T Nation

2.5 Years on TRT and Never Got Better

Looking for some guidance. I have been on trt for 2.5 years and never feel like I started to feel better. Before I started TRT, my levels were at 247. Very early on I started injecting IM 2x per week .25 ml.

It has very much helped with muscle growth where as before I always struggled with muscle growth. I never felt like I got a boost in energy levels and have no drive. I am still always tired.

4 months ago while I was injecting IM 2x per week .25 ml, my T was 500ish and my E was 126. So I took AI and am pretty sure I crashed my E from taking it for 3 weeks so I stopped taking the AI. Switched to subq and upped my cyp dose to .35 ml.

Currently I am injecting subq 2x per week .35 ml. Just got my bloods back and my T level is 1341 and my E is 40. I did notice my FSH is <0.2 and my LH is <0.2. Not sure what those are and if that is affecting me. Still tired. No energy. Still no drive at all. Feel like I have depression.

You need more lab testing to find out what is going on, I had an ion deficiency the entire time on TRT and was always fatigued even though I had excellent muscle gains. We need to know how much of your testosterone is free, Total T by itself in not very informative.

LH and FSH are suppressed on TRT, do not concern yourself with these values. Low thyroid function will make TRT less effective, most doctors don’t know what normal thyroid function looks like on paper. To them in range is normal and are not overly concerned with low numbers, except TRT will not work well when thyroid hormones are low.

Your really need to describe dosing in mg, not ml. Testosterone varies by strength in milligrams, ml is volume, we need to know the strength. We cannot help you unless you return here after running at least a thyroid panel, mineral panel and a more complete hormone panel.

If your doctor gives you a headache when asking for these very necessary labs, you can always go to discount labs and order them yourself. I doubt you would be here asking for help if your doctor was exceptional in managing your care. You also need to include lab ranges and lab units of measure.

If your SHBG is very low, twice weekly injections is not appropriate, I didn’t do very well on twice weekly dosing because I have low SHBG. I did extremely well on daily dosing. I have no clue how much testosterone your injecting so I cannot help.

  • Total T
  • Free T
  • SHBG
  • Estradiol Sensitive (E2)
  • Prolactin
  • Iron panel
  • Cortisol
  • Ferritin
  • Thyroid Panel
  • CBC-complete blood count
  • Comprehensive Metabolic Panel
  • Lipid profile/panel

I am currently injecting 70mg 2x per week.

Now where does your SHBG currently sit or what was it previously? If you have no SHBG testing then there is no way to know if this protocol is appropriate.

SHGB 4 months ago was 17

SHBG 17 requires daily injections

As I thought, your protocol is not appropriate, you are more than likely dealing with excess T and E2 and this is why you are exhausted, when you are in excess TRT is less effective and nothing works correctly. Whenever I see a low Total T pre-TRT, usually SHBG is low.

You’re like me, I didn’t do well at all on twice weekly dosing, I didn’t start seeing benefits to TRT until I started 20-25mg EOD protocols, but found I did even better on 7-10mg daily dosing using 29 gauge insulin syringes and inject in the shoulders and quads.

I even saw an increase in SHBG on daily dosing, 14 pre-TRT and 22 on TRT doing daily dosing.

You can order 27-29 gauge insulin syringes online.

Damn ok. Where can I go to read more about it? I am the type to want to know more so I understand it. Or if you could explain it in a post. I guess just the benefits of injecting every day when SHGB is low.

TRT has been neglected (ignored) for many decades by western medicine and has existed in private practice in sports medicine and anti-aging, most of what is known is through trial and error of what doctors are seeing in practice, that is low SHBG men do better when injecting very frequently.

I see the same thing across multiple forums, if a guy has low SHBG and injecting large to moderate doses, he will find himself on forums asking for help.

If your SHBG was 30>, you would more than likely be doing very well on TRT on your current dosing schedule.

What should I change my protocol to? Should I lower my total weekly dose as well as dividing into more frequent doses?

It could be so many things. Are you overweight? How’s your life? Are you happy? Are you stressed out a lot? Do you have sleep apnea? Do you stay up late often and get very little sleep? How’s your diet? It could be mental, it could be physical, there’s just so many possibilities to your symptoms my friend. Take a step back and examine your overall life first.

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You should do 18mg daily, this is based off you total weekly dosage and the levels you are scoring, you seem to be metabolizing and/or secreting testosterone quickly.

I would only need 7-10mg daily to achieve similar levels.

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I shoudnt lower my weekly dose though?

Do you have your free testosterone levels?

Interesting, your total test on 50mg 2x/week was in the 500s while E2 was 126. When moving to 70mg 2x/week you were at 1341 test but E2 was 40 and that is without an aromatase inhibitor? Which E2 test was it? The LC/MS/MS is known for inconsistent results.

Regardless, your results are not satisfactory so you need to look at things and maybe try something different. Before changing anything I would want to look at the lab results for the tests listed above. You should discuss this with your doctor.

This certainly was not my experience nor that of hundreds of competitive athletes I knew back in the day. Using 500-1000mg per week is nothing today and back then nobody taking testosterone used less than 400mg unless they were in the lighter weight classes, and even then it was 200-300mg. Heavyweights typically used 500-1000mg a week and I can say for sure that 800mg was better than 400mg.

Sure, there is a point of diminishing returns, but that is not happening when moving from 100 to 140mg a week.

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I don’t know what my free T is.

When I went from 50mg to 70mg, I switched to SubQ and also used and AI for 3 weeks.

Problem is my doctor wanted to keep me at 50mg and said my E levels were normal. He isn’t up to date with T at all and doesn’t want to deviate.

So the 1341 test and 40 E2 levels were when doing 70mg 2x sq and an AI? How much?

Yes. .5mg 2x per week for 3 weeks. That was 3-4 months ago. Just doing the T now.

This is rubbish. I really don’t like guys pushing injection frequency based on shbg. Cypionate has a 1/2 like of 7 days. Many guys with varying shbg inject 1 or twice a week and are fine.
I would stop any ai if u taking and wait 6 weeks for things to stabilize.

When did you start the 70 2x a week? Give it 6-8 weeks to stabilize.

Ever did thorough labs.

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CBC
Metabolic panel
Lipid panel
Ferritin
Prolactin
Dhea-s
Thyroid panel
Free testosterone

It has been 3 months