Wanting to change my TRT protocol.

[6-5-285]

First I would like to thank all those that contribute to this forum. I have learned so much in my short time at Ology
I am currently 3 weeks into my TRT treatment. After reading many Stickies and posts I have realized the benefits of pinning twice per week vs once. To save some time I think I will just post my current protocol given to me by my TRT clinic.
BTW I'm 42 6'5" 270 (was 285 4 weeks ago) If I had to guess 20-24%bf

Wednesday- .25ml (500 units) hCG (I saw Megatron use the lower (h) and stole it from him..lol)
Thur- .25ml (500 units) hCG
Friday- 200mg Test Cyp
Sat - .5mg Anastrozole

Can you guys review this protocol and tell me how you would adjust? or would you leave it alone?
One problem I will have if I split the Test into a (every 3.5) is that my Anastro came in capsules and it might be difficult for me to split them accurately.
The reason I ask so soon into my therapy is that I am getting some (more than before TRT) acne on my face. I'm in sales so thats a problem. Its not the small little pimples either.
I have only done the initial Bloods at the start of the program. At what time should I do the next?

Thanks in advance for you advice?

 

[Megatron28]

That is how they show hCG here too.

Human chorionic gonadotropin - Wikipedia, the free encyclopedia

 

[Mprtz]

That's exactly my starting protocol... wonder if we go to the same place.
Well actually I reconstitute my hCG to half that concentration.

My E2 was too high on that protocol, and I also broke out in acne (back mainly) after some weeks. My protocol was adjusted to 0.5mg adex twice a week.
Then I asked to be switched to injecting T twice weekly. At that point 1mg per week anastrozole was too much and I pared it back to 0.75mg and finally 0.5mg (split up in two 0.25mg doses).

My TRT clinic supplied me with capsules from the compounding pharmacy in the lower dose.

So the upshot is that there really seems to be an advantage to twice weekly injection in terms of AI required. I have not had acne problems since that initial time.

EDIT: I should emphasize that dosages are individual... i'm a much smaller and leaner guy. You should test E2 with bloodwork and probably double your anastrozole, but without bloodwork that's a guess.

 

[Megatron28]

I would split the Test and AI dose so you can take it twice a week. If your Arimidex is capsules full of powder you can empty them and dose them by weight. You would need a scale capable of measuring small amounts though. Or just ask your pharmacy for pills instead.

Most guys only take 250iu of hCG twice a week.

You can get blood work in 6-8 weeks. When does your doc want you back in?

I take it you have secondary hypogonadism. What was your TT, Prolactin, LH and FSH at?

Also, if you start splitting your Test dose, hold off on using the AI. You may not need it. Wait until blood work confirms the need for an AI.

 

[Mprtz]

I would split the Test and AI dose so you can take it twice a week. If your Arimidex is capsules full of powder you can empty them and dose them by weight. You would need a scale capable of measuring small amounts though. Or just ask your pharmacy for pills instead.

Most guys only take 250iu of hCG twice a week.

You can get blood work in 6-8 weeks. When does your doc want you back in?

I take it you have secondary hypogonadism. What was your TT, Prolactin, LH and FSH at?

Also, if you start splitting your Test dose, hold off on using the AI. You may not need it. Wait until blood work confirms the need for an AI.

respectfully disagree - if he's breaking out on 0.5mg, I don't think splitting that hefty 200mg/week dose is likely to let him get by with no AI, especially at his somewhat high bodyfat level.

 

[6-5-285]

Mprtz, Its possible I live in Florida.

After I added the Bacteriostatic water the vial had 11,000 units.

Thanks for the advise.

 

[Megatron28]

respectfully disagree - if he's breaking out on 0.5mg, I don't think splitting that hefty 200mg/week dose is likely to let him get by with no AI, especially at his somewhat high bodyfat level.

It is likely but I would still recommend getting blood work before taking an AI.

