T Replacement
 
TRT: Protocol for Injections
 

clarkster
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KSman wrote:
You can mix peptides, do not know if the hCG would impede or limit $GH absorption. Do not mix with a peptide that has more than BA water or sterile water.

Take other questions to your own thread.

KSman- This thread is a wonderful resource, however, it's gotten off track a couple times and I'm curious to see if you still a supporter of the protocol that you first put up on 7-19-2009. I'd like to pm you personally, but don't have that option yet. Do you have any experience with what's called the Testosterone Trifecta (50mg Test every 3rd day, .25mg Arimidex every 3rd day and 500IU HCG every 3rd day.) It seems pretty close to your original protocol. My Dr. mentioned this to me today and wanted to get your opinion.

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KSman
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That will work for T+AI, however, for most, that is not enough AI. With a liquid product, you are not a slave to how an anastrozole tablet can be split.

hCG half life makes EOD dosing better, and your hCG dose is a bit excessive. Too much hCG can create E2 problems that AI cannot fix. For those who want to inject hCG EOD, injecting taking T+AI at the same time is an easier procedure to follow.

Yes, this thread has been abused.

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happy_Ed
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Im just shaking my head reading this thread..
I went to the doc and said I was feeling like crap and had been for years.
He put me on testosterone and voila, done deal..
Been on for 13 months of 7 X 40mg caps of testosterone per day and I feel great..
Best I have felt in years.. Nuts aint shrunk..
Now Im reading I should be on hCG and or arimidex and I need to have blood tests?

Eh? You guys sure about all this stuff. Seems all very complicated! :-(

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happy_Ed
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KSman wrote:
Many guys ask for these details. Here is enough info to get started. You probably will not get your doctor aligned with this without a struggle [or a new doctor]. This is really a small part of what most guys need to know.

TRT: Protocol for Injections

* 100mg test cypionate or ethanate injected per week with two or more injections per week.
* 250iu hCG SC EOD [every other day]
* 1.0mg Arimidex/anastrozole per week in divided doses.

Injecting testosterone once a week induces spikes in testosterone levels followed by lows. This can make many feel bad or worse at the end of the week than their pre-TRT state. As time goes on the dead zone gets wider and they feel no relief with injections. These feel much better injecting twice a week or even EOD [every other day].

Injecting every 2, 3 or 4 weeks is horrible. You need to self inject and inject frequently. With frequent injections the volumes are very small and one can inject in the quads [vastus lateralis] with #29 0.5ml 0.5" [50iu] insulin syringes.

These are slow to load but injection times are reasonable as the small plunger diameters create very high pressures. Do not use 1.0ml syringes. This same size syringe can be used for hCG injections, which are also SC.

EDIT: Injecting EOD [sometimes written as E2D] or E3D [every third day] can be a difficult schedule. You can set up reminders or appointments in calendar software, such as MS Outlook, for E2D or E3D etc.

Small needles will reduce muscle damage. Some use #25 1" needles, but this may not be any "faster" than the above 50iu insulin needles.

You do not need to inject into your gluts with 1.5" needles!

Canadian clinical research has demonstrated that TRT by SC [under the skin injections into body fat] produce steadier testosterone levels and improves sense of well-being. Feel free to find out what is more comfortable for you.

For those who train and sweat/shower a lot, transdermal T creams and gels are not appropriate.

Transdermal T creams [and patches] are expensive. At best, only about 10% of applied testosterone is absorbed. Transdermal delivered dose is a crap shoot. Guys who have low thyroid levels are typically non-absorbers. Some absorb transdermals at the start, but skin changes can shut off absorption after a while. With injections, there are no unknowns about drug delivery.

hCG is a water based peptide hormone can be injected to replace the lost LH hormone that TRT shuts down. Without hCG, the LH receptors in the testes are no longer getting activated. The results are:

* The testes shrink. Over time for some the testes can eventually become small undifferentiated lumps of collagen. This is drug induced organ failure. The degree of shrinking varies from guy to guy and may be more of a problem for the older guys.

