Advice on adding A1 to TRT

[one way step]

Hello all,

A quick background; I have been on TRT for several years. At first it worked well but then it lost its touch. For the past several years I have been trying to find a right TRT regimine with minimal success. I have taken various doses of test cyp and HCG.

Right now I am seeing a new endo and he suggested that I drop the HCG. Prior to seeing the endo, I was taking 200mg test and 2500iu HCG from my original endo (outrageously high HCG dose, I know). He also gave me Arimidex to take. I got BW while I was there and my test was at 480 and my e2 was "okay" (in my doctors words).

The doctor has put me on 250mg test cyp per week and 1mg arimidex per day.

Two things;
1) Based upon reading this and other forums, the 1mg daily of arimidex seems very high. What would be a more appropriate dose for 250mg test a week?
2) The biggest issue that I have had with TRT is with my sex drive. It seems that I can never really get it to where I want it to be, and most of the time during this journey my libido has been either very low or non-existent (thank god for Cialis). It is obviously very frustrating. Is there anything I should add to test cyp and arimidex to improve it?

Both my old and new endo seem to be offering the same suggestions that haven't worked.

Thanks all

 

[hiram1st]

Was this bloodwork a peak or trough reading?

Do you self inject?

If you do you can split it into 2 injections 125mg e3.5d. Monday morning and Thursday evening alot of us do that. That will make your hormone levels more balanced instead of big swings from peak to trough.

He didn't tell you what your e2 reading was? If not request it and post it here.

The adex is to high. Without knowing what your e2 was of your old protocol I wouldn't do more than .25mg e3d to start get blood work and see where e2 is in 6 weeks.

You can get it yourself online privatemdlabs. Get the female hormone panel that will give you your e2 and tt. This e2 is the regular essay which is 10 to 20 higher than the sensitive essay.

The sensitive essay is what alot of the guys use cause its geared for males. That is a separate test you have to add also from privatemdlabs labs.

I've used them several times dialing in my protocol it's been a valuable tool.

Good luck

 

[Megatron28]

Please post your blood work results.

 

[theheat]

The 200mg/week dose of test is on the higher end and should have raised your TT higher than 480, never mind that HCG dose. 1,000 IUs of HCG 2x per week is a typical monotherapy dose. Most people are on 250 IUs 2x per week, but I've read that 500 IUs 2x per week is ideal to maintain fertility. The Adex dose us very high, and a typical dose for 200mg/wk test would be .5mg 2x per week or .25mg EOD. Of course, that's highly dependent on your BW, and it often takes time to get the optimal doses of T, HCG, and Adex dialed in. As far as your libido, if one thing is off, it can have an adverse effect, and low as well as high e2 can decrease your libido. At that dose of Adex, I suspect low e2 might be your problem, as you shoildn't have low T with that dose, but BW should be your first step. Don't drop any of the meds arbitrarily, as they all play a key part, just adjust the dosages to get yourself dialed in.

Keep in mind that it's a gradual process and it may take months to get all your hormones at the optimal level. Other things might be effecting your libido as well, like low dopamine, high seratonin, high prolactin, depression, lack of sleep, stress, thyroid issues, etc, but that's a whole other topic of discussion. You have to narrow down the most likely causes and eliminate them until you achieve your desired results. Even then, your libido may not be what it was during your glory days. You may have a certain level of libido in mind from your youth, but you can't always replicate that with a pharms, but that doesn't mean you shouldn't try.

I also wanted to say that I'm shocked at how variable some people's dosages are depending what Dr they see (endo, urologist, TRT specialist, etc). Some people end up with ridiculously low dosages, and other have one or two meds that are too high. I never realized what a crap shoot it was as far as TRT. There's also no substitute for knowledge, so read everything you can about T so you can make educated choices about your health. Don't always rely on one doctor's opinion, and if their protocol isn't working for you, then see someone else.

Good luck, and keep us posted as to how you're doing.....

 

[SJC]

250mg of Test a week should make you feel great...should

1mg adex ED is to me crazy for that amount of test.

Like Hiram said .25mg twice a week should be plenty. I'd actually get bloods done asap just to see what is going on with your test and e2. Private labs can get you results usually in 2 days. My doc is useless and I do everything myself. I just use him for the scrip.

