4 months on TRT, needing help

[firemedic731]

Hey ya'll,

Like the topic states, I have been on TRT for 4 months now and am having some issues and I need some help. I am 28 years old, I am 5'7 and I was 142 pounds. My sex drive was fine, but i was having issues with putting on and keeping on the weight, insomnia, irritability, as well as weakness and fatigue. I went and got tested, and my labs were as follows initially;

Total test 304 ng/ml, range 350-1000
CFT 6.66, range 10-29
DHEA-S 290.7 UG/ML, range 82-690
SHBG 26.15 NMO/L, range 12.30 to 89.50
Estrogen low, below 15, range 15-55
FSH 3.19 MIU/ML, range 1.27-19.26
HGH 0.027 NG/ML, range 0.003-0.971
LH 2.98 MIU/ML, range 1.24 to 8.62
Progesterone 0.69 NG/ML, range 0.14 to 2.06
Prolactin 5.73 NG/ML, range 2.64 to 13.13
TSH 1.009 uIU/ML, range .450 to 5.330
Vita D 31.88 NG/ML, range 30-100.00
Hemoglobin 15.8
Hematocrit 46.1%

So, I jumped the gun and before finding out WHY i had low T, I just went ahead and started on TRT. I was also almost vita D deficient so I started taking 10,000 daily. I was started at 140 MG once a week IM of test Cyp. For the first 6 weeks I noticed my energy level increase and my mental clarify improved as well as my memory, goodbye brain fog. I had my 6 weeks labs done, and they were as follows;

CFT 14.3, range 10-29
Total test 513, range 350-1000
Estrogen 35.22 pg/ml, range 15-55
SHBG 18.78 nmo/l, range 13.30 to 89.50

I was still feeling pretty good, they increase my test cyp to 180 mg a week. but I started to get acne on my back, so they started me on a DHT blocker for the ace and they also had me start taking 2 DIM PLUS pills a day, or 400 MG, after my estrogen more than doubled. I also noticed my balls were achy and starting to shrink, so I started taking 500 units twice a week of HCG SQ, in case I ever wanted to have kids, and I wanted to fight the atrophy mostly. People started asking me If i was sun burnt, as i was pretty red in the face. I was starting to see some pretty good gains in weight and strength, I was up to 157 pounds now, people were starting to notice. I had labs in 6 weeks again for my third time (total of 18 weeks now) and were as follows;

total test 765 ng/dl, range 350-1000
CFT 15, range 10-29
E2 46.89 pg/ml, range 15-55
SHBG 34.6, range 13.30 to 89.50
Vita D 60.34
hematocrit 50.3%

At this point, my hematrocit was getting high and they advised me to donate blood, so I did. They increased my test cyp to 210 once a week, I continued the 500 units twice a week on days 3 and 5 of the HCG followed by DIM PLUS and DHT daily. But here is where the real issues started to arise, I was no longer having morning wood. My erection quality and frequency seemed to have gone down, as well as my sex drive. I wasn't getting the "rock hard" hard ons at all anymore and morning wood was minimal. I jumped in weight from 157 to 165 and fluctuate between 162 and 165 now. I am having night sweats pretty bad, and hot flashes. I was put on 0.5 MG of Anastrozole 48 hours following my injection. I continued this for a few weeks and had more labs done as follows;

E2 46.61 pg/ml, range 15-55
SHBG 32.30 nmo/l, range 13.3 to 89.5
total test 746
CFT 17.2
hematocrit 47.1

they increased my dose yet again from 210 now to 240 MG of Test Cyp. a week, followed by the same 0.5 MG of Anastrozole 48 hours after my injection, and my 500 units of HCG SQ twice a week on days 3 and 5, I am now taking 3 DIM PLUS or 600 mg daily with my DHT blocker. I continue to have the same issues, fluctuating between 162-165 pounds, no morning wood, weaker erections, night sweats and hot flashes. My strength gains seem to have plateaued again, and my joints are hurting.

My main concern is obviously my sex drive and erection quality. The sex drive is still there some what, especially again after this last jump from 210 to 240, but the quality is still down, they feel soft, I am having morning wood again but its also pretty soft. They recommended me to use cialis and start taking a progesterone cream, but I didn't want to add more fuel to the fire and complicate things, so i turned the offer down. I am not really sure what to do here, they want me to lower the Anastrozole dose, but I was thinking the opposite, that I should increase the dose. If my estrogen was low, below 15, when my test was 300, and now E2 is 46 at a test of 750, that's proportionately high E2 for me, even though its within "normal" lab values. I feel like they are treating the lab values and not my symptoms. I have been voicing my concern for a few weeks now, about 5 going on 6, and I am not really too happy that im 28 and having erection issues now where I am being pushed towards adding additional products like cialias and progesterone cream at 28 years old.

