# TRT Overview for Beginners



## Spongy (Apr 9, 2012)

HRT, as we know, refers to Hormone Replacement Therapy.  In the context of the body building and fitness world HRT or TRT are used to give males the levels of testosterone that they enjoyed in their 20s.  This allows us to maintain our muscle mass as well as stave off many, if not all, of the unwanted sides associated with have low testosterone including low sex drive, loss of muscle, depression, mental fogginess, and increase in body fat.


*TESTOSTERONE*

The base of any H/TRT protocol is going to be testosterone.  While this comes in many forms, anecdotal evidence coupled with blood work seems to suggest that regular injections of testosterone appear to be the most effective form of administration.  Bear in mind that is important to find an Endo or Urologist who is competent.  Many will error on the side of caution out of fear of reprisal from the various governing bodies of the medical community.  It is not uncommon for a doctor to prescribe a single injection of testosterone every 2 weeks.  This creates problems on its own.  The most common form of testosterone injection prescribed in the United States is Cypionate, which has 8 carbons attached.  As a result, the half-life is much longer than that of propionate, but nowhere near long enough to justify a 2 week lapse between injections.  The issue with this is that immediately after your injection, your levels will be very high and you will feel normal, or better than normal.  As the first week passes you will not notice much of a change until the end.  Towards the end you may start to feel a bit less energized, maybe less interested in sexual exploits, etc.  As you go through the second week you will find yourself becoming more and more irritable, less social, etc...  You may even have erectile issues and eventually feel the exact same, or worse than you did before starting TRT.  Then once you have your injection, you will start the cycle again.  The reason for this is that the influx of exogenous testosterone inhibits your body’s ability to produce testosterone naturally, therefore effectively shutting down production.  Your levels will continue to drop off as the exogenous testosterone leaves, and your levels will eventually drop to below where you started before TRT because your body is unable to produce even enough testosterone to bring you to that level.  As a point of reference I used myself as a guinea pig, so to speak.  My current protocol calls for injections every 5 days.  I know that after my injection, my levels are high, which is good.  I also know that on day 5, immediately before my next injection, my levels are at 738, which is mid-high normal.  That is exactly where I want them.  Out of curiosity I went 8 days without injection a got blood work.  My levels were at 217!  As you can see, between days 5 and 8, my levels dropped over 500 points!  The reason, once again, being that the exogenous test was no longer in my system, and my natural production was suppressed.  Bear in mind that my natural levels pre TRT were 377.  By injecting every 5 days, I limit the peaks and valleys and rarely notice any change in my sex drive or mood.  It is my opinion that beginning TRT protocols should consist of injection every 5 to 7 days of a Cypionate or Enanthate ester.  Injecting less frequently than that will lead to unwanted side effects.

*AROMATASE INHIBITORS*

While testosterone may be the base of any TRT protocol, there are other things to consider...  One of the most overlooked aspects of testosterone by many Endos/Urologists is the rate at which it is converted into estrogen within the body.  Because of this it is incredible important to monitor estrogen levels and add an aromatase inhibitor.  I personally take anastrozole the day after my testosterone injection.  

An aromatase inhibitor is generally used to treat postmenopausal women with breast cancer or ovarian cancer, but is used as an off label treatment for men with gyno or for men with overly high levels of estrogen.  They are enzymes which either block the production of estrogen, or block the action of the estrogen on the receptors.  

Now, there are two types of AI's.  Either irreversible steroidal inhibitors (exemestane) or non-steroidal inhibitors (anastrozole).

The Irreversible Inhibitors forms a permananent deactivating bond with the aromatase enzyme, basically acting as an estrogen killer.  The non-steroidal inhibitors prevent the conversion by competing with the receptor, but this is reversible meaning that ceasing to take the AI will allow the conversion to take place.

I prefer using a non-steroidal inhibitor because in my experience they are less harsh and allow for easier tweaking and monitoring of blood levels.  I have also found that keeping my estrogen levels between 20 and 25 are ideal for me.  At my dose every 5 days, I am able to keep my levels at 21.  

Keep in mind that estrogen is vital in the male body!  If your estrogen is too low you will have many of the same side affects you experienced from having low testosterone.  Fatigue, lethargy, sexual disinterest, etc.  Interestingly enough, these side effects can be the same if your estrogen is too high!  The differences that I have found are that having low estrogen can lead to joint pain because of the drying out of the joint, and high estrogen can lead to nipple itching or pain because of the possible onset of gyno.  As you can see, regular blood work is very important when dialing in your proper protocol.  

