37 y/o contemplating TRT, pls help him

[Ephemeral]

Hey guys, I could use some advice on my situation. I'm 37, 5'8", 150 lbs. 6 years ago my total T was at 650, just before when I did a weak 10 week var only cycle (stupid idea I know, but at least I did a good PCT afterwards). I don't think it had an effect on my low T, I was okay until 3 years ago, but u never know. So 3 years ago I started to have some symptoms, low libido, ED problems, worse and worse sleep (diagnosed with RLS, which I got under control with pregabalin), fatigue, brain fog. I thought it was just the result of my autoimmune illness / meds (psoriasis arthritis, started 8 years ago). I didn't do any T tests then, only 1 year ago, when my total T was 420, SHBG 39.5 (no other hormones were tested).

I thought it wasn't low enough to warrant TRT so I went on with my life. Symptoms got much worse, and the latest BW shows TT at 291, SHBG 44, albumin 5.05, and according to online calculators that puts my free T at 4.45 ng/dl. I did a second BW a few days later (so one BW in the morning, one in the evening), TT 369, SHBG 64.7, albumin 5.31, so free T is almost exactly the same. The high albumin might be because of my illness which comes with chronic inflammation, and the high SHBG might be the result of the stress on my liver thanks to my meds (low dose methotrexate), but my liver numbers seem okay so far.

6 years ago i could work out 2-3 times a week, although with great pain and slow recovery, now I struggle to go even once a week. I'm gonna see a doc in 7 days who seem to be pretty good, but I want to go in there with a plan, so my question is guys, what options do I have? Is it a no-brainer to go on TRT? Since my LH is on the low side at 2.4, could HCG alone cut it? If I go with T injections, what dose should I start with? The standard 40mg cyp E3D? Any other advice do u guys have for me, additional tests I should run etc? Thanks!

Here are my latest BW results:

TT 291 ng/dl (2nd test: 369) range: 176 - 782
SHBG 44 nmol/l (2nd test: 369) 13 - 89
albumin 5.05 g/dl (2nd test: 5.31) 3.5 - 5.2
LH 2.4 IU/l (1.2 - 8.2)
FSH 3.9 IU/l (1.27 - 19)
TSH 1.6 mIU/l (0.4 - 4)
Estradiol 23 pg/ml (EIA method, haven't found a place with LCMS) 0 - 47
Prolactin 3.24 ng/ml (2.6 - 13)
Progesterone 56.6 ng/dl (15.7 - 207)
DHEA-S 8 nmol/l (230 ng/dl) 2.9 - 12.6
PSA 1.35 ug/l (0 - 4)
GOT/AST 25 U/l (5 - 37)
GPT/ALT 31 U/l (5 - 41)
GGT 13 U/l (11 - 50)
HDL 1.1 mmol/l (42.5 mg/dl) 0.9 - 2.7
LDL 2.18 mmol/l (84 mg/dl) 2.6 - 3.9
Triglycerides 0.75 mmol/l < 2.3

[kelkel]

Well, if all potential causative factors are ruled out then replacement would be a viable option for you.
HCG does not replace LH, it mimics it. HCG Mono is actually a little used form of TRT which over time is suppressive to endogenous T production.
HCG "should" be a part of any replacement protocol. If your doc doesn't know this it may be time to find another one.
Starting with 40-50mgs cyp/enth X 2 pw would be great. Again, assuming you have a doc in the know who understands hormones, but they're few and far between.

Before you see this doc it may be prudent to call his office and ask one of his staff if he treats TRT patients how you desire to be treated. Such as self-injections, HCG, adex if needed, etc. His staff should be able to answer this so as not to waste your time or theirs with an uneccessary appointment. You also want to know that you'll be treated based on how you feel, not as a number on a chart.

Update this thread with how things go please! Welcome to the Forum.

[Ephemeral]

Well, if all potential causative factors are ruled out then replacement would be a viable option for you.
HCG does not replace LH, it mimics it. HCG Mono is actually a little used form of TRT which over time is suppressive to endogenous T production.
HCG "should" be a part of any replacement protocol. If your doc doesn't know this it may be time to find another one.
Starting with 40-50mgs cyp/enth X 2 pw would be great. Again, assuming you have a doc in the know who understands hormones, but they're few and far between.