* Fertility can be greatly reduced or eliminated. If making babies is important, you need to inject hCG. If hCG is not used, its use after a long time may or may not recover fertility.

* When the testes get smaller, some feel an ache in their testes 24x7. hCG injections can eliminate that pain or avoid the whole episode.

* When there is no LH or hCG, the scrotum pulls up tight to the body. This has the appearance of a pre-pubescent boy. This is not good for ones sexual self image and this also affects how women perceive you sexually. Some women get very upset when they see this maleness disappear, thus affecting their sexuality and interest in you.

* The testes are the single largest producer of the hormone pregnenolone. Pregnenolone is important for proper mental functioning, and is the precursor to all of the steroid hormones such as DHEA, testosterone, DHT, estrogen, cortisol... Injecting hCG prevents a drug induced pregnenolone deficiency and helps support the other hormones. When guys are on T without hCG and then start hCG, they report a significant improvement in mood that many attribute to restored pregnenolone levels. [If that is not the case, hCG must have some direct effects in the brain.]

When injecting hCG, you inject into the fat under the skin just the same as diabetics inject insulin. The product literature is all about use a fertility drug for women with large IM [injected into muscle] doses. There is no need for men to inject hCG IM.

Research using SC injections in men has demonstrated the effectiveness of the 250iu EOD dosing. You can seek diabetic patient educational material for insulin injection techniques to use for hCG and/or testosterone injections.

Elevated normal [30pg/ml and up] serum E2/estradiol can block many of the benefits of testosterone replacement. Serum E2=22pg/ml is near optimal and one should dose anastrozole to get close to this level. Many who start TRT have some good results that soon vanish as E2 levels increase. My recommendation is to start anastrozole at 1.0mg per week [in divided doses] starting the day of the first injection. The let the first follow up E2 lab drive any needed anastrozole dose adjustments. It is not a good idea to wait and see how high E2 levels go before taking action. Dose anastrozole EOD if possible.

A few guys are anastrozole over responders. This is not known in the drug literature. These guys will get E2 in the single digits and will feel like crap physically and mentally. They may feel a spike of short lived libido as they fall through the E2 levels sweet spot. These guys need to take 1/4th or 1/8th of the expected anastrozole dose -something to watch for. If this is suspected, stop anastrozole for 6-7 days then resume at 1/4th the dose.

The 100mg dose of injected T should get guys into the 800-900 total testosterone [TT] range. That is nice to see, but one should be looking at free testosterone [FT] or bio-available testosterone [bio-T]. Some docs, who know what they are doing, will not bother checking TT numbers at all. SHBG levels increase with age and FT ratios drop.

A TT=1000 in a young man is not the same as TT=1000 in an older man with higher SHBG levels as the FT numbers will be well below that of the young man with the same TT. This may very well create TT levels that are above the youthful lab ranges and should not be a concern. Lab ranges shown on lab reports will be age adjusted. You need to be using the ranges for youthful men.

You need to know about PSA, prostate issues and DREs [digital rectal exam]. E2 is a large cause or aggravator of BPH [enlarged prostate]. Many find that lowering E2 to near E2=22pg/ml improves their BPH and urine flow is improved.

You need to monitor hematocrit levels as part of your routine lab work.



dang, just posted and its disappeared..
lets try this again.

I have been on testosterone caps for aprox 13 months now..
Gee after reading the first post in this thread Im wondering if I should try to come off.

I went to a doc who put me on test caps 7 x 40 mg's per day and I feel great!

Now Im reading this thread and apparently need to be taking other meds as well?????

hCG? arimidex?

And I need to be getting bloods done too? Gee its all starting to sound mighty complicated..

don't suppose there is a quide to all this stuff in a very abbreviated form..
Something that shows what needs doing with out all the reasons and the *unknown to me* abbreviations????

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happy_Ed
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ok, just figured it out.. message needs to be approved first!

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KSman
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Do not post personal details here, this is a sticky, read on...