Should I drop the HCG or the anastrozole? Or stay at 0.5 MG anastrozole and increase my test again until i find the sweet spot in proportion to each other? is the OTC DIM actually doing anything at all, or a gimmick and a waste of time and money? I continue to have acne on my back, despite the DHT blocker, and I really don't want to add EVEN more products such as creams or antibiotics on-top of everything else.

[JdFlex]

I would bet the erections issues are DHT related. DHT controls sex functions and yours might be too low. That happened to me.
Also, I have found the back acne to be more estrogen related than DHT. Once I started anastrozole my acne was minimal.
I find it odd that your TRT test injections have increased up to 240mg test per week. That's really high for TRT. Sounds like you go to a clinic, not a personal Dr.

[Windex]

Keep HCG, it's replacing two hormones FSH and LH.

Inject Test 2-3 times per week not once.

Reduce Vitamin D to 35IU per lb of body weight and retest in 4-6 months. Add in Magnesium and 100mcg of Vitamin K2. Consume all 3 with high fat meal. If you don't do this Vitamin D will leech calcium from bones.

Drop the AI and reduce DIM to 200mg per day. I would do chemotherapy before using an AI for the rest of my life.

Read all the TRT stickies so you understand what you signed up for the rest of your life.

If you are at a clinic switch to a doctor.

Total testosterone bloodwork is useless and waste of your money. Results mean literally nothing. Test free bio available testosterone.

Would reduce Test down to 120-150mg per week and monitor.

Stop changing the program so frequently - it's half the reason you are having problems. Your body is on a hormonal roller coaster making changes so often.

Run the program - test in 4 months - tweak of necessary - retest in 4-6 months, etc.

[Youthful55guy]

Got to run off to a meeting. I'll comment more later, but this statement concerned me:

At this point, my hematrocit was getting high and they advised me to donate blood, so I did.

YOU SHOULD NOT DONATE BLOOD WHILE ON FINASTERIDE (the DHT blocker)!!!!

Finasteride is on the forbidden list of drugs for blood donation. it is EXTREMELY teratogenic to the developing male fetus. You are forbidden to donate blood for at least a month after discontinuing finasteride.

[firemedic731]

Got to run off to a meeting. I'll comment more later, but this statement concerned me:

At this point, my hematrocit was getting high and they advised me to donate blood, so I did.

YOU SHOULD NOT DONATE BLOOD WHILE ON FINASTERIDE (the DHT blocker)!!!!

Finasteride is on the forbidden list of drugs for blood donation. it is EXTREMELY teratogenic to the developing male fetus. You are forbidden to donate blood for at least a month after discontinuing finasteride.

Well the first and only time I “donated” wasn’t really a donation, come to find out the clinic waste the blood, and they charged me $40 to bleed. From now on I was going to actually donate at carter for free and help someone else. The list of ingredients in the DHT blocker are as follows;
Iron 25 mg
Biotin 2 mg
Zinc 5 mg
Saw palmetto 200 mg
Beta Sitosterol 50 mg
Horse tail extract 50 mg
Nettle extract 50 mg
Fo-ti polygonum multiform root 50 mg
Pygeum bark powder 50 mg
Green tea extract 30 mg

So unless I am mistaken, there is no finasteride

[firemedic731]

Keep HCG, it's replacing two hormones FSH and LH.

Inject Test 2-3 times per week not once.

Reduce Vitamin D to 35IU per lb of body weight and retest in 4-6 months. Add in Magnesium and 100mcg of Vitamin K2. Consume all 3 with high fat meal. If you don't do this Vitamin D will leech calcium from bones.

Drop the AI and reduce DIM to 200mg per day. I would do chemotherapy before using an AI for the rest of my life.

Read all the TRT stickies so you understand what you signed up for the rest of your life.

If you are at a clinic switch to a doctor.

Total testosterone bloodwork is useless and waste of your money. Results mean literally nothing. Test free bio available testosterone.

Would reduce Test down to 120-150mg per week and monitor.

Stop changing the program so frequently - it's half the reason you are having problems. Your body is on a hormonal roller coaster making changes so often.

Run the program - test in 4 months - tweak of necessary - retest in 4-6 months, etc.

They are checking my free T (CFT) it was 6.66 on a range of 10-29 and is currently at 17.2

[Youthful55guy]

My overall reaction is that they don't have a clue as to how to implement TRT. Most guys with normal SHBG levels (as you did at the start) don't nee more than 120mg per week (in divided doses) and many can get by with less. They are totally messing up your hormones.

I've already commented on the use of finasteride and blood donation. It is ethically unconscionable that they would advise a patient to donate blood while on finasteride. They should be closed down and have their medical license stripped for that alone.

