T Nation

2 Weeks into TRT, Did I Jump in Too Quickly?


#1

Any input greatly appreciated.

Quick background.

30 yr, m, 6'2" 250 muscular build currently about 20-22%BF

For a while now been feeling extremely sluggish; if I don't manufacture some artificial energy, strong coffee, caffeine pills, supplements, etc, I just don't feel well. Cognitive ability, remembering things in the short term, focus -all declined alot over last few years. No motivation. I grew up playing sports, working out frequently, not often enough tho, never done much cardio outside of sports.

I also work shift work, 12hr shifts, rotating from days to nights each week.

I went to doctor at work to get labs and asked for testosterone check.

Came back 344 total t.

Went to clinic and doc immediately put me on axiron after an initial tes shot. I did that for a week, hated it, asked him Monday to put me on shots, got another shot, and he prescribed me to self inject weekly .5ml tes cyp, which I was thinking of splitting into 2x a week at half the dosage.

He also prescribed hcg, to be taken via 500 unit sublingual trouches, every 3 days. Took first one yesterday.

I've been reading so much over last few weeks, asking questions. So much conflicting advice, which is understandable, yet frustrating.

Just found this site today. Been reading all morning.

I'm just overwhelmed and can't retain much info as it is, just worried and wondering which direction I should go, what information I should persueat this point.

The shot on Monday, I could really feel the boost. It made me want to lift weights, which I did, first time in months. As well as on Tuesday, GREAT workouts, felt like I could just keep going. Rested Wednesday, back to work this morning, feeling good overall tho.

I'm just wondering if I need to slam the breaks, look into anything, check things out another way. I just don't want make a long term mistake, if thereasonfor my low testosterone could be solved otherwise.

Thanks for listening guys, your help will be very much appreciated.


#2

If you haven’t done so, you should definitely push to get some of the lab work from the “New Guys” and “Lab Work” stickies. Your doc should have likely wanted at least some of it done before putting you on a full TRT regimen at 300-something TT; it’s strange that he jumped in so easily.


#3

Agree with Nyrin. Also get a copy of your blood work and post the results. Hit up the “KSman is here” thread. Put a link up to this thread once you get the blood work posted. He will be able to shed some light on what he thinks is the issue. I know how you are feeling as this was the same boat I was in a month ago. It is overwhelming, but the more you read the more you will be able to help yourself and figure out what to ask for as far as testing goes. Read those stickies mentioned above. I actually copied and pasted a ton of info into a word document so I could print it out, read it and take it to my Urologist. We seem to be on the same page so that is good.

Good luck on getting this under control. I know I have felt so much better over the past few weeks that I wish I had done this years ago.


#4

Hello:Your test is in the medium Normal range: My friend what about other things like depression? Depression manifests in all the above mentioned. can you please elaborate on the Sublingual hcg.I thought hcg other than injectable was this Homeopathic junk that doesant work.I.E. Scam,but if your DR.actually wrote a prescription can you please advise me of brand name and such. thank’s john


#5

"If you haven’t done so, you should definitely push to get some of the lab work from the “New Guys” and “Lab Work” stickies. Your doc should have likely wanted at least some of it done before putting you on a full TRT regimen at 300-something TT; it’s strange that he jumped in so easily. "

Thanks, I already have an appt monday with doc at my work to run full labs so I can see a fuller picture. There is so much info - overwhelming really, online stating that 300ISH Total T is really low, that optimal for my age is 650+; now whether that is true or not, that is the reason after I got my results I rushed to see someone. I went to a longevity clinic. They are general practitioners, but I heard a few there deal alot, and treat low testosterone. My “doc” is only a PA. My first impression? He is ready to write TRT scripts. I believe he does TRT himself, believes in it, etc.

I was given other prescriptions to treat weight loss, shift work disorder, depression - on top of the TRT HCG regimen.

I’m not someone who wants to take alot of meds. I really want to keep that to a minimum. I am not even taking the anti depress’s as I feel my depression only spawns from how I feel physically. Stimulants that get me up and going make me feel great, BUT I really don’t want to lead a stimulant driven life, if something is wrong with me, I want to find out.

PROS and CONS to my current “doc”

PROS
He will work with me on whatever regimen I decide I want to go with.
Easy access

CONS
He really didn’t look at or for any of my numbers past total t. I wasn’t labbed for estrogen or many other things I am learning daily are important to diagnose low t properly. The more research I do, the more anxious I get about having gotten started on this so rapidly.