Keep reading the stickies, nothing to add that is not there now.

Balancing your hormones is more than just adding T. Start your own thread and keep everything about you there. Read the advice for new guys sticky, provide info about you, post your labs with ranges, post body temps and iodine intake [see thyroid basics for more info].

You should not be starting TRT without knowing what went wrong, you need LH and FSH for that. If you started TRT without labs, then one has to wonder about safety issues such as PSA, DRE and HTC that your doc may not be doing. You do not even know if your are absorbing T well.

Oral T can be expensive because so much is not absorbed or metabolized by first pass thru the liver. You are taking 280mg/week or 280mg/day?

Please do not respond, here, start your own thread.

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thehebrewhero
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Is there such thing as a good protocol for HGH? The place I go for T just annouced they will be scripting HGH. I've read it can be dangerouse but the stuff they are pushing says it promotes better mood, sex, motabolizim, faster healing.. It sounds good but whats the proper protocol for such a thing. Im interested in trying it but Im doing just fine on my TRT...

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KSman
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As with TRT, injecting GH will suppress your own production. If you are younger and producing 1iu per day on your own, if you then inject 1iu, your serum IGF-1 levels will not change much, probably would stay the same. So that means a cost of around $3,600 per year for nothing. If you inject 1.5iu per day, then your IGF-1 would increase about 50% above your baseline and that will cost $5400.

So you can see from the above that the benefits of injected GH go to those who have a deficiency.

For someone who is deficient, T+GH has a much better results that T or GH alone.

Getting Rx hGH at $10 per unit is hard to find, often the cost will be higher.

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thehebrewhero
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Thanks Im really not sure what my GH levels are maybe its in one of my old labs.. Im pretty sure the cost is $80 per bottle of HGH at the spa.. I'll ask what brand/other info they have on it before I try it. Would HGH promote a decrease in scar tissue or increaces it? I have alot of scar tissue in shoulder and need to break it up for 100% The doc wants to do a manipulation to break it up but Im fearful that could result in a new tear. Would HGH at 5iu EOD or ED be a good short cut to 100% recovery with the ability to skip manipulation? Should I consider uping my T past 100mg per week to promote healing?

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shockwave843
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Sir,
How would you adjust this protocol for subq?

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KSman
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Just inject SC/SQ instead of IM?

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shockwave843
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KSman wrote:
Just inject SC/SQ instead of IM?


Some seem to do eod for subq and I was wondering how the Ai and hcg would adjust. Sorry for not being specific.

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KSman
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Subway? Your weekly dose for AI and hCG is not affected. With T EOD, your FT will be steady and then you want a steady matching amount of AI. My preference is to inject T and hCG at the same time and dose AI at the same time, just as a workable routine. This is in the stickies. hCG is also injected SC. SC avoids decades of IM muscle damage.

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102workout
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I have been on trt for many years using 250 hcg two days before and day before my 200mg of cypionate. I would like to switch to a lower dose and shoot every 3 days. My question is when would I take my hcg? and would i shoot every 3 days or pick two days during the week and stay with those days....I apologize if this has been answered I did look through some previous posts and was unable to find anything

Thanks everyone

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threepercenter
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102workout wrote:
I have been on trt for many years using 250 hcg two days before and day before my 200mg of cypionate. I would like to switch to a lower dose and shoot every 3 days. My question is when would I take my hcg? and would i shoot every 3 days or pick two days during the week and stay with those days....I apologize if this has been answered I did look through some previous posts and was unable to find anything

Thanks everyone


It's not huge science, just split your doses. Do your total weekly hcg split into 4 doses for the week - for me that's 250iu e2d. And your 200mg of t-cyp say in two 100mg shots e3d (I know you said 3, but two is easier to manage. Some days the two shots will overlap, it's fine. USe calendaring software like google calendar to set your reminders and track what and when.

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H2878
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KSman wrote:
.

TRT: Protocol for Injections

* 100mg test cypionate or ethanate injected per week with two or more injections
per week

* 250iu hCG SC EOD [every other day]

* 1.0mg Arimidex/anastrozole per week in divided doses.





