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Seeking TRT advice for a 59 year old

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TRT_Guy

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Well, this is my first post.

I’ve searched the Internet/forums for informatiion/guidance on TRT and AAS and I have some questions.

I’m 59, in good shape and have been patiently working with doctors for the past 2 years to address my low testosterone. My untreated testosterone levels are from 4-6 nmol/l... pretty low!

Two years ago I was put on Androgel, which didn’t work and was too expensive. So the doctor put me on a dose of 100mg of test e a month. Of course that wasn’t enough so he upped me to 200mg a month... and that kept me at 6 nmol/l — except for probably the week of the injection.

I asked to see an endocrinologist and he literally laughed and assured me my levels were fine. That was the last time I saw him. So to cut to the chase... I got a new doctor, and the endo put me on 150mg every 2 weeks. I started to feel good but I was crashing hard between injections. I asked for an increase and my new Dr said ‘no way’ and, in fact, said that I may not need injections in a year. Confusing based on what I’ve researched.

Fed up, I purchased some UGL cypionate and inject 150 mg every other week — so that’s a total of 150 mg every week.

I’ve never felt such a strength increase and mood boost. It’s fun going to the gym and lifting heavier every time. It feels great!

Now, I would like to add some muscle so I was planning on upping my testosterone to 250 mg/week and adding 250 mg/week of deca. I want an easy, beginner’s cycle. My BP is good as is the rest of my BW and I’m very healthy for my age. I’ve exercised most of my life and have had muscle gains in the past.

Am I going about this in a good way?
Are my doses good?
How long should I stay ‘clean’ before my next BW, which won’t be for at least 2 months?
Is deca a good choice?
Do I need PCT at these levels and if so, what?

Hopefully, I haven’t asked too much, and I promise my replies will be less wordy. Thanks.
 

MRX

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Makes no sense why he'd say you might not need TRT in a year but DR's are certainly not exempt from being ignorant on this issue, case in point his retarded monthly dosing protocol.
You're on TRT for life unless you cease it and return to the levels you had pre=trt

I'd change dosing to twice a week to level test and E2 levels: start at 40 mg test every Sunday a.m and Wednesday eve for example as a base dosing protocol; this is somewhat in line with your 150mg every 2 weeks protocol
Get BW done and adjust accordingly from there

You don't need PCT after doing a blast (add-on) as you're already shut down from TRT
Never done deca personally but I hear it's a bad choice for TRT add-on due it's potential erectal dysfunction sides so many talk about
Why mess with your jimmy after fixing it (hopefully) by being on TRT?
Perhaps you could bump up your test a bit after you are dialed in on your ideal TRT dose
it's pertinent you have a base line dose that you know you can return to, confirmed by BW, or else you're gonna be all over the place
it took me about a year to figure out that 110 mg test weekly is my max before E2 elevates
 
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TRT_Guy

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I'd change dosing to twice a week to level test and E2 levels: start at 40 mg test every Sunday a.m and Wednesday eve for example
Get BW done and adjust accordingly from there

You don't need PCT as you're already shut down from TRT
never done deca personally but I hear it's a bad choice for TRT add-on due it's deca dick sides
why mess with your jimmy after fixing it (hopefully) by being on TRT
Thanks... so you’re saying a total of 80 mg test a week? Unfortunately, I can’t get BW until I see my endo in 10-12 weeks. My MD won’t order it before then.
 

MRX

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Its a suggestion, comparable to your 150 bi weekly dose
Frequent smaller injections all the way man
You want your hormones balanced, not up and down
I find every twice weekly perfect myself
You may even need to lower dose at that
more frequent doses seems to be more potent
 
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TRT_Guy

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Perfect! This is the kind of advice I was looking for — twice a week. I like the feeling of the dose I’m at, though, so I would dose 75 mg twice a week. Without BW I’m doing a lot of guessing.
 
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usually recommend dialing in your Trt before playing with a “boost”

At 59, I would avoid Deca as you will get stronger but puts your tendons at risk. I would recommend to sticking to just testosterone.