Another level of incompetence is prescribing an AI with an E2 level of only ~47 pg/ml (range 15-55). Your E2 is not high and it's Low E2 (with the AI) that is probably what is messing up your libido and erections. GUYS NEED E2 too! Without it, we have no libido, symptoms similar to Low T, and we go limp. Sound familiar?

Finally, once weekly injections are old school. I'm guessing that this is an Low T clinic and you have to go their to get your injections (i.e., they don't prescribe self injections). No only is this costing you way too much, you have to break these injections up into at least 2X per week (I recommend E3D dosing) of MUCH smaller amounts. This will give you much more stable T levels and help to minimize the side-effects like high DHT, high E (which you don't have), and high hemoglobin (driven mainly by high DHT). I strongly recommend you read the "Best Practices in TRT" sticky on the first page on this subfourm. Their I outline everything you need to know.

BTW, how much finasteride are they prescribing and are they following this up with DHT labs? I don't see them posted. If you overdo finasteride, you can bring on Low T symptoms. Finasteride is a VERY POWERFUL drug. Based on my experience, even at your whopping dose of at 210mg per week, you'll need at the VERY MOST 1 mg of finasteride per day to keep DHT within the normal range.

[JdFlex]

As a point of reference, I was prescribed 100mg a week Test by my TRT Dr and after bloods I'm at 80mgs per week and all test results are where the Drs want to see them, including my primary Dr.

[firemedic731]

My overall reaction is that they don't have a clue as to how to implement TRT. Most guys with normal SHBG levels (as you did at the start) don't nee more than 120mg per week (in divided doses) and many can get by with less. They are totally messing up your hormones.

I've already commented on the use of finasteride and blood donation. It is ethically unconscionable that they would advise a patient to donate blood while on finasteride. They should be closed down and have their medical license stripped for that alone.

Another level of incompetence is prescribing an AI with an E2 level of only ~47 pg/ml (range 15-55). Your E2 is not high and it's Low E2 (with the AI) that is probably what is messing up your libido and erections. GUYS NEED E2 too! Without it, we have no libido, symptoms similar to Low T, and we go limp. Sound familiar?

Finally, once weekly injections are old school. I'm guessing that this is an Low T clinic and you have to go their to get your injections (i.e., they don't prescribe self injections). No only is this costing you way too much, you have to break these injections up into at least 2X per week (I recommend E3D dosing) of MUCH smaller amounts. This will give you much more stable T levels and help to minimize the side-effects like high DHT, high E (which you don't have), and high hemoglobin (driven mainly by high DHT). I strongly recommend you read the "Best Practices in TRT" sticky on the first page on this subfourm. Their I outline everything you need to know.

BTW, how much finasteride are they prescribing and are they following this up with DHT labs? I don't see them posted. If you overdo finasteride, you can bring on Low T symptoms. Finasteride is a VERY POWERFUL drug. Based on my experience, even at your whopping dose of at 210mg per week, you'll need at the VERY MOST 1 mg of finasteride per day to keep DHT within the normal range.

Again, i was not prescribed finasteride. The DHT blocker is some saw palmetto OTC stuff. And yes, it is a clinic. I’ll ask if I can take it home or split into bi weekly injections, back down from 240 to 180, reduce dim and drop the AI. At least I’ll be headed back in the right direction, ultimately I’ll probably have to switch to a primary and away from the clinic.

[Youthful55guy]

Again, i was not prescribed finasteride. The DHT blocker is some saw palmetto OTC stuff. And yes, it is a clinic. I’ll ask if I can take it home or split into bi weekly injections, back down from 240 to 180, reduce dim and drop the AI. At least I’ll be headed back in the right direction, ultimately I’ll probably have to switch to a primary and away from the clinic.

Thanks for clarifying the finasteride/Saw palmetto thing. There are no restrictions on saw. The rest of your plan looks like a good plan. You definitely don't need an AI with the labs you posted and I suspect that is part of your problem. The other part is wide swings in hormone levels with weekly injections. Splitting the dose should help a lot. Most guys on split doses can get by with a lot less T and that helps to control the side-effects.

[JdFlex]

Everything the clinic is selling you is $$ for them. Its all "justified", health wise. You should get a TRT Dr.
Unless you do all your own research and only buy from them what you think you need for your personal protocol.

[firemedic731]

Well I had my labs done again and wanted to update, run a few things by ya'll.