Before you see this doc it may be prudent to call his office and ask one of his staff if he treats TRT patients how you desire to be treated. Such as self-injections, HCG, adex if needed, etc. His staff should be able to answer this so as not to waste your time or theirs with an uneccessary appointment. You also want to know that you'll be treated based on how you feel, not as a number on a chart.

Update this thread with how things go please! Welcome to the Forum.

Is HCG suppressive by lowering the natural LH over time, or by some other mechanism?
The doc seems to be decent, he knows about HCG, adex, clomid etc. TRT is one of his main things. Unfortunately I live in a small country where my choices both in docs and labs are quite limited. The only form of T that u can legally buy here is Nebido (which is cool but not when u're trying to dial things in), if u can believe that, everything else needs to be imported.

Thanks man!

[Youthful55guy]

Is HCG suppressive by lowering the natural LH over time, or by some other mechanism?
The doc seems to be decent, he knows about HCG, adex, clomid etc. TRT is one of his main things. Unfortunately I live in a small country where my choices both in docs and labs are quite limited. The only form of T that u can legally buy here is Nebido (which is cool but not when u're trying to dial things in), if u can believe that, everything else needs to be imported.

Thanks man!

HCG is suppressive because it stimulates T production, which then feeds back negatively on the hypothalamus for decreased GnRH, and thus decreased LH/FSH. Bottom line is that HCG monotherapy does not work because you have to take a boatload of it and that gets really expensive. Don't go there.

If your doc understands HCG, adex, clomid etc., I would suspect he pretty much knows what he's doing and will get you on a good protocol. If given the choice of Clomid monotherapy and TRT, I'd skip the clomid and go straight to TRT. Clomid monotherapy is another protocol that just does not work well. Clomid has too many side-effects that mimic Low T.

If Nebido is all you can legally obtain, then I guess the decision is made for you. Personally, I have no desire to switch to the long lasting ester. I think they are still learning how to administer it, but it's certainly better than some of the old school barbaric weekly or bi-weekly protocols with T-cyp I still see guys being prescribed. I'm a big supporter of E3D 40-50 mg T-cyp or T-eth. I like it better than 2X per week because the shots are spaced evenly, so it doesn't matter which shot you time your labs to. With the 2X protocol, you have to pick one time interval and stick with it to compare results.

Finally, at your age, I'd be wanting to get a better understanding of why your T is on the slide.

[Ephemeral]

HCG is suppressive because it stimulates T production, which then feeds back negatively on the hypothalamus for decreased GnRH, and thus decreased LH/FSH. Bottom line is that HCG monotherapy does not work because you have to take a boatload of it and that gets really expensive. Don't go there.

If your doc understands HCG, adex, clomid etc., I would suspect he pretty much knows what he's doing and will get you on a good protocol. If given the choice of Clomid monotherapy and TRT, I'd skip the clomid and go straight to TRT. Clomid monotherapy is another protocol that just does not work well. Clomid has too many side-effects that mimic Low T.

If Nebido is all you can legally obtain, then I guess the decision is made for you. Personally, I have no desire to switch to the long lasting ester. I think they are still learning how to administer it, but it's certainly better than some of the old school barbaric weekly or bi-weekly protocols with T-cyp I still see guys being prescribed. I'm a big supporter of E3D 40-50 mg T-cyp or T-eth. I like it better than 2X per week because the shots are spaced evenly, so it doesn't matter which shot you time your labs to. With the 2X protocol, you have to pick one time interval and stick with it to compare results.

Finally, at your age, I'd be wanting to get a better understanding of why your T is on the slide.

Thanks for your reply! Yeah the negative feedback thing makes sense. Hopefully I'll be able to import cyp, we'll see. I looked at graphs about T levels after taking Nebido, it gets somewhat smooth after like 6 months, but I was not convinced at all.
Any ideas about how I could understand the reason behind my low T? I'm sure the doc will have something to say about it, but the more ideas I hear the better. The lowish LH points to secondary hypogonadism to me, so maybe a GNRH injection test, or an MRI to rule out some things?

Also, what do u guys think about the effect lifestyle can have on T? Like sedentary guy with no sex life vs an active person? Is there any data on that?

