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Author Topic: Post-HRT Taper -> Back to TRT -> Now Steady on TRT  (Read 30781 times)

Balderdasher

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Re: Post-HRT Taper -> Back to TRT
« Reply #30 on: November 04, 2015, 02:20:55 am »
Hey Fellas -

Looking for a bit of advice on how to proceed.

Current protocol: 37mg T Cyp 2x/week SubQ (Sunday Morning/Wednesday Evening); 500IU HCG 3x/week (MWF)

Latest lab results, pulled on a trough day:

Total T: 1298 (348-1197)
Free T: 31.6 (8.7-25.1)
Estradiol: 76.6 (7.6-42.6)

Really shocked to see E2 skyrocket from my last labs, as the protocol is the roughly the same (I am now ~16 weeks in as opposed to 8), but with a lower dose of T Cyp.  Haven't been feeling particularly horrible - in fact, feeling much better as compared to the time I pulled 8 week labs.

Any suggestions re: protocol adjustments from here?  Considering adding in .5mg adex/week, and knocking the T dose down to 30mg 2x/week.  Of course, would prefer to stay off adex altogether, but not really sure if that is an option in the face of pretty ridiculous E2 numbers.

Funny you bring this up.  I just wrote a page covering this:

http://www.peaktestosterone.com/estradiol_dosage_frequency

Can you back down the HCG a bit.  I got "plumped up" from just 250 IU twice per week.

Great page Peak, and I was wondering the same about the HCG (although my doc, who is well respected in the field, seems to feel pretty strongly that the 500iu 3x/week protocol is key for testicular maintenance).  Right now I'm at about 8% body fat, so not a lot of wiggle room there, and a little concerned that just lowering my dose won't be enough to get such a high read down.
I am not a medical doctor.  All suggestions are meant to be discussed with your doctor.

Age: 30 | Height: 6ft 1in | Weight: 175

Protocol: 40mg T Cyp 2x/week + 400u HCG 2x/week.

Original Results - 9-2012:
TT: 387 ng/dl
FT: 11.2 pg/ml

Varicocele repair -> on TRT for 1 year -> tapered off T for 1 year -> back to TRT

PeakT

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Re: Post-HRT Taper -> Back to TRT
« Reply #31 on: November 04, 2015, 03:38:11 pm »

Great page Peak, and I was wondering the same about the HCG (although my doc, who is well respected in the field, seems to feel pretty strongly that the 500iu 3x/week protocol is key for testicular maintenance).  Right now I'm at about 8% body fat, so not a lot of wiggle room there, and a little concerned that just lowering my dose won't be enough to get such a high read down.

Sure, you can make a case that is a pretty natural option.  I just don't think it seems to work that well in guys in getting them back on their feet.  Haven't seen it on here anyway.

I want to get on HCG with HRT in a few months.  I think that's a pretty smart way to do as far as keeping everything in maintenance mode and activated.  Money is a little tight right now though.
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.

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Re: Post-HRT Taper -> Back to TRT
« Reply #31 on: November 04, 2015, 03:38:11 pm »


Balderdasher

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Re: Post-HRT Taper -> Back to TRT
« Reply #32 on: November 06, 2015, 02:26:42 am »

Great page Peak, and I was wondering the same about the HCG (although my doc, who is well respected in the field, seems to feel pretty strongly that the 500iu 3x/week protocol is key for testicular maintenance).  Right now I'm at about 8% body fat, so not a lot of wiggle room there, and a little concerned that just lowering my dose won't be enough to get such a high read down.

Sure, you can make a case that is a pretty natural option.  I just don't think it seems to work that well in guys in getting them back on their feet.  Haven't seen it on here anyway.

I want to get on HCG with HRT in a few months.  I think that's a pretty smart way to do as far as keeping everything in maintenance mode and activated.  Money is a little tight right now though.

I'm with you on the HCG, though I'm lucky in that my Doc sent me to a pharmacist who sells Pregnyl for $90 for 10,000 units. 

What don't you think seems to work well in getting guys back on their feet?
I am not a medical doctor.  All suggestions are meant to be discussed with your doctor.

Age: 30 | Height: 6ft 1in | Weight: 175

Protocol: 40mg T Cyp 2x/week + 400u HCG 2x/week.

