HRT 101 - Introduction to HRT

TR90125

New member
While killing time on the internet, I found this information on a male hormone replacement therapy website. I am not posting this information as gospel, nor am I promoting any specific company or website, but I thought this basic information could be beneficial to anyone in the beginning stages of Hormone Replacement Therapy (HRT) research or in search of an Hormone Replacement Therapy (HRT) provider. Again, please do not take this information too literally, as it is posted for general information as a starting point on the path to Hormone Replacement Therapy (HRT). It seems everyday we see a new post from a frustrated member whose doctor is out of line on dosage, frequency, using AI's, Human Chorionic Gonadotropin (HCG) or any other of the several components of Hormone Replacement Therapy (HRT) many of us consider very basic.
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The following information is the culmination of today's best practices in hypogonadism treatment, developed by leading doctors in hormone replacement therapy.

T Treatment Trifecta
Testosterone + Human Chorionic Gonadotropin (HCG) + Arimidex

If your doctor only prescribes testosterone by itself, you will most likely be in for a rough ride.

The problem with test only regimens is that one of the main metabolites (estrogen), tends to get out of control.

High estrogen negates most of the benefits of testosterone replacement therapy (TRT), resulting in many of the same symptoms of low testosterone you had in the first place!

Fatigue, impotence, water retention (bloat), depression, and brain fog are all commonly associated with high estrogen.


Arimidex Lowers Estrogen Levels
The solution, is to add an estrogen lowering medication, commonly Arimidex (anastrozole) or Aromasin (exemestane). It's from the class of medications called aromatase inhibitors, which essentially block the conversion of testosterone to estrogen.

It helps by forcing testosterone output to remain high while keeping estrogen levels low.

Once your testosterone and estrogen levels are dialed in, it's time to stop the next inevitable decline... shrinking testicles and it's often associated fertility problems.

HCG Injections/Shots and Side Effects
This is where the medication Human Chorionic Gonadotropin (HCG) (Human Chorionic Gonadotropin) comes in. It helps prevent the side effects of infertility and testicle shrinkage that commonly occurs during testosterone treatment.

Basically, your testicles shrink because your body's under the misguided notion it doesn't need to make testosterone anymore.

When your androgens are being supplied from an external source, your balls are essentially saying "That's ok, we already have enough. It's time to shut things down."

For some, small testicles may just be a cosmetic problem. But HGC injections do more than increase testicle size, it also increases adrenal function, which has many positive effects on well-being, libido, and energy in of itself.

Testosterone Treatment Dosages for Men
•- 50mg Testosterone enanthate/cypionate every third day.

•- 0.25mg Arimidex every third day.

•- 500IU Human Chorionic Gonadotropin (HCG) every third day.

All medications taken on the same day.

Many doctors want to prescribe dosages over longer periods of time, however testosterone's half life should be kept in mind to prevent fluctuations and the variable effects that go with it.

The half life of a medication is the amount of time it takes to metabolize to half it's original dose.

Half Life of Testosterone
For example... both testosterone cypionate and enanthate have a half life of approximately 7 days. A 100mg injection would then result in 50mg after 7 days, 25mg after 14 days, and so on and so on.

If you wait a week, two weeks, or even a month (like some doctors suggest), you may well imagine the mental, physical, and emotional roller coaster ride you will be in for! For this reason it's extremely important dosing is scheduled properly!

An every third day (E3D) dosing regimen, results in the most stable androgen levels over time.

Once you've been on the test, Arimidex, and Human Chorionic Gonadotropin (HCG) protocol for 6 weeks, it's usually a good idea to get your blood levels tested to see where you're at.


Ideal Hormone and T Levels for Optimal Health
•- Total Testosterone 800 - 1,000 ng/dl

•- Free Testosterone 250 - 300 pg/ml

•- Estradiol 20 - 30 pg/ml

•- SHBG 10 - 30 nmol/l

•- DHT 60 - 70 ng/dl

•- Prolactin 2 - 3 ng/ml

•- DHEA-S ~ 300 ug/dl

You may need to adjust your medications accordingly to meet the desirable hormone ranges. Of course, it goes without saying "symptoms should always trump numbers."

Most important is assessing how you feel during testosterone treatment, and not just scraping the bottom of a "healthy" range.
 
I've seen this before here.

That's a real nice writeup. A few things that I've gathered is.

HCG on that is a very high level to be starting out with.

.25 arimidex is a good starting point, but will probably need to be at least doubled, especially with that much HCG.

Total test can be higher. Say 1100-1200
Free test... Check your range. The range that I have is 6.8 to 21.5 I would need to go 11.5 to 13.8 TIMES over the max range to hit that level.