[MuscleScience]

Thanks for your reply! Yeah the negative feedback thing makes sense. Hopefully I'll be able to import cyp, we'll see. I looked at graphs about T levels after taking Nebido, it gets somewhat smooth after like 6 months, but I was not convinced at all.
Any ideas about how I could understand the reason behind my low T? I'm sure the doc will have something to say about it, but the more ideas I hear the better. The lowish LH points to secondary hypogonadism to me, so maybe a GNRH injection test, or an MRI to rule out some things?

Also, what do u guys think about the effect lifestyle can have on T? Like sedentary guy with no sex life vs an active person? Is there any data on that?

I fought going on TRT for probdbly 12 years or so. I knew I had low T in my early 20’s but could function fine. Finally sides and now all the research that points to just how terrible low T is for a mans health is, drove me to finally give in. I only wish I would have started it much sooner, I’m your age and just started if this year. My total T was never more that 350 mg/dL even in my early 20’s. Finally it got to be so low I just couldn’t function. It’s made a world of difference now that I have it dailed in.

[Youthful55guy]

Thanks for your reply! Yeah the negative feedback thing makes sense. Hopefully I'll be able to import cyp, we'll see. I looked at graphs about T levels after taking Nebido, it gets somewhat smooth after like 6 months, but I was not convinced at all.
Any ideas about how I could understand the reason behind my low T? I'm sure the doc will have something to say about it, but the more ideas I hear the better. The lowish LH points to secondary hypogonadism to me, so maybe a GNRH injection test, or an MRI to rule out some things?

Also, what do u guys think about the effect lifestyle can have on T? Like sedentary guy with no sex life vs an active person? Is there any data on that?

Your prolactin does not seem excessively high, and high prolactin is often a sign of a pituitary adenoma, so I don't really suspect that's the problem, but an MRI certainly wouldn't hurt. Talk to your doc about it.

Also, when posting labs, ALWAYS include the normal ranges and the units. They differ by lab and by country, so a particular number may mean different things, depending on what the normal range is for that lab. For example, your prolactin is Prolactin 3.24 ng/ml, but how do I know that is high or low without a range to compare it to. For my lab, the "normal" range is 4.0-15.2 pg/mL, so your number falls below the normal range. However, your lab may have a lower end of the range, depending on methodology.

A GnRH challenge test might prove useful to see if your pituitary is responsive to GnRH. One question I forgot to ask is whether or not you've had any head injuries in the timeframe that things started going bad with the T? Head injuries, particularly whiplash, can damage the delicate blood vessel plexus connecting the hypothalamus (part of the brain where GnRH is made) to the pituitary (where it stimulates the release of LH/FSH). A GnRH challenge test might help to narrow the problem organ down to either the hypothalamus or the pituitary.

[Ephemeral]

Your prolactin does not seem excessively high, and high prolactin is often a sign of a pituitary adenoma, so I don't really suspect that's the problem, but an MRI certainly wouldn't hurt. Talk to your doc about it.

Also, when posting labs, ALWAYS include the normal ranges and the units. They differ by lab and by country, so a particular number may mean different things, depending on what the normal range is for that lab. For example, your prolactin is Prolactin 3.24 ng/ml, but how do I know that is high or low without a range to compare it to. For my lab, the "normal" range is 4.0-15.2 pg/mL, so your number falls below the normal range. However, your lab may have a lower end of the range, depending on methodology.

A GnRH challenge test might prove useful to see if your pituitary is responsive to GnRH. One question I forgot to ask is whether or not you've had any head injuries in the timeframe that things started going bad with the T? Head injuries, particularly whiplash, can damage the delicate blood vessel plexus connecting the hypothalamus (part of the brain where GnRH is made) to the pituitary (where it stimulates the release of LH/FSH). A GnRH challenge test might help to narrow the problem organ down to either the hypothalamus or the pituitary.

I've edited my first post with the ranges, thanks for saying. I was under the impression that the ranges given by the labs don't mean much, because it doesn't tell us the sensitivity of the tests, it's just a recommended range to have for a given thing. For example, for E2 the range is 0 - 47 (0 rofl), but upon further inquiry they told me that the test doesn't go below 19.9, and it probably goes way higher than 47.

