coming back from a hip replacement ... on TRT ... want to try my first cycle

[deeoeraclea]

Hi all. Glad to be a part of this community.

A bit of background: I'm 41, been lifting weights since I was 16. But, I never really achieved anything impressive (best lifts were 385 lb squat, 265 lb bench, and a chin-up with BW + 135 lbs at a body-weigh of 190 ... I'm 6'2"). I started TRT about 6 months ago, just before I had a hip replacement. I was hoping that the extra testosterone would help prevent muscle-loss during the 6-month recovery period, when I couldn't lift). I'm more or less back to where I was prior to my operation (e.g., squatting 315 x 5, benching 225 x 5, chin-ups with 70 lbs x 5). I'd like to do my first cycle and see where it gets me.

Current TRT dose is 0.2 mL of testosterone cypionate every other day at a concentration of 200 mg/mL. So, that works out to roughly 140 mg of testosterone per week. I actually ordered some anavar and deca from a source I found on IndiaMart (as well as some other drugs, like rapamycin and empagliflozin). I know that rapamycin and empagliflozin were legit, because they give me the same side effects that I get from the pharma-grade stuff. But, the deca was seized (got a letter confirming tis) and I think the Anavar was either not dosed properly or not legit. I was taking 20 mg/day and I didn't notice anything.

I was thinking of trying to run 50 mg nandrolone decanoate per week on top of my TRT does of test. But, if any of you have suggestions for a 1st cycle (e.g., different substance or different dose), I'm open to suggestions. Thanks in advance for any advice! I'm totally new to this, so I have a lot to learn here.

 

[Deucalion]

Bruh... Firstly, was a bad idea to decide around surgery to start TRT and rapamycin... Increased clot risk and you put yourself at an even higher risk for infection. Unless you take sirolimus for an actual organ transplant?

I think your plan is actually good though, TRT and 50mg/wk nand is nice for that joint.. I wouldn't want to hit anything too hard yet still, you don't want to hit pr's and pop that joint out of place. Stay consistent on form.

So long as you aren't having any issues, I don't see any need to add to this. Watch your E2 sides. You could always re-assess in a month and increase test a little more too as long as you feel comfortable with the joint...

 

[deeoeraclea]

Thanks for the reply. Actually, I have been on Rapa for a long time (5 mg/week). And, the clotting risk was super minimal for me, as I am always anemic (RBC, ferritin, hemaglobin, etc. are always below the normal reference range). Actually, being on TRT has brought me into the low normal range for RBC, ferritin and hemaglobin for the first time in my life. Anyway, the surgeon was well aware of my TRT before the operation and didn't have any concerns.

So far, no side effects from the TRT. I was on 0.15 mL every other day of test cyp for the first 3 montns. This got me to high normal range (about 1000 ng/dL). But, then retested after 6 months and my test had dropped to around 500 ng/dL. So, the doc upped my dose to 0.2 mL every other day. I haven't retested again since the change. Haven't notcied any side effects yet other than a slight deepening of my voice and slightly oily skin. No other side effects that I can tell.

I have heard that nandrolone decanoate can help with lubrication of my joints. So, that's definitely a plus. Though, I can't say my joints hurt at this point. And the surgeon said I don't need to limit myself in any way on the lifts now that it has been 6 months. Dislocation risk is really minimal, because I had a resurfacing rather than a replacement. So, my femur heard (or, the replacement of it) is as large as my original femur head.

 

[Deucalion]

Thanks for the reply. Actually, I have been on Rapa for a long time (5 mg/week). And, the clotting risk was super minimal for me, as I am always anemic (RBC, ferritin, hemaglobin, etc. are always below the normal reference range). Actually, being on TRT has brought me into the low normal range for RBC, ferritin and hemaglobin for the first time in my life. Anyway, the surgeon was well aware of my TRT before the operation and didn't have any concerns.

So far, no side effects from the TRT. I was on 0.15 mL every other day of test cyp for the first 3 montns. This got me to high normal range (about 1000 ng/dL). But, then retested after 6 months and my test had dropped to around 500 ng/dL. So, the doc upped my dose to 0.2 mL every other day. I haven't retested again since the change. Haven't notcied any side effects yet other than a slight deepening of my voice and slightly oily skin. No other side effects that I can tell.

