T Nation

20 y/o with Severe Problems on TRT


A little story to explain why is 20 year old on TRT. Seems odd, right?

For majority of my teenage years I’ve felt unmotivated, depressed, had no libido or interest in girls it felt as I’m worse than anyone else. So I’ve read about it and when I was about 19 I did blood: Testosterone and Prolactin it returned as following:

Total Testosterone: 277 ng/dl (ref. range: 241-827)
Prolactin: 25 ng/ml(ref.range 2-17)
I thought this is it. I went to the doctor and told him about the problems I’m experiencing and how it’s ruining “what could be the best years of my life” He agreed, but told me to do more tests before we commit to TRT, so I did:

TSH: 4 mIU/l (ref.range 0.38-5.33)
LH: 5.28 mUI/ml (ref.range 1.5 - 9.3)
FSH: 7.5 mIU/ml (ref range 1,4-18,1)
Cortisol: 25 ug/dl (ref range 6.7 - 22.6 )
Total Test: 190ng/dl (ref range 241-827)
DHEA SO4: 361 ug/dl (ref range 80 - 560)
Androstedion: 3.15 ng/ml (ref range 0.6- 3.1)

With that checked, he put me on 250mg of Sustanon every two weeks and the first week I had more energy, I won’t lie, my penis started working too I think. But the next week was a nightmare, so I checked the blood again, because I thought it’s Estrogen spike related, it turned out to be true:

Total Test: 1300 ng/dl
E2: 90 pg/ml (ref range to 39.8)
So I went back again and told him I want to split the dosage, 125mg/a week seemed like a smart thing to do.
Things didn’t get any better. After a month of doing just 125mg a week I did blood again, it came back:
Total Test: 650 ng/dl
E2: 60 pg/ml (ref range to 39.8)

It’s hell, side effects are terrible.
Sides are:
-Huge Depression, especially in the morning
-Penis is cold almost all day, even when it gets hot it feels limp and dead
-no libido, even the hottest girl wouldn’t do anything to it, I’m just not interested and it hurts me the most
-tired as hell, not as tired as I was pre-TRT, but it’s damn close. it almost feels like I’m after a long night of heavy drinking
-sometimes get dry and red skin
-bloat occurs as well with weird oily skin
-acne, well yeah, but nothing terrible
-sometimes I feel like suicide might be the best option for me
-I also get the weird urge to kill someone

So with all of that, I came up with the idea that it might be Thyroid related, right? Maybe that’s why even 125mg of test is converted into so much E2. My grandmother has the problems with thyroid, so I checked:
TSH: 3 mIU/l (ref range 0.38 - 5.33 mIU/l)
FT3: 6.36 pmol/l (ref range 4.7 - 7.2 pmol/l)
FT4: 15.86 (ref range 10.7 - 18.4 pmol/l)
E2: 58 pg/ml (ref range up to 39.8)
Prolactin: 14ng/ml(ref range 2.1 - 17.7 ng/ml)
Total Test: 664.55 ng/dl
SHBG: 9.04nmol/l (ref range 11.4 - 52.3 nmol/l)
So it’s not thyroid related, right? What else could be wrong?

If you can please share some thought, I’m in the dead end. Majority of doctors in my country only care about thyroid related problems as they lack the knowledge beyond that. Maybe AI? If so, what dosage and what to use.

Thank you for your time.


What country are you from? It definitely sounds estrogen related.

Are you able to get an AI from a doc?


Poland, unfortunately. Yes, I think I can persuade him to give me AI.


Try to get AI and get to Ksmans recomended e=22 pg/ml.

Usually its recommended to take 1 mg of AI per 100 mg of testosterone


What AI are you referring to?


Polish chicks are hot. Definite hormone imbalance :wink:

Yes, it sounds like you need an AI (aromatase inhibitor, such as anastrozole) which should help with your E2 (estrogen) levels. With your lab levels I would think your doctor could prescribe it.


Thank you for the detailed post.

Your testes have not been working properly.
Are you very tall?

waist size=

Your thyroid is a mess.
TSH should be near 1.0, lab ranges are useless.
May be from not using iodized salt.
Please read the thyroid basics sticky.
Evaluate your overall thyroid function via last paragraph in this post.

We do get a lot of guys your age with low T from various reasons.

Please get your semen checked to see if you are fertile now.
Do this as soon as possible, because TRT is shutting down your testes.
If semen looks OK, you need to inject 250iu hCG subq EOD/E2D to preserve your testes and fertility. If you cannot get that, 20mg Nolvadex oral EOD, or 25mg Clomid EOD.

Please read the stickies found here: About the T Replacement Category

  • advice for new guys - need more info about you
  • things that damage your hormones
  • protocol for injections
  • finding a TRT doc

Evaluate your overall thyroid function by checking oral body temperatures as per the thyroid basics sticky. Thyroid hormone fT3 is