7.5 years ago I was in a car accident, I headbutted the airbag after a 25 mph - 0 full stop. I can't remember having neck pain or stiffness afterwards, but it's possible that I did have. T was at 650 1.5 years later though, and no other injuries since then.

[Ephemeral]

I fought going on TRT for probdbly 12 years or so. I knew I had low T in my early 20’s but could function fine. Finally sides and now all the research that points to just how terrible low T is for a mans health is, drove me to finally give in. I only wish I would have started it much sooner, I’m your age and just started if this year. My total T was never more that 350 mg/dL even in my early 20’s. Finally it got to be so low I just couldn’t function. It’s made a world of difference now that I have it dailed in.

I'm glad u feel better man, hopefully it's gonna make a difference for me as well. My wellbeing is in the gutter (not just because of this) to the point that it endangers my ability to make a living, so I gotta try what I can.

[kelkel]

Search up some of the threads here regarding Nebido. There are multiple guys here from Europe who have been on it for years and absolutely love it.

[BuddyGlove1]

[QUOTE=kelkel;7352657]

Before you see this doc it may be prudent to call his office and ask one of his staff if he treats TRT patients how you desire to be treated. Such as self-injections, HCG, adex if needed, etc. His staff should be able to answer this so as not to waste your time or theirs with an uneccessary appointment. You also want to know that you'll be treated based on how you feel, not as a number on a chart. [QUOTE]

Awesome advice. I went to several doctors before I was pissed off and went to a clinic. Still looking for a better dr as they don't cover insurance.

[kelkel]

[QUOTE=BuddyGlove1;7353743]

Awesome advice. I went to several doctors before I was pissed off and went to a clinic. Still looking for a better dr as they don't cover insurance.

See if you can submit it yourself. You may get a partial reimbursement. Pain in the ass but may be worth it.

[Ephemeral]

Went to the doc, it was a big letdown, he didn't ask anything beyond the very basics, didn't even look at my BW, he based his decision only on the things that I told him about my T and LH levels etc. He prescribed 25mg clomid a day, and recommended taking more arginine, carnitine, taurine, Q10, Vit C (really dawg?), and said androgel or injection was an option, but he wanted to try clomid first. I didn't push it, which I kinda regret, but I wouldn't want him as my long term doc anyway (I felt like a nobody with trivial problems), and I was thinking about giving clomid a chance. I know you guys think it's not working long term, and it has side effects (I used it once after my var cycle, and I think I had blurry vision, and I developed eye floaters around that time, maybe that was a coincidence, but I def don't want to have more of them). So now I'm not sure if I should shop around for another doc who's not a moron, and waste time and money in the process, or take matters into my own hands. Or maybe I should just take Vit C! Lol.

What do u guys think?

[kelkel]

It can't hurt to try it. Doubtful you'll have side effects at such a low dose.

[Ephemeral]

It can't hurt to try it. Doubtful you'll have side effects at such a low dose.

I might give it a go. Can I have a permanent increase in LH with it, or is it just a temporary fix? I've a seen a couple of threads here with guys whose T got back to previous levels after discontinuing clomid.

[kelkel]

Odds are slim that it would be a permanent bump.

[Ephemeral]

Started clomid yesterday (only 12.5mg), it was pretty bad, headache, bad sleep, but most importantly, discomfort in my right testicle. I wouldn't call it pain, more like an ache. Very similar to what I had before in the past (docs didn't find anything just by manual inspection), it went away over the years until it came back now. I should probably get an ultrasound, I doubt it's something major, but can't hurt to check. So right now I'm not taking clomid until I figure this shit out. Yay.

[Ephemeral]

Did the ultrasound, radiologist said it's probably an inflammation (I feel better now), which explains why I felt like crap for 2-3 days, but otherwise negative (just a minor hydrocele). So now I'm wondering if I should give clomid another chance or not.

Also, I don't know if I should do a brain MRI, my LH and FSH are not extremely low and my prolactin is not high, so I doubt we'd find anything. Or if I should just accept the fact that the reason behind my low T remains forever a mystery.

