Thinking of TRT...?

R

roamer7

New member
I'm just looking for the opinions and experiences of guys with more experience with this topic. I live in a rural area where there are no TRT clinics or even Docs with any TRT experience so the internet and youtube have been my sole source of information so far. I did get my GP to do a total T lab but it's the only # I have so far.

I'm 54 years old. My symptoms are low energy, poor moods, loss of libido, morning wood almost never, poor sleep. My workouts (weights) and recovery has also gone downhill. My fasting morning total T level was 384 NL/DL. I don't know my free-T level yet as my crappy doc did not feel it mattered (looking for a different doc at present).

To me this level seems low especially when you consider that my SHBG levels have likely been climbing as my T levels have been dropping with age.

I've ordered some Testosterone Cypionate since I want to be able to take matters into my own hands if I'm unable to find a Doc to help me. I'm 6' 1" and 280 lbs at present (50 lbs overweight which is another issue). I'm thinking starting bi-weekly injections of 75 mg (.3 ml of 250mg/ml test) to begin and see what effect I get.

Thanks for reading.
 
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Hi, what is your questions?

Couple of observations:
  • TRT is a dosage that puts your free test within physiological range and all BW remains within range.
  • TRT - the goal should be to find your maximum dosage without an AI. (sorry @gondar1 stealing but still can't remember your acronym...where is the damn t-shirts and hats????)
  • Most people will feel good with free test between 500-700. at 150mg per week you will be at the top of that range and more than likely over. (which might be ok)
  • At 50lbs overweight you will likely be a high converter to E2 so that, plus 150mg of test per week will put you above the E2 ideal top of range of 30 pg/ml
  • Over 30gpml E2 if blasting is not a big deal as it short term but for TRT this is 52 weeks per year, at your age the biggest thing to watch out for with high E2 is estrogen stimulates the prostate (current research shows that test is protective of the prostate and E2 stimulates. (This also assume you do not have the gyro gene...because that sucks)
  • Most people will start with 100mg per week, wait 8 weeks to reach homeostatis on test cyp. and get blood work. then adjust up or down to get all Blood Work in range. (test, E2, hemoglobin, hematocrit, etc). Two shots per week is a good idea to limit sides.
  • you will also want to know your Hemoglobin and hematocrit. If overweigh, and a big man your diet is likely not ideal and full of red meat. TRT will increase your Red Blood Cell count so you want to make sure you are not already at the top of range. Blood clots also suck.
Let us know your specific questions and we can likely steer you right.

Cheers
 
Oldguyjiujitsu said:
Hi, what is your questions?

Couple of observations:
  • TRT is a dosage that puts your free test within physiological range and all BW remains within range.
  • TRT - the goal should be to find your maximum dosage without an AI. (sorry @gondar1 stealing but still can't remember your acronym...where is the damn t-shirts and hats????)
  • Most people will feel good with free test between 500-700. at 150mg per week you will be at the top of that range and more than likely over. (which might be ok)
  • At 50lbs overweight you will likely be a high converter to E2 so that, plus 150mg of test per week will put you above the E2 ideal top of range of 30 pg/ml
  • Over 30gpml E2 if blasting is not a big deal as it short term but for TRT this is 52 weeks per year, at your age the biggest thing to watch out for with high E2 is estrogen stimulates the prostate (current research shows that test is protective of the prostate and E2 stimulates. (This also assume you do not have the gyro gene...because that sucks)
  • Most people will start with 100mg per week, wait 8 weeks to reach homeostatis on test cyp. and get blood work. then adjust up or down to get all Blood Work in range. (test, E2, hemoglobin, hematocrit, etc). Two shots per week is a good idea to limit sides.
  • you will also want to know your Hemoglobin and hematocrit. If overweigh, and a big man your diet is likely not ideal and full of red meat. TRT will increase your Red Blood Cell count so you want to make sure you are not already at the top of range. Blood clots also suck.
Let us know your specific questions and we can likely steer you right.

Cheers
Click to expand...

LOLZ.
"AFART" - Ancillary Free Androgen Replacement Threshold

Shirts are still available but only in extra medium.

Ask your Dr if AFART is right for you!
 
roamer7 said:
I'm just looking for the opinions and experiences of guys with more experience with this topic. I live in a rural area where there are no TRT clinics or even Docs with any TRT experience so the internet and youtube have been my sole source of information so far. I did get my GP to do a total T lab but it's the only # I have so far.

