Here is a shot at a few of these questions : others will probably chime in with their take on some these topics before I post this. Most of the answers should be similar since we all read stuff off this forum. It will take a while for you to absorb all this. If you are going to be in TRT, you might as well start now. Also, no such thing as a perfect answer since the human body is pretty complex.
So even on Cyp ester, you think 2x per week is better To stabilize more consistent levels ... I deduce.
Yes, levels are more constant: T level does not peak as high or drop as low. There are actually pros and cons to each approach. I like to keep my levels more constant. As your T level rises and drops, you will see more estrogen production. Estrogen production seems to be more linked to the change in T level as opposed to the absolute level. In my case, I have trouble controlling E2 if I let my levels rise and fall.
By "trouble" I mean that my E2 goes out of range on the high side on blood tests. For example, if the preferred range for E2 is like 20-40 ... I end up with blood tests with E2 in the 60+ range. I hit 90 once. Do I feel any symptoms from this ... no, not really. I do start to get some acne, this is a sure sign for me that the E2 is drifting up. I have also taken too much AI and dropped my E2 into the single digits. Do I feel any symptoms from this ... only once, my joints felt like they were on fire for about a day. If this happens, you make a small adjustment and all is well.
Letting your levels rise and fall does have some advantages. First, this is kinda what the body does, the body does not keep your T level at 800-900 day and night. Second, red blood cell production is reduced (Iron ... hemoglobin, hematocrit). Keeping levels high all the time cranks up red blood cell production big time. Some people are worse than others. Some folks basically can't be on TRT - blood gets too thick, too fast. I saw a post from one guy - he had to donate more than once per month and can't even stay in the normal range for hemoglobin, hematocrit. I have to donate every 2 months and just barely keep things under control. If I were to let my T levels drop a bit, I might see some relief on the red blood cell production - but it comes at the expense of estrogen control.
How does my bodyfat play a role in strozole dosage?
Males do not have a gland/organ (like ovaries) to produce estrogen. Instead males convert testosterone into estrogen. This is done by the aromatase enzyme that is generally stored in or is part of fat cells. So the higher you push your testosterone, more aromatization and more estrogen. You can't stop this -> more testosterone = more estrogen. Plus, the more fat cells you have, the more aromatase enzyme in the system ... and therefore even more estrogen is produced. This is why we always ask about body fat. This is why body builders typically do not recommend running huge amounts of testosterone when you are overweight, because you can't control estrogen levels. Of course this is just a rule of thumb kind of thing, everyone is different. Some people don't aromatize much, others do -with wide ranges of body fat.
What is the benefit of the HCG & Strozole at the same time; why would a Doc Rx both? ... What does HCG do to your/my Estrogen?
So Human Chorionic Gonadotropin (HCG) and an AI like Anastrozol(Arimidex) are two totally different things - opposites really. HCG basically stimulates your own natural T production. The testes get two "signals" to turn on T production ... FSH and LH. HCG basically mimics LH and stimulates the leydig cells in the testes. When you take testosterone, your body sees it. It turns your natural T production off. So both FSH and LH basically go to zero. Your testicles shrink. Your natural production T pretty much ceases. This can affect fertility and have other side effects. HCG at least partially turns on your natural T production, keeps the testes going, helps with fertility and good things like that. Like anything else this is both good and bad. Also, it's only partially turning on your natural production since HCG only mimics LH. There are other compounds that mimic FSH like hMG (human Menopausal Gonadotrophins) - less common, it's typically used for fertility issues.
So what is the down side to HCG (and there is always a down side) ? - aromatization. HCG causes more aromatization ... something about the stimulation of those leydig cells can cause a nice spike in estrogen. I have trouble controlling E2 when taking HCG.
If you took test only and your peak T level was 1100 ... and then added HCG and your natural production was like 300 -> you might see T levels of 1400+ on your next blood test (I did). This is not ideal, you can't feel anything "extra" from being at 1400. More likely, T levels like this will just cause you more side effect (like estrogen raging out of control).
As for the AI, it's intended to reduce your E2 from the elevated T levels and also the extra bonus effects of HCG, extra T and a nice spike in E2. You are shooting for E2 around 20-25 ... this is not so easy to do. If you overshoot on the AI, you crash your E2 - and feel like crap. Too little AI and your estrogen will be too high - this is also bad in the long term. You may see some acne, but ultimately you could actually start to develop ... female features like breasts. So we don't want to go there either. You don't need to make your self crazy over this ... but you do want to get dialed in within some reasonable time frame.
