Best Practices in Low Testosterone Treatment
When performed correctly, testosterone treatment can have profound effects on mental, physical, and emotional health.
If performed incorrectly, side effects and diminished quality of life are common.
The following information is the culmination of today's best practices in hypogonadism treatment, developed by leading doctors in hormone replacement therapy.
T Treatment Trifecta
Testosterone + HCG + Arimidex
If your doctor only prescribes testosterone by itself, you will most likely be in for a rough ride.
The problem with test only regimens is that one of the main metabolites (estrogen), tends to get out of control.
High estrogen negates most of the benefits of TRT, resulting in many of the same symptoms of low testosterone you had in the first place!
Fatigue, impotence, water retention (bloat), depression, and brain fog are all commonly associated with high estrogen.
Arimidex Lowers Estrogen Levels
The solution, is to add an estrogen lowering medication, commonly Arimidex (anastrozole) or Aromasin (exemestane). It's from the class of medications called aromatase inhibitors, which essentially block the conversion of testosterone to estrogen.
It helps by forcing testosterone output to remain high while keeping estrogen levels low.
Once your testosterone and estrogen levels are dialed in, it's time to stop the next inevitable decline... shrinking testicles and it's often associated fertility problems.
HCG Injections/Shots and Side Effects
This is where the medication HCG (Human Chorionic Gonadotropin) comes in. It helps prevent the side effects of infertility and testicle shrinkage that commonly occurs during testosterone treatment.
Basically, your testicles shrink because your body's under the misguided notion it doesn't need to make testosterone anymore.
When your androgens are being supplied from an external source, your balls are essentially saying "That's ok, we already have enough. It's time to shut things down."
For some, small testicles may just be a cosmetic problem. But HGC injections do more than increase testicle size, it also increases adrenal function, which has many positive effects on well-being, libido, and energy in of itself.
Testosterone Treatment Dosages for Men
50mg Testosterone enanthate/cypionate every third day.
0.25mg Arimidex every third day.
500IU HCG every third day.
All medications taken on the same day.
Many doctors want to prescribe dosages over longer periods of time, however testosterone's half life should be kept in mind to prevent fluctuations and the variable effects that go with it.
The half life of a medication is the amount of time it takes to metabolize to half it's original dose.
Half Life of Testosterone
For example... both testosterone cypionate and enanthate have a half life of approximately 7 days. A 100mg injection would then result in 50mg after 7 days, 25mg after 14 days, and so on and so on.
If you wait a week, two weeks, or even a month (like some doctors suggest), you may well imagine the mental, physical, and emotional roller coaster ride you will be in for! For this reason it's extremely important dosing is scheduled properly!
An every third day (E3D) dosing regimen, results in the most stable androgen levels over time.
Once you've been on the test, Arimidex, and HCG protocol for 6 weeks, it's usually a good idea to get your blood levels tested to see where you're at.
Ideal Hormone and T Levels for Optimal Health
Total Testosterone 800 - 1,000 ng/dl
Free Testosterone 250 - 300 pg/ml
Estradiol 20 - 30 pg/ml
SHBG 10 - 30 nmol/l
DHT 60 - 70 ng/dl
Prolactin 2 - 3 ng/ml
DHEA-S ~ 300 ug/dl
You may need to adjust your medications accordingly to meet the desirable hormone ranges. Of course, it goes without saying "symptoms should always trump numbers."
Most important is assessing how you feel during testosterone treatment, and not just scraping the bottom of a "healthy" range.