[Ephemeral]

Update:

6 days after that single dose of 12.5mg clomid I had a BW done. Interesting that total T got higher just from that, but since the half life of clomid is pretty long (5-7 days, right?), it makes sense. LH isn't that higher, so I wonder how that works lol.
The E2 test can't measure lower values than mine, so it's possible that I have low E2. Maybe that's why I have sides? Unfortunately I don't have access to a better lab but I'll keep looking.

Took a baby dose of 7mg yesterday, felt like crap again, like i have the flu. The plan is to run it for around 5 days, and hope that the sides get better, and to rule out possible nocebo effects after my first encounter with this poisonous substance.

TT 16.6 nmol/l (479 ng/dl) 6 - 27
LH 2.6 IU/l 1.2 - 8.2
FSH 4.4 IU/l 1.3 - 19.3
SHBG 47.6 nmol/l 13.3 - 89.5
Cortisol 314 nmol/l 185 - 624
E2 73 pmol/l (19.9 pg/ml) 0 - 172

[kelkel]

Are you taking the clomid at bed time?

[Ephemeral]

Are you taking the clomid at bed time?

Nope, I wanted to see the effects so I took it once in the morning and once early afternoon so far. Both times the headaches persisted the next day, so I doubt it would make a difference, but I guess why not try it, right.

[kelkel]

Exactly. up your fluid intake as well.

[Youthful55guy]

Update:

6 days after that single dose of 12.5mg clomid I had a BW done. Interesting that total T got higher just from that, but since the half life of clomid is pretty long (5-7 days, right?), it makes sense. LH isn't that higher, so I wonder how that works lol.
The E2 test can't measure lower values than mine, so it's possible that I have low E2. Maybe that's why I have sides? Unfortunately I don't have access to a better lab but I'll keep looking.

Took a baby dose of 7mg yesterday, felt like crap again, like i have the flu. The plan is to run it for around 5 days, and hope that the sides get better, and to rule out possible nocebo effects after my first encounter with this poisonous substance.

TT 16.6 nmol/l (479 ng/dl) 6 - 27
LH 2.6 IU/l 1.2 - 8.2
FSH 4.4 IU/l 1.3 - 19.3
SHBG 47.6 nmol/l 13.3 - 89.5
Cortisol 314 nmol/l 185 - 624
E2 73 pmol/l (19.9 pg/ml) 0 - 172

LH and FSH are highly episodic, so it's hit or miss with the blood draw. I would not place much value in the fact they are only small increases.

Why are the units different in your TT with this test (nmol/l) and your previous test (ng/dL). Makes comparisons difficult. I'll take your word that TT went up, which indicates that the clomid is working despite the marginal difference in gonadotropin labs (again, they are episodic).

I wouldn't run the E2 test if you can't get the right one. Bad information with the wrong E2 test is worse than no information at all.

You might want to consider taking the clomid at night. More than half of your daily Gonadotropin secretion is during sleep, so having higher clomid levels at night would probably result in a more pronounced effect for the same dose.

[Ephemeral]

Exactly. up your fluid intake as well.

Will do, thanks for the tips!

[Ephemeral]

LH and FSH are highly episodic, so it's hit or miss with the blood draw. I would not place much value in the fact they are only small increases.

Why are the units different in your TT with this test (nmol/l) and your previous test (ng/dL). Makes comparisons difficult. I'll take your word that TT went up, which indicates that the clomid is working despite the marginal difference in gonadotropin labs (again, they are episodic).

I wouldn't run the E2 test if you can't get the right one. Bad information with the wrong E2 test is worse than no information at all.

You might want to consider taking the clomid at night. More than half of your daily Gonadotropin secretion is during sleep, so having higher clomid levels at night would probably result in a more pronounced effect for the same dose.

I used the same lab as before, but in my first post I converted the nmol/l numbers to ng/dl (including ranges) because I thought that u guys were more used to that metric. This time I thought it doesn't matter, sorry for the confusion.

I agree with u that acting on bad information can cause more harm than good, but I was too curious not to throw in E2 as well. I've found a new lab that uses a similar method (Direct CLIA), but slightly more accurate, measuring range is 11.9 - 3000 pg/ml (with suggested range for males is 0 - 39.8), but I guess that's not good enough either due to the fact that it's inaccurate at the lower part of the range.
Thanks for taking the time to help me guys!