What would be the dosing and frequency be of hcg and anastrozole when useing 1000 mg Testoterone undecanoate ?

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KSman
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hCG dose has nothing to do with T dose, when you are shutdown, that is all that matters. As for AI, you need a more when serum T levels are high. So the answer with this ester will depend on your lab results. With infrequent dosing, the T peaks and troughs make AI dosing impossible to get right.

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bobbos21
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Amazing thread!!! I have been on t for a while and my doctor never mentioned anything thing to me. It was get your shot and be done. I have found places online to purchase hCG and an AI but im wondering if it would be more cost effective to go to on of those anti aging places = (

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KSman
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Those places are where people go to get ripped off when they can't get help elsewhere. There are some exceptions. Many will over over-prescribe and most sell you the drugs at a high markup. You want to get scripts in-hand.

An enthusiastic GP is always your best bet. Not an endo or uro with an entitlement attitude whereby they do not need to learn anything new.

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iw84aces
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I'm reading that Adex lowers igf-1? any insight on this?


Product Effect on igf-1 percentage
Femara/Letrozole increases igf-1 24%
Arimidex/Amastrozole decreases igf-1 18%

For Ksman this wouldn't matter so much cause he is on hgh and had low igf-1 I'm wondering if this is the reason why igf-1 was low?

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KSman
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So is your data for women seeking E2-->0? If so what has that got to do with men seeking normal E2=22?

Are the stats that you list for pre or post menopausal women? Are the effects from the drug or from the the low estrogens. If premenopausal, are the effects from the pituitary reacting to low E2? Does low E2 alter pituitary functions and thus GH? Does low E2 alter the livers ability to release IGF-1 in response to GH?

Do you have data for males on TRT? Body builders seeking BF<10% and very low E2 are not acceptable.

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iw84aces
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KSman wrote:
So is your data for women seeking E2-->E2? If so what has that got to do with men seeking normal E2=22?

Are the stats that you list for pre or post menopausal women? Are the effects from the drug or from the the low estrogens. If premenopausal, are the effects from the pituitary reacting to low E2? Does low E2 alter pituitary functions and thus GH? Does low E2 alter the livers ability to release IGF-1 in response to GH?

Do you have data for males on TRT? Body builders seeking BF<10% and very low E2 are not acceptable.



I will try and find the site i was on. It was a question that's all.

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iw84aces
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[quote]iw84aces wrote:
[quote]KSman wrote:
So is your data for women seeking E2-->E2? If so what has that got to do with men seeking normal E2=22?

Are the stats that you list for pre or post menopausal women? Are the effects from the drug or from the the low estrogens. If premenopausal, are the effects from the pituitary reacting to low E2? Does low E2 alter pituitary functions and thus GH? Does low E2 alter the livers ability to release IGF-1 in response to GH?

Do you have data for males on TRT? Body builders seeking BF<10% and very low E2 are not acceptable.[/quote]



http://jcem.endojournals.org/.../85/7/2370.full

Here is one of them. Although they do say it lowers igf-1 it appears that didn't have an effect on GH levels which would be odd wouldn't it? I had another one that i was reading but I can't seem to find it.. I'll edit it in when i do...Do you really want me to answer those questions?
I don't have the answers that's why I'm here :)

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KSman
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I have seen research papers indicating that anastrozole increase IGF-1 levels. So there may be mixed signals. There is data that Nolvadex lowers IGF-1 and the bro-science guys may be confusing these.

GH-->IGF-1 via processes in the liver, so liver function can create the disconnect that you noted.

We know that TRT can improve GH levels. We know that E2 can lower T. We know that anastrozole can lower T and increase T. So there is a pattern there for the intact HPTA. Most guys here do not have an intact HPTA. Hard to make generalizations without proper context.

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iw84aces
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So with having a fatty liver and pancreas If one were to test IGF-1 is it possible that GH levels could still be low if the liver is not functioning optimally?

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