Dosage and trough

[Jimmyjusa]

My doctor prescribed the old-school 200mg every two weeks. I've read enough here to know that weekly injections are the longest I should be waiting. My concern is if I do 100mg weekly on my own, would my trough level make my doctor (who is likely not the most up to date about dosage or injection methods) think about dropping my dosage? We didn't discuss what numbers he is going to expect when I retest, I just don't want to screw anything up now that I'm just starting.

 

[Vince Carter]

I think the trough, is the trough, in that regard. I don't think it would be obvious. On that archaic protocol you'd probably look to be back to low t state on the 14th day. It would be easy enough to make the statement to him that the half-life is ~6 days on Cyp (barring your SHBG influencing that up/down), he may not know this and need to be helped in that way that even once per week is pretty poor.

 

[CoastWatcher]

For future reference, here's the gold-standard study that clearly establishes the futility of injecting every two weeks.

https://www.excelmale.com/forum/showthread.php?12771&p=88718#post88718

 

[Jimmyjusa]

Thank you, I know the most common seems to be twice per week from reading on here and on the fb group. I can't really see any issue if the overall dose adds up to the prescription. So 50mg twice a week still adding up to 200mg every two weeks but overall is a better protocol. I just worry that if I went to that frequent my trough would be way higher than he is used to do I'd have to do some explaining and that means I'd need documents to show him because I can't always convey what I'm trying to explain.

 

[madman]

Thank you, I know the most common seems to be twice per week from reading on here and on the fb group. I can't really see any issue if the overall dose adds up to the prescription. So 50mg twice a week still adding up to 200mg every two weeks but overall is a better protocol. I just worry that if I went to that frequent my trough would be way higher than he is used to do I'd have to do some explaining and that means I'd need documents to show him because I can't always convey what I'm trying to explain.

100 mg/week is a common starting trt dose and as you and many know 200 mg every two weeks is a horrible protocol and would result in low t 10-14 days later aside from having an insanely high supra-physiological peak within the first 24-36 hrs after your injection and would also definitely result in sky high e2 levels due to aromatization of the T--->E2.

Even though the most sensible approach which would keep blood levels stable throughout the week and minimize big fluctuations between peaks/troughs and lessen conversion of T--->E2 among other things would be splitting the 100 mg/week dose and injecting 50 mg (every 3.5 days) mind you on this protocol you would definitely have a higher trough come the end of the week as oppose to injecting 100 mg/week.

If you are concerned about your total t trough reading than I would just inject 100 mg/week (assuming your shbg is not low) and have trough tested and at 100 mg/week it is highly unlikely your testosterone (trough) will be out of range and if anything it will be mid to low/normal depending on other factors. Try this protocol for 6 weeks gauge how you feel overall regarding improvement or lack there of your low t symptoms/overall well being and than get labs done at 6 weeks to see where your trough sits.

If it is too low and you do not feel overall improvements than look into changing your protocol and splitting 100 mg/week dose and start injecting 50 mg every 3.5 days than reassess in 6 weeks.

Even though injecting 2x weekly (every 3.5 days) is a common trt protocol and is much better overall than injecting 1x weekly it is not a given and there are men on trt that do well injecting 1x week ( men with normal-higher shbg) as oppose to ( men with low shbg ) where injecting 2x weekly would be needed but many end up injecting ( M/W/F or EOD or even daily).

 

[Jimmyjusa]

Thank you for your input. I did my first injection this morning of 100mg and will go with this weekly until my first lab check up then adjust as needed from there. I don't have a recent total AND free but the last one i did was 335 ng/dl total and 25.5 pg/ml? Free which was 2.55 once converting to the same measurement as total of ng/dl. This makes me think I have a higher shbg but I know the only true way is testing for it.