“Hello:Your test is in the medium Normal range: My friend what about other things like depression? Depression manifests in all the above mentioned. can you please elaborate on the Sublingual hcg.I thought hcg other than injectable was this Homeopathic junk that doesant work.I.E. Scam,but if your DR.actually wrote a prescription can you please advise me of brand name and such. thank’s john”

As far as test range, please refer to above statment. From MOST of the reading I am doing, its rare I come across someone stating 340 total T is something you want to accept (if it correlates with low FREE T as well.) But once again, at the end of the day. I really don’t KNOW much. There are so many different opinions.

Also, the HCG I was prescribed in 500iu sub lingual troches is that available through a pharmacy in Florida. I am not sure of the rules regarding listing ACTUAL names of places, so thats all I’ll say on here.

If anyone has some links (proof) stating the ineffectiveness of sub lingual hcg, I would love to take to my next visit.


#6

Read that sticky, that is the best thing that you can do now. Post all of your lab work.

So they did not test LH/FSH and you do not know if you have primary or secondary hypogonadism? Too late to test LH/FSH now.

You should be looking to find the cause of your low T and fix that. Low T is a symptom, not a cause. If you go to a hormone shop, that is what they will sell you. “T tunnel vision”

You need to inject hCG, everything else is bogus.

We often see guys here with hypo-thyroidism and/or adrenal fatigue. Check body temps and iodine intake as per thyroid basics sticky.


#7

Thanks KSman, read and printed all the stickies out as well.

During the “finding out process” should I continue the trt process? Hold off on any more injections? Treatment so far to the present:

200 injection on day 1
Axiron day 2-8
100 injection on day 9

Today is day 15

As soon as I get results will post.

Thanks a ton for your help. If I hadn’t found this site, I may have just gone full steam ahead without second guessing.


#8

That is a protocol?

You should really try the “standard protocol”

100mg T ester per week, injected SC twice a week or EOD, see sticky for recommended syringe
1mg anastrozole per week, 1/2mg at time of injection if injecting twice a week, or EOD divided dosing if EOD injections
250iu hCG SC EOD -if injecting T EOD, inject hCG at same time [not in the same syringe.] Same size as T syringe
Adjust anastrozole dose to get close to E2=22pg/ml
Adjust T dose to get TT in 900-1000 range testing always 1/2 between injections, increase anastrozole dose by same factor as T.

Get balanced on the above and see where things go from there.


#9

Nah not protocol, he started me off with a shot to boost the process and prescribed axiron and sublingual hcg.

After a week on axiron, I just knew I didn’t want to do that every day, indefinitely. Asked to go on shots, and he prescribed 100mg IM once a week.

Well def follow above recommendations, and in the meantime troubleshoot the cause for the low t. Thanks again.


#10

OP, you are already on TRT, so at this point it is too late to do a lot of the tests to determine causes of low T. The injected T will have modified some of the important blood values.

I don’t get the idea of starting a patient on anastrozole as a “standard” therapy without even knowing if the patient needs it.

After all, most healthy men not on TRT with normal testosterone levels don’t aromatize so much that they need anastrozole just to get through the day, so why should anastrozole be “standard” in testosterone REPLACEMENT therapy when NORMAL testosterone levels are restored (we are not talking about supraphysiological augmentation here after all, are we?). What makes the testosterone from TRT aromatize more than the natural testosterone made by a healthy eugonadal man?

Most men in the world on TRT do quite well without anastrozole, after all.

And if you look at studies you’ll find that healthy young men tend to have E2 in the low 30s, not 22.


#11

Appreciate the replies, I’ll take all the info I can get.

I’ll be getting the labs in the morning, one full week after my 2nd injection on TRT. I have felt like trash the last 3 days.

I’m hoping labs will give me SOME insight, I’m going to try and get as many values back as I can.

Main thing I have to do tomorrow after labs is switch to SC on the test and the hcg.

I would much prefer the SC method, and am curious to see results after a month.


#12

[quote]jsnewtotrt wrote:
Appreciate the replies, I’ll take all the info I can get.

I’ll be getting the labs in the morning, one full week after my 2nd injection on TRT. I have felt like trash the last 3 days.

I’m hoping labs will give me SOME insight, I’m going to try and get as many values back as I can.

Main thing I have to do tomorrow after labs is switch to SC on the test and the hcg.

I would much prefer the SC method, and am curious to see results after a month.

[/quote]

What is the benefit of sub q testosterone injections? Besides being less painful I mean. Does it affect how much of the Testosterone Cypionate is needed to get someone in the top of the range? I know that more sub q HCG is required to get the same results as IM HCG injections.


#13

SC delivers slower than IM, so levels are steadier. Also avoids a lifetime of muscle damage. Not really a pain issue, but the #29 needles are about as painless as you can get. Absorption is 100% in any case. Note that pellets are SC, not IM.

I did IM for a while and areas that I injected, the muscle was hard and thick. That cleared up after a few months on SC.