At 59 you’ll likely have a high oestrogen conversion so you will need an AI to keep it below 30pg/ml. you’d probably be happy with 250 mg of testosterone per week. With a small dose of AI per week it will prevent conversion and you’ll likely get an added testerone boost (25-35%) with no water retention (and BP increase)

If you insist on adding another compound I would recommend mast or Primo if you have no history of enlarged prostate issues

Please remember to donate blood
 
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TRT_Guy

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usually recommend dialing in your Trt before playing with a “boost”

At 59, I would avoid Deca as you will get stronger but puts your tendons at risk. I would recommend to sticking to just testosterone.

At 59 you’ll likely have a high oestrogen conversion so you will need an AI to keep it below 30pg/ml. you’d probably be happy with 250 mg of testosterone per week. With a small dose of AI per week it will prevent conversion and you’ll likely get an added testerone boost (25-35%) with no water retention (and BP increase)

If you insist on adding another compound I would recommend mast or Primo if you have no history of enlarged prostate issues

Please remember to donate blood
Thanks for the advice!

I know I’m moving quickly with the ‘boost’... it’s just so motivational to step into the gym and lift heavier weights... and see the results. I’ll consider waiting and do a little research into mast — my PSA is all good.

Can you recommend an AI — I find PCT confusing.
 

66Chevy

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You need to do a little reading. 😉

AI is a aromatise inhibitor, and you can read about all of them in our steroid profile section. ( arimidex, Aromasin, letrozole)

PCT is post cycle therapy, which you do not need to worry about as you are on trt.
 
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You need to do a little reading. 😉

AI is a aromatise inhibitor, and you can read about all of them in our steroid profile section.

PCT is post cycle therapy, which you do not need to worry about as you are on trt.
Sounds good... thanks.
 
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Once you review the literature on Arimidex and Aromasin. If you have questions just write.

Do you have an E2 baseline? Do you know what your Estrogen is on TRT. If not familiar with healthy estrogen levels in men I would recommend doing a little reading in that too.

Also you will need to understand key bloodwork markers like haemoglobin and red blood cell count.

PS still recommend just test until you know how you respond to test at different dosages above TRT. (You will be amazed, at your age, how good you can look and feel on just 200mg test)
 
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TRT_Guy

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Once you review the literature on Arimidex and Aromasin. If you have questions just write.

Do you have an E2 baseline? Do you know what your Estrogen is on TRT. If not familiar with healthy estrogen levels in men I would recommend doing a little reading in that too.

Also you will need to understand key bloodwork markers like haemoglobin and red blood cell count.

PS still recommend just test until you know how you respond to test at different dosages above TRT. (You will be amazed, at your age, how good you can look and feel on just 200mg test)
Thank you for the support on AI — I’ll do my part and research.

I don’t know any of my current blood levels and my Dr is definitely not part of the team. It will be some time before I see the endo again.

I’m considering going test alone to start now — a few have given that advice. The power of testosterone amazes me!
 
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From what I've read, Deca is usually not a good choice for trt if/when BW gets done regularly. It lasts too long. NPP clears faster.
 

Mnemonic

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Lots of great advice, 150mg bi-weekly is a good quantity but awful dosing regime.

As stated, 75mg weekly which is 37.5mg twice a week (2x a week is better for hormone stability). Your choice in days, I started Mon/Thurs but wound up preferring Sun/Wed. May be easier to round up to 40mg 2x/week, difference will be negligible. You will more than likely not need an AI with this dose.

As for cycle, 250mg/wk split will be mind boggling for you compared to what you're used to in the past.
Though you will need to see some bloods on your first cycle with an AI on hand to see how you convert to estradiol, as many people are different and it's a case to case basis. Some may be good with no AI, and some may need quite a bit.

From what I have read with the moronic doctors you've been visiting, it might be wise to look for a new doctor or endo.
A lot of us go to a men's health clinic for a specialist, or a naturopath (these are more expensive, but more lenient & potentially knowledgeable). I can't believe that idiot thinks you won't need more after a year of injections? What does he think the stuff is permanent? What's a half-life? -PHD

Lots of great literature here, best of luck in your newfound life!
 