[Ephemeral]

Update:

So I ran clomid 12.5mg ED for a week, felt like crap the whole time (and for a while afterwards), constant headaches, hot flashes, like I had the flu. The only good thing about it was that it seemed like my libido was higher.

3 weeks after the last dose I had a BW (results below), total T increased slightly, LH is a bit higher too, and surprisingly my SHBG is the lowest yet, I guess it fluctuates a lot. My next appointment with the doc is in 2 days, and now I'm wondering if I should try nolva too, since it seemed like I somewhat responded to clomid (my previous BW after that single dose showed a significant increase, up to 16 nmol/l from 10-12), and probably just waste a few months with it, or if I should just do the real thing.

It's pretty annoying coz in a perfect world, where I didn't have my illness and I could have an active lifestyle, it's quite possible that my T would be in the normal range.

A question: In general how long can clomid have an effect on T after discountinuing? Since it has a long half life, maybe for around a month?

Total T 13.6 nmol/l (392 ng/dl) 6 - 27
SHBG 36 13 - 89
LH 3.7 1.2 - 8.2
FSH 3 1.2 - 19
calculated free T 7.2 ng/dl (up from the original 4.5 ng/dl)

[Ephemeral]

Update:

I've been on androgel for a month now (no HCG yet), the 50mg dose didn't do it for me, from day 3 to 8 I felt pretty awesome, but then I got back to my old self, feeling tired all the time and stuff. After 3 weeks my Total T was 11.5 nmol / l (range: 6 - 27, blood was taken 3 hours after applying the gel, that's what the doc wanted), so I upped it to 2*50mg.

I'm gonna ask the doc to switch to cyp plus HCG. Currently I feel alright on 2*50mg, but it's pretty expensive and dealing with the gel is a pain in the ass.

My question is, should I add HCG with the cyp now, or should I wait for another month or 2, to see what the cyp does? What's the longest time one can go without HCG before the testes start to atrophy?

[Youthful55guy]

Update:

I've been on androgel for a month now (no HCG yet), the 50mg dose didn't do it for me, from day 3 to 8 I felt pretty awesome, but then I got back to my old self, feeling tired all the time and stuff. After 3 weeks my Total T was 11.5 nmol / l (range: 6 - 27, blood was taken 3 hours after applying the gel, that's what the doc wanted), so I upped it to 2*50mg.

I'm gonna ask the doc to switch to cyp plus HCG. Currently I feel alright on 2*50mg, but it's pretty expensive and dealing with the gel is a pain in the ass.

My question is, should I add HCG with the cyp now, or should I wait for another month or 2, to see what the cyp does? What's the longest time one can go without HCG before the testes start to atrophy?

My experience is that after about a month you can begin to feel a decrease in size. But I'm sure you can go a lot longer and they would come back. I wouldn't worry about not having HCG in the mix for a long time. It's best to sort out your TRT protocol and then layer in the HCG and/or E control (if the labs indicate it's needed).

I'd push for the T-cyp and not mess with the gels. Way too expensive if insurance doesn't cover it and seems like a pain in the behind to apply (though I've never tried it).

[Ephemeral]

My experience is that after about a month you can begin to feel a decrease in size. But I'm sure you can go a lot longer and they would come back. I wouldn't worry about not having HCG in the mix for a long time. It's best to sort out your TRT protocol and then layer in the HCG and/or E control (if the labs indicate it's needed).

I'd push for the T-cyp and not mess with the gels. Way too expensive if insurance doesn't cover it and seems like a pain in the behind to apply (though I've never tried it).

Yeah the gel was the doc's idea and I didn't mind doing it for a month, but now it's time for the real deal. Thanks!

[Ephemeral]

Update:

Had my 2nd subq enanthate injection today (cyp was not available). My protocol is 100mg T a week total (43mg E3D), no HCG yet. I think I hit the abs with it, I used a 29g 12.5mm needle at a 45 degree, but it was still deep enough. It was a bit painful, and the pain lasted for a few hours but not too bad.

Unfortunately a separate 8mm needle is hard to find, I only got one that comes with the syringe together. Do u guys have any sources for that? So the plan now is to draw with 30g 8mm syringes from the 1 ml ampoule (with my dose I can fill 5 syringes from 1 ml), and recap them for later use. That's safe enough, right? It's gonna take a long ass time to draw, but at least with these built together things there's almost zero waste of T.

