If someone first starts with just T, then later adds HCG , is that gonna increase his T level?

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    I'd rather E be slightly higher for several reasons as long an individual is not gyno sensitive . Better libido for one. Also with higher E comes higher natural GH and IGF-1 levels.
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    Ephemeral is online now Junior Member
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    Quote Originally Posted by kelkel View Post
    Well with head trauma (TBI, concussions), I don't believe they can predict when the negative effect (hormone disruption, etc) will occur. Meaning it can be sooner or it can be much later, which of course is of no help other than the fact that we know the negative result can be delayed. Couple that with the fact that hormone levels aren't normally tracked at such a young age makes accurately pointing the finger at something difficult.

    Keep pushing. One way or another you'll get back. I know quite well the feeling of extreme low T having had mine at a 59 level due to an adenoma. You will get through this.
    I didn't know that negative effects can be delayed, I'm glad u mentioned that (might be relevant for me too). I just googled it now, and in one study they say the effects can occur up to 3 years later, and in another they didn't find significant correlation between TBI and hypopituitarism after 5 years have passed (these were adult patients, maybe it's different for children, I don't know).

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    fossilk1 is offline Junior Member
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    So I officially got my 10ml vial of Cypinate, and 5000iu of HCG today prescribed. I have to contac the doctor again on how many times I should administer HCG but from the vague instructions I am suppose to take 35 units, just not sure how many times a week (2-3?).

    I want to make sure this is done right this time since now I will be on it for life.

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    Quote Originally Posted by Ephemeral View Post
    If someone first starts with just T, then later adds HCG, is that gonna increase his T level?
    It can increase both T and E. Which is why we subsequently monitor with BW.
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    Quote Originally Posted by fossilk1 View Post
    So I officially got my 10ml vial of Cypinate, and 5000iu of HCG today prescribed. I have to contac the doctor again on how many times I should administer HCG but from the vague instructions I am suppose to take 35 units, just not sure how many times a week (2-3?).

    I want to make sure this is done right this time since now I will be on it for life.

    Twice weekly should be adequate. What are your Test dosing instructions?
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    Schof1 is offline New Member
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    Anyone run HUNTER pharmaceuticals gear just got NPP 150 to rock with cyp 300 and testopel. Just wondering if Hunter is legit,my guy is but I have never saw Hunter

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    fossilk1 is offline Junior Member
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    Quote Originally Posted by kelkel View Post
    Twice weekly should be adequate. What are your Test dosing instructions?
    @Kelkel, I am not sure yet, I haven’t picked up the Cypinate since CVS is still not in stock. They called me letting me know it will be in tomorrow so I assume the protocols will be on there.

    Got a response, 100mg weekly cypinate and Hcg 35units three times weekly. So 50mg every 3 days?
    Last edited by fossilk1; 03-14-2018 at 11:54 AM.

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    Post it up when you obtain it please.
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    Youthful55guy is offline Knowledgeable Member
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    Quote Originally Posted by Ephemeral View Post
    If someone first starts with just T, then later adds HCG, is that gonna increase his T level?
    Need advice 29 y/o low T and E2-coviello-2005_j-clin-endocrinol-metab-90-5-p25.png

    Figure 2 from: Coviello, A.D., Matsumoto, A.M., Bremner, W.J., Herbst, K.L., Amory, J.K., Anawalt, B.D., Sutton, P.R., Wright, W.W., Brown, T.R., Yan, X., et al. (2005). Low-dose human chorionic gonadotropin maintains intratesticular testosterone in normal men with testosterone-induced gonadotropin suppression. J Clin Endocrinol Metab 90, 2595-2602.

    Serum T during the treatment phase by group. Values are the mean  SEM (bars). The shaded box represents the normal reference range of serum T in healthy men for this assay. Serum T increased from baseline in all four groups in response to TE (200 mg, im, weekly; P0.05) and remained elevated during the treatment phase. The two higher hCG dose groups (250 and 500 IU, sc, every other day) had serum T levels above the normal range during the treatment phase.