I'm 54 years old. My symptoms are low energy, poor moods, loss of libido, morning wood almost never, poor sleep. My workouts (weights) and recovery has also gone downhill. My fasting morning total T level was 384 NL/DL. I don't know my free-T level yet as my crappy doc did not feel it mattered (looking for a different doc at present).

To me this level seems low especially when you consider that my SHBG levels have likely been climbing as my T levels have been dropping with age.

I've ordered some Testosterone Cypionate since I want to be able to take matters into my own hands if I'm unable to find a Doc to help me. I'm 6' 1" and 280 lbs at present (50 lbs overweight which is another issue). I'm thinking starting bi-weekly injections of 75 mg (.3 ml of 250mg/ml test) to begin and see what effect I get.

Thanks for reading.
Click to expand...

Nice post by @Oldguyjiujitsu which should set up this discussion nicely. Such a big subject, you obviously have some understanding of it so following OJJ's lead it's probably some specific questions would be most efficient.

Got a couple for you - What did ur doc say? No go? More bloods?

BTW there is no need to fast for am T testing specifically. Also if you do start supplementing with exogenous T time of day becomes irrelevant other than with regards to consistency meaning comparing your own tests to your own prior tests and timing of testing in relation to your shots and protocol.


The single most important advice I would give you right this moment is to NOT START the test you have ordered yet. This is what I always refer to as the golden opportunity time. Get a more comprehensive blood panel or two done to establish your baselines before you take anything. To me that information is priceless and once you consume exogenous hormones you change the whole ecosystem forever. Lots of good previous discussion here if you poke around abit. You can search members posts if you catch a conversation that you see someone has an interest in. It won't take long to see who that is, starting with @Oldguyjiujitsu is a good bet.
 
I think 150 is a good starting point. Most docs will worry about being 'in range' leading to subpar trt treatment. Some need to be at the top of the range...others above 'range' for symptom relief. Use bloodwork and keep an eye on hematocrit rbc..hemo..etc. You can check e2 and manipulate those numbers through injection frequency. More frequent=lower e2 for most.

You can tweak all that after you get bloods to give you can idea of what your bodies doing at that point and adjust from there.
 
Agentchuckles said:
I think 150 is a good starting point. Most docs will worry about being 'in range' leading to subpar trt treatment. Some need to be at the top of the range...others above 'range' for symptom relief. Use bloodwork and keep an eye on hematocrit rbc..hemo..etc. You can check e2 and manipulate those numbers through injection frequency. More frequent=lower e2 for most.

You can tweak all that after you get bloods to give you can idea of what your bodies doing at that point and adjust from there.
Click to expand...
disagree. like @Oldguyjiujitsu said. the goal should be to find your maximum dosage without an AI. i think most people will be over that line. 150mg is what dudes pray they will be prescribed.
 
zenmonky said:
disagree. like @Oldguyjiujitsu said. the goal should be to find your maximum dosage without an AI. i think most people will be over that line. 150mg is what dudes pray they will be prescribed.
Click to expand...
I never said to take an ai...you can 'manipulate' e2 with injection frequency. 150 is a starting point. If you look at what trt docs in the states prescribe, 150 is middle of the road. Canada sucks for trt frankly. Most gps will start you off at 50/week. Off course theyll have you inject 100mg once every 2 weeks...cause thats what it states on the actual bottle of pharma test. Both terrible starting protocols. A min start of course in my opinion would be 100mg. 50x2 pins per week. Just my opinion.

If you are on the multitude of trt specific forums you can see a trend in people that are discontent with the results. This could be resolved for most with a simple small bump in dose. Just my observations
 
Agentchuckles said:
I never said to take an ai...you can 'manipulate' e2 with injection frequency. 150 is a starting point. If you look at what trt docs in the states prescribe, 150 is middle of the road. Canada sucks for trt frankly. Most gps will start you off at 50/week. Off course theyll have you inject 100mg once every 2 weeks...cause thats what it states on the actual bottle of pharma test. Both terrible starting protocols. A min start of course in my opinion would be 100mg. 50x2 pins per week. Just my opinion.

If you are on the multitude of trt specific forums you can see a trend in people that are discontent with the results. This could be resolved for most with a simple small bump in dose. Just my observations
Click to expand...

