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Author Topic: Injecting < 100 mg Per Week  (Read 20974 times)

Kierkegaard

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Injecting < 100 mg Per Week
« on: January 11, 2015, 11:47:49 pm »
Dr. Mark Gordon is one of the heavyweights in TRT; he's a good friend of Dr. Crisler, and also the guy who invented the phrase "interventional endocrinology" to replace "antiaging medicine".  Turns out both of these guys are moving against the standard 100 mg per week injections.  Gordon said he averages about 60-80 mg per week, usually in divided doses, for his patients to reach good levels, and he doesn't use an AI for this reason (although he does use up to 160 mg per day of Zinc balanced with copper as an alternative to arimidex when needed), also because of health concerns with arimidex.  The following is a quote from Gordon (taken from another forum because the original link to this quote is broken):

Quote
First off why would anyone need an estrogen blocker? Not rhetorical but, I can't hear your answer. So here is my take on this whole issue of testosterone replacement . If you replace or supplement the body with the amount of testosterone that it makes you don't run into needing estrogen blockers EBs. A number of studies from as far back as 1963 (in my collection) show that healthy solid males between the age of 25-35 produce from 4.1-10mg of T a day. That is about 60mg a week (median). So why would you need more?

I believe that the medical world has relied on the bodybuilding world for directions in how to abuse our bodies with super physiological doses of T. In 15 years with over 10,000 patient cycles (3 months) I've never used EBs to recover from E2 overload in a male. Also, Zinc blocks conversion of T to E2 by competitive inhibition of magnesium at the estradiol synthetase enzyme that we call Aromatase. So if you perform comprehensive assessments of your patients before starting hormones then add the Zn.

More than 80% of my population use 60-40mg [typo?  80 mg?] of T a week. I have some very physically active males...who use 40mg twice a week. A rare 100mg a week. I am in shock at the number of traditional physicians that start a patient on 200-300mg a week and automatically use an EB. I am even more perplexed over those of us who trained in interventional endocrinology and use excessive amounts. If we are to promote ourselves as safe alternatives to traditional medicine should we not provide that to our patients? All the best. M L Gordon. Watch for my new Medical Tidbits coming exclusively to the Anti-Aging Space.

All this is both interesting and perplexing.  I don't know if Dr. Gordon does subcutaneous injections, but since I've started them I've noticed my levels get too high (with T and E2) on two different occasions, even though I was only injecting around 77 mg per week.  So it's looking like, at least since going subq, Dr. Gordon's advice is likely spot on for me -- I've been injecting too much all along, causing my estrogen to get too high, and should be aiming for 60 mg a week (which is what I'm trying now, third time's a charm).  It's also perplexing in that there are plenty of guys whose bloodwork shows that 100 mg or less per week clearly isn't enough.  Dr. Gordon (and Crisler) also believe in supplementing pregnenolone and other hormones preceding testosterone.

On a related note, it's interesting how all the studies on subcutaneous injections use 50-60 mg per week, such as the following:

http://online.liebertpub.com/doi/abs/10.1089/lgbt.2014.0018?journalCode=lgbt (average 46.4 mg per week for average T level of 521 ng/dl)

https://endo.confex.com/endo/2013endo/webprogram/Paper9064.html (50-60 mg per week for average T level of 608 ng/dl)

Maybe we're all injecting too much?
"The same thing that makes you live can kill you in the end." -- Neil Young

March 2014: Dx low T (158ng/dl)
September 2015: Dx hypothyroidism, other adrenal hypofunction
2016: chronic fatigue, unspecified

Depression and anxiety guide: http://www.peaktestosterone.com/Help_Anxiety_Depression

VinnAY

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Re: Injecting < 100 mg Per Week
« Reply #1 on: January 11, 2015, 11:59:55 pm »
Injecting only what you need to survive, which is some poetic license but that's how I read it, I think, is rather short-sighted. I am though, totally in the camp for less to no Anastrozole and that it shouldn't be viewed as a necessity to any TRT protocol. I for one am on what most would call the upper limit of weekly TRT but I'm also a gym rat and enjoy being >1k TT, with my Dr's concurrence. I would not however, go above this dosing. I'm much more concerned now with E2 management after having been too low and caught up in this "must take 1mg Anastrozole per week" that seems standard.

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Re: Injecting < 100 mg Per Week
« Reply #1 on: January 11, 2015, 11:59:55 pm »


PeakT

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Re: Injecting < 100 mg Per Week
« Reply #2 on: January 12, 2015, 12:28:05 am »
You have to watch your hematocrit and hemoglobin if you go on the high side witb trt.  Try his is a decades long thing and it could predispose one to stroke, etc.
THE MOST COMPREHENSIVE BOOK ON TRT/TESTOSTERONE:
https://www.amazon.com/Natural-Versus-Testosterone-Therapy-Myer/dp/1523210532/ref=sr_1_1?ie=UTF8&qid=1499116128&sr=8-1&keywords=natural+versus+testosterone+therapy
And check out my New Peak Testosterone Program: http://www.peaktestosterone.com/peak_testosterone_program
If you are on medications or have a medical condition, always check with your doctor first before making any lifestyle changes or taking new supplements.  And low testosterone is a medical condition.