    The above graph shows that 125 IU HCG E2D (438 IU/wk) did not significantly affect T production in 6 healthy young male volunteers receiving 200 mg T-Eth per week. However both 250 IU E2D (875 IU/wk) and 500 IU E2D (1,750 IU/wk) were effective in increasing serum T levels. In both groups, there was an equivalent boost of about 10 nmol/L (~290 ng/dL).
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    Youthful55guy is offline Knowledgeable Member
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    Quote Originally Posted by fossilk1 View Post
    So I officially got my 10ml vial of Cypinate, and 5000iu of HCG today prescribed. I have to contac the doctor again on how many times I should administer HCG but from the vague instructions I am suppose to take 35 units, just not sure how many times a week (2-3?).

    I want to make sure this is done right this time since now I will be on it for life.
    You will need to take a lot more than 35 IU. I recommend starting at about 150 to 200 IU 3X per week for a total weekly dose of about 450 to 600 IU per week. This should have minimal impact on T production per previous post and graph, and prevent over testicular atrophy. Even if it's just for cosmetic purposes, I think it's worth it.

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    Quote Originally Posted by Youthful55guy View Post
    You will need to take a lot more than 35 IU. I recommend starting at about 150 to 200 IU 3X per week for a total weekly dose of about 450 to 600 IU per week. This should have minimal impact on T production per previous post and graph, and prevent over testicular atrophy. Even if it's just for cosmetic purposes, I think it's worth it.

    I assumed he meant 350 IU's?
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    fossilk1 is offline Junior Member
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    Quote Originally Posted by kelkel View Post
    I assumed he meant 350 IU's?
    Correct Kelkel, just the Doctor was visually showing me when to pull back on the insulin syringe. I have 31G 1ml/cc syringes, and pulling back to the 35 unit mark would be 350 IU correct?

    Stupid question but what is the ethical/proper way of disposing syringes? Obviously I don’t want to throw them in the garbage, nor do I want to throw them in a 1liter bottle. Do pharmacies take the used garbage syringes and dispose of them? I know with insulin users who have diabetes have this tool which snip off the tips so no one could be poked.
    Last edited by fossilk1; 03-14-2018 at 03:26 PM.

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    kelkel's Avatar
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    Depends on how much bac water you use to mix it. If it's 5000 iu's I'd suggest 2 cc's. If 10000 iu's go with 4 cc. Then every 10 you pull back to = 250 iu's. Some instruction will have you using a ton of water which is simply unnecessary to inject.

    If concerned with state laws re syringe disposal, look here:

    https://safeneedledisposal.org/
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    fossilk1 is offline Junior Member
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    Quote Originally Posted by kelkel View Post
    Depends on how much bac water you use to mix it. If it's 5000 iu's I'd suggest 2 cc's. If 10000 iu's go with 4 cc. Then every 10 you pull back to = 250 iu's. Some instruction will have you using a ton of water which is simply unnecessary to inject.

    If concerned with state laws re syringe disposal, look here:

    https://safeneedledisposal.org/
    Thank you, and yes you are right I forgot to mention the doctor made me mix 5ml of bac water.

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    Youthful55guy is offline Knowledgeable Member
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    Quote Originally Posted by fossilk1 View Post
    Correct Kelkel, just the Doctor was visually showing me when to pull back on the insulin syringe. I have 31G 1ml/cc syringes, and pulling back to the 35 unit mark would be 350 IU correct?

    Stupid question but what is the ethical/proper way of disposing syringes? Obviously I don’t want to throw them in the garbage, nor do I want to throw them in a 1liter bottle. Do pharmacies take the used garbage syringes and dispose of them? I know with insulin users who have diabetes have this tool which snip off the tips so no one could be poked.
    My preferred method is to mix 5000 IU with 5 mL bacteriostatic injection saline. Then each 0.1 mL (10 units on an insulin syringe) delivers 100 IU. Makes the math really easy for us mathematically challenged guys.

    Alternatively, if you want to also supplement with B12, mix the 5000 IU with 1.5 mL injection saline + 3.5 mL B12 (10,000 mcg/10mL solution). Then when you use the HCG at 1000 IU/wk, you also supplement with about 900 mcg B12 per week.

    As for syringe disposal, most states require that sharps me disposed of as medical waste. Our local garbage service supplies free sharps containers and free disposal. You might want to call yours to see if they do the same.

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    fossilk1 is offline Junior Member
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    Quote Originally Posted by Youthful55guy View Post
    My preferred method is to mix 5000 IU with 5 mL bacteriostatic injection saline. Then each 0.1 mL (10 units on an insulin syringe) delivers 100 IU. Makes the math really easy for us mathematically challenged guys.