I agree that contentment correlates with appropriate dosage, as well as the suggested minimum start dose. However, I know several people who are on prescribed trt, and never heard of 50mg/wk. It might happen, but 'most' gps? Nope. 50mg at most may equal normal production in some, but there are many other factors to consider. Normal testosterone production is around 6mg/day.
Wrt to the pharm test. I'm prescribed test and have both dela and depo and neither state any such thing on the bottle. It does state, Usual dose: 100 - 400mg every four weeks. Far too many assume you need high doses, and just because one can obtain a script for 200mg/wk does not mean that it is a suitable dose.

I'm sorry that you have had a poor trt experience, but an endocrinologist is the way to go. I've read many forums, and the one consistent thread I've noticed is that people seem to believe that once you are on trt everything is suddenly great. There are many factors to consider and be aware of, and while it can dramatically improve one's quality of life too many seem to believe it is as simple as take the shot and everything is fantastic. It's a compromise, and it requires diligence and research.

Injection frequency is the easiest way to manage E2 symptoms. That's important to remember.
 
Last edited:
gondar1 said:
Nice post by @Oldguyjiujitsu which should set up this discussion nicely. Such a big subject, you obviously have some understanding of it so following OJJ's lead it's probably some specific questions would be most efficient.

Got a couple for you - What did ur doc say? No go? More bloods?

BTW there is no need to fast for am T testing specifically. Also if you do start supplementing with exogenous T time of day becomes irrelevant other than with regards to consistency meaning comparing your own tests to your own prior tests and timing of testing in relation to your shots and protocol.


The single most important advice I would give you right this moment is to NOT START the test you have ordered yet. This is what I always refer to as the golden opportunity time. Get a more comprehensive blood panel or two done to establish your baselines before you take anything. To me that information is priceless and once you consume exogenous hormones you change the whole ecosystem forever. Lots of good previous discussion here if you poke around abit. You can search members posts if you catch a conversation that you see someone has an interest in. It won't take long to see who that is, starting with @Oldguyjiujitsu is a good bet.
Click to expand...
I'm lost. Ecosystem? ;)
 
resilient1 said:
I agree that contentment correlates with appropriate dosage, as well as the suggested minimum start dose. However, I know several people who are on prescribed trt, and never heard of 50mg/wk. It might happen, but 'most' gps? Nope. 50mg at most may equal normal production in some, but there are many other factors to consider. Normal testosterone production is around 6mg/day.
Wrt to the pharm test. I'm prescribed test and have both dela and depo and neither state any such thing on the bottle. It does state, Usual dose: 100 - 400mg every four weeks. Far too many assume you need high doses, and just because one can obtain a script for 200mg/wk does not mean that it is a suitable dose.

I'm sorry that you have had a poor trt experience, but an endocrinologist is the way to go. I've read many forums, and the one consistent thread I've noticed is that people seem to believe that once you are on trt everything is suddenly great. There are many factors to consider and be aware of, and while it can dramatically improve one's quality of life too many seem to believe it is as simple as take the shot and everything is fantastic. It's a compromise, and it requires diligence and research.

Injection frequency is the easiest way to manage E2 symptoms. That's important to remember.
Click to expand...

resilient1 said:
I agree that contentment correlates with appropriate dosage, as well as the suggested minimum start dose. However, I know several people who are on prescribed trt, and never heard of 50mg/wk. It might happen, but 'most' gps? Nope. 50mg at most may equal normal production in some, but there are many other factors to consider. Normal testosterone production is around 6mg/day.
Wrt to the pharm test. I'm prescribed test and have both dela and depo and neither state any such thing on the bottle. It does state, Usual dose: 100 - 400mg every four weeks. Far too many assume you need high doses, and just because one can obtain a script for 200mg/wk does not mean that it is a suitable dose.

I'm sorry that you have had a poor trt experience, but an endocrinologist is the way to go. I've read many forums, and the one consistent thread I've noticed is that people seem to believe that once you are on trt everything is suddenly great. There are many factors to consider and be aware of, and while it can dramatically improve one's quality of life too many seem to believe it is as simple as take the shot and everything is fantastic. It's a compromise, and it requires diligence and research.

Injection frequency is the easiest way to manage E2 symptoms. That's important to remember.
Click to expand...
The OP is choosing to self medicate. Thats fine. Trying 150/week is fine to start. I wouldnt recommend a gp or endo. More often than not theyre out to lunch. Ive seen endos refuse to even treat you at all if 'in range' . I would recommend a private trt clinic if you wish to do trt with a doc or NP...if you want pharma.