Still a little up and down, mostly down I guess unfortunately. Most nights I am restless and don’t sleep very good, other nights I sleep okay, but never good. Not like before, when I first started there was a period there that I slept GREAT. Energy seems down, I have noticed I am taking more naps again in the middle of the day, maybe cause I am not sleeping as good at night. I feel like the brain fog is back, cant seem to focus, my mental clarity isn't as good. Its a weird combination, I am tired yet restless, yet I would rather nap in the day and lay around, I don't have much interest or desire to do things I would normally do on my days off. At work I seem to have more of a "F*** it" attitude again, and my drive is diminishing, maybe due to stress at work though. I am waking up from my naps hot and sweaty, but the overnight sweats seem to have diminished. I am generally pretty sore, I feel like my recovery is worse, but I may be over training. I feel tired, and seem to be getting more and more irritable. Sex drive and quality seem ok, for awhile there I had no interest, its not raging but its also not non existent either. I asked if I could split my testosterone dose from one into two injections a week, and they said no. They wont give me a prescription and let me take it home either. I was feeling sluggish, overall negative and in a grumpy mood. I could feel it in my chest at night that I felt my pressure was up, my HCT came back at 49 so I donated again, he advised me to donate at 49, thats when he said he donates personally as well when he notices it. Thats only the second time I have donated now in 6 months. My weight is up, I am around 167 now, so I have put on in total about 25 pounds in the last 6 months. I am getting stronger, I am benching more than I ever have, so there is that I guess. I am still having pretty decent acne on my back, the OTC saw palmetto stuff did seem to help a little for awhile, but I don't imagine its worth continue to take. I am still taking the DIM though. My vitamin D came up to over 60, I reduced from 10K a day to 5K a day.

PSA is 0.65 range 0.0080-4.0, good here
SHBG is 32 range 13-89
Total test 828
free test 19.3
HCT came back at 42 a week or two after donation


My E2 is 45, range 15-55. I stopped taking the anastrozole. Previously was 46-47 at the highest, even both before and while on anastrozole. It actually dropped lower by 1 point after stopping the anastrozole? Why would this be? Even when I was on the Anastrozole on day 3 following my injection, and had my labs done on day 7, my E2 was still at 46-47. Is this because of the HCG? I have heard that the anastrozole only works as an AI to keep test from converting to E2, but doesn't affect the natural production caused by HCG in the testicles. Should I lower my HCG dose to 250iu x2 a week and see what happens to my E2? Am I compounding my E2 by taking higher dose test and higher dose HCG? I honestly initially expected the anastrozole to tank my E2, but it didn't seem to have an affect on it at all really...


I have been having pain in my shoulders, i had an MRI done and they said I had tendonopothy or tendonitis, and I also pulled my groin last week squatting… They recommended Deca, in a small "therapeutic" dose of either 100 or 200 MG a week to help with the joint pain, strength, and recovery. Its a 10 week cycle, max. Not gunna lie, its tempting, but I don't want to add some thing else ontop of everything yet. I asked him about prolactin issues, he didn't seem to know much about it, he couldn't remember the name for the drug caber, but he said hes never had anyone have an issue, especially on such a low dose and only for 10 weeks. I am honestly almost looking at this as more of a cycle, thinking of riding it out then stopping all together with PCT then reevaluate if I actually have low t and what the cause is. I went and saw my primary and got a referral to a Urologist, I plan on going to see them. I feel like I didn't actually have low T, I was just not working out, being sedentary, drinking and dipping a lot, not sleeping enough.. etc and I just wanted the test. Even with that lifestyle my first total T labs came back as 384, over their 350, so I actually didn't qualify the first time, they ran second labs and ran a free t with total T and were able to "qualify me". I feel like if I come off, and I keep a healthy lifestyle, my T levels would be fine and I wouldn't qualify for TRT, but I guess I wont know until i come off and see the urologist. I feel like they know what they are doing, and I should just take advantage of it and "blast" it legally. Surely they know what they are doing, giving me now 250mg test a week with 200 mg of deca a week and 1,000 units HCG a week, and offering anastrozole to keep my E2 in check while they pump me full of test, despite the elevated E2, donating blood due to high HCT and back acne? I realize that if i come off "trt" I will obviously drop back to my normal, even if my normal is actually low T levels, and probably feel crappy for awhile, hell if its even worse than the way I am feeling now, maybe id at least get some sleep. But I am getting pretty tired of messing with all of it to be honest.. i really honestly never intended to be on TRT for life, i think i always knew in my head i just wanted to try test for awhile and quit.

One other question though, If I do drop TRT, what kind of PCT should I be looking at? If I have run HCG the entire time iv been on, and I have no atrophy, I should be up and running, no? Do I stop the test and continue the HCG? Or do I stop both together and need anything besides the anastrozole, like clomid or tamoxifen?

[Youthful55guy]

Well I had my labs done again and wanted to update, run a few things by ya'll.

I asked if I could split my testosterone dose from one into two injections a week, and they said no. They wont give me a prescription and let me take it home either.

