Getting dialed in? Most new guys have no idea what this means. It is actually the most important aspect of any testosterone replacement therapy protocol and if your not doing it in the most efficient way you may give up on your TRT protocol due to side effects or just plain not feeling good.
Getting dialed in simply means finding the amount of testosterone and ancillaries your body needs to put your levels within healthy physiological range. Meaning within a range that a human being can produce naturally.
If your levels are too high or too low you will not feel and experience the benefits of TRT. This includes more hormones than your total testosterone levels, it also includes free testosterone, estradiol, DHT, thyroid, and even epinephrine and norepinephrine.
Many of these hormones convert to other hormones and even influence other hormones through the negative feedback loop.
So lets first start with what we need to start a basic TRT protocol and get your hormone levels and ratios dialed in:
Getting dialed in requires playing with your schedule and dosages. Many like to run out and get lab work done after 4 weeks but what if your hormone levels have not reached steady state? Now your measuring a point in time that you will not be at in 2 weeks so the information is useless, its literally a waste of money because it gives us zero insight.
What we all should be doing is adjusting our schedule and titrating dosages based on symptoms first, after all if TRT does not alleviate your symptoms why would we take it? So this is the first order of business. This could easily take a full 3 months to do.
Over the next 4 weeks based on whether your holding water, getting acne or have achey joints, dosages of anastrozole need to be titrated in order to make sure your estradiol is not too high or too low. If it gets high it can lead to acne and edema which can also lead to high blood pressure. Far too many times have I seen men discontinue TRT based on a few high blood pressure readings instead of fixing the root of the problem and allowing blood pressure to normalize and potentially be even better than before starting TRT.
Once we have estradiol levels dialed in the best we can according to our symptoms and we feel good, now we can get a blood test. Here is where I have seen many rookie mistakes that end up making the data useless. It is imperative that you get your blood drawn the day of your testosterone injection, before you do your injection. This is so we can get a reading of your lowest point, or your trough. At this point its only important to get your total testosterone, free testosterone and estradiol tested. You can usually get this tested for $100 bucks or less. We offer it for $99.
Now we are 12 weeks in. Just the first go at getting dialed in. It may take a couple times it may not. Its a process of elimination that takes time so new guys please try to remain calm instead of worrying so much you actually impact your TRT program 🙂
Now that you have these results in hand you can decide if you need to lower your testosterone dosage, I personally believe it will usually need to happen because I think these esters hang around in our body longer than everyone thinks.
After these results you need to make minor adjustments to your protocol based on the lab results, just to drop your numbers into to optimal range. Some guys fear doing it at this point because they feel so much better, but you have to realize you may be able to feel even better by tweaking certain things, minor things that will not make you feel worse.
3 more months go by and your now your feeling great and you can get a comprehensive blood test to check things like DHT and your Thyroid. Maybe you feel good but you still have a few adrenal insufficiency symptoms like getting sleepy between 3-5 pm. Now you need to get a DHEA-S blood test and a 4 point cortisol saliva test.
So as you can see it can take a full year to actually learn your body and truly get your protocol dialed in and thats if you are with someone that knows what they are doing. You could very well wind up with a doctor that has you on every 2 week injections for 6 months before you even get started on a real TRT protocol.
So my advice is go with someone that knows what they are doing otherwise don't do it at all or you can end up worse off than you started.
My last piece of advice to the new guys is to be patient, this is something you have to learn on your own because its your body, those of us with plenty of experience can only guide you.
Hope you enjoyed the read please comment below!
~ Todd Thomas