Original Results - 9-2012:
TT: 387 ng/dl
FT: 11.2 pg/ml

Varicocele repair -> on TRT for 1 year -> tapered off T for 1 year -> back to TRT

PeakT

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Re: Post-HRT Taper -> Back to TRT
« Reply #33 on: November 06, 2015, 04:22:10 pm »

I'm with you on the HCG, though I'm lucky in that my Doc sent me to a pharmacist who sells Pregnyl for $90 for 10,000 units. 

What don't you think seems to work well in getting guys back on their feet?

Okay, that was poor wording on my part.  What I have noticed is that HCG will give men a decent boost in testosterone and also restore fertility usually of course.  So, if those are your goals, then that is great.

However, what is missing is the "wow factor."  I cannot remember any man on HCG Mono saying, "Man this is great stuff!"  Of course, I'm sure it happens - I just havent seen it on here.

Now another quite common thing that I have seen - and some smart guys on here dispute this - is quite a few men with testosterone of 700 with HCG Mono and E2 of like 70 or something very high.  So then they have to pack their dose to the 500's or so and they just don't feel that great.
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.

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Re: Post-HRT Taper -> Back to TRT
« Reply #33 on: November 06, 2015, 04:22:10 pm »


Balderdasher

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Re: Post-HRT Taper -> Back to TRT
« Reply #34 on: November 07, 2015, 03:26:52 pm »

I'm with you on the HCG, though I'm lucky in that my Doc sent me to a pharmacist who sells Pregnyl for $90 for 10,000 units. 

What don't you think seems to work well in getting guys back on their feet?

Okay, that was poor wording on my part.  What I have noticed is that HCG will give men a decent boost in testosterone and also restore fertility usually of course.  So, if those are your goals, then that is great.

However, what is missing is the "wow factor."  I cannot remember any man on HCG Mono saying, "Man this is great stuff!"  Of course, I'm sure it happens - I just havent seen it on here.

Now another quite common thing that I have seen - and some smart guys on here dispute this - is quite a few men with testosterone of 700 with HCG Mono and E2 of like 70 or something very high.  So then they have to pack their dose to the 500's or so and they just don't feel that great.

Ahhh I'm with you now - thanks for the explanation.  On both T Cyp + HCG now, so I'm thinking I'll adjust down from 500iu 3x/week to 250iu 3x/week and hang out with T Cyp at ~35mg 2x/week.  Considering adding in a bit of adex, .25mg 2x/week or so, just to get this E2 down before gyne starts to set in.
I am not a medical doctor.  All suggestions are meant to be discussed with your doctor.

Age: 30 | Height: 6ft 1in | Weight: 175

Protocol: 40mg T Cyp 2x/week + 400u HCG 2x/week.

Original Results - 9-2012:
TT: 387 ng/dl
FT: 11.2 pg/ml

Varicocele repair -> on TRT for 1 year -> tapered off T for 1 year -> back to TRT

PeakT

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Re: Post-HRT Taper -> Back to TRT
« Reply #35 on: November 07, 2015, 09:05:08 pm »
Why would you just jump into Arimidex?  Shouldn't you do this?

http://www.peaktestosterone.com/Estradiol_Dosage_Frequency
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.

Balderdasher

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Re: Post-HRT Taper -> Back to TRT
« Reply #36 on: November 08, 2015, 12:59:31 am »
Why would you just jump into Arimidex?  Shouldn't you do this?

http://www.peaktestosterone.com/Estradiol_Dosage_Frequency

Absolutely, I would much prefer to go sans-AI than to take a pharmaceutical.  My concerns are:

1) I don't have any pounds/body fat to lose
2) My dose frequency is already pretty regular (2x a week on the T cyp, 3x a week on the HCG) - definitely don't want to inject every day if I can avoid it.

So that (as far as I can tell) leaves cutting my dose, which I am dropping from 500u 3x/week to 250iu.  My concern is that this won't be sufficient to tackle an E2 level as high as 70+.  I'm also pretty freaked out at the idea of what a level that high for any extended period of time could do, especially in the way of gyne.

That said, if anyone else has ay suggestions for how I could avoid the AI, and get my E2 down relatively quickly, I'm very open to it!
I am not a medical doctor.  All suggestions are meant to be discussed with your doctor.

Age: 30 | Height: 6ft 1in | Weight: 175

Protocol: 40mg T Cyp 2x/week + 400u HCG 2x/week.