 

[6-5-285]

I would split the Test and AI dose so you can take it twice a week. If your Arimidex is capsules full of powder you can empty them and dose them by weight. You would need a scale capable of measuring small amounts though. Or just ask your pharmacy for pills instead.

Most guys only take 250iu of hCG twice a week.

You can get blood work in 6-8 weeks. When does your doc want you back in?

I take it you have secondary hypogonadism. What was your TT, Prolactin, LH and FSH at?

Also, if you start splitting your Test dose, hold off on using the AI. You may not need it. Wait until blood work confirms the need for an AI.

I'm a little embarrassed to say this, but my TRT clinic is a hands off type I guess. I never actually saw the Doctor. They sent me a kit and gave my a clinic close by that could take the blood and ship it off to a lab. The office is about 4 hours from where I live. I have a "Coach" / sales Rep who does answer my calls, but he gave me some weird answers so I started doing my own research which brought me to Ology.
Technically I could drive there and see the Doctor if I wanted to. IMO it was a little too easy.
The "Coach" said I wouldn't need to do Blood Work for a year unless I wanted to do it on my own.
Pre-TRT
Test, total 328
Test free 8.43
LH 3.8 (1.7 - 8.6)
FSH 2.0 (1.5 - 12.4)
E2 8.8 (7.6 - 42.6)
I Don't see Prolactin on my lab
You didn't ask but,
T3 3.8 (1.8 - 4.6)
T4 1.61 (.9 - 1.7)
TSH 4.51 (.27 - 4.2) Showing High on Lab.
I believe I am Secondary not Primary Hypogonadal.
I am feeling better less the acne and insomnia. I stopped drinking a month ago. I used it to fall asleep easier.
I researched acne and insomnia here on Ology, but still had a few questions.

 

[Megatron28]

What are you doing about your hypothyroidism? Did you try treating that before starting to TRT to see if that was causing your Low T?

You definitely need to check Prolactin. Did you have an MRI of your pituitary performed?

 

[Mprtz]

I'm a little embarrassed to say this, but my TRT clinic is a hands off type I guess. I never actually saw the Doctor. They sent me a kit and gave my a clinic close by that could take the blood and ship it off to a lab. The office is about 4 hours from where I live. I have a "Coach" / sales Rep who does answer my calls, but he gave me some weird answers so I started doing my own research which brought me to Ology.
Technically I could drive there and see the Doctor if I wanted to. IMO it was a little too easy.
The "Coach" said I wouldn't need to do Blood Work for a year unless I wanted to do it on my own.
Pre-TRT
Test, total 328
Test free 8.43
LH 3.8 (1.7 - 8.6)
FSH 2.0 (1.5 - 12.4)
E2 8.8 (7.6 - 42.6)
I Don't see Prolactin on my lab
You didn't ask but,
T3 3.8 (1.8 - 4.6)
T4 1.61 (.9 - 1.7)
TSH 4.51 (.27 - 4.2) Showing High on Lab.
I believe I am Secondary not Primary Hypogonadal.
I am feeling better less the acne and insomnia. I stopped drinking a month ago. I used it to fall asleep easier.
I researched acne and insomnia here on Ology, but still had a few questions.

Yeah, that's "scary-hands-off"... mine is a bit like that too but not as extreme.

You will need to really be on top of things yourself to stay safe. Do your own blood testing... I do mine about every 3 months (in addition to the testing the clinic does, which is pretty basic). I recommend male hormone panel from privatemdlabs.com.

Your HCT is going to climb and will need to be watched and you will probably need to give blood.

You should keep an eye on your lipids. And keep educating yourself.

 

[6-5-285]

What are you doing about your hypothyroidism? Did you try treating that before starting to TRT to see if that was causing your Low T?

You definitely need to check Prolactin. Did you have an MRI of your pituitary performed?

