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How to Figure Out Your TRT Regimen

Discussion in 'Random Thoughts from Dr. John' started by Dr. John Crisler, Dec 19, 2014.

  1. Dr. John Crisler

    Dr. John Crisler Lord of the Forum Staff Member Super Moderator

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    Draw a graph, with time (7 days) on the horizontal (X) axis, and serum level on the vertical (Y) axis.

    You inject on Day 1 (and any other days), per your particular regimen. Mark it/them at the bottom.

    Draw how your serum T level will rise, to a peak in about 48-72 hours, then begin to drop. For each and every shot.

    If you are taking HCG, mark those points as well.

    Now plot the day(s) and dosage(s)--yes, sometimes I have guys take different doses on different days of the week--of anastrazole, if you are on estrogen control.

    Using this system, you can really get a feel for what is happening on each day. When you compare to how you feel on those days, we can better tune up your protocol.

    Of course, SHBG level, half-life of the ester, and any potential "HYPERS" (hyper-metabolization/hyper-excretion) will affect all this. Again, this is why you may need a physician who is well-trained in this field to interpret and direct your care.
     
  2. BadassBlues

    BadassBlues Super Moderator Staff Member Super Moderator

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    Do you have an example of the graph your describing?
     
  3. Dr. John Crisler

    Dr. John Crisler Lord of the Forum Staff Member Super Moderator

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    Perhaps someone who is good at that sort of thing could put one together.
     
  4. Bulldog

    Bulldog Administrator Staff Member Administrator

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    I bet @JanSz could create an example using his protocol.
     
  5. JanSz

    JanSz Well-Known Member

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    To create graph is easy.
    That would be Blood testosterone levels in time as function of three inputs,
    testosterone, HCG, AI

    Then testosterone levels=y1+y2+y3

    Unknown are:
    y1=function(T)
    y2=function(HCG)
    y3=function(AI)

    So far only x are known, ie days 1...7
    All y's are unknown
    There are programs that estimate blood testosterone levels in time due variety of injected testosterone oils. I posted in the past this type of charts.
    If dr John would agree with results of those programs I do not know. The resolution of output there is in days, we would likely want hours.
    Dr John says:
    I am not even sure if the two programs that I was experimenting with are still available.

    We need more information from dr John.


    How to estimate effects of using HCG & AI I do not know.


    http://www.allthingsmale.com/community/threads/nebido.21701/

    [​IMG]









    [​IMG]
     
    Last edited: Dec 22, 2014
  6. BadassBlues

    BadassBlues Super Moderator Staff Member Super Moderator

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    What would be nice is to have something like an excel spreadsheet in this format that a user could plug in their individual stats to have a customized graph.
     
  7. JanSz

    JanSz Well-Known Member

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    But............

    dr John is on the roll,

    expectations are high

    /
     
  8. JanSz

    JanSz Well-Known Member

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    To create spreadsheet on must understand function.

    =========
    But, if you mean that someone would create timeline of inputs (testosterone, HCG, AI)
    and blood test results.
    Then we are talking about experiment on live person, preferably, 20-50 people,
    with IV in their veins
    having blood drawn hourly
    for at least a week


    //
     
  9. TX Tornado

    TX Tornado Member

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    Boy...I would find this to be really interesting info to do such a chart on myself and might help me figure out an effect I've been experiencing for a few months.
    For example......I do 60mg of Test cyp sub-q every 3rd day and do 100IU of HCG daily.....I noticed that the day before my test cyp shot my libedo and erections are strongest.....then the day I do my test cyp shot...a few hours later, my libido and erections disappear and my penis feels a bit insensitive....24 hours later everything's back to normal till shot day again.....so something is going on on shot day!!!

    Doing this chart my help figure that out!
     
  10. BadassBlues

    BadassBlues Super Moderator Staff Member Super Moderator

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    No, the example Doctor Crisler gave could be made into a form that could have open fields to input user specific data. You are referring to the interpretation of the data.
     
