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Chapter 07 · TRT Men

Weeks 1-4 schedule — daily and weekly rhythm

What you'll be able to do

Four weeks isn't a warm-up. It's the window where your HPG axis decides whether to fully shut down (the classic TRT trajectory) or whether the adjunct stack you're running keeps the upstream signaling alive. Testosterone enters the bloodstream and the hypothalamus reads the elevated androgen, drops GnRH pulse frequency, LH and FSH collapse, and Leydig cells stop producing intratesticular testosterone within 7-14 days. Without intervention, testicular volume drops measurably by week 4. The adjuncts — HCG, Kisspeptin-10, or Gonadorelin — exist to interrupt that cascade at different points in the axis. Weeks 1-4 is where the timing of those injections either keeps the lights on or doesn't.

What's actually happening cellularly

The exogenous testosterone you inject Monday and Thursday saturates androgen receptors and signals "abundance" to the hypothalamus. GnRH neurons reduce pulse frequency. The pituitary, no longer driven, stops releasing LH. The Leydig cells inside the testes, no longer stimulated by LH, stop converting cholesterol to pregnenolone to testosterone. Intratesticular testosterone — which is roughly 100x higher than serum testosterone in an unsuppressed system — crashes. Sperm production halts. Testicular tissue begins atrophying.

HCG bypasses the upstream blockade entirely. It mimics LH directly at the Leydig cell receptor, restarting intratesticular steroidogenesis regardless of what the hypothalamus is doing. The practitioner corpus describes 250-500 IU on TRT injection days as the standard dose — enough to maintain testicular volume and fertility potential without driving estradiol conversion into runaway territory. Expert tier.

Kisspeptin-10 works further upstream. It stimulates GnRH neurons directly — the layer above the pituitary — and the practitioner corpus describes it producing LH pulses that "mirror natural physiology" rather than the constant flatline signal HCG produces at the Leydig level. The mechanism described: kisspeptin neurons normally pulse, GnRH neurons respond, the pituitary releases LH in pulses, and the testicular machinery responds to pulses rather than continuous stimulation. This is the more physiologic intervention. Expert tier, leaning Experimental for long-term use.

The first 28 days is also when injection-site discipline either gets locked in as habit or fails. Lipodystrophy from repeated same-site injection shows up at week 3-4 as palpable hardened tissue, scar formation, and progressively worse absorption from that site. Once it forms, you can't inject there for months. Site rotation isn't a nice-to-have. It's the difference between a stack that works at week 10 and one that's running on degraded absorption by week 6.

The Weeks 1-4 stack

Compound Dose Route Frequency Evidence Tier Notes
Testosterone Cypionate 50-100 mg IM or SubQ Mon + Thu (twice weekly, every 3rd day) Clinical EOD at 25-50 mg/dose is acceptable alternative for men sensitive to peak-trough swings
HCG 250-500 IU SubQ On TRT injection days (Mon + Thu) Expert Lower abdomen, alternate side from testosterone injection site
Kisspeptin-10 50-100 mcg SubQ Daily Experimental Optional upstream layer. Morning preferred. Skip if running HCG and stable
Gonadorelin Pulsatile (see notes) SubQ 2-3x daily micro-doses Experimental [practitioner corpus thin on exact pulsatile dosing for TRT adjunct context — track and report]

Reconstitution note for adjuncts: Standard 5 mg vial of Kisspeptin-10 reconstituted with 2 mL bacteriostatic water yields 250 mcg per 0.1 mL (10 units on an insulin syringe). Refrigerate after reconstitution (36-46°F), use within 28-30 days, never freeze post-reconstitution.

The injection map

Lower abdomen, two inches minimum from the navel, alternating left and right. The corpus describes a clockwise rotation pattern around the navel as the standard across leading practitioner protocols.

Weekly site rotation example:

29-gauge insulin needle for SubQ adjuncts. Same syringe for drawing and injecting at this gauge. One syringe per injection — never re-use, never share a syringe between two compounds.

Daily and weekly rhythm

Morning (fasted, before food):

Evening:

Sleep:

What you should feel

Week 1:

Week 2:

Week 3:

Week 4:

What's NOT happening yet

The Weeks 1-4 schedule is the compliance test. Skip a Thursday injection because you traveled, and trough testosterone drops measurably before Sunday. Inject in the same square inch of abdomen seven times in a row, and absorption from that site degrades for the rest of the protocol. The compounds are not the variable. The schedule is.

Research describes this. Track it. Adjust.

Practice Quiz
Question 1 of 20 · 0 answered · 0/— correct
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Within how many days does intratesticular testosterone production typically halt after starting exogenous TRT without an adjunct?

How sure?
01 / 20
Slide deck · 16 slides
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  1. 01titleWeeks 1-4: The Window That Decides Everything
  2. 02sectionThe Cellular Cascade
  3. 03contentWhat Shutdown Actually Looks Like
  4. 04big-ideaThe Key Insight
  5. 05sectionThree Points of Interruption
  6. 06two-columnHCG vs. Kisspeptin-10
  7. 07contentThe Weeks 1-4 Stack
  8. 08contentReconstitution Math (Kisspeptin-10)
  9. 09quoteThe Practitioner Corpus on Site Discipline
  10. 10sectionDaily and Weekly Rhythm
  11. 11contentThe Injection Map
  12. 12big-ideaSleep Is Part of the Stack
  13. 13contentWhat You Should Feel — Week by Week
  14. 14quoteWhat's NOT Happening Yet
  15. 15contentWeek 4 Bloodwork — The Trough Pull
  16. 16contentKey Takeaways
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Weeks 5–10 schedule — layering CJC-1295 + Ipamorelin

Research use only · Not medical advice · The practitioner corpus speaks in mechanisms, not prescriptions