I have heard that nandrolone decanoate can help with lubrication of my joints. So, that's definitely a plus. Though, I can't say my joints hurt at this point. And the surgeon said I don't need to limit myself in any way on the lifts now that it has been 6 months. Dislocation risk is really minimal, because I had a resurfacing rather than a replacement. So, my femur heard (or, the replacement of it) is as large as my original femur head.

Ortho Dr's would operate on a corpse if they thought insurance would pay for it... They do not care about your real risk, they will just say the risk is high and operate anyway. I digress though...

What are your RDW's and MCHC, MCV, MCH looking like? You should look to correct the cause of your anemia. TRT will stimulate your bones to make RBC, but if you don't have the "resources" to do so they come out "funky" and won't be as effective haha.

My bad, when I saw hip replacement I assumed total. Anyways though, I like the stack you have picked out, I don't know why you would want anavar on before upping your T dose though.

 

[deeoeraclea]

Most result blood work (after having been on TRT for about 6 months) were:
LAB: my result (ref range) ... just giving approximate values, as I don't want to bother with decimal points right now
MCV 91 (81 - 98)
MCH 28 (24 - 34)
MCHC 32 (32 - 36)
RDW 13 (11 - 14) ... was previously as high as 22
Prior to hopping on test, all these values were out of the ref range. I've been anemic my entire life. I've tried iron supplements of different forms with and without vitamin C, as well as iron infusions. Getting on test was the only thing that worked to get the values in the normal ranges. Might have something to do with eating a low carb diet for the past 20 years and/or intermittent fasting.

BTW, the surgeon did put me on heparin injections for two months following the operation to prevent clotting.

Most people do get a full hip replacement. So, you weren't wrong to guess I had a similar operation. I opted for a hip resurfacing because I'm young (for a hip replacement) and a resurfacing allowed me to keep a lot more of my femur. If I need another replacement down the road, I can get a standard total hip replacement at that point. If I had gotten a full replacement now, another replacement down the road would have resulted in a pretty bad outcome. Hip resurfacing is actually not done my many surgeons. There's only two or three people in the USA that do it. I decided to go to Europe to have mine done.

BTW, a friend of mine recommended NPP over Deca. Any reason to use one over the other? I hadn't heard of NPP until he mentioned it. Seems to be the same steroid as Deca, but a different esther.

 

[Deucalion]

That is interesting, I have heard of TRT affecting iron metabolism, which is probably why it helped with your anemia in this case, would be my guess. Your advanced iron labs came back normal after T too?

Makes total sense to get a resurfacing if you can. Sadly, yea, a lot of people need new replacements down the road. Then, on other people I have seen their replacements last 30 years no issues, really depends. How much did a hip replacement in Europe cost you?

It depends what your goal for Deca or NPP are?
Deca= joint pain relief/ collagen production
NPP is not going to do that or doesn't for many people

Honestly, for your first cycle jumping back in if you don't want a small amount of deca for joint relief I would nix it and run a nice Testosterone blast?

What are your goals for the cycle in general?

 

[deeoeraclea]

My understanding from talking with a number of different hip surgeons is that the main mechanism for failure these days is "stress shielding." Basically, when you get a hip replacement or resurfacing, this changes how stress is distributed on your bone. Less stress (or different stress) results in bone loss over time. And this is what ends up failing -- not the materials from which your replacement is constructed. The ceramic, metal and highly cross-linked polyethylene that make up the new hip joint is extremely robust an unlikely to fail. So, lifting weights is probably the best thing one can do to protect a hip replacement, because it puts stress on the bone, which over time, helps it to maintain its strength.

The total cost of my hip resurfacing was about $20,000 USD. This included EVERYTHING, from the hospital stay, to the surgeon, to the anesthesia to the PT. Hotel and flights were separate. And, actually, my health insurance paid for 90% of the cost. Many health insurers in the USA will treat out-of-country procedures as "in-network". So, you can actually save a lot by going abroad. In the USA, for example, the same operation would have run about $80,000 (with my insurance covering 90%). So, I probably saved money by going to Europe. And, frankly, I think the quality of care I received in Europe was far better than what I would have received in the USA. If anybody is wondering, I went to Dr Koen De Smet at Anca Clinic in Belgium. I highly recommend him. Just yesterday, I squatted 315 x 5 on my artificial hip. It feels great and I'm only 7 months post op.

My main goals for my first cycle are to improve strenght. I'd love to be able to squat 405 lbs. The closes I ever got was 385 -- and that was about 8 years ago. Obviously, I'd love to stay lean while getting stronger. As a natural, to get really strong, I felt like I had to get kind of fat to do it. I don't know what is realistic on gear. Can I add body weight without adding much body fat if I eat in a surplus and do a cycle of Deca with TRT?