In regards to the hypothyroidism no one at the clinic brought it up. I didn't know TSH referred to that. I will research that moving forward. No MRIs either.
To be real honest I thought more testing would occur to see if I qualified for TRT. I guess at my clinic all you needed was relatively low T. I've said it earlier, but it was a little to easy. With that said I was feeling quite shitty before I started and feel a ton better now. When it all showed up in the mail I figured well I guess the Doctors knows best and I started the program. I will check Prolactin on next bloods.
One question about (labsmd / privatemdlabs) . How does that work exactly? Surely you don't draw your own blood? Do they send you a kit and you take to a clinic then they send it in?
Thanks for all you help.

 

[Chiefy]

In regards to the hypothyroidism no one at the clinic brought it up. I didn't know TSH referred to that. I will research that moving forward. No MRIs either.
To be real honest I thought more testing would occur to see if I qualified for TRT. I guess at my clinic all you needed was relatively low T. I've said it earlier, but it was a little to easy. With that said I was feeling quite shitty before I started and feel a ton better now. When it all showed up in the mail I figured well I guess the Doctors knows best and I started the program. I will check Prolactin on next bloods.
One question about (labsmd / privatemdlabs) . How does that work exactly? Surely you don't draw your own blood? Do they send you a kit and you take to a clinic then they send it in?
Thanks for all you help.

They send you a lab order like your doctor would write for you. Then you take it to a lab and have your blood drawn.

 

[Mprtz]

Re privatemdlabs: You go to the website and create an account. Then you choose the test(s) you want and pay via credit card. One of their doctors rubberstamps the lab order and they send you a pre-paid lab requisition which you take to any LabCorp location, of which there are many thousands and unless you live in a rural area there is likely one near you.

Privatemdlabs asks you to choose a location, but your order won't be specific and you can take it anywhere. No appointment required. You hand the staff your piece of paper, wait your turn and they take the blood/urine sample(s).

A few days later (depending on tests ordered) you get an email that your results are ready and you go to the secure website and can view, download or print the .PDF with your lab results.

EDIT: there is a rotating discount code you can use that will lower all prices by 15%, make sure you get it before ordering. the current code is 7H35TK9

 

[Mprtz]

In regards to the hypothyroidism no one at the clinic brought it up. I didn't know TSH referred to that. I will research that moving forward. No MRIs either.
To be real honest I thought more testing would occur to see if I qualified for TRT. I guess at my clinic all you needed was relatively low T. I've said it earlier, but it was a little to easy. With that said I was feeling quite shitty before I started and feel a ton better now. When it all showed up in the mail I figured well I guess the Doctors knows best and I started the program. I will check Prolactin on next bloods.
One question about (labsmd / privatemdlabs) . How does that work exactly? Surely you don't draw your own blood? Do they send you a kit and you take to a clinic then they send it in?
Thanks for all you help.

This is not at all an attack on you, but the process you describe is what gives TRT a bad name. I say that having had a somewhat similar (slightly less extreme) experience.

How comfortable are you at this point with the (lifetime) committment to taking medication? Possibly your clinic downplayed this aspect, but it's something to think about especially as you are not that old and possibly not in a position of having no choice health-wise (because you could be only borderline or not hypogonadal).

Regarding the hypothyroidism, I wouldn't take action based on a single borderline test result. Test again and see how consistent the result is. It could be significant if you decide to change course and explore treatment alternatives.

 

[Megatron28]

Sounds like your doctors at the clinic are not looking at your overall health picture. Even though you are using them, I recommend that you keep your Primary Doc in the loop. You need someone who can step back and look at your overall care. And of course, don't blindly trust docs unless you are in the emergency room and facing imminent death. You really need to be your own best advocate for good health.

 

[6-5-285]

Mprtz/ Megatron. Thank you both for taking the time to review this thread and I do appreciate your honest opinions. I cannot deny I feel better since starting TRT, but I have reservations now. Some thinking to do.

Thanks again.