Therein is your basic problem. I also started out on the TRT clinic track and faced very similar problems as yours. The clinic would not split the dose or give me T to take home but they were willing to keep giving me more and more per weekly injection. Within a couple of months my hematocrit went sky high and I knew this wasn't a sustainable treatment. My E2 went out of range and they gave me anastrozole to bring it down, but that crashed my E2 to less than detectable levels. I was a mess and had an extremely bad case of ED too boot. Plus they charged me an arm and a leg for HCG. All in all it cost me a fortune and had a 40-mile long cord between me and the clinic, which meant I couldn't be gone from home for more than a week at a time. An upcoming 3 week vacation to Europe forced me to find alternatives. That and constantly having to donate blood.

I am still taking the DIM though.

My understanding from prior posts is that your E2 was within range, even while on that huge dose (E2 46.61 pg/ml, range 15-55), and is still within range (45) per information below. I would not be at all concerned about this level of E2. Probably no harm in taking DIM (I do too), but that's as far as I recommend you take E2 control. Guys need E2 too. More than likely, it will come down slowly as you reduce the T dose.

PSA is 0.65 range 0.0080-4.0, good here
SHBG is 32 range 13-89
Total test 828
free test 19.3
HCT came back at 42 a week or two after donation


My E2 is 45, range 15-55. I stopped taking the anastrozole. Previously was 46-47 at the highest, even both before and while on anastrozole. It actually dropped lower by 1 point after stopping the anastrozole? Why would this be? Even when I was on the Anastrozole on day 3 following my injection, and had my labs done on day 7, my E2 was still at 46-47. Is this because of the HCG? I have heard that the anastrozole only works as an AI to keep test from converting to E2, but doesn't affect the natural production caused by HCG in the testicles. Should I lower my HCG dose to 250iu x2 a week and see what happens to my E2? Am I compounding my E2 by taking higher dose test and higher dose HCG? I honestly initially expected the anastrozole to tank my E2, but it didn't seem to have an affect on it at all really...

See above discussion. HCG at 1000 IU per week (500 IU 2X, if I recall from a prior post) likely has little effect on E2 other than through the small bump it might have on T production. It is the higher end of the dose range that I recommend (but is the dose I use). I'd recommend breaking it up into a minimum of 3 doses per week. It's half life is about 24-36 hours. The information you have on anastrozole only affecting natural T-produced E2 is a bunch of bull$#!%. HCG works the exact same way as LH/FSH by binding to receptors in the testicles. It predominately binds to LH receptors to produce T (the exact same mechanism as LH). To a lesser extent it also binds to FSH receptors to stimulate spermatogenesis in the same way as FSH.

They recommended Deca, in a small "therapeutic" dose of either 100 or 200 MG a week to help with the joint pain, strength, and recovery. Its a 10 week cycle, max. Not gunna lie, its tempting, but I don't want to add some thing else on top of everything yet.

That's troubling to me that a TRT clinic would offer a synthetic anabolic hormone. yes, I know some guys here recommend it too, but once you head down this road, it's difficult to return. Nandrolone is extremely androgenic and carries a lot of side-effects. I'd do a bunch more research on this before you jump into bed with a TRT clinic that obviously doesn't know what they are doing and doesn't have your best health interests in mind. The more products they can sell you the more money they make. Nandrolone sticks around your system for a very long time and will screw up your endocrine system. Have you ever heard of "Deca Dick"? Also, if you ever break the cord with the clinic and find a real TRT doctor, I doubt you'll get that person to write a prescription for Nandrolone.

I asked him about prolactin issues, he didn't seem to know much about it, he couldn't remember the name for the drug caber, but he said hes never had anyone have an issue, especially on such a low dose and only for 10 weeks.

Your prior labs don't indicate prolactin levels are a problem (Prolactin 5.73 NG/ML, range 2.64 to 13.13). I'd not pursue this any longer unless future labs tell you otherwise.

I am honestly almost looking at this as more of a cycle, thinking of riding it out then stopping all together with PCT then reevaluate if I actually have low t and what the cause is.

Agree, except I'd not go down the Deco road. PCT will not fix the problems it causes for a very long time.

See above responses in blue/bold.

[firemedic731]

See above responses in blue/bold.

Well I had heard that deca can cause prolactin issues, so I tried to do my research ahead of time. I know my prolactin levels up front were normal, I expect them to elevate at least a little, and if any issues arise I wanted to be aware and know I needed or had access to the caber. Most people I see run test/deca have anastrozole and caber at least on hand if not preemptively in their protocol. I hear most people have issues with deca when they run a lot, like 600mg a lot, I figured 200 would practically be nothing and on the lower or safer end of the spectrum with less potential for sides. I was planning on running test for at least a few months and cruising after the deca to let it clear my system, and I am going to run HCG the entire time as well, I figured with all the above said (low dose, w/ test and HCG) I would be fine. It would be a lie though if I said I wasn’t nervous or wasn’t thinking about chickening out in the deca.

