T Nation

12 Months In, Need Help

1 Year of TRT through Canadian MD, and have hit a wall of feeling forced to choose between shitty side effects with effective treatment vs. less side effects and shitty treatment. Been on Delatestryl for 12 months solid, at all sorts of dosages. Will list them below with their associated bloodwork.

39
6’,1"
176lbs.

Background:

At age 38 showed numerous signs of Low T that I’d been accumulating for at least 6 years (fatigue, lack of strength, muscle aches and pains, joint pain, shitty immune system, easily exhausted, easily injured, couldn’t gain weight, anxiety). I had never heard of low T. Has likely been a somewhat lifelong problem, as I hit puberty late, grew late, and legit weighed only 135lbs. at 6,1 until I was 32 years old. Despite eating anything, training, etc. Could not gain weight. Similar to others, was recommended SSRI’s for the anxiety component almost immediately and never had my T tested until last year.

A new doc finally picked up on the symptoms and suggested I have my TT tested; came back 158 ng/dl. Retested it a month later along with FT and Bio; was TT 250 ng/dl, FT at 48 pg/ml and Bio at 112.39 ng/dl. Under value even for Canada’s system. Referred to local internist as we have no Endo locally. He has no idea why it’s low and listed the cause as idiopathic. Rest of the blood work is fine, otherwise healthy aside from some anxiety, no probs with ED or libido and I fathered children easily.

He started me on 1 IM injection per week of 200mg Delatestryl, and motherfucker I felt great within 24 hours of the first injection. Was like magic, gained 10lbs in 3 weeks without touching a weight or changing my diet. All aches, pains and exhaustion gone. Haven’t been sick since. Already good libido was 18 year old insanity. But, by week 5 was like someone flipped a switch and the dick was non existent and the libido at absolute zero. Also, acne became just ridiculous by week 4 and has never let up, worse than teenage.

What followed was 11 months of labs with dosage adjustments as he’s trying to avoid side effects, and attempting to get to a Free T value of around 20% under the max listed on the labs. (His idea)

Bloodwork/Dosages:

All converted to US units. Protocol has been 1 injection per week IM, self administered into the Quad (vastus lateralis). Nothing else. CBC is always fine except for an MCHC that hovers around lab max.

Pre TRT Baseline =

TT = 158-250 ng/dl
FT = 48 pg/ml
Bio = 112 ng/dl
TSH = .95 miu/l
FT4 = 0.85 ng/dl (11 pmol)
FT3 = 260 pg/dl (4.0 pmol)

4.5 weeks 200mg, blood 5 days after dose. Felt amazing for first 4 then ED & 0 Libido + wicked acne =

TT = 1328 ng/dl
FT = 388 pg/ml
TSH = .76 miu/l

2 weeks on 150mg, blood 4 days after dose. Libido improved 50%, ED still shit =

TT = 1075 ng/dl
FT = 315 pg/ml
E2 = 34.9 pg/ml
TSH = .69 miu/l
FT4 = 0.70 ng/dl (9 pmol)
FT3 = 325 pg/dl (5 pmol)
Prolactin = 15.8 ng/ml

3 weeks on 100mg, blood 3 hrs after dose. Libido a bit worse, ED improved =

TT = 1093
FT = 312 pg/ml
E2 = 32.7 pg/ml
TSH = .87 miu/l
FT4 =0 .78 ng/dl (10 pmol)
FT3 = 370 pg/dl (5.7 pmol)
Prolactin = 10.2 ng/ml

9 weeks on 70mg, blood 1 day after dose. Libido and ED issues gone, back to insanely good =

TT = 807 ng/dl
FT = 213 pg/ml
E2 = 28.1 pg/ml
TSH = .94 miu/l
FT4 = 0.85 ng/dl (11 pmol)
FT3 = 344 pg/dl (5.3 pmol)
Prolactin = 11.4 ng/ml

13 weeks on 60mg, blood 1 day after dose. Libido down a bit, No ED =

TT = 810 ng/dl
FT = 225 pg/ml
E2 = 26.2 pg/ml
TSH = 1.16 miu/l
FT4 = 1.01 ng/dl (13 pmol)
FT3 = 357 pg/dl (5.5 pmol)
Prolactin = 14.6 ng/ml

*Was instructed to lower it to 50mg for 3 weeks and then to 40mg and remain until next lab. I managed 2 weeks at 40mg before I threw in the towel and upped it myself. Felt like complete ass, almost all symptoms of low T returned, or it was withdrawals or something. Upped it to 75mg where I had felt might work best based on previous levels.

8 weeks on 75mg, blood 3 days after dose. Great at the start, felt like the beginning for about 3 days. All physical symptoms gone almost immediately. Great libido, but some annoying ED returned 6 weeks in =

TT = 680 ng/dl
FT = 185 pg/ml
E2 = 32.7 pg/ml
TSH = .76 miu/l
FT4 = 1.01 ng/dl (13 pmol)
FT3 = 299 pg/dl (4.6 pmol)
Prolactin = 10.7 ng/ml

*He suggested it was medication resistance and that I raise it up even further to sort out the ED, so I went back 100mg and immediately and completely killed my dick/libido.

This is where I started searching for further answers online and found this site. Learned a lot, mostly that he’s got me changing some early dosages way too fast and that trying to achieve a FT of 20% under lab max is retarded.

I feel this could have gone better. I specifically asked him before I started, I’m willing to try this as long as I don’t lose my hair and I can still be fertile. He said it wouldn’t effect either. Well, my balls are atrophied as fuck and my otherwise normal hair started thinning like crazy at about month 4. Certainly feel a hell of a lot better physically, can’t possibly argue against that, but what the fuck I have to give up a lot to get that. Has to be a better choice than struggling with sexual problems, ridiculous acne, etc., just to feel normal. I’m not shooting for gains or anything, just normal.

