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Best Practices for TRT • 1. Blood Testing “Always start with comprehensive labs, including total testosterone, free testosterone, estradiol, SHBG, LH, FSH, and prolactin. Recheck regularly.” • 2. Dosing “Injectable testosterone is the gold standard: cypionate or enanthate, typically dosed weekly or bi-weekly. Topical gels work but aren’t as reliable.” • 3. Aromatase Inhibitors (AIs) “Some men convert excess testosterone into estrogen. If needed, an AI like anastrozole can help prevent this—but it should be used sparingly to avoid crashing estradiol.” • 4. Lifestyle Support “TRT works best when paired with a healthy lifestyle: sleep, training, diet, and stress management. Don’t think of it as a shortcut—it’s a tool.” • 5. Monitor Side Effects “Keep an eye on hematocrit, lipids, and prostate markers (PSA). Too much testosterone can thicken your blood or increase other risks if not monitored.” Here’s a sample Testosterone Replacement Therapy (TRT) protocol incorporating testosterone, DHEA, progesterone, HGH, and HCG. This protocol focuses on optimizing hormonal balance while minimizing side effects. Note that individual doses vary & require adjustments based on labs, symptoms, and goals. This is a starting point that you can adapt based on regular monitoring. 1. Testosterone (Primary Hormone in TRT)    •   Form: Intramuscular (IM) injection (Testosterone cypionate or enanthate)    •   Dose:       •   IM Injection: 100–200 mg per week (can split doses to 2x per week to stabilize levels)    •   Goal Levels: Total testosterone 800–1,200 ng/dL, Free testosterone in the upper normal range.    •   Monitoring: Check SHBG, estradiol (E2), hematocrit, lipids, and DHT regularly. Estradiol Consideration: If aromatization occurs (E2 30–40 pg/mL), consider aromatase inhibitors (e.g., anastrozole 0.25 mg 1–2x/week). Use cautiously to avoid overly suppressing estrogen. “I shy away from this one mostly” 2. Human Chorionic Gonadotropin (HCG)    •   Purpose: Maintain testicular function and prevent testicular atrophy, preserve fertility, and support endogenous testosterone.    •   Dose: 250–500 IU subcutaneous (SC) injections 2–3x per week.    •   Benefits: Supports natural testosterone production and balances mood, libido, and spermatogenesis. 3. DHEA (Dehydroepiandrosterone)    •   Purpose: Supports androgen production, energy, and libido while helping adrenal function.    •   Form: Oral or transdermal    •   Dose:       •   Men under 50: 25–50 mg/day (morning dose to mimic natural production)       •   Men over 50: Start at 25 mg/day and titrate based on DHEA-S levels.    •   Monitoring: Aim for DHEA-S levels in the upper third of the reference range.    •   Caution: Over-supplementation may lead to excess estrogen or DHT. 4. Progesterone (Balance for Estrogen and Neuroprotective)    •   Purpose: Helps balance estrogen, reduce estradiol-related side effects (e.g., gynecomastia), and supports brain health.    •   Form: Oral or transdermal (bioidentical preferred)    •   Dose:       •   Oral: 25–50 mg at bedtime (may improve sleep and anxiety)       •   Transdermal: 10–20 mg/day if preferred.    •   Benefits: Protects against excessive estrogenic effects, may improve mood, sleep, and mitigate DHT-related side effects (like hair loss). 5. Human Growth Hormone (HGH) / Peptides (IGF-1 Optimization)    •   Purpose: Improve muscle mass, recovery, fat metabolism, and anti-aging benefits.    •   Form: Subcutaneous injections (or GH-releasing peptides like CJC-1295 or Ipamorelin if HGH is not an option)    •   Dose:       •   HGH: 1–2 IU/day (inject before bed or split AM/PM based on IGF-1 response)       •   Peptides: CJC-1295 or Ipamorelin, 200 mcg/day (1–2x/day) Monitoring: IGF-1 levels; maintain within the upper third of the reference range but avoid excess (400 ng/mL). 6. Aromatase Inhibitor (if needed)    •   Use aromatase inhibitors (AIs) cautiously if estradiol becomes elevated.   Example: Anastrozole 0.25 mg once or twice per week, depending on estradiol levels. • Regularly monitor estradiol, as it’s crucial for bone, cardiovascular, and libido health in men. Don’t suppress too low (20 pg/mL). Additional Components • Omega-3s and anti-inflammatory support: Helps mitigate cardiovascular risks. • Liver support supplements (e.g., NAC or TUDCA): For protection when using hormones long term. Monitoring Checklist Every 3–6 months, check: • Total Testosterone / Free Testosterone • Estradiol (E2) • DHEA-S • Progesterone • IGF-1 • SHBG, LH, FSH •Hematocrit / Hemoglobin (risk of polycythemia)• Liver function and lipids • PSA (prostate monitoring, especially if over 50) Expected Benefits • Testosterone: Increased energy, muscle mass, libido, & mood improvement. • DHEA: Improved adrenal function & mental clarity. • Progesterone: Neuroprotection, better sleep, and reduced estrogen-related side effects. • HGH: Improved body composition, recovery, and skin quality. • HCG: Fertility maintenance & testicular size preservation.

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