You said,"I think we can assume at this point that your test levels are good and solid." Do you know of poor quality or "bunk" T coming from Pharmacies through the legal HRT
This was a bit of sarcasm. The T from compunding pharmacies totally legit - not bunk at all, it's pharmacuitical grade medication prescribed by a doctor. Pretty much as good as it gets - plus you got HCG as well. Some folks don't really respond to testosterone injections (their levels are lower than expected give the dose they take). In your case, your T levels are probably huge, perhaps even off the scale for typical blood test (some blood tests can only measure so high - so the T level comes back as >1400 or something like that). Basically, you are almost running a cycle like you see in the bodybuilding forums. But this is OK for now. You just started, and your doc has cranked your T levels up big time. Let's just see what the T can do. Let's just say, your doc did not go at this half way. Nope, he/she went all in. You want to know what happens when you crank the T levels up well above the normal range, well you are about to find out. One day you will want to cut this back, because your protocal is probably more than is needed and could cause some unnecessary long term issues. Again, let's not worry about that for now.
Like you have read from many posts, the effects from T are kinda glacial. You may not feel much for a while. Even though you are totally juiced. Most people start to feel better, but it's slow. Hopefully, it will just happen. One day you will suddenly notice that you feel OK. Hopefully it will get better from there.
If I were to try .5mg strozole every 2 or 3.5 days like those recommended before you, can I just pour a half cap sublingual?
Yes, it does not matter how you swallow it. Dump half into you mouth (or dump it into a glass of liquid) and swallow it. Not ideal, that it's in capsul form, but this is what I would do.
Exercise ... but I developed a horrible tennis elbow
Been there done that. Not fun at all - no sir. Do what you can. Work everything else. You know what they say. The weight does not care about your excuses. So you get in there and move some weight. Work around the tennis elbow if possible. I found there were certain movements I could do (no way I could curl with a bar) such as hammer curls with a dumbell. Does not matter whether you use a machine or very light weights. In fact, I'm a pretty big fan of keep the number of repetitions higher than 15. Pick up a light weight and do 30+ reps until the muscle is burning. Increase the weight and do a set of 25 ... and so on. Get those muscles pumped full of blood until you feel like the skin is going to rip and you want to die - and then repeat. I find that if I keep the weight reasonable, the joints don't mind. I'm not saying to never lift heavy. But when you are older like me, the joints don't like it. So I do what I can. Keep the reps higher, protect the joints, only do those exercises that don't aggravate the joint in question, watch the form, no slouching or hunching over, no wild ass jerking movements or crazy cheating to lift weights that are just way too heavy. When I go the gym, I see a lot of this. A bunch of you kids trying to lift way too much weight, cheating, looking like idiots - but they are young and can get away with it (like I did when I was young). Older guys can't do this - so your only option is to increase the reps. Does this still work - yep. Can you add mass doing this - yep, you sure can.
The tennis elbow will go away. Mine took many months of effort and it's still not quite 100% perfect. If you can't really do anything at all, I would go to a physical therapist of you can swing the cost. I went to a physical therapist for about 2 months and he gave me a bunch of silly looking exercises to do. Did they fix the problem, they sure as heck did. Mostly stability type things. Simple movements using a large ball or bands/straps. Slowly but surely, the pain got better.
Yes, you would want to order the "Hormone Panel for Females". This can be ordered by males and females. Look for coupons, total cost like less that $60. This will give you pretty much all that is needed. Does not include "Free T" but I don't care about this. I typically want to see total T, Estradiol and hemoglobin, hematocrit (part of the CBC). Once you are dialed in, you won't need to run blood tests that often. Certain states don't allow this kind of testing (NY, NJ, RI, MA or MD) hopefully you can use their service.
So your doc has no plans on following for 6 months to a year - holy crap. First of all, I love your doc, huge protocol, hands off, life is good. Seriously, I really love him/her. But you need to get on top of this. This shit is not going to manage itself.
You have some flexibility on timing. I would switch to 0.5 AI right away. I was already at 17.5 hemoglobin within 2 months of going on TRT. My best guess is that you will be also. Why not just run the lower AI dose for two weeks and then get the female hormone panel and see what is going on. This will give you enough data to figure out whether or not it is time to donate blood.
By the time you see your doc, you will be dialed in. You will be able to present him/her with nice orderly blood work. No levels off the charts. He/she will then give you the same prescription for the same dose and you will manage it all from your end - and life will be good. Honestly, you will probably want to back things down by then. There is just no reason to be waking around with T levels at 1400+ on a daily basis. No good can come from this. But let's just get your symptoms under control so you are feeling good first.