[Youthful55guy]

Update:

Had my 2nd subq enanthate injection today (cyp was not available). My protocol is 100mg T a week total (43mg E3D), no HCG yet. I think I hit the abs with it, I used a 29g 12.5mm needle at a 45 degree, but it was still deep enough. It was a bit painful, and the pain lasted for a few hours but not too bad.

Unfortunately a separate 8mm needle is hard to find, I only got one that comes with the syringe together. Do u guys have any sources for that? So the plan now is to draw with 30g 8mm syringes from the 1 ml ampoule (with my dose I can fill 5 syringes from 1 ml), and recap them for later use. That's safe enough, right? It's gonna take a long ass time to draw, but at least with these built together things there's almost zero waste of T.

I get all my syringes from Total Diabetes supply: https://www.totaldiabetessupply.com/...355_a_7c328280.

Good prices and fast home delivery. I usually use 28G 1/2 inch (12.7 mm) one piece insulin syringes. Works great. I don't do subcutaneous. Just inject into the upper outh quad. Been doing it this way for over 6 years. Works great.

[Ephemeral]

I get all my syringes from Total Diabetes supply: https://www.totaldiabetessupply.com/...355_a_7c328280.

Good prices and fast home delivery. I usually use 28G 1/2 inch (12.7 mm) one piece insulin syringes. Works great. I don't do subcutaneous. Just inject into the upper outh quad. Been doing it this way for over 6 years. Works great.

Thanks, unfortunately they don't sell needles, however I've found a source for 30g 8mm, I might use that. The ideal combo would be 28-29g 8mm for me, but of course no one makes that (since there's no market for it).
I try to avoid IM if I can help it coz of the discomfort, possible scarring and hitting veins, not a big deal but it might add up over a lifetime.

I have my first bruising + lump from a belly subq, hopefully it goes away in a few days. I might try subq in the leg, but I seem to have very little fat there, lol.

[Youthful55guy]

Thanks, unfortunately they don't sell needles, however I've found a source for 30g 8mm, I might use that. The ideal combo would be 28-29g 8mm for me, but of course no one makes that (since there's no market for it).
I try to avoid IM if I can help it coz of the discomfort, possible scarring and hitting veins, not a big deal but it might add up over a lifetime.

I have my first bruising + lump from a belly subq, hopefully it goes away in a few days. I might try subq in the leg, but I seem to have very little fat there, lol.

Why do you want to use a two piece syringe? I've used one piece units for over 6 years. makes the whole process a lot easier to draw and inject with one needle.

[Ephemeral]

Why do you want to use a two piece syringe? I've used one piece units for over 6 years. makes the whole process a lot easier to draw and inject with one needle.

Two reasons, it takes forever to draw with a 30g and it might be more sterile to switch needles just before injecting, instead of storing the one piece recapped for a week or two (the latter reason is probably pretty insignificant).

[Youthful55guy]

Two reasons, it takes forever to draw with a 30g and it might be more sterile to switch needles just before injecting, instead of storing the one piece recapped for a week or two (the latter reason is probably pretty insignificant).

There's a much higher chance of contamination with the two needle method of drawing and injecting, though it is probably negligible if you use clean technique. I can draw up 0.25 mL (my current dose) in less than a minute with a 28G needle. I occasionally use a 30G and it's not a lot longer, maybe 2 minutes at the very most. Given the simplicity of the one needle method, I much prefer it, but everyone has their preferences. My motto with TRT, is that if it's not broken, don't much with trying to fix it. I tell my doc that every year when she suggests I try the gel.

[Ephemeral]

There's a much higher chance of contamination with the two needle method of drawing and injecting, though it is probably negligible if you use clean technique. I can draw up 0.25 mL (my current dose) in less than a minute with a 28G needle. I occasionally use a 30G and it's not a lot longer, maybe 2 minutes at the very most. Given the simplicity of the one needle method, I much prefer it, but everyone has their preferences. My motto with TRT, is that if it's not broken, don't much with trying to fix it. I tell my doc that every year when she suggests I try the gel.