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TRT_Guy

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From what I've read, Deca is usually not a good choice for trt if/when BW gets done regularly. It lasts too long. NPP clears faster.
I originally chose deca because of the low side effects, which I planned to keep low with a dose of 250 mg. I actually purchased some deca already, but I’m going to investigate further... thanks.

I,would be able to stop deca for 1 month defore BW. I’ll research NPP.
 
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TRT_Guy

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Lots of great advice, 150mg bi-weekly is a good quantity but awful dosing regime.

As stated, 75mg weekly which is 37.5mg twice a week (2x a week is better for hormone stability). Your choice in days, I started Mon/Thurs but wound up preferring Sun/Wed. May be easier to round up to 40mg 2x/week, difference will be negligible. You will more than likely not need an AI with this dose.

As for cycle, 250mg/wk split will be mind boggling for you compared to what you're used to in the past.
Though you will need to see some bloods on your first cycle with an AI on hand to see how you convert to estradiol, as many people are different and it's a case to case basis. Some may be good with no AI, and some may need quite a bit.

From what I have read with the moronic doctors you've been visiting, it might be wise to look for a new doctor or endo.
A lot of us go to a men's health clinic for a specialist, or a naturopath (these are more expensive, but more lenient & potentially knowledgeable). I can't believe that idiot thinks you won't need more after a year of injections? What does he think the stuff is permanent? What's a half-life? -PHD

Lots of great literature here, best of luck in your newfound life!
Thanks for taking the time to look at my situation.

I’m mature enough to know that 250 mg is a big beginner dose, but the testosterone makes me feel like an irresponsible younger me ;-) Good and bad. More frequent doses make sense... I’m just getting OK with pinning,

I do need a new MD but endo appointments are hard to find. I looked a little at clinics and I’ll have to look deeper at costs. I’m considering oldguyjiujitsu’s advice of getting BW through let’s letsgetchecked.com.

One this is for sure... I like where this is going. I’m a preacher for testosterone for the mature low-T guy.
 

CdnTRT4415

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The twice weekly injections does create a more stable T level with respect to estradiol impact however studies show that HCT can significantly increase with the frequent injections with the same weekly MG dosing. I've done this test on myself switching between twice weekly injections vs once per week injections of T-enan and found the following: once per week was preferable for hematocrit but not estradiol and the reverse held true as well. Both labs run at the same time of the week post injection.

CBC panels are even more important to look closely at as we get older as other heart related complications may tend to arise vs the younger athlete. Blood viscosity isn't something you really want to play with at the expense of additional muscle mass (although it seems like a great idea at the time...it usually does).

If your HCT is running higher than .52 then you should consider the following:
  1. lower your TRT dose (sucks I know but we're in this for the long term)
  2. try once per week injection protocol if not already following this
  3. donate blood every few months (monitoring your iron levels as these can tend to decline in some frequent donors)
  4. switch from injection to gel/patch/cream (I know this isn't the most desirable delivery system but again...long haul here)
  5. add a good quality fish oil/krill oil product daily (clinically proven to thin the blood to prevent clotting)
  6. add a low dose daily (or baby aspirin) daily to thin the blood
  7. request your physician perform an INR blood test to determine clotting time
  8. quit smoking
As an older athlete myself, I know how tempting it is to jump on some of the oldies and goodies when hitting up a blast but we also have to be cognizant of that window of health that slowly closes as we age that should supersede all else.

If you're going to go at TRT on your own accord please consider the following (now I'm not a medical professional but I have been researching PED's for several decades.