Original Results - 9-2012:
TT: 387 ng/dl
FT: 11.2 pg/ml

Varicocele repair -> on TRT for 1 year -> tapered off T for 1 year -> back to TRT

PeakT

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Re: Post-HRT Taper -> Back to TRT
« Reply #37 on: November 08, 2015, 04:36:18 am »
Why would you just jump into Arimidex?  Shouldn't you do this?

http://www.peaktestosterone.com/Estradiol_Dosage_Frequency

Absolutely, I would much prefer to go sans-AI than to take a pharmaceutical.  My concerns are:

1) I don't have any pounds/body fat to lose
2) My dose frequency is already pretty regular (2x a week on the T cyp, 3x a week on the HCG) - definitely don't want to inject every day if I can avoid it.

So that (as far as I can tell) leaves cutting my dose, which I am dropping from 500u 3x/week to 250iu.  My concern is that this won't be sufficient to tackle an E2 level as high as 70+.  I'm also pretty freaked out at the idea of what a level that high for any extended period of time could do, especially in the way of gyne.

That said, if anyone else has ay suggestions for how I could avoid the AI, and get my E2 down relatively quickly, I'm very open to it!

Okay, I admit you've done your due diligence.  Just want to make sure...
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.

Balderdasher

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Re: Post-HRT Taper -> Back to TRT
« Reply #38 on: November 08, 2015, 07:22:14 am »
Why would you just jump into Arimidex?  Shouldn't you do this?

http://www.peaktestosterone.com/Estradiol_Dosage_Frequency

Absolutely, I would much prefer to go sans-AI than to take a pharmaceutical.  My concerns are:

1) I don't have any pounds/body fat to lose
2) My dose frequency is already pretty regular (2x a week on the T cyp, 3x a week on the HCG) - definitely don't want to inject every day if I can avoid it.

So that (as far as I can tell) leaves cutting my dose, which I am dropping from 500u 3x/week to 250iu.  My concern is that this won't be sufficient to tackle an E2 level as high as 70+.  I'm also pretty freaked out at the idea of what a level that high for any extended period of time could do, especially in the way of gyne.

That said, if anyone else has ay suggestions for how I could avoid the AI, and get my E2 down relatively quickly, I'm very open to it!

Okay, I admit you've done your due diligence.  Just want to make sure...

Thanks Peak - definitely on board with subscribing to as few meds as possible.  Wish someone had questioned the use of an AI the first time I tried it, certainly would have saved me a lot unwarranted headaches!
I am not a medical doctor.  All suggestions are meant to be discussed with your doctor.

Age: 30 | Height: 6ft 1in | Weight: 175

Protocol: 40mg T Cyp 2x/week + 400u HCG 2x/week.

Original Results - 9-2012:
TT: 387 ng/dl
FT: 11.2 pg/ml

Varicocele repair -> on TRT for 1 year -> tapered off T for 1 year -> back to TRT

Hydranted

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Re: Post-HRT Taper -> Back to TRT
« Reply #39 on: November 08, 2015, 07:48:47 am »
I think you're on the right track by lowering your dose of hCG.  Some guys are very prone to high estradiol levels with hCG, and it's possible that you're one of them. 

In my opinion it makes a ton of sense to figure out if that's your issue, and fixing it, before adding an AI.  While 1500IU of hCG per week isn't an astronomical dose, it's enough to cause problems for a lot of us.

I think that dropping it down to 250IU 3x per week is a good move.  If you see improvement you may even be able to titrate that dose down a little further if you need to. 

Any chance that you're injecting more testosterone than you think you are?  I'm not trying to insult your math skills, it's just interesting to see these lab values on a protocol like yours. 

I'm betting that it's the hCG that is complicating things for you, but I suppose we will figure that out pretty soon.

Balderdasher

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Re: Post-HRT Taper -> Back to TRT
« Reply #40 on: November 08, 2015, 08:05:51 am »
I think you're on the right track by lowering your dose of hCG.  Some guys are very prone to high estradiol levels with hCG, and it's possible that you're one of them. 

In my opinion it makes a ton of sense to figure out if that's your issue, and fixing it, before adding an AI.  While 1500IU of hCG per week isn't an astronomical dose, it's enough to cause problems for a lot of us.

I think that dropping it down to 250IU 3x per week is a good move.  If you see improvement you may even be able to titrate that dose down a little further if you need to. 

Any chance that you're injecting more testosterone than you think you are?  I'm not trying to insult your math skills, it's just interesting to see these lab values on a protocol like yours. 

I'm betting that it's the hCG that is complicating things for you, but I suppose we will figure that out pretty soon.

Yeah, it was definitely a surprise to see this read, especially considering that E2 was ~30s on the same protocol just 8 weeks or so ago.  Good point re: changing one thing at a time - always hard to keep track of the root causes when a lot of things are in flux. 