    Alternatively, if you want to also supplement with B12, mix the 5000 IU with 1.5 mL injection saline + 3.5 mL B12 (10,000 mcg/10mL solution). Then when you use the HCG at 1000 IU/wk, you also supplement with about 900 mcg B12 per week.

    As for syringe disposal, most states require that sharps me disposed of as medical waste. Our local garbage service supplies free sharps containers and free disposal. You might want to call yours to see if they do the same.
    Thank you Youthful, I wonder if B12 can also be prescribed to me. But I have never tested B12 in my labs, I guess next time it wouldnít hurt to see where my levels are at and possibly supplement.

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    Youthful55guy is offline Knowledgeable Member
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    Quote Originally Posted by fossilk1 View Post
    Thank you Youthful, I wonder if B12 can also be prescribed to me. But I have never tested B12 in my labs, I guess next time it wouldn’t hurt to see where my levels are at and possibly supplement.
    I buy mine on line from Canada where it is OTC. I have no idea of its regulatory state in the USA (Rx or OTC). So far there have not been any issues with delivery. Here's where I get it, but I'm sure there are other suppliers out ther too: https://www.buy-otc.com/index.aspx

    I also like that it colors the HCG solution red, which makes it easier to read the mark on the syringe.

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    Ephemeral is online now Junior Member
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    Quote Originally Posted by Youthful55guy View Post
    Click image for larger version. 

Name:	Coviello 2005_J Clin Endocrinol Metab 90(5)p25.png 
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    Figure 2 from: Coviello, A.D., Matsumoto, A.M., Bremner, W.J., Herbst, K.L., Amory, J.K., Anawalt, B.D., Sutton, P.R., Wright, W.W., Brown, T.R., Yan, X., et al. (2005). Low-dose human chorionic gonadotropin maintains intratesticular testosterone in normal men with testosterone-induced gonadotropin suppression. J Clin Endocrinol Metab 90, 2595-2602.

    Serum T during the treatment phase by group. Values are the mean  SEM (bars). The shaded box represents the normal reference range of serum T in healthy men for this assay. Serum T increased from baseline in all four groups in response to TE (200 mg, im, weekly; P0.05) and remained elevated during the treatment phase. The two higher hCG dose groups (250 and 500 IU, sc, every other day) had serum T levels above the normal range during the treatment phase.

    The above graph shows that 125 IU HCG E2D (438 IU/wk) did not significantly affect T production in 6 healthy young male volunteers receiving 200 mg T-Eth per week. However both 250 IU E2D (875 IU/wk) and 500 IU E2D (1,750 IU/wk) were effective in increasing serum T levels. In both groups, there was an equivalent boost of about 10 nmol/L (~290 ng/dL).
    Thanks! But in that case it makes sense to me to start HCG right away, because it will effect T levels so that way it's faster to dial things in. But I think u recommended someone to wait with the HCG, am I missing something here?

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    fossilk1 is offline Junior Member
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    Thank you for all the input guys, greatly appreciate it. I just have one last question on how you would spread this protocol out. Obviously I would do 2 injections of 50mg per week (total 100mg), and HCG 350iu 2-3 times per week but combination. If I were to start on Monday & Thursday for Cypinate, what days should I pin HCG to balance everything correctly?

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    Quote Originally Posted by fossilk1 View Post
    Thank you for all the input guys, greatly appreciate it. I just have one last question on how you would spread this protocol out. Obviously I would do 2 injections of 50mg per week (total 100mg), and HCG 350iu 2-3 times per week but combination. If I were to start on Monday & Thursday for Cypinate, what days should I pin HCG to balance everything correctly?

    Pin your hcg Monday, Thursday and Saturday. If it were me I'd probably just start with twice per week (on test injection days) and go from there. Keep it simple.
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    Quote Originally Posted by Ephemeral View Post
    Thanks! But in that case it makes sense to me to start HCG right away, because it will effect T levels so that way it's faster to dial things in. But I think u recommended someone to wait with the HCG, am I missing something here?
    Add one substance at a time and learn exactly what it does to/for you via BW before you add another. Otherwise pinpointing good or bad sides becomes difficult.
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