  • after changing any dosing wait at least six weeks prior to getting labs done. Have them done at two points in the week; the first two days post injection and the second immediately before your next injection. This will determine your baseline at that particular dose and give you the values at trough and roughly at peak. You want to make sure that the highs aren't too high and the lows not too low.
  • Pay particular attention to the following blood profile numbers
    • CBC - red blood cell count, hemoglobin and hematocrit
    • Estradiol (E2) - requesting a sensitive assay if available - many places in Canada this is not available
    • Thyroid Panel
    • FSH, LH - if you're planning on parenting in the near future (consider an HCG/HMG protocol if you are)
    • PSA - prostate specific antigen - this number may tend to increase as we get older
    • SHBG - this will scavenge available T and affect your free testosterone - no point having optimal levels if you're not getting the most bang for your buck
    • Total Test - individual labs vary on what their 'normal' range is but consider that anything above 600ng to roughly 1000ng is likely optimal for most - providing all the other blood values are in check

For those of us who don't have the availability to go in for labs on a fairly regular basis (which is highly recommended wherever possible) consider some of these markers when considering to increase dosages or continue with the present dosing protocol: (note that for every symptom there are likely a whole host of other variables which could cause the same side effect so take it with a grain of salt)

  • Blood pressure greater than 135/85 over consistent readings at different times during the day
  • redness or flushed feeling in the face (strong indicator of elevated red blood cell production)
  • itchy skin when coming out of shower or during/after training
  • lower back pain that is dull and ongoing
  • upper abdominal pain that is dull and ongoing
  • bloating of extremities (specifically hands/feet)
  • low grade headaches that are consistent
As our blood gets thicker (due to EPO brought on by PED's) the heart often has to work harder and your blood becomes less efficient at transporting oxygen to the cells. This can lead to elevated blood pressure, increased incidence of heart ailments and stroke.

All of these side effects are relatively easy to correct but you have to be willing to recognize them, diagnose them and properly treat them which in some cases (including my own) may involve lowering your TRT dosage protocol. There are definitely distinct performance advantages to having increased RBC (ask any cyclist or marathon runner) but it comes with a steady decline in performance once you cross a threshold where your body isn't as efficient as it was in performing these basic functions.

Sorry for the long winded post but I just wanted to share some of my experiences and research in the area. I would highly recommend finding a physician who specializes in low T AND who is not prejudice to following the proper treatment protocols which may also involve the use of aromatase inhibitors, HCG and erectile dysfunction meds. In researching many local Toronto based "TRT clinics or "Mens' Centers" I learned that many of them won't follow complete protocols when dealing with their patients.

My humble recommendation is to wait out Dr. Komer's waiting list and ask to be put on his cancellation list if you're able to attend on short notice.

Cheers, best wishes and continued good health!
 

CdnTRT4415

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@CdnTRT4415 extremely informative and well written first post!

Hmm.. not a doctor you say.. I have my suspicions lol
Thank you very much Veteran and thanks for overseeing a great forum. My TRT doc made a similar comment and I think I've even persuaded him to consider some things that he may not have considered otherwise.

I've been in the iron game for the better part of 40 years; competing a number of times (albeit not that successfully but heck, it's great to have goals to keep you on track lol) but as a result of the PED usage over the years, I developed steroid induced secondary hypogonadism which has got me on TRT for life. Not that this is a bad thing by any means as I'm a true believer in living better through science. Heck I'll even go so far to say that the odd blast and cruise from time to time can be warranted! o_O

My problem with the TRT is that I probably, as the late Dr. Crisler would proclaim, got 'greedy' with my TRT dosage and became solely focused on the T lab results as opposed to other underlies which may contradict the therapy over the long term. First and foremost I would recommend dealing with symptom relief in relation to dosing values. The physiological 'normal' TRT range varies so drastically that when you get to the top end of the 'normal' spectrum (32 nmol or roughly 900 ng/dL) the returns are somewhat diminishing unless you start adding in a greater dosage or additional compounds; while at the same time running the gambit of increased sides.

If your Dr/Health Practitioner/Holistic specialist/Mens Clinic wants to dose you greater than 10 days or won't consider ancillary medications such as anastrozole, femara, HCG, Clomid monotheraphy (dubious effectiveness) I would suggest shopping around for another opinion.

Most primary care physicians don't receive much, if any, requisite training on low testosterone treatment and function and thus know, in many cases, less than our average bro's on the forum.

Thanks again Vet and I appreciate being able to share my small triumphs and pitfalls.

(y)(y)
 
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