You cant compare 6mg endogenous production to an equivalent exogenous dose. It doesnt work like that. Thats trt 101.

Youre right about trt not being a magical pill but compared to zombie mode pre trt its quite the change.
 
Agentchuckles said:
The OP is choosing to self medicate. Thats fine. Trying 150/week is fine to start. I wouldnt recommend a gp or endo. More often than not theyre out to lunch. Ive seen endos refuse to even treat you at all if 'in range' . I would recommend a private trt clinic if you wish to do trt with a doc or NP...if you want pharma.

You cant compare 6mg endogenous production to an equivalent exogenous dose. It doesnt work like that. Thats trt 101.

Youre right about trt not being a magical pill but compared to zombie mode pre trt its quite the change.
Click to expand...
I don't want to get into a debate on this. I'll make my point and that's all I'll say. I believe the OP would be far better off to start with 50mg twice weekly, and increase from there. If he is a high converter he runs the risk of other issues that are avoidable by starting low and slowly increasing. I'm for avoiding the use of an AI at all costs. If it is unavoidable cross that bridge when you get there, don't start there. When you take the half life of an ester into consideration it's far easier to adjust your dosage upwards. The other consideration is that when you start higher than needed it is very easy to get used to that feeling. Instead of going down that road start low and take small steps. He may end up requiring 150mg, but I would be surprised.

OP, search the TRT forum, and review the contributions of the members. Many members run 100mg and do just fine at that dose avoiding the use of an AI as well as side effects. I would be very surprised if 100mg/wk didn't result in a noticeable improvement, but it is possible you may require a higher dose. Your reading of 384 ng/dL is equivalent to 13.3nmol. Depending on your sensitivity it is realistic to expect that 100mg/wk will easily place you in the 20+nmol range. If so, that's a 35% increase.

Regarding the exogenous dose I'll defer to Dr. Chrisler who is quoted as stating 10mg daily of propionate sub-q to be ideal trt, which is equivalent to 100mg long-ester. He also started all his patients on 100mg/wk, then adjusted from there.

As the OP's FT is above the lower threshold, I don't believe he would be provided with a referral to an endo. I was below, and I needed two positive readings before a referral would be supported. In the OP's situation, yes, a private trt clinic, but so long as he educates himself, does proper bloodwork, I don't see the point of a trt clinic. If he has the disposable income, sure, otherwise no.
 
resilient1 said:
I don't want to get into a debate on this. I'll make my point and that's all I'll say. I believe the OP would be far better off to start with 50mg twice weekly, and increase from there. If he is a high converter he runs the risk of other issues that are avoidable by starting low and slowly increasing. I'm for avoiding the use of an AI at all costs. If it is unavoidable cross that bridge when you get there, don't start there. When you take the half life of an ester into consideration it's far easier to adjust your dosage upwards. The other consideration is that when you start higher than needed it is very easy to get used to that feeling. Instead of going down that road start low and take small steps. He may end up requiring 150mg, but I would be surprised.

OP, search the TRT forum, and review the contributions of the members. Many members run 100mg and do just fine at that dose avoiding the use of an AI as well as side effects. I would be very surprised if 100mg/wk didn't result in a noticeable improvement, but it is possible you may require a higher dose. Your reading of 384 ng/dL is equivalent to 13.3nmol. Depending on your sensitivity it is realistic to expect that 100mg/wk will easily place you in the 20+nmol range. If so, that's a 35% increase.

Regarding the exogenous dose I'll defer to Dr. Chrisler who is quoted as stating 10mg daily of propionate sub-q to be ideal trt, which is equivalent to 100mg long-ester. He also started all his patients on 100mg/wk, then adjusted from there.

As the OP's FT is above the lower threshold, I don't believe he would be provided with a referral to an endo. I was below, and I needed two positive readings before a referral would be supported. In the OP's situation, yes, a private trt clinic, but so long as he educates himself, does proper bloodwork, I don't see the point of a trt clinic. If he has the disposable income, sure, otherwise no.
Click to expand...
Thats good advice. If he decides he does want a doc the advantages too are that trt clinics do zoom and telemedicine. So he can do appointments from his home being hes rural.
 
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