Hm I didn't know that about the 2 needle thing, but makes sense if I touch it at the wrong place or something. Also, luer-lock is not available here, only luer-slip, and things can go wrong when I try to take the first needle off, so I think I'll just stick with the 1 piece.

Speaking of the gel, I felt better on it. Maybe it's early to tell, but it's been 3 weeks now with the injections. I'll be curious to see my first BW. Also, enanthate kinda stings when I inject it (sticking the needle in is painless), do u have that with your IM cyp shots?

Thanks again for helping, I always learn something new from your comments.

[Youthful55guy]

Hm I didn't know that about the 2 needle thing, but makes sense if I touch it at the wrong place or something. Also, luer-lock is not available here, only luer-slip, and things can go wrong when I try to take the first needle off, so I think I'll just stick with the 1 piece.

Speaking of the gel, I felt better on it. Maybe it's early to tell, but it's been 3 weeks now with the injections. I'll be curious to see my first BW. Also, enanthate kinda stings when I inject it (sticking the needle in is painless), do u have that with your IM cyp shots?

Thanks again for helping, I always learn something new from your comments.

Correct regarding the higher chance of contamination with the two piece system. Though, if you are careful, the risk of infection should be minimal, just less of a chance of things going wrong with a one piece.

No Pain from T-cyp when I use it at 100%. However, I use a blended T-cyp/T-prop, and I do get some residual dull pain from T-prop. This is a well known phenomena with T-prop. It's discussed in many forums. I have no experience with T-eth. I do find that occasionally, if I go in at an angle, or I simply hit a nerve ending, there can be some minimal and temporary stinging.

[Ephemeral]

Update:

It's been 5 weeks since I'd switched to 100mg / week injections (43mg E3D), and the latest lab results are in (blood taken just before injection). Total T is only 14.4 nmol/l (6.1 - 27.1), but SHBG is improved from 44 to 26.5 (13 - 89).
Estradiol is fine but it's not the sensitive type, so who knows. Everything else seems to be normal, my RBC and hematocrit was low before TRT and now it's in range, so that's a good thing.

In 2 days I'll have an appointment with the doc, and we'll start adding HCG, I'll ask for around 750 IU per week. My question is, given my poor total T, should I increase the 100mg T now, or should I wait to see how HCG is gonna affect it? I doubt it will give me enough of an increase since I'd like to keep T at the higher end of the healthy range. If I decide to wait, should I give it another 6 weeks before a BW?

In terms of how I feel, the high dose gel was much better, no question about it.

[Youthful55guy]

It would have been a lot easier if they tested for Free T using the direct method. Then we could compare that number to the normal range to see how you are actually doing in bioavailable T.

As it is now, I see you about mid-range in Total T and in the lower 33% of the SHBG range, so I would anticipate that Free T would be quite good, but we have no direct measurement to confirm this. I do not recommend dosing based on Total T.

At this point, I'd probably layer in the HCG and then retest in 6 weeks for Total T, Free T (both direct method, not calculated free T). I'd also retest for E using the correct sensitive method. I doubt that the HCg will have that great of an influence of Total or Free T, but it might bump it up a little.

I think a more important thing for you to do is press them to ALWAYS test for Free T, not just Total T, and to use the correct E test.

[Ephemeral]

It would have been a lot easier if they tested for Free T using the direct method. Then we could compare that number to the normal range to see how you are actually doing in bioavailable T.

As it is now, I see you about mid-range in Total T and in the lower 33% of the SHBG range, so I would anticipate that Free T would be quite good, but we have no direct measurement to confirm this. I do not recommend dosing based on Total T.

At this point, I'd probably layer in the HCG and then retest in 6 weeks for Total T, Free T (both direct method, not calculated free T). I'd also retest for E using the correct sensitive method. I doubt that the HCg will have that great of an influence of Total or Free T, but it might bump it up a little.

I think a more important thing for you to do is press them to ALWAYS test for Free T, not just Total T, and to use the correct E test.

Unfortunately direct free T is not available here, neither is sensitive E2. I'd have to travel to another country (or send my blood somehow) to get those, and it would probably cost a lot.

An online calculator (that takes total T, SHBG and albumin) puts my free T at 9.12 ng/dl, which is not great but not terrible either. I'd like to be above 15 at all times, but 12 the very least (assuming I don't run into any problems).