VinnAY

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Re: Injecting < 100 mg Per Week
« Reply #3 on: January 12, 2015, 01:29:29 am »
Even the Doc's that don't know what they're doing on Test replacement they at least run CBC which gives you the RBC, Hematocrit, etc

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Re: Injecting < 100 mg Per Week
« Reply #3 on: January 12, 2015, 01:29:29 am »


Regulus

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Re: Injecting < 100 mg Per Week
« Reply #4 on: January 12, 2015, 12:36:10 pm »
Hold the phone.

I'm not 100% clear on the math here. 

100 mg of testosterone CYPIONATE… Is that really the same as 100 mg of testosterone?

My understanding (which may be completely incorrect) is that the ester is approximately 30% of test cyp.

So assuming this figure is correct, 100 mg of test cyp equates to 70 mg of testosterone.  Which would put the standard 100 mg dose pretty much right in line with the median natural production.
Late 40's, on TRT since 2011.
Test cyp 50 mg twice per week
Vegan and loving it since late 2015

PeakT

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Re: Injecting < 100 mg Per Week
« Reply #5 on: January 12, 2015, 04:13:29 pm »
I've scaled it down to 80 mg per week to see how I feel.  In my case, I'm worried I may go a little low with estradiol.  So we'll see...
THE MOST COMPREHENSIVE BOOK ON TRT/TESTOSTERONE:
https://www.amazon.com/Natural-Versus-Testosterone-Therapy-Myer/dp/1523210532/ref=sr_1_1?ie=UTF8&qid=1499116128&sr=8-1&keywords=natural+versus+testosterone+therapy
And check out my New Peak Testosterone Program: http://www.peaktestosterone.com/peak_testosterone_program
If you are on medications or have a medical condition, always check with your doctor first before making any lifestyle changes or taking new supplements.  And low testosterone is a medical condition.

Kierkegaard

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Re: Injecting < 100 mg Per Week
« Reply #6 on: January 12, 2015, 07:38:57 pm »
Hold the phone.

I'm not 100% clear on the math here. 

100 mg of testosterone CYPIONATE… Is that really the same as 100 mg of testosterone?

My understanding (which may be completely incorrect) is that the ester is approximately 30% of test cyp.

So assuming this figure is correct, 100 mg of test cyp equates to 70 mg of testosterone.  Which would put the standard 100 mg dose pretty much right in line with the median natural production.

I've heard the same.  Unfortunately, I don't know for sure if Gordon is referring to testosterone injectibles or the 70% number you mention.  My guess is it's the former.  And 70 mg is at the top end of the range if guys max 10 mg a day.  The sticky with E2 stuff has a figure by Nelson Vergel and it has even lower ranges for natural testosterone production. 
"The same thing that makes you live can kill you in the end." -- Neil Young

March 2014: Dx low T (158ng/dl)
September 2015: Dx hypothyroidism, other adrenal hypofunction
2016: chronic fatigue, unspecified

Depression and anxiety guide: http://www.peaktestosterone.com/Help_Anxiety_Depression

Kierkegaard

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Re: Injecting < 100 mg Per Week
« Reply #7 on: January 12, 2015, 08:07:00 pm »
I'm in a tricky situation since going subq.  I was feeling the best I've ever felt in my life while going literally 30mg E4D IM, but this lasted about two weeks before my numbers got a little low and I started feeling fatigued.  After this I got the okay from my doc to go subq, and started feeling very good but not quite the 100% I experienced at the end of my IM journey.  My guess is that I was injecting 10-20% too much subq at the time.  Another confound is that I ended up going too high with my numbers and started over with 33 mg E3D instead of 35 mg E3D, and again I gradually went too high, which is a little confusing: either my levels added up regardless of the 2 mg difference (because I was on 33 mg longer than 35 mg before I started having problems), or the few pounds I added have influenced my E2 conversion slightly, explaining the 2 mg difference.  Now I'm saying fuck it and injecting 24 mg E3D and sticking with it. Judging from my previous numbers, this should be put me at around 700 ng/dl total T, but we'll see. 
"The same thing that makes you live can kill you in the end." -- Neil Young

March 2014: Dx low T (158ng/dl)
September 2015: Dx hypothyroidism, other adrenal hypofunction
2016: chronic fatigue, unspecified

Depression and anxiety guide: http://www.peaktestosterone.com/Help_Anxiety_Depression