[firemedic731]

As for the anastrozole, I don’t know if I was clear. I was told the HCG could be causing my estrogen related sides, because HCG can cause a spike in your natural E2. That being said, the anastrozole I was told only works to inhibit the exogenous synthetic testosterone arimitizatiin. I was told the anastrozole will not inhibit the natural estrogen produced by the HCG because it’s not arimitization, therefore the arimitization inhibitor doesn’t work on it. If that makes sense?

[Windex]

AI's like Anastrozole are extremely toxic, like mentioned previously you should look to remove it and monitor accordingly.

HCG is not going to increase your estrogen by any relevant amount.

Deca is not something I would introduce 4 months in - save it until you've fine tuned your HRT protocol.

The clinic you are at is just milking your money and are not prescribing based on health. Find a proper HRT doctor.

[Krb367]

Welcome to the club! Lol sorry this post is of no help, but I am/was having the same problem. Not quite as in depth as yours, but trt with normal bloods and weak ass erections. Jumped on the cialis 5mg every day train. My wife can’t get enough

[firemedic731]

AI's like Anastrozole are extremely toxic, like mentioned previously you should look to remove it and monitor accordingly.

HCG is not going to increase your estrogen by any relevant amount.

Deca is not something I would introduce 4 months in - save it until you've fine tuned your HRT protocol.

The clinic you are at is just milking your money and are not prescribing based on health. Find a proper HRT doctor.

I talked to him again today, I mentioned my sleep being worse, my energy being down and napping during the day. He did bring up lowering my test dose, but said he didn’t want to lower my test if I was going to do the deca, which I had already went ahead and said f it and ordered. My deca hasn’t come in yet, so I haven’t started it yet. I’ll see how this week goes, if I continue to have issues I’ll probably talk to him next week and see if I can get my money credited back for the deca and skip it and just lower my test dose. I think that’s the right thing to do, at least from a true replacement therapy standpoint, But part of me just wants to ride it out and take the deca then just quit and do pct after. Go see the real urologist and if I actually need TRT then go back on, insurance instead of self pay, and get the take home RX so I can split my dose and get serious about it if it’s for life.

[CaptainCurious]

Well, personally, I don't think you can call what you're doing trt.

The main problem is, and will likely continue to be, your dose. You're testing your troughs, so you don't notice how high T is going. Doses from 100-300 mg are all 500-900 7 days out, and this makes them look reasonable, but on 200 /wk in 1 shot, the spike is ~2,000. Pull up a Testosterone dose response curve online and you'll notice all the action happens earlier in the week. They are testing here by design, because some undoubtedly like the highish doses from clinics, so they can keep clients interested in this protocol. I suggest you avoid it.


The fact that you even think you need an ai at your age is protocol failure imo. E2 is important in men but it too lowers over the week as T declines. If it's 45 on day 7, it is likely 50-60 during the middle of the week.

I'm only posting on this once as I'm too busy frankly, but you should lower your dose to 80-140 mg/wk and find a clinic that'll let you dose at 5 day intervals max, adjusting your dose to maintain the proper total mg/wk amounts.

And:
- that's too much vitamin D. 2,000-4,000 /day depending on geography and season, max (somewhat of an opinion) or dosing to vitamin d 35-50 on blood tests. Take some preformed Vitamin A or eat liver if you supplement much D.
- If you donate blood often you need to test ferritin, which is your storage iron, and try to keep it 100-150. If you lower your dose you likely won't have this issue.

[firemedic731]

Well, personally, I don't think you can call what you're doing trt.

The main problem is, and will likely continue to be, your dose. You're testing your troughs, so you don't notice how high T is going. Doses from 100-300 mg are all 500-900 7 days out, and this makes them look reasonable, but on 200 /wk in 1 shot, the spike is ~2,000. Pull up a Testosterone dose response curve online and you'll notice all the action happens earlier in the week. They are testing here by design, because some undoubtedly like the highish doses from clinics, so they can keep clients interested in this protocol. I suggest you avoid it.


The fact that you even think you need an ai at your age is protocol failure imo. E2 is important in men but it too lowers over the week as T declines. If it's 45 on day 7, it is likely 50-60 during the middle of the week.

I'm only posting on this once as I'm too busy frankly, but you should lower your dose to 80-140 mg/wk and find a clinic that'll let you dose at 5 day intervals max, adjusting your dose to maintain the proper total mg/wk amounts.

