Greetings from Budapest, Hungary. A lot of you have been asking what my current protocol for my testosterone replacement therapy is. Today I’ll break down my TRT Protocol for 2018 and the changes made based on my latest blood test results.
Just A Second…
Before we begin, I need to stress the following important point:
Please DO NOT use my TRT protocol as your own!
My protocol is based on my doctor’s prescription and has been tailored specifically to me.
We continue to change the protocol on an ongoing basis based on my bloodwork each year.
You need to develop a unique TRT protocol with your medical practitioner based on your own bloodwork.
Please do not “wing it” and experiment on yourself without a medical professional’s help. You could be putting your hormones and health at risk of long term damage and side-effects.
Rather use this as a guide or information source to reference when discussing your testosterone replacement therapy with your medical practitioner.
I’m not just saying this as a disclaimer, but because it’s extremely important.
Let’s get to it.
My 2018 TRT Protocol – Dosage and Frequency
Sustanon/TRT Dosage for 2018
My protocol for the first half of 2018 was almost identical to that of 2017.
250mg (one ampoule) of Sustanon every 10-14 days, or 125mg every 5-7 days.
This is what was prescribed by my doctor.
However, I did deviate from this slightly.
At the start of 2018, I increased the injection frequency to every 3-4 days and decreased the dosage per injection from 125mg to 62.5mg.
In other words, instead having two shots of 125mg every 5-7 days, I had four shots of 62.5mg every 3-4 days.
Basically halving the dose and doubling the injection frequency so that I’m injecting more often, but injecting less each time.
This is the equivalent of 250mg every 12-16 days. So the injection frequency increased, but the total overall dosage remained the same more or less – 250mg, or one ampoule every two weeks.
I did this after seeing numerous reports, data and anecdotal experiences that higher injection frequency led to more stable testosterone blood levels.
While it wasn’t officially prescribed by my doctor, I still did so under the supervision of my medical facilitator.
I responded well to this and stuck with it until my latest bloodwork in July 2018.
Changes To My TRT Protocol In 2018 After July Bloodwork
In 2018, we did two testosterone blood tests. One during the peak, and one during the trough(dip).
The Peak Results
My peak blood test was done three days after my last injection.
During the peak, my total and free testosterone levels were at the top end of the scale. My total testosterone came in at 40nmol/l, or 1154ng/dl. My free testosterone was 0.82nmol/l.
These results fall outside of the top end of the laboratories normal range, but I’ve been assured by my doctor that this is fine during the peak, as long as I’m not experiencing any side-effects.
Also, while some of these results in red fall out of this particular lab’s reference range, they still fall within the non-red/normal range of the lab I used last year. (see my 2017 blood test results for reference)
Blood Test Results During Peak
As you can see on the Nebido calculator below, these levels still fall within the top end of normal range, although they are borderline.
Yikes! We’re getting close to off the charts.
The elevated testosterone also resulted in elevated oestradiol. While elevated oestradiol may be a cause for concern in other circumstances, it is to be expected during peaks. As long as you are aren’t experiencing any side-effects, there is no cause for concern.
The Dip/Trough Results
The dip/trough blood test was done seven days after my last injection.
You will notice that all levels dropped significantly to the lower end of the ranges.
Total testosterone, free testosterone and oestradiol all dropped significantly.
Blood Test Results During Dip/Trough
This is to be expected. However, these levels are dangerously close to the low end of the normal range (especially free testosterone), putting me at risk of low testosterone symptoms and side-effects.
Adjustments To TRT Protocol Based On Bloodwork
These results tell us that at my peak, my levels are at the top end of the range, but probably slightly too high still. During the dip, they are nearing symptom levels.
According to my doctor, there is no cause for concern here – only a small change is necessary, to address the elevated peak levels.
My protocol was changed from 125mg every 5-6 days to 125mg every 6-8 days.
With my increased injection frequency, that would be from 62.5mg every 3-4 days to 62.5mg every 4 days.
Increasing the injection frequency usually tends to lead to more stable testosterone levels. It may be possible that this has led to higher testosterone levels this year too.
It is also possible that other lifestyle changes I made during 2017/2018 contributed to higher testosterone levels this year, including a massive reduction in alcohol consumption.
My medical facilitator also suggested introducing an aromatase inhibitor to control estrogen, if necessary. However, considering that I am not experiencing any side-effects from the peak oestradiol levels, we decided to wait and continue monitoring the levels for now.
Other Changes – Injection Site
Another change I made to my TRT protocol over the last year is changing my injection site from my glutes to my quads.
This is not going to have any effect on my testosterone levels (that I am aware of), but was more just a matter of convenience and experimentation for experience.
I have done glute injections for many years, since starting testosterone replacement therapy.
I had heard about other injection sites like the quads, the deltoids and the stomach. I was just too shit-scared to try them out.
I decided to confront my fears in 2018 and try out quad injections.
It was a great decision. Especially for smaller, more frequent injections.
Quads are more convenient. Easy to access and less pain once you’ve found the sweet spot. I highly recommend, if your doctor supports this.
I also have a full guide on how to do quad injections on YouTube for those interested.
Conclusion
Very minor changes were made to my TRT protocol this year. Mostly to address the peak blood hormone levels at the top end of the range.
I appear to be responding well to increased injections with smaller doses.
Other lifestyle changes I’ve made this last year may also be contributing to higher testosterone levels.
As always, the most important factor to consider is that your symptoms of low testosterone remain resolved and that you have a general feeling of well-being.
If you have any questions regarding these results, feel free to leave a comment below.
What otc do you take ? Pregnenlone, Dhea, vitamin d, creatine ?
Nothing related to hormones. Only a few supplements related to general health, like D3 and Probiotics. I also take ZMA, which some people believe helps with testosterone, but that’s not why I take it personally.
