New Labs

[AZ4Stringer]

I am 43 years old and have been on TRT for about 3 years. I am thankful for finding this forum and have been lurking for some time, searching through the wealth of information.

Before TRT, my test level was 232 and 197 tested about 3 months a part. Symptoms were no energy or drive, low libido, tired, falling asleep after dinner and some ED. Urologist put me on 1 tube of Testim which worked great for about 6 weeks then I started getting a really bad rash so I had to discontinue. I went to Test cyp injections 200mg every two weeks. I started crashing before the next shot and after doing some Internet searches I found weekly shots are best.

I spoke to my GP about this and he agreed that weekly shots are better. He seems more up to date on TRT and told me to try 200mg every week and get blood work done after 8 weeks.

My most recent blood work taken 3.5 days after the shot:

Serum Estradiol 3.0 ng/dL range .8 - 3.5
% Free Estradiol, 3.4 range 1.7 - 5.4
Free Estradiol Serum 1.0 range .2 -1.5
SHBG 22 range 20 - 60

Total Testosterone 1130 ng/dL range 350-1030
% Free Testosterone 2.9 range 1.5 - 3.2
Free Testosterone 328 pg/mL range 52-280

I feel pretty good other than I am still experiencing some ED, morning wood is intermittent and spontaneous erections are nil. From my recent blood work, it looks like my Estradiol is high and causing the ED issues. My GP liked these numbers and liked seeing my test level at 1130 at the mid point.

I tried doing 120mg per week along with 250IU of HCG on days 5 and 6. For the first four weeks I felt great and had the best sex with my wife, morning wood and spontaneous erections. But after week 4, I did not feel as good and the ED returned with a vengeance. I couldn't get it up if Catherine Zeta-Jones sat in my lap naked. Frustrated, I went back to the 200mg per week protocol. Again, I think the HCG increased my Estradiol way too much after 4 weeks.

I am thinking about going back to 120mg per week and try HCG at a lower dose of 150IU on days 5 and 6. I now have some Liquidex on hand.

Any advice or thoughts would be greatly appreciated. I am just trying to get this dialed in like a lot of guys. I think I am getting close. My GP seems pretty flexible and will work with me as long as I do regular blood work.

Thank you.

[chilln]

Urologist put me on 1 tube of Testim which worked great for about 6 weeks then I started getting a really bad rash so I had to discontinue.

Bummer that. Not because of the rash, but because your medical professional adviser initially missed the whole testicular contribution to testosterone.

Provided our testicles still function when stimulated by LH and FSH (which is true for most of us) then we should really be boosting our testosterone predominantly via stimulation of the testicles, using subcutaneous injections of HCG, and the additional testosterone or gel is icing on the cake.

It is not true to say that we should start out on testosterone and add HCG when our testicles start shrinking.

Our testicles are major contributors to our pregnenolone, progesterone, androstendione, and a plethora of other hormones. Just because their names are not "testosterone" doesn't make them useless hormones. They are indeed critical. We didn't evolve them just so we could make testosterone.




I went to Test cyp injections 200mg every two weeks. I started crashing before the next shot and after doing some Internet searches I found weekly shots are best.

Your dose was only that high because you're not supplementing with HCG. Assuming your testicles still function when stimulated by LH and FSH, then you should be supplementing with HCG, so your testosterone ester dose should be lower.



I spoke to my GP about this and he agreed that weekly shots are better. He seems more up to date on TRT and told me to try 200mg every week and get blood work done after 8 weeks.

Again, missed the HCG connection at this point.



My most recent blood work taken 3.5 days after the shot:

Serum Estradiol 3.0 ng/dL range .8 - 3.5
% Free Estradiol, 3.4 range 1.7 - 5.4
Free Estradiol Serum 1.0 range .2 -1.5
SHBG 22 range 20 - 60

Total Testosterone 1130 ng/dL range 350-1030
% Free Testosterone 2.9 range 1.5 - 3.2
Free Testosterone 328 pg/mL range 52-280

I feel pretty good other than I am still experiencing some ED, morning wood is intermittent and spontaneous erections are nil. From my recent blood work, it looks like my Estradiol is high and causing the ED issues. My GP liked these numbers and liked seeing my test level at 1130 at the mid point.