And:
- that's too much vitamin D. 2,000-4,000 /day depending on geography and season, max (somewhat of an opinion) or dosing to vitamin d 35-50 on blood tests. Take some preformed Vitamin A or eat liver if you supplement much D.
- If you donate blood often you need to test ferritin, which is your storage iron, and try to keep it 100-150. If you lower your dose you likely won't have this issue.

So I continue to have the same issues, I had them pull labs early a few weeks and drop my dose from 250mg to 200mg. Results came back as follows;

Free T; 960 (350-1000)
E2; 40 (15-55)
CFT: 26 (10-29)
SHBG 25 (13-89)
HCT 46

I feel the same(tired, napping during the day, not sleeping well, brain fog, etc..) but my hands no longer feel swollen. I could have SWORN that my dose was too high , and it probably was and still is, and that it was an estrogen issue with the swollen hands and a too high T level for the restlessness. I would have bet my life savings on the fact that my estrogen was going to come back high and i would say "i told you so". However, my estrogen came back at 40. WTF?! This is so frustrating and confusing. When i was on 140 MG my estrogen was 35, when I jumped to 180 it was 45, then 210 it was 47. Even when I started taking half a MG of anastrozole once a week, even in my trough on day 7, my estogen was 46. Now, on the highest dose of testosterone iv been on to date at 250 MG a week, feeling the worst I have felt, my estrogen without anastrozole is only 40 in my trough? Thats damn near as low as when I first started on my lowest dose. What the hell is going on? Theres no way thats accurate, my test dose goes up from 210mg to 250mg, with no AI, and my estrogen drops from 47 to 40? And I actually tested a day early on day 6 instead of 7.

[Windex]

I talked to him again today, I mentioned my sleep being worse, my energy being down and napping during the day. He did bring up lowering my test dose, but said he didn’t want to lower my test if I was going to do the deca, which I had already went ahead and said f it and ordered. My deca hasn’t come in yet, so I haven’t started it yet. I’ll see how this week goes, if I continue to have issues I’ll probably talk to him next week and see if I can get my money credited back for the deca and skip it and just lower my test dose. I think that’s the right thing to do, at least from a true replacement therapy standpoint, But part of me just wants to ride it out and take the deca then just quit and do pct after. Go see the real urologist and if I actually need TRT then go back on, insurance instead of self pay, and get the take home RX so I can split my dose and get serious about it if it’s for life.

Well if you aren't serious about signing up for HRT then the last thing you should be doing is running Deca because that is the one steroid that can induce hypogonadism and force you to be on HRT.

I don't mean to be rude but it sounds like your all over the place. The clinic you are going to is absolutely clueless and you are being advantage of. You need to spend time reading and understand the endocrine system and how HRT + Andrology works.

The sticky threads are an excellent place to start.

[JdFlex]

So I continue to have the same issues, I had them pull labs early a few weeks and drop my dose from 250mg to 200mg. Results came back as follows;

Free T; 960 (350-1000)
E2; 40 (15-55)
CFT: 26 (10-29)
SHBG 25 (13-89)
HCT 46

I feel the same(tired, napping during the day, not sleeping well, brain fog, etc..) but my hands no longer feel swollen. I could have SWORN that my dose was too high , and it probably was and still is, and that it was an estrogen issue with the swollen hands and a too high T level for the restlessness. I would have bet my life savings on the fact that my estrogen was going to come back high and i would say "i told you so". However, my estrogen came back at 40. WTF?! This is so frustrating and confusing. When i was on 140 MG my estrogen was 35, when I jumped to 180 it was 45, then 210 it was 47. Even when I started taking half a MG of anastrozole once a week, even in my trough on day 7, my estogen was 46. Now, on the highest dose of testosterone iv been on to date at 250 MG a week, feeling the worst I have felt, my estrogen without anastrozole is only 40 in my trough? Thats damn near as low as when I first started on my lowest dose. What the hell is going on? Theres no way thats accurate, my test dose goes up from 210mg to 250mg, with no AI, and my estrogen drops from 47 to 40? And I actually tested a day early on day 6 instead of 7.

Do you think you have an additional medical issue? I too get bouts of chronic fatigue and its origin, for me, is mind/body syndrome, aka TMS.
https://www.unlearnyourpain.com/blog...body-syndrome/

[firemedic731]

Another update:

6 weeks labs came back as follows after dropping my dose from 250mg to 200mg and reducing DIM.
Total T: 672
Free T: 18.9
SHBG 20
E2 52.84

The restless legs at night has mostly stopped, but It still happens from time to time as well as the swelling in the hands and the hot flashes, but not as bad. I dont understand why my E2 has spiked to the highest its ever been after lowering my dose. Even when I was at 210MG originally my E2 wasnt this high, it was only around 47. The Acne on my back seemed to flare up again.