  11. JanSz

    JanSz Well-Known Member

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    I can't figure how to make a table here, so I could post it, but I think that you mean empty table
    columns--->T, HCG, AI, Total test
    rows 7days*24hrs=168 rows

    Each interested person would fill in that table with available data.
    Practically that table would be mostly empty.

    ....
    Is that what you mean?

    I could use help with how to post table.

    ..
     
    Last edited: Dec 22, 2014
  12. BadassBlues

    BadassBlues Super Moderator Staff Member Super Moderator

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    That is what I meant. The table would have empty fields that the individual would input their own specific data. This could also be a useful tool for anyone wanting an AOC with Dr. Crisler to have completed prior to the consultation.
     
  13. JanSz

    JanSz Well-Known Member

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    Got it.
     
  14. Desert Eagle

    Desert Eagle Banned

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    I split dose 40mg monday mornings and 40mg thursday evening. peak is 900-1000ng/dL, trough is 500-600ng/dL.
    My reference is the study LEF publishes from time to time that has 530ng as the threshold where heart attack and stroke drop by 30%.
    Testosterone controls/influences hepcidin the master control hormone for iron that is located in the liver.
    I have tested peak & trough to get the above numbers, but only assume a consistent decrease from peak to trough, assuming SHBG is 20-30.
    I have been able to affect ferritin increase and iron serum by paying attention as Dr. Crisler is recommending and can lock them down at will.
    Hematocrit and Hemoglobin are now the key levels for me to track as associated with TRT.

    Dr. Crisler: assuming a healthy youth at peak hormone production, is that lads testosterone output in more of a square wave, less peak/trough?
     
  15. Jimo

    Jimo Member

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    DE, I use the same variables as well as HDL, Trigs, and Creatine levels to gauge testosterone absorption
     
  16. Dr. John Crisler

    Dr. John Crisler Lord of the Forum Staff Member Super Moderator

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    Thank you for all your efforts, you guys are the best!

    But I was really thinking of something much simpler. For instance, just a line roughly showing TT levels when giving a once per week shot of testosterone cypionate. Then marking at the bottom when you take an AI, or a shot of HCG. This just helps you see the whole week at once.

    Of course, you really don't know how much of an effect a single shot on HCG will have; the important thing here is just to help you visualize what is going on.

    You can make a couple marks on the graph showing the results of your actual testing, for TT, and E. This very simple tool really helps us correlate what we see in labs (depending upon which day the labs are drawn), and how we feel. It may show us we need a little more, or a little less, of a medication. But mostly, it shows us what was going on at the time.

    This can be especially useful when interpreting estrogen effects across the week.
     
  17. Dr. John Crisler

    Dr. John Crisler Lord of the Forum Staff Member Super Moderator

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    Often times while I am talking to the patient I am making out a diagram such as this.
     
  18. Dr. John Crisler

    Dr. John Crisler Lord of the Forum Staff Member Super Moderator

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    Where you make your marks along the bottom, make sure to also note the dosages. T, HCG, Arimidex, even Dostinex (if you are simultaneously controlling Prolactin).

    Some TRT regimens I design get sort of complicated. Some use different doses of AI, for instance, taking one dose on test cyp shot day, but maybe a smaller dose a couple days later. Toward the end of the week, when T levels are dropping, by the half-life of the cypionate ester, E will similarly lower, due to less by conversion; so an AI on board then might be a detriment.

    This simple tool helps you see your "TRT at a Glance".
     
  19. BadassBlues

    BadassBlues Super Moderator Staff Member Super Moderator

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    This is why seeing a qualified physician is key to success. Putting together that kind of protocol takes expertise and a lot of clinical experience.
     
  20. Personal Best

    Personal Best New Member

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    You can do this in Excel. In a former life I used to use it to graph my data for presentations and technical documents. For injection quantities per data point you could just add a label - it's somewhat tedious but it won't kill you. Also, you want to describe everything on the y axis as a function of what's on the x axis e.g. Test as a function of time etc.. Also2, I'd like to see a plot of what you're calling a "square wave" as that may not be the correct term. I know, I've heard the youtube lectures where the hrt docs are talking about it but it nonetheless may not be correct.

    Thanks
     

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