These are just my opinions and I'm no Dr.
 
Thank you guy's for posting......The 29th will be 8 weeks so I am due to get my blood work done. After about 3 or 4 pins in, things were feeling like they were moving in the right direction, but over the last two weeks I seem to be sliding back downward.

I have been sticking with my conservative protocall of 210mg E5D, but as I posted in another thread I don't have that Kick-Ass feeling yet so many here speak of, and the morning wood and libido haven't kicked in like I was expecting. I don't expect to be able to paint the side of a barn like I did when I was in my 20's, but I would like to at least paint the damn door, if you get my drift :destroy::destroy::destroy:
 
I've seen this before here.

That's a real nice writeup. A few things that I've gathered is.

HCG on that is a very high level to be starting out with.

.25 arimidex is a good starting point, but will probably need to be at least doubled, especially with that much HCG.

Total test can be higher. Say 1100-1200
Free test... Check your range. The range that I have is 6.8 to 21.5 I would need to go 11.5 to 13.8 TIMES over the max range to hit that level.

These are just my opinions and I'm no Dr.

I agree with what you have said and considered removing all hard numbers from this write up specifically to avoid protracted discussions on why a total T level of 1200 is better than 1000 etc. etc., and I may still edit. I'm primarily just trying to give newer Hormone Replacement Therapy (HRT) patients a 50,000 foot view of basic Hormone Replacement Therapy (HRT) in hopes it may speed up their search for the right provider or improve communication with their current provider.

Thanks!
 
Thank you guy's for posting......The 29th will be 8 weeks so I am due to get my blood work done. After about 3 or 4 pins in, things were feeling like they were moving in the right direction, but over the last two weeks I seem to be sliding back downward.

I have been sticking with my conservative protocall of 210mg E5D, but as I posted in another thread I don't have that Kick-Ass feeling yet so many here speak of, and the morning wood and libido haven't kicked in like I was expecting. I don't expect to be able to paint the side of a barn like I did when I was in my 20's, but I would like to at least paint the damn door, if you get my drift :destroy::destroy::destroy:
I suspect your E2 is high and that is keeping your libido down. Another explanation could be that your libido issue was/is not testosterone related. Labs should help shed some light. As for the "kick-ass" feeling, it may never come. That sort of thing is probably more psychological than physiological.
 
Thank you guy's for posting......The 29th will be 8 weeks so I am due to get my blood work done. After about 3 or 4 pins in, things were feeling like they were moving in the right direction, but over the last two weeks I seem to be sliding back downward.

I have been sticking with my conservative protocall of 210mg E5D, but as I posted in another thread I don't have that Kick-Ass feeling yet so many here speak of, and the morning wood and libido haven't kicked in like I was expecting. I don't expect to be able to paint the side of a barn like I did when I was in my 20's, but I would like to at least paint the damn door, if you get my drift :destroy::destroy::destroy:


Check where your Estradiol levels are at?
 
FWIW, My E2 has been running consistently at 14ish for a few weeks on the following protocol

Test cyp .5ml/75mg every 84 hours
HCG 300 IU's EOD
Adex .25 EOD

I feel very good on this protocol, but my libido is average at best. I haven't worried about it because my average libido seems to mesh with my wife's below average libido better. For reference, we shag about 2-3 times a week, almost exclusively between Friday and Sunday.

I recently adjusted my Aromatase inhibitor (AI) dosage down to .25mg 2x weekly. Earlier this week I began waking up with varying degrees of morning wood, which I hadn't really had in a while and I have been noticeably hornier.

Got blood drawn yesterday and my E2 is up from 14ish to 24.8. My suspicion is 25-30 might be a better range for my E2.

I do want to reiterate that I felt fine in the 14 range and had no symptoms of low E2 other than old man dick.

My SHBG is 16.2 nmol/L.

Just figured I would share this in case it helps. E2 can suck due to the fact negative symptoms occur at both ends of the spectrum.
 
I'm on 150mg E5D with 1mg Anastrozle and 250iu's Human Chorionic Gonadotropin (HCG) the day after injection. Should I switch to more frequent injections or at least more frequent Aromatase inhibitor (AI) and Human Chorionic Gonadotropin (HCG) dosages?
 
I'm on 150mg E5D with 1mg Anastrozle and 250iu's Human Chorionic Gonadotropin (HCG) the day after injection. Should I switch to more frequent injections or at least more frequent Aromatase inhibitor (AI) and Human Chorionic Gonadotropin (HCG) dosages?

Depends on what you are trying to accomplish.