I lowered my dose again from 200 to 160 now, and increased my DIM again.

I talked to them about quitting, they didnt really seem to have an "exit protocol" other than to gradually lower my dose before stopping. I asked about other RX and they didnt say anything about clomid or nova for PCT. If they wont give it to me, what do i do? I have been running HCG 2x a week at 500iu, so hopefully worst case it wont be that bad?

[firemedic731]

Well I quit. I stopped the Test Cyp, continued the HCG until 18 days after my last shot, then started clomid at 50/50/25/25. I went back to pre trt levels. Total was 304 now 355, free t was 6.6 now 7.8, E2 was 15 now 25. Feel like crap though, left the clinic and went to a urologist. waiting for labs and follow up before going back on.

[Windex]

Well I quit. I stopped the Test Cyp, continued the HCG until 18 days after my last shot, then started clomid at 50/50/25/25. I went back to pre trt levels. Total was 304 now 355, free t was 6.6 now 7.8, E2 was 15 now 25. Feel like crap though, left the clinic and went to a urologist. waiting for labs and follow up before going back on.

Take the time to read all the sticky threads. This is not something you flip flop back and forth. HRT is serious lifelong commitment and impacts your entire life.

Own the responsibility of your health. If you cannot make that commitment to yourself then I would caution going back into HRT.

[Youthful55guy]

Well I had heard that deca can cause prolactin issues, so I tried to do my research ahead of time. I know my prolactin levels up front were normal, I expect them to elevate at least a little, and if any issues arise I wanted to be aware and know I needed or had access to the caber. Most people I see run test/deca have anastrozole and caber at least on hand if not preemptively in their protocol. I hear most people have issues with deca when they run a lot, like 600mg a lot, I figured 200 would practically be nothing and on the lower or safer end of the spectrum with less potential for sides. I was planning on running test for at least a few months and cruising after the deca to let it clear my system, and I am going to run HCG the entire time as well, I figured with all the above said (low dose, w/ test and HCG) I would be fine. It would be a lie though if I said I wasn’t nervous or wasn’t thinking about chickening out in the deca.

Sorry, there was a missing word in my response in the prior (blue font) response. My keyboard sometimes cuts out when typing in FB. The problem seems to be isolated to PF posts. My response is missing the word not.It should have read: Your prior labs don't indicate prolactin levels are not a problem (Prolactin 5.73 NG/ML, range 2.64 to 13.13). I'd not pursue this any longer unless future labs tell you otherwise. That is why I said I'd not pursue prolactin testing any further while on TRT unless for some reason you suspect it's a problem.

[Youthful55guy]

As for the anastrozole, I don’t know if I was clear. I was told the HCG could be causing my estrogen related sides, because HCG can cause a spike in your natural E2. That being said, the anastrozole I was told only works to inhibit the exogenous synthetic testosterone arimitizatiin. I was told the anastrozole will not inhibit the natural estrogen produced by the HCG because it’s not arimitization, therefore the arimitization inhibitor doesn’t work on it. If that makes sense?

I've heard these same discussions in forum posts. To my knowledge there's no medical information on the topic of AIs affecting (or not affecting) testicular E2 conversion. My experience is that when E2 is within range (or even slightly high) you should not muck with trying to control it. AIs are very difficult to control when using typical TRT doses of T. Then again, if you are playing with stacking nandrolone compounds onto TRT, your getting outside of my area of experience, so I have no advice to offer in that situation.

[Youthful55guy]

AI's like Anastrozole are extremely toxic, like mentioned previously you should look to remove it and monitor accordingly.

HCG is not going to increase your estrogen by any relevant amount.

Deca is not something I would introduce 4 months in - save it until you've fine tuned your HRT protocol.

The clinic you are at is just milking your money and are not prescribing based on health. Find a proper HRT doctor.

I echo this sound advice.

[Youthful55guy]

Well I quit. I stopped the Test Cyp, continued the HCG until 18 days after my last shot, then started clomid at 50/50/25/25. I went back to pre trt levels. Total was 304 now 355, free t was 6.6 now 7.8, E2 was 15 now 25. Feel like crap though, left the clinic and went to a urologist. waiting for labs and follow up before going back on.

Catching up with your posts. Leaving the TRT clinic is probably a good long term strategy but quitting cold turkey, even with HCG, can be brutal as you have discovered. Also, given your relatively low Total T and normal SHBG levels pre-TRT, I'd expect you'd end up with similar T levels after all the exogenous T has cleared your system.

Many guys have good luck with urologists. I hope you have a sympathetic one that understand male hormone replacement. Hope it all works out for you. keep us posted.