If you tell me what iron labs you are interested, I can look up the most recent values.

 

[Deucalion]

My understanding from talking with a number of different hip surgeons is that the main mechanism for failure these days is "stress shielding." Basically, when you get a hip replacement or resurfacing, this changes how stress is distributed on your bone. Less stress (or different stress) results in bone loss over time. And this is what ends up failing -- not the materials from which your replacement is constructed. The ceramic, metal and highly cross-linked polyethylene that make up the new hip joint is extremely robust an unlikely to fail. So, lifting weights is probably the best thing one can do to protect a hip replacement, because it puts stress on the bone, which over time, helps it to maintain its strength.

The total cost of my hip resurfacing was about $20,000 USD. This included EVERYTHING, from the hospital stay, to the surgeon, to the anesthesia to the PT. Hotel and flights were separate. And, actually, my health insurance paid for 90% of the cost. Many health insurers in the USA will treat out-of-country procedures as "in-network". So, you can actually save a lot by going abroad. In the USA, for example, the same operation would have run about $80,000 (with my insurance covering 90%). So, I probably saved money by going to Europe. And, frankly, I think the quality of care I received in Europe was far better than what I would have received in the USA. If anybody is wondering, I went to Dr Koen De Smet at Anca Clinic in Belgium. I highly recommend him. Just yesterday, I squatted 315 x 5 on my artificial hip. It feels great and I'm only 7 months post op.

My main goals for my first cycle are to improve strenght. I'd love to be able to squat 405 lbs. The closes I ever got was 385 -- and that was about 8 years ago. Obviously, I'd love to stay lean while getting stronger. As a natural, to get really strong, I felt like I had to get kind of fat to do it. I don't know what is realistic on gear. Can I add body weight without adding much body fat if I eat in a surplus and do a cycle of Deca with TRT?

If you tell me what iron labs you are interested, I can look up the most recent values.

Eh idk I am jaded bc I see the worst sometimes but hardware failure was pretty prominent at the 10-yearish mark. Damn, I didn't know USA insurance could cover out-of-country haha.

I am confused as to why you are adding in anything other than upping your T to like 200-300mg/ wk and when you plateau jumping up to 500mg/ wk. The newbie special lol. You need to learn how to control E2 sides with AI on an increased T dose and then cycle 2 worry about adding in other compounds. I thought the hip replacement was why you wanted a low-dose deca for your joints. Keep it simple this go around learn to control E2 and move up to other compounds when you can do so.

Ferritin, TIBC, serum iron, transferrin, sat%

 

[deeoeraclea]

You can correct me if I'm wrong. But, I thought the reason to go on something other than just test was that things like Deca have a higher ratio of anabolic to androgenic effects. At least, that was why I was going to hop on Deca. It's easy enough for me to increase the test dose. I don't use of the of the test that my MD prescribes. I'm sure I have enough to double it. And, I have anastrozole if I need it.

Looks like I don't have a lot of the more advanced test you asked for recently. I'm attaching the results I had after doing the iron infusions a few years ago. It got most of my labs more or less into the normal levels. But, they didn't stay there.

 

[deeoeraclea]

BTW, just looked up the original email I have from my surgeon. Here's what he wrote regarding survival.

"At your age, with this bone quality and being a male patient, the best what you can have is a well done metal on metal resurfacing, where we have a survival of 98% at 22 years!!"

In the end, I actually got a ceramic on ceramic hip resurfacing. The reason was that there was concern (I think unwarranted) that the metal ions would stress my kidneys.

 

[Deucalion]

You can correct me if I'm wrong. But, I thought the reason to go on something other than just test was that things like Deca have a higher ratio of anabolic to androgenic effects. At least, that was why I was going to hop on Deca. It's easy enough for me to increase the test dose. I don't use of the of the test that my MD prescribes. I'm sure I have enough to double it. And, I have anastrozole if I need it.

Looks like I don't have a lot of the more advanced test you asked for recently. I'm attaching the results I had after doing the iron infusions a few years ago. It got most of my labs more or less into the normal levels. But, they didn't stay there.