*TESTICLES*

So, we've talked about raising testosterone and lowering estrogen...  but what about the all-important task of keeping our testicles full and plump?  The introduction of exogenous testosterone over an extended period of time can and will lead to diminished testicle size.  This comes as a result of the endogenous testosterone production shutdown associated with TRT as discussed in the first section.  The bad news is it is bound to happen.  The good news is there are things we can do about it.

The most widely accepted remedy for shrinking testicles is the addition of HCG to the protocol.  This serves two purposes...  First, it can actually raise testosterone levels further.  Secondly (more importantly), it simulate luteinizing hormone (LH) in the body.  LH, in males, acts on the leydig cells by stimulating the production of testosterone and acts alongside FSH when looked at in the context of fertility.  Because HCG simulates LH in the male body you will find that shrunken testicles will often return to normal size after a couple weeks of using HCG regularly.  

Those that do not want to use HCG can simply use Clomid as needed.  This is an effective method but requires you to keep a close eye on “the boys.”  In this case, a TRT patient simply adds Clomid to their treatment for a length of time until their testicles return to an acceptable side, then cease the Clomid until the next time.

*FERTILITY*

One of the biggest concerns many younger men on TRT treatment bring to my attention is the fertility suppression often associated with TRT or running cycles in general.  I’m not going to lie, this is an issue and it is something that needs to be taken in to consideration.  I am currently 26 and would like to have kids, so I hear you all on this matter.  Fortunately there are steps we can take to increase the chances of maintaining fertility during treatment.  The first step is to include HCG in your treatment.  While HCG only simulates LH in the body, rather than actually being LH, it has been shown to increase fertility in men who have problems.  The bottom line, however, is that the majority of people who are on TRT will have to cease treatment for the duration.  For this a fairly aggressive PCT alongside HCG is suggested.  I have seen a couple of logs where TRT patience have successfully PCT’d off of TRT and tested with T levels in the 900’s despite no exogenous testosterone in their systems.  Whether this is a permanent level or not remains to be seen, but even if not their levels will hopefully maintain that level long enough to get the deed done.  

If a fertility issues continue for a couple of months after PCT and HCG treatment, the patient may want to consider adding HMG.  HMG (Human Menotropin Gonadatropin), actually contains FSH which is directly related to sperm production in men.  It is, however, fairly costly and should be used as a last resort at this point.

You will see that I have left out dosing.  The reason for this is because each individual is different and will respond different to dosages.  There is no “one size fits all” when it comes to TRT.

Now, there are many other things that can be added to TRT to make it even better for you, but those are more advanced topics and I will cover those in other posts to follow.


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## Zeek (Apr 9, 2012)

Great thread Spongy!


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## PFM (Apr 9, 2012)

Great write Spongy.

I also found by trial and error the E5D injection is best for both C and E estered testosterone. In the event I should travel and miss a day I found going E6D is better then going too close. So E4D just overlaps the Half Life too much.

I'd like to see this as a "sticky" as everyone interested in TRT or running cycles should read this thread.


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## gfunky (Apr 11, 2012)

Good thread!  You were still making some at least when I got stuck on TRT due to Doctors leaving me on narcotics for years mine was total 19 and free 1.1 I had pretty much stopped making it at all!  I found that my body eats up the ester faster than most people and at lower TRT doses I had to inject 3 times per week to get my blood level stable.  This is something that everyone will be a bit different with but usually E5D works for most everyone!  Good read man


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## Lulu66 (May 7, 2012)

Good read thanx.


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## Spongy (May 7, 2012)

thanks bro, I was going to write a more advanced guide, but got sidetracked.



Lulu66 said:


> Good read thanx.


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## brown1106 (Dec 29, 2012)

Spongy, this is the best read I have found so far on SI. As a testosterone user because of low T, this protocol will help me dramatically. Thanks bro, the one good thing about the issue we have been dealing with has led me to start reading a lot of ur info. You're top notch Spongy!


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## ken Sass (Dec 29, 2012)

cashout has a thread were he recommends every 3 and 1/2 days so wed morn and sat night, i am presently using this schedule and will have blood draw end of jan. at once every 7 days my e2 was high so we shall see what it is with the lower dose of test e3d.


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