 

[IMT staff]

Ive never had steak sauce with my TRT

 

[halfwit]

Ive never had steak sauce with my TRT

LMAO! I was thinking the same thing, hahahaha.

OP: Blood work will determine what and how much you need. FYI it's AI (Aromatase Inhibitor) . 1mg of adex a week is a ton for most, but if you have significant body fat, it may be a good fit for now. I'm really surprised that 200mg/wk puts you lower than me, you're either a HUGE sob, or really REALLY unlucky.

Welcome to ology!

My .02c

 

[one way step]

Thanks for all the advice everyone!

i have the endo tomorrow so i will get my BW results from the last visit (12/30). i will also discuss the AI (not A1 lol) and HCG with him. I still have an AI script from my original endo.

Idk why my test is 480 with 200mg/wk. I am 6'1" and 175lbs. But naturally, I definitely want to get this under control. Idk why the fuck I have been having such a problem with this.

Do you think 250mg test once a week and .25 AI twice a week would be a good start? Would it be worth it at this point to add any HCG into this equation or should I just try it without HCG at first?

 

[theheat]

Definitely do the 250mg of T with 250 IUs of HCG 2x a week, unless you want your balls to shrink. Take the .25mg of Adex 2x a week when you do your HCG.

 

[one way step]

Here are the numbers of my last BW (12/30/14). I had new bloods drawn today and will post those when I get them next week.

TSH, Ultrasensitive 2.40 uIU/ml
Free T-4 1.15 ng/dl
T-3 Uptake 37.5%
T-3 (Total) 1.14 NG/ML

LH <0.1 mIU/ml
Prolactin 5.6 ng/ml
Estradiol, serum 40 pg/ml
Testosterone 490ng/dl

I asked my doctor why my test was so low at 200mg per week (plus HCG), and he said that the 490 number "was normal." I asked about the estradiol being so high and he said it was likely from the HCG and shouldnt be causing the lack of sex drive I'm experiencing.

Clearly my doctor is of very little help to me.

I'm ready to try 250mg test per week, 250iu HCG 2x per week, and .25 Arimidex twice per week.

A few questions;
1) Is the estradiol the likely culprit for my low sex drive?
2) What benefit would I receive from adding the HCG, aside from testicular size preservation?
3) Would it be wise for me to increase arimidex to .5 twice per week, or would that send estradiol too low?
4) What else could be a physiological cause from a shitty sex drive? Again I am 6'1" and 175lb
5) Once implemented, how long would you think it would take to take effect?

Thanks for all the help all! It's frustrating that my new endo and original endo have been so unhelpful.

 

[Mprtz]

This is 490ng/dL ONE WEEK after a 200mg injection? That is pretty unusual, especially for an average size guy.

Are you sure there isn't some misunderstanding somewhere regarding the dose? Maybe "200mg" refers to the concentration and you are getting less than 1mL in your shot?

 

[one way step]

That's from a steady 200mg test cyp per week dose, not just a one week shot. I've been on 200mg test cyp per week and HCG for a while (1.5 years)

 

[Megatron28]

That's from a steady 200mg test cyp per week dose, not just a one week shot. I've been on 200mg test cyp per week and HCG for a while (1.5 years)

How many millileters are you injecting? How many milligrams does your bottle of test say each milliliter has in it?

 

[one way step]

View attachment 560237

I use this vial and take 200mg out of it per week for my shots. I get 10 doses out of it.

 

[Megatron28]

View attachment 560237

I use this vial and take 200mg out of it per week for my shots. I get 10 doses out of it.

So you draw one ml? Just making sure.

 

[one way step]

Correct. Sorry I'm a little unfamiliar with some of the numbers.

 

[theheat]

Your e2 of 40 isn't overly high, and at that level it shouldn't be causing decreased sex drive. I would start out at a low dose with Adex (.25mg 2x week)/and do more BW in 4-6 weeks. .5 mg 2x a week will probably crash your e2 since you're really not that high. Definitely use the HCG. 250 IUs 2x a week is a typical dose.

I didn't see your ranges, but low bioavailable T might be your problem. It doesn't matter how high your total T is if your body can't use it. If you have high SHBG and low bio/free T, you might want to consider Danazol or Proviron.