You haven't "maxed" your test potential. There is no need to jump on numerous compounds when the simple answer is to increase your test. This will help you in the long run, start from newb basics bro. No question deca or Npp is androgenic, but when people crash their E2 they take deca to increase it quicker,

I have seen individuals run Trt + low-dose deca for joint support. If your goal is strength etc, Test is 100%. Why would you want to jump on NPP or deca first? You're putting yourself at higher side effect risk with lower rewards than just upping T. So not only will you have to worry about E2 but prolactin possibly too.

If you are on Dr trt you have to be mindful of blood work, consider a shorter test ester and more frequent pinning.

I see, I would just watch that MCHC moving forward. Clearly looks like iron deficiency anemia, resolved.
Hmm I don't want to make any harsh accusations without knowing the brand of implant, etc. Even with ceramic, that sounds too good to be true, I think it will hold up for a long time, and you have good potential for it to last 20 yrs possibly, but a 2% failure rate within 20 yrs..... Consider me skeptical.

 

[deeoeraclea]

I think the results for hip resurfacing depend highly on getting a skilled surgeon. In the USA, Dr. Gross (in SC) and Dr. Pritchett (in Seattle), having been doing resurfacing for 20+ years and claim to have results similar to what Dr De Smet mentioned. The McMinn intitute in the UK has similar results. I think the higher survivorship for resurfacing is due to the fact that it is typically only done on males under 50 with large femoral heads. Younger, healthier males just tend to do better overall. In any case, there doesn't seem to be any reason for me to worry about it. There's no evidence that being more active or lifting heavier weights is detrimental. And, even if I need another replacement down the road, I just get a regular hip replacement at that point.

Can I ask what kind of side effects would be worse with Deca + TRT than with just a higher does of TRT? I'm mostly concerned about androgenic effects like hair loss. My LDL and ApoB and completely fine. And, if E2 gets too high, I have anastrozole on hand. To be clear, I'm not pushing against your advice. I just want to better understand your reasoning.

 

[Deucalion]

I think the results for hip resurfacing depend highly on getting a skilled surgeon. In the USA, Dr. Gross (in SC) and Dr. Pritchett (in Seattle), having been doing resurfacing for 20+ years and claim to have results similar to what Dr De Smet mentioned. The McMinn intitute in the UK has similar results. I think the higher survivorship for resurfacing is due to the fact that it is typically only done on males under 50 with large femoral heads. Younger, healthier males just tend to do better overall. In any case, there doesn't seem to be any reason for me to worry about it. There's no evidence that being more active or lifting heavier weights is detrimental. And, even if I need another replacement down the road, I just get a regular hip replacement at that point.

Can I ask what kind of side effects would be worse with Deca + TRT than with just a higher does of TRT? I'm mostly concerned about androgenic effects like hair loss. My LDL and ApoB and completely fine. And, if E2 gets too high, I have anastrozole on hand. To be clear, I'm not pushing against your advice. I just want to better understand your reasoning.

Sure, I am speaking generally, you personally, more than likely have a very low risk of failure. Although, idk if it is as low as what that Dr was selling to you.

Deca can increase prolactin, which can cause decreased libido, erectile dysfunction, and gyno. In a small dose, it may take a little while to build up but prolactin is nasty, ever heard of deca dick it is speculated it is decreased DHT, increased strong estrogen, and/or prolactin? I can tell you high prolactin is an awful feeling. Deca may not aromatize as fast as other compounds but the estrogen it does "create" is substantially stronger and will make you have estrogen side effects much easier. Plus BP sides may be more severe, as I have seen for some people.

While T your main concern is gonna be E2 and possibly some bp effects realistically.

Hair loss is a pressing issue for me too, I am young and have great hair genetics, and I would hate to lose it haha... I personally did have a bit of hair shedding starting 500mg T but after I dropped back down to trt level, within a couple weeks it all grew back, as thick as it was before. Idk if that is how others respond too though.

Honestly, it is kinda up to you to find a nice middle ground for your body. Anything that is going to preserve hair could potentially put your wiener out of service. Finasteride, deca, I have even seen people talk about npp and prolactin and estrogen sides causing the above. If you want to go the TRT deca or npp route, try it out you may not have too bad sides, but you need to be prepared if you do.

This is where a T blast first cycle is needed in my opinion, you are going to know what high E2 feels like and dose your AI accordingly. Whereas if you are on deca or npp you may feel off and it could be prolactin, estrogen, or both. This is more work than is needed for a first cycle, but if it is the route you want to try, just be prepared.

 

[deeoeraclea]

Thanks so much for all of the detailed information. Really kind of you to take the time to explain all of the above to me.