Hi Paolo,
I am on the same protocol as you are with the option of 250mg (1ml) every 2 weeks or 125mg every 7-10 days.
How did you address the peek values being too high ? By extended the frequency to 8-10 days what were your results from this ?
Yes. We have not done any further followup blood work since reducing the dose. That will get measured in the next blood work this year. Naturally though, the T levels should have fallen somewhat, probably to below the red peaks. Either way, I still feel fine with no symptoms of low T (or too high T), which is the goal.
How do you break up the shots? It says on the package of sust250 containing the vial to use all at once.
Hi Kevin.
You have two options.
1) You can use 125mg and throw out the other half remaining. This is what is recommended by doctors.
2) You can split the 250mg into two 125mg syringes/injections, use one, then save the other till the next injection. Doctors do not recommend this approach.
hello, do you inject subcutaneously? or intramuscular, have you tried subcutaneous injection?
Intramuscular. Intramuscular is the recommended method for testosterone injections. Subcutaneous injections can be done too though.I have not tried it – yet. I will in future for research purposes and for illustrating to other viewers/readers.
Your levels during dip were very close to low t and your doctor still reduced your dose? How does that work? I thought that means increase the dose or spacing between the dosage so it doesn’t go too low ?
My second test when they came back low was done 7 days after my last shot. Normally my shots are every 3-4 days, so they don’t get that low. I waited longer than usual for the second test to be done so that I could see for sure that they were in fact dropping down to the lower end (and the rough levels, more or less)
Also, You mentioned you divided your dose into two injections. Did the peak and dip test happen with divided dose or you did a full 0.5ml shot and then measured 3 and 7 days after?
I’m not sure, it was a while back. Whatever it was, it would have been whatever protocol I was using at the time. So either 1/4 shots or 1/2 shots around the time of the injections. I’m pretty sure it was 1/4, but I can’t say with certainty.
If injecting every 3-4 days, is it best to test blood around day 4 or hold off injecting and test around day 7?
It depends on what you’re testing for. If you’re testing the peak levels, you’d test whenever that particular testosterone type is expected to be in full effect. If you’re testing for your normal levels, then you’d test once the peak has started to come down (i.e. round about the half life of that particular testosterone). For example, 1ml Sustanon 250 peaks in a day or two, is supposed to last 10-14 days *some docs say 21 even), and I usually have my tests around day 5-7. Just look up the half life of whatever testosterone ester you’re using and use that as a guideline.
Thanks for the quick response, very helpful! I’m currently on Cypionate, but hopefully going to switch or try out Sustanon soon.
Greetings, I live in the U.S. and get Sustanon 250 from Mexico since I live on a border town. Anyways, my TRT protocol based on bloodwork, specifically TOTAL T levels is currently one full injection every 7 days. I have had no issues and my levels continue to be between 500-700 Total T with this regimen and feel great. I use to shoot one full injection every two weeks, but my total T ended up being in the early 400’s and personally I think thats really low; however, I didnt feel awful with that regimen either. I think Im gonna continue with the shot every two weeks to avoid the constant pinning and possible side effects which I havent had any ever. Still have lots of hair and I take finasteride just in case. I still workout well and everything. Anyways, has anyone ever done once per week TRT with Sustanon, by full injection, meaning the whole 250?
I was on a similar protocol of 0.4 ml Sustanon every 6 days, my test went up from 9 to 32 and estrogen went through the roof too. I was suffering from Aromatase symptoms re nipples etc and so doc put me on Arimidex 0.25 twice weekly. This sorted the issues out. I made a big error in August when I thought more frequent injections with same quantity would be better. For 6 weeks I was on 0.4 ml every 3/4 days !. I noticed that it didn’t make me feel any better and in fact libido almost disappeared and resting heart rate had increased a lot. Thankfully I did a full blood work at end of Sept and the results weren’t good. Haemoglobin, red and white blood cells, haemocrit and total cholesterol etc had gone into red !!. Test was at 36 and estrogen was <18 !,. I discussed this with my doc, I immediately stopped trt and AI to allow levels to drop. I donated blood after 3 weeks and on 4th week had full blood work again. Bloods had all returned to normal, and cholesterol from 6.05 to 3.8. Test was 16 and estrogen 89. Docs put me on hcg as for personal reasons I would not be able to continue with trt for 6-8 months. That helped, but now circumstances have changed and I can restart trt. Next week I will be starting a new protocol with Test Enathanate instead of Sustanon. Getting back to my point, I realised that the frequency of Sustanon was too short because of the 4 different Ester half life’s !!!. I was overloading every 3/4 days and bloods didn’t like it. So although I was feeling that my original protocol was not sufficient, my own decision to increase this without doc advice was stupid and I only felt worse with potentially dangerous blood levels. Because of the Ester half life in Sustanon I would not suggest less that 6/7 day dosage irrespective of dose. I was only on 0.4 ml, less that 125 test and my bloods went off the charts. Lesson learned, don’t experiment without consulting your doc first. As far as test goes, less is more.
Thanks for sharing your experience, Gary. Some good points to take note of there. It’s interesting to see how people can have such different experiences with similar treatments. But it just proves the point that these treatments need to be based on each individuals specific situation and done under the care of a professional who can monitor things properly.
What’s also great about your experience is that you actually did the proper bloodwork, monitored the changes, and were able to see where and how you went of course as a result. And then take ownership of the mistake and correct things. You can’t do much better than that. All the best for the new protocol and please feel free to share your experience with it.
Thanks Paolo, I’ll share the results of my new protocol following my first blood work at 4 weeks. This is a great forum to read and share trt experiences. Cheers.
How long is the trt usually?
Usually for life. However, some guys do make a come back and in those cases their natural production starts to work again.