Think my math is good on the T Cyp (though please correct me if I'm wrong) - have been pulling from a 1ml vial of 200mg/ml at .17ml (calculating 34mg) 2x per week. 

Looking back a few posts ago, at 45 mg 2x/week I was at:

Testosterone: 962ng/dl (348-1197)
Free T: 16.9pg/ml (9.3-26.5)
E2 (Sensitive): 21 pg/ml (8-35)
E2 (Standard): 26 pg/ml (7.6-42.6)


After adding HCG 500u 3x/week, my results popped up to (peak levels, 8 weeks into the protocol):

Tests: (3) Testosterone,Free and Total (140103)
Testosterone, Serum [H] 1496 ng/dL 348-1197 *1 Comment: See report
Adult male reference interval is based on a population of lean males up to 40 years old.
Free Testosterone(Direct) [H] 43.5 pg/mL (8.7-25.1 *2)
Tests: (4) Estradiol (004515) Estradiol 36.0 pg/mL (7.6-42.6)
Roche ECLIA methodology


So it definitely looks like my body has taken the HCG and just run with it, with E2 just slipping out of hand the past couple of months.

Also thinking about getting E2 retested just to be sure, given the dramatic jump in a relatively short period of time.
I am not a medical doctor.  All suggestions are meant to be discussed with your doctor.

Age: 30 | Height: 6ft 1in | Weight: 175

Protocol: 40mg T Cyp 2x/week + 400u HCG 2x/week.

Original Results - 9-2012:
TT: 387 ng/dl
FT: 11.2 pg/ml

Varicocele repair -> on TRT for 1 year -> tapered off T for 1 year -> back to TRT

Hydranted

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Re: Post-HRT Taper -> Back to TRT
« Reply #41 on: November 08, 2015, 08:21:25 am »
Well it definitely looks like the hCG is the "problem".  I think your dose just needs to be adjusted and some time needs to pass for things to balance out. 

1500IU of hCG is generally an unnecessarily high weekly dose to keep your fellas working properly anyway, and now there's the bonus of your hCG prescription lasting longer and saving you a bit of money!

Balderdasher

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Re: Post-HRT Taper -> Back to TRT
« Reply #42 on: November 08, 2015, 08:38:38 am »
Well it definitely looks like the hCG is the "problem".  I think your dose just needs to be adjusted and some time needs to pass for things to balance out. 

1500IU of hCG is generally an unnecessarily high weekly dose to keep your fellas working properly anyway, and now there's the bonus of your hCG prescription lasting longer and saving you a bit of money!

Really appreciate the insights!  Certainly won't hurt to spread my HCG dollars out a little further.  Thanks again Peak and Hydranted.
I am not a medical doctor.  All suggestions are meant to be discussed with your doctor.

Age: 30 | Height: 6ft 1in | Weight: 175

Protocol: 40mg T Cyp 2x/week + 400u HCG 2x/week.

Original Results - 9-2012:
TT: 387 ng/dl
FT: 11.2 pg/ml

Varicocele repair -> on TRT for 1 year -> tapered off T for 1 year -> back to TRT

Balderdasher

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Re: Post-HRT Taper -> Back to TRT
« Reply #43 on: December 13, 2015, 07:52:57 am »
Hey All -

So, after my last post I consulted with my Doc and went down to 32mg T Cyp 2x/week + 250iu HCG 3x/week + .25mg Adex 1x/week.  The results were pretty dramatic (just posting the ones that are relevant/abnormal) - drawn on a trough day for reference, though my levels tend to remain pretty stable between trough and peak.  Worth noting that during this time I was feeling fatigued, experienced decreased penile sensitivity, felt dehydrated, and had very dry lips.

CBC With Differential/Platelet
WBC - 4.6 x10E3/uL (3.4-10.8)
RBC - 5.67 x10E3/uL (4.14-5.80)
Hemoglobin - 17.9 g/dL HIGH (12.6-17.7)
Hematocrit - 52.2% HIGH (37.5-51.0)