Sorry for the long ass post, but I don’t know what the hell and you guys seem to like information.

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Ill let the Enanthate guys help you out with the dosing and protocol required to make this a successful thing for you. But I will tell you this. TRT will shut your natural production of Test. No need to worry, you can become fertile again with HCG if you need to become fertile for a few months. Anyway, regarding hair. If you are prone to male pattern baldness it will speed up the process. Who cares, Im one those guys, and Im not like Friar Tuck, but a shorter haircut has been the norm for me now. You clearly have informed yourself a bit in knowing that these are some of the side effects of TRT. As for acne, theres a chance that youre taking your doses incorrectly and either not enough or too much. You’re gonna hafta see things the way your body wants to feel. Im ok with going bald and becoming infertile, knowing that Ive become a better version of myself. You might have to work on that part along with your TRT. Dont expect miracles, but you can become a sex machine with a nice core , stable mindset, and maybe you will keep your hair. Plenty of guys on T with their natural hair. Dont sweat it.

I see several problems. First, your blood draw HAS to be at trough. As in the day of shot, BEFORE the shot. These labs are not comparable, as they are all over the place schedule wise.

So, you shut down and felt worse. The response was to lower your dose. Let’s think about that. Your available testosterone decreased, you felt worse, so you decreased your available testosterone. There are surely other factors at play, but this was the exact opposite of the logical decision. You would probably benefit from giving twice a week or daily shots a chance. This would allow you to have slightly lower total T, but higher trough levels. It really gets it for some guys, along with a scrub for the bacne. I’m sure @ncsugrad2002 or someone else could make a recommendation on scrubs. Go up in dose, but split it up and don’t change it for at least 8 weeks. The experience of guys like @dextermorgan show that some guys need to let things settle out for a while before they get good. Some of the sides will likely go away over the course of time, like a year. Sadly, you were going to lose the hair anyway, just a little slower with low test levels.

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Didn’t know about when to draw, good to know thanks! Makes sense, my values changed a lot at similar dosing based on when the blood was taken. Doc has been titrating dosages based on unreliable data if that’s the case.

Regarding the initial shutdown at 200mg, just doing what he recommended on that one but you make a good point.

I am starting twice a week injection tomorrow based on what I’ve read here and some of Danny’s videos. Even though I never really felt a low point on day 6 or 7, the practice makes sense. The question is, what dosage. Just split the 75mg? Seems like the first few days are going suuuuuck being 37.5mg.

I’m not overly hung up about hair… just annoying I made it to 39 without any sign of hair loss at all, and now she’s thinning fast baby. The part that irks me most is the guy told me flat out it wouldn’t cause that or my nuts to shrivel… clearly full of shit.

The first few days won’t be a lot different, honestly. It may be not different at all for weeks. I would just split to start and figure out adjustments at 8 weeks.

I hope not. As I stated, when I got down to 40mg once a week like he wanted, I felt like smashed ass pretty fast. True, there would be another 40 coming 3.5 days later. Will see.

40 a week is just painful. Almost no one could feel good on that, no matter what injection frequency they sue.

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I would check to see if he actually went to med school.

75mg/week is pretty low. It out works for you then by all means stay there but the difference between 100mg and 175-200mg was astronomical in every way.

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There you have it. You got F’d in the A by your doc. You should take over your dosing, and find a better doc. Also, never test hours after a dose, I would test on the day of injection, before injection.

That he did, somewhere in India, in 1960… That’s what we have to work with here.

He’s a genuine dude, old as fuck, probably 78. Refused to retire because he wants to help people a couple days a week. But that’s why I’m telling strangers about my medical problems, I just don’t feel the guy is even aware of certain things. What he does do, is prescribe lots of refills willy nilly. I hope he doesn’t get taken advantage of by guys that just want gear.

That’s what I’m gathering ya.

You are correct, I physically and mentally feel awesome at those dosages, even once per week protocol was no problem for me at the start of this. The problems is, currently, if I go above 80mg once per week my dick and libido disappear within 24 hrs.

How long have you tried staying at the higher dose to see if things improve?

Overall, spent the initial 10 weeks on TRT 100mg and over. However, it was 5 weeks at 200, 2 weeks 150 and 3 weeks 100, as the doc gave no shits about changing dosages whenever he saw my levels weren’t dropping to what he deemed acceptable. Granted, I had dick probs starting at week 4 and didn’t really get to 100% resolved until 75mg.

I can say for me it typically takes 7 weeks at a steady dose for stuff like that to work themselves out, so just more time at the higher dose may be all you need.

Yep, you have to leave the protocol alone. Your body will never stabilize with changes being made. Its not cocaine.

This is the point I’ve been trying to make/research. It seems some get some benefits of TRT at one level, and other benefits at another.

You get good wood/libido at lower levels, and mental benefits at another.

I’d rather be a miserable SOB but have a sex drive personally.

Agreed, didn’t know that until I started researching it myself. I am making the switch to a split dose every 3.5 days to see what happens as well. I seem to do okay on once per week, but it’s worth a shot.

Ya, It’s a bastard. I was disappointed the libido/wood issues started creeping up after 2 months at 75mg. I’d hate to think my dosage range is limited to between 50 and 70 per week.

There is another poster on this site, i can’t recall his name at this point, but he only gets good results with like 35mg PER WEEK. Insane.

Who cares what your dosage range is, as long as you’re getting libido i think.

I"m currently on 300mg test per week and STILL can’t find libido. I’m going to try the low low dose approach next (after a couple months).

Did you ever get SHBG tested? I’m guessing yours is very low.

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