I increased my Human Chorionic Gonadotropin (HCG) frequency to see if it increased my libido, the total weekly dosage stayed the same. Didn't really notice much of a change at all really.

The only outlier in my protocol has been libido.

Regarding Adex, most of the stuff I read regarding frequency is EOD, whether in the anabolic steroid forum or here or other sources, seems like EOD is common. I believe the half life of Adex (my AI) is 48 hours.

Took me a while to get the Aromatase inhibitor (AI) piece dialed in. I started at 1mg EOD and that fucked my shit up real good. With Adex, I have learned to err on the side of caution by not taking enough vs. taking too much. Regardless of my dosage, I will most likely try to adhere to an EOD frequency with Adex.

I had blood drawn yesterday because I woke up Monday and Tuesday with wood. Monday's wood was more like steel, and Tuesday's not as strong, but I wanted to gauge my E2 based on that.

I also had my SHBG checked because I am not taking anything at all to specifically lower SHBG. I was on Danazol, but could never really feel a difference and that stuff isn't cheap.

My SHBG was 16.2 and I'm not going to complain about that.

In short, my .02 is you might want to consider a more frequent dosing schedule with your ADEX, but, if it ain't broke, don't fix it. Taking it E5D when the half life is 48 hours doesn't make a lot of sense, but then again, I'm not a doctor....and what works for me may not necessarily work for you.

Early results of my experiment lead me to believe that I will use Adex .25mg EOD unless I have a reason to run my E2 higher (increased libido) at which time I will drop to E3D or take 12.5 mg EOD.
 
I didn't think it made much sense either....although this is how I interpret it....

I believe that by taking 1mg of Adex E5D around the same time as your Human Chorionic Gonadotropin (HCG) and testosterone shot might work about the same as a lower dose EOD because your E2 is sure to shoot up after 150mg shot and 250iu's Human Chorionic Gonadotropin (HCG) within 24 hours of each other. This 1mg may be what it takes to get your E2 to 20-30 at that time. As your test level drops for the next 4 days, so does your E2, hence the half life of it not mattering much with this method.

It makes sense that you would need more Aromatase inhibitor (AI) around the time of your test/HCG than at the other times of the week. As your test level drops, the less need for an Aromatase inhibitor (AI) as you get closer to your next shot.
 
I didn't think it made much sense either....although this is how I interpret it....

I believe that by taking 1mg of Adex E5D around the same time as your Human Chorionic Gonadotropin (HCG) and testosterone shot might work about the same as a lower dose EOD because your E2 is sure to shoot up after 150mg shot and 250iu's Human Chorionic Gonadotropin (HCG) within 24 hours of each other. This 1mg may be what it takes to get your E2 to 20-30 at that time. As your test level drops for the next 4 days, so does your E2, hence the half life of it not mattering much with this method.

It makes sense that you would need more Aromatase inhibitor (AI) around the time of your test/HCG than at the other times of the week. As your test level drops, the less need for an Aromatase inhibitor (AI) as you get closer to your next shot.

That acutally does make sense. My Human Chorionic Gonadotropin (HCG) is still EOD and my Test is 84 hours so EOD on the Adex is probably best.
 
Right, for you that'd be the best bet. For the E5D protocol, I'm thinking that's probably how it works. But what do I know!

Had any bloods done lately? Anything about how you feel you'd like to change?

I'm real happy with my protocol, just trying to pin down the libido thing.

:doggy:
 
I havent had them lately, I'll probably wait another six weeks since I just switched from prop back to cyp (couldnt stand the EOD injections)...more power to those who can haha
 
One thing I like about every 84 hours is my injections are always at the exact same day and time.

I pin Monday mornings at 7AM and Thursday evenings at 7PM.

I travel a lot for work and 90% of my travel occurs between Monday morning and Thursday evening so I rarely have to pin on the road.
 
Great thread.

I really like hcg. It really brings out my animalistic sex. It has also helped my morning wood and now an occasional wood during they day. My package stays larger all the time. Just watch E2. If this sounds interesting... IM the Human Chorionic Gonadotropin (HCG) and see if you can tell the difference.

And as was mentioned the half life of adex doesnt matter.
 
Have any of you guys ever got your libido cranking and then have it seem to fade away without making changes to your protocol?

Mine definitely seems like a moving target and it never really seems to be strong for more than a few days.

When I first cut back on my Test dosage from like 125 to 75 and switched my Adex to .25 EOD I had awesome libido and then after a while it sort of mellowed. I feel like it is only really kicking when I am in the middle of making a change and then my body adjusts to the change and bam, no libido.

Anyone have the same experience?

For those of you who consider your libido strong, how long of a period has it been strong?
 
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