PeakT

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Re: Injecting < 100 mg Per Week
« Reply #8 on: January 12, 2015, 09:30:03 pm »
I'm in a tricky situation since going subq.  I was feeling the best I've ever felt in my life while going literally 30mg E4D IM, but this lasted about two weeks before my numbers got a little low and I started feeling fatigued.  After this I got the okay from my doc to go subq, and started feeling very good but not quite the 100% I experienced at the end of my IM journey.  My guess is that I was injecting 10-20% too much subq at the time.  Another confound is that I ended up going too high with my numbers and started over with 33 mg E3D instead of 35 mg E3D, and again I gradually went too high, which is a little confusing: either my levels added up regardless of the 2 mg difference (because I was on 33 mg longer than 35 mg before I started having problems), or the few pounds I added have influenced my E2 conversion slightly, explaining the 2 mg difference.  Now I'm saying fuck it and injecting 24 mg E3D and sticking with it. Judging from my previous numbers, this should be put me at around 700 ng/dl total T, but we'll see.

Wow.  You win the award for lowest dosing I think...
THE MOST COMPREHENSIVE BOOK ON TRT/TESTOSTERONE:
https://www.amazon.com/Natural-Versus-Testosterone-Therapy-Myer/dp/1523210532/ref=sr_1_1?ie=UTF8&qid=1499116128&sr=8-1&keywords=natural+versus+testosterone+therapy
And check out my New Peak Testosterone Program: http://www.peaktestosterone.com/peak_testosterone_program
If you are on medications or have a medical condition, always check with your doctor first before making any lifestyle changes or taking new supplements.  And low testosterone is a medical condition.

euphorixx1

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Re: Injecting < 100 mg Per Week
« Reply #9 on: January 13, 2015, 12:26:18 am »
I would still love to know why when I was going subQ, i could get T levels of 615 and have E2 levels of 30+, but using the same dose(with HCG) intra muscular, my E2 never gets above 22... any thoughts on that?

Kierkegaard

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Re: Injecting < 100 mg Per Week
« Reply #10 on: January 13, 2015, 12:33:13 am »
I would still love to know why when I was going subQ, i could get T levels of 615 and have E2 levels of 30+, but using the same dose(with HCG) intra muscular, my E2 never gets above 22... any thoughts on that?

What were your T levels on the same dose HCG?
"The same thing that makes you live can kill you in the end." -- Neil Young

March 2014: Dx low T (158ng/dl)
September 2015: Dx hypothyroidism, other adrenal hypofunction
2016: chronic fatigue, unspecified

Depression and anxiety guide: http://www.peaktestosterone.com/Help_Anxiety_Depression

euphorixx1

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Re: Injecting < 100 mg Per Week
« Reply #11 on: January 13, 2015, 12:50:42 am »
I would still love to know why when I was going subQ, i could get T levels of 615 and have E2 levels of 30+, but using the same dose(with HCG) intra muscular, my E2 never gets above 22... any thoughts on that?

What were your T levels on the same dose HCG?

When I switched to 120mg a week IM my T was 922, and E2 was 22.  When I switched to 60mge3.5d with 250HCG mixed in the same syringe, my T was about 850 and sensitive E2 was 15.

euphorixx1

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Re: Injecting < 100 mg Per Week
« Reply #12 on: January 13, 2015, 12:51:27 am »
I dont know why, but I convert my T to E2 with subQ, and I have over 5 blood tests that verify this.  Unless I am injecting SUBQ incorrectly, I don't understand it.

PeakT

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Re: Injecting < 100 mg Per Week
« Reply #13 on: January 13, 2015, 01:08:07 am »
I dont know why, but I convert my T to E2 with subQ, and I have over 5 blood tests that verify this.  Unless I am injecting SUBQ incorrectly, I don't understand it.
You mean that you get more, proportionately, E2 when using subQ, right?

Well, the old concern was that injecting into fat where the aromatase is would lead to overly high estradiol levels.  That's not supposed to be an issue, but who knows?  Maybe with some guys this is an issue.
THE MOST COMPREHENSIVE BOOK ON TRT/TESTOSTERONE:
https://www.amazon.com/Natural-Versus-Testosterone-Therapy-Myer/dp/1523210532/ref=sr_1_1?ie=UTF8&qid=1499116128&sr=8-1&keywords=natural+versus+testosterone+therapy
And check out my New Peak Testosterone Program: http://www.peaktestosterone.com/peak_testosterone_program
If you are on medications or have a medical condition, always check with your doctor first before making any lifestyle changes or taking new supplements.  And low testosterone is a medical condition.

euphorixx1

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Re: Injecting < 100 mg Per Week
« Reply #14 on: January 13, 2015, 01:12:15 am »
Maybe so.

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Re: Injecting < 100 mg Per Week
« Reply #14 on: January 13, 2015, 01:12:15 am »