 

[CoastWatcher]

You mentioned you need studies/documents. This study stresses the importance of SHBG testing. Your doctor may benefit from it.https://www.excelmale.com/forum/sho...rum-Levels-and-Urges-Testing-for-TRT-Patients

 

[Jimmyjusa]

Thank you for that link to the other thread. I am very happy that I'm finally starting and very hopeful. I took my first shot today and was in a better mood all day than I have been in a long time. I know it's not the medication but more likely the relief off my shoulders of fighting to be taken seriously for the past few years about my issues and trying many other treatments for those individual symptons (depression, anxiety, sleep issues)

 

[iraklisapo]

Ξεκίνησα πριν δύο εβδομάδες την πρώτη trt με λάθος δοσολογια 250ml και σε 8 μέρες πάλι 250 εφιάλτης πολες παρενεργειες πίεση υπερένταση σαν πολύ άρρωστος περιμενο άλλες τρεις μέρες να ξεκινήσω με 100ml την εβδομάδα θα είναι καλητερα

[Moderator's note: From Google Translate this is "I started my first TRT two weeks ago with the wrong dosage of 250ml and in 8 days again 250 a nightmare many side effects blood pressure hyperactivity as if very sick I wait another three days to start with 100ml a week it will be better"]

 

[madman]

Ξεκίνησα πριν δύο εβδομάδες την πρώτη trt με λάθος δοσολογια 250ml και σε 8 μέρες πάλι 250 εφιάλτης πολες παρενεργειες πίεση υπερένταση σαν πολύ άρρωστος περιμενο άλλες τρεις μέρες να ξεκινήσω με 100ml την εβδομάδα θα είναι καλητερα

I started two weeks ago with my first TRT, but with the wrong dosage—250 ml, and then again 250 after 8 days. It was a nightmare: many side effects, high blood pressure, extreme agitation—I felt very sick. I’m waiting another three days to start with 100 ml per week. Will it be better?

This is way too high a starting dose.

The standard starting dose is 100 mg T/week or 50 mg split twice-weekly.

You will be far better off here!

Look over my reply post #2

Post in thread 'Defy dosage. Need opinions'

Saturday at 9:14 AM

Hey guys. Had my consultation with Defy the other day. Starting me at 220mg weekly. I’m going to go with 2 days per week. .55ml. Thinking about going with shallow IM.

My numbers are

- 558 ng/dl

- free - 45.2 pg/ml

- SHGB - 70. High.

- estradiol 20 pg

- LH - 2.9

- DHEA-S - 131

I’d like to know your thoughts on this and what you guys would do. I’ve been working out my whole life. I’m 47. 6ft 1 200lbs. I work out 4 to 5 days per week. Count my calories, etc. the whole nine. Would love to hear your thoughts. I know 220 is high but my SHGB is high as well. Thanks in advance. Should...

• madman

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[madman]

Ξεκίνησα πριν δύο εβδομάδες την πρώτη trt με λάθος δοσολογια 250ml και σε 8 μέρες πάλι 250 εφιάλτης πολες παρενεργειες πίεση υπερένταση σαν πολύ άρρωστος περιμενο άλλες τρεις μέρες να ξεκινήσω με 100ml την εβδομάδα θα είναι καλητερα

[Moderator's note: From Google Translate this is "I started my first TRT two weeks ago with the wrong dosage of 250ml and in 8 days again 250 a nightmare many side effects blood pressure hyperactivity as if very sick I wait another three days to start with 100ml a week it will be better"]

This is what to expect here when first starting therapy or in cases where one needs to tweak the protocol.

Look over my reply in the thread I posted below.

Every protocol needs to be given a fighting chance as in 12 weeks before claiming success or failure as the first 6 weeks means nothing when looking at the bigger. picture here.

The body needs time to adapt to its new set-point in order to truly gauge the effectiveness of a protocol.

Make sure you put in the time otherwise you will be chasing your tail. endlessly.

Best piece of advice here is start low and go slow and give your body the time needed to adapt to its new set-point!

There will always be time to increase the dose of T or throw in hCG if need be this is a given.

Post in thread 'HELP - Doubts about TRT'

Apr 13, 2024

Okay Madman, so now my question is:

What is the solution then? Besides Natesto?

Because from the sound of it, TRT is not a viable option, better stay low T for life (considering everything is done to raise it but the balls just don’t seem to work as they should).

For example, would injecting twice per week a 80-100 mg dose (so 40-50 mg twice per week) would be closest to having at least peaks and downward levels that most closely ressemble natural healthy levels?

In my case I honestly don t care about levels. If i get symptom relief in the 500-600s I ll take it...

• madman

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