MCV - 92 fL (79-97)
MCH - 31.6 pg (26.6 - 33.0)
MCHC - 34.3 g/dL (31.5-35.7)
RDW - 12.3% (12.3-15.4)
Platelets - 256 x10E3/uL (150-379)
Neutrophils - 60%
Lymphs - 30%
Monocytes - 9%
Eos - 0%
Basos - 1%
Neutrophils (Absolute) - 2.8 x10E3/uL (1.4-7.0)
Lymphs (Absolute) - 1.4 x10E3/uL (0.7-3.1)
Monocytes (Absolute) - 0.4 x10E3/uL (0.1-0.9)
Eos (Absolute) - 0.0 x10E3/uL (0.0-0.4)
Baso (Absolute) - 0.0 x10E3/uL (0.0-0.2)
Immature Granulocytes - 0%
Immature Grans (Abs) - 0.0 x10E3/uL (0.0-0.1)

Comp. Metabolic Panel
Glucose, Serum - 72 mg/dL (65-99)
BUN - 14 mg/dL (6-20)
Creatinine, Serum - HIGH 1.42 mg/dL (0.76-1.27)
eGFR If NonAfricn Am - 66 mL/min/1.73 (>59)
BUN/Creatinine Ratio - 10 (8-19)
Sodium, Serum - 141 mmol/L (134-144)
Potassium, Serum - 4.5 mmol/L (3.5-5.2)
Chloride, Serum - 99 mmol/L (97-108)
Carbon Dioxide, Total - 26 mmol/L (18-28)
Calcium, Serum - 9.8 mg/dL (8.7-10.2)
Protein, Total, Serum - 7.5 g/dL (6.0-8.5)
Albumin, Serum - 4.9 g/dL (3.5-5.5)
Globulin, Total - 2.6 g/dL (1.5-4.5)
A/G Ratio - 1.9
Bilirubin, Total - 0.7 mg/dL (0.0-1.2)
Alkaline Phosphates, S - 95 IU/L (39-117)
AST (SGOT) - 24 IU/L (0-40)
ALT (SGPT) - 9 IU/L (0-44)

Hormones n' Such
Testosterone, Total 721 ng/dL (348-1197)
Free Testosterone (Direct) 12.8 pg/mL (8.7-25.1)
Estradiol (Standard Assay) <5.0 pg/mL LOW (7.6-42.6)

DHEA, Serum 332 ng/dL (31-701)

TSH 1.490 uIU/mL (0.450-4.500)
Free T4 1.55 ng/dL (0.82-1.77)
Free T3 3.7 pg/mL (2.0-4.4)

Planning on:

1) Dropping Adex altogether (had a sneaking suspicion I was low E2 when labs were drawn based on PeakT's E2 symptoms page, and did this about 1.5 weeks ago)

2) Will likely up my T Cyp to 40mg 2x/week

3) Getting blood donated ASAP to knock hematocrit down

A few thoughts:

1) By just dropping HCG from 500iu to 250iu 3x/week + adding in 25mg adex 1x/week, my E2 levels (standard assay, though in the past I've not noticed much difference between sensitive and standard) dropped from 70+ to under 5 pg/mL.  For those who have followed this thread from the beginning, you'll know that my original protocol (per Doctor's orders) was 1mg Adex 3x/week.  Crazy to think now, but obviously Adex is powerful stuff.

2) Curious if my HCG may be losing its potency over time as it nears it's expiration date.  I keep it refrigerated, but usually leave it hanging on the fridge door and have wondered in the past if it worked less effectively after some time had passed based upon symptoms.

3) Also had a urine analysis come back with slightly high proteinuria levels (+1).  This, combined with the elevated creatinine levels are causing me to wonder if something is going on with the kidneys.  I had a varicocele embolization awhile back, and vaguely remember some concern that the coils could cause kidney issues (perhaps from floating into the kidneys).  Does anybody have any experience/thoughts surrounding elevated creatinine and proteinuria?
« Last Edit: December 13, 2015, 08:16:53 pm by Balderdasher »
I am not a medical doctor.  All suggestions are meant to be discussed with your doctor.

Age: 30 | Height: 6ft 1in | Weight: 175

Protocol: 40mg T Cyp 2x/week + 400u HCG 2x/week.

Original Results - 9-2012:
TT: 387 ng/dl
FT: 11.2 pg/ml

Varicocele repair -> on TRT for 1 year -> tapered off T for 1 year -> back to TRT

explorer

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Re: Post-HRT Taper -> Back to TRT
« Reply #44 on: December 13, 2015, 02:27:59 pm »
If you're donating, you should test ferritin and iron saturation to know how far you can/need to go.
« Last Edit: December 13, 2015, 02:34:26 pm by explorer »

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Re: Post-HRT Taper -> Back to TRT
« Reply #44 on: December 13, 2015, 02:27:59 pm »