Your body is trying hard to dump this much testosterone. That's why your estradiol is so high, and why your SHBG is at the bottom of the scale. These are two telltale signs that your body prefers lower levels of testosterone.

That doesn't mean to say that your body is right, but I would start out by discussing with your medical professional adviser, to experiment with a lower overall dose of testosterone boost, to see if simply lowering the overall testosterone boost by a little (say by 15%) experiences a much larger decline in excess E2 (estradiol) (say by 40%)

That may be your sweet spot.



I tried doing 120mg per week along with 250IU of HCG on days 5 and 6. For the first four weeks I felt great and had the best sex with my wife, morning wood and spontaneous erections. But after week 4, I did not feel as good and the ED returned with a vengeance. I couldn't get it up if Catherine Zeta-Jones sat in my lap naked. Frustrated, I went back to the 200mg per week protocol. Again, I think the HCG increased my Estradiol way too much after 4 weeks.

It's not the HCG which is solely responsible for the E2 increase - it's the combined contribution of both the testicular-testosterone-increase-triggered-by-HCG, plus the injected testosterone ester.

Again, your body is fighting the excess testosterone, first try reducing your overall testosterone boost. Discuss with your medical professional adviser, to aim for more boost from HCG than testosterone ester, to improve the range of testicular hormones.



I am thinking about going back to 120mg per week and try HCG at a lower dose of 150IU on days 5 and 6. I now have some Liquidex on hand.

Any advice or thoughts would be greatly appreciated. I am just trying to get this dialed in like a lot of guys. I think I am getting close. My GP seems pretty flexible and will work with me as long as I do regular blood work.

Thank you.


I think you should discuss with your medical professional adviser, to aim for more boost from HCG than testosterone ester, to improve the range of testicular hormones.

Also, You really do need to space out your HCG contribution to your weekly testosterone. You want those testicular produced hormones to be available all day every day - not just towards the end of the week.

The testosterone esters should just be "icing on the cake", so to speak.




I am 43 years old and have been on TRT for about 3 years. I am thankful for finding this forum and have been lurking for some time, searching through the wealth of information.

Awesome, and glad to hear it!

We're looking a little low on funds this month, any small donation would be most welcome.

[AZ4Stringer]

Thank you Chillin for your knowledgeable response.

Chillin: "Your body is trying hard to dump this much testosterone. That's why your estradiol is so high, and why your SHBG is at the bottom of the scale. These are two telltale signs that your body prefers lower levels of testosterone."

I completely agree this is my case.

Chillin: "Also, You really do need to space out your HCG contribution to your weekly testosterone. You want those testicular produced hormones to be available all day every day - not just towards the end of the week.

The testosterone esters should just be "icing on the cake", so to speak."

Absolutely makes sense. I am going to start on the 120mg per week and HCG protocol again once I acquire some more HCG. I will work with my GP on this and he will have no issue running the same blood work after 6-8 weeks of starting the new protocol. My GP is much easier to work with than my Urologist, also I have a good realationship with my GP.

The reason I was doing the HCG injections at 250IUs on days 5 and 6 was due to reading Dr. Crisler's updated HCG protocol. Should I stay with 250IUs of HCG or drop the dosage a little to keep aromatase activity in check. My last experience with HCG seemed to elevate my aromatase activity thus the difficulties encountered around week 4. I tend to respond strongly to medications in general and usually require taking a lower dose than normally prescribed to most people.

Chillin: "We're looking a little low on funds this month, any small donation would be most welcome."

Done. This is the most knowledgeable and helpful forum I have found regarding TRT and anti-aging topics combined with real world experiences.

Side note: I was almost completely bald on the top of my head before TRT. Since I have been on TRT, I noticed that my hair is growing back. Not a lot but definately thicker with a lot of peach fuzz. I believe this is due to lower DHT levels since being on TRT.

[JanSz]

You have got excellent advice from chilln.
my 2c

With SHBG=22 (on average) (with totally shut down testis) your replacement dose of testosterone is around 140mg/week

Everytime you are able to induce testis to produce testosterone, that should require less of external test.

HCG & T are best when applied daily or E2D, more frequent are conducive to keep E2 lower, less frequent raise E2.
HCG-250iu/EOD is good starting dose

Choice between transdermal or injectable testosterone depends on your DHT status.

It is good and hardly cost anything to keep DHEAs(500-640), but good benefits.

Any change in schedule should be followed with blood testing around two 2 -3 months latter.

These tests, done at Quest Diagnostics should cover the topics discussed.

25 Hematocrit
42 DHEA sulfate
48 Estradiol, Ultrasensitive, LC/MS/MS (30289X)
50 Testosterone, Free, Bio/Total (LC/MS/MS) Code: 14966X
51 Dihydrotestosterone (204X)

Goals:

Hematocrit<50
DHEAs(500-640)
E2(25-29)
BAT(460-575)
DHT(60-90)
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[AZ4Stringer]

Thanks JanSz.

Great advice from those most knowledgeable and have been there.

JanSz: "With SHBG=22 (on average) (with totally shut down testis) your replacement dose of testosterone is around 140mg/week."

Is the 140mg per week with HCG or without? I assume with HCG from your response. How did you come up with 140mg per week from my SHBG of 22? Not questioning your knowledge in anyway, just curious for a better understanding :)

JanSz: "It is good and hardly cost anything to keep DHEAs(500-640), but good benefits."

I will have DHEAs tested with my next blood work in about 2-3 months. If I test low on DHEA, supplement with regular DHEA?

Thank you again gentlemen for your responses and sharing your knowledge. I have HCG on order and will start with the 140mg per week of T with HCG protocol once the HCG arrives. Also, I do have some Liquidex on hand just in case. I see my GP in a couple of weeks and I will let him know what I am doing. Blood work in 2-3 months

The last time I used HCG my testicle size came back pretty quickly. I am really looking forward to that and just feeling better overall :)

[JanSz]

Thanks JanSz.

Great advice from those most knowledgeable and have been there.

JanSz: "With SHBG=22 (on average) (with totally shut down testis) your replacement dose of testosterone is around 140mg/week."

Is the 140mg per week with HCG or without? I assume with HCG from your response. How did you come up with 140mg per week from my SHBG of 22? Not questioning your knowledge in anyway, just curious for a better understanding :)

JanSz: "It is good and hardly cost anything to keep DHEAs(500-640), but good benefits."

I will have DHEAs tested with my next blood work in about 2-3 months. If I test low on DHEA, supplement with regular DHEA?

Thank you again gentlemen for your responses and sharing your knowledge. I have HCG on order and will start with the 140mg per week of T with HCG protocol once the HCG arrives. Also, I do have some Liquidex on hand just in case. I see my GP in a couple of weeks and I will let him know what I am doing. Blood work in 2-3 months

The last time I used HCG my testicle size came back pretty quickly. I am really looking forward to that and just feeling better overall :)

How can you say:
"Is the 140mg per week with HCG or without? I assume with HCG from your response."

When two lines above I said:
"(with totally shut down testis) "
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I suggest that you start with getting your
DHEAs(500-640)

next use HCG (without external testosterone).
Establish your best HCG dose
and then go from there,
add testosterone on as need basis.

If your testis will produce anything, your need for testosterone (injections) should be (on average) less than 140mg/week, assuming your current SHBG level (big assumption).

Note that depending on your DHT status, you may need transdermal testosterone (not injectable).

Everything, at least on the beginning, will vary widely, after you change any element in your schedule, wait 2 months, do blood test, evaluate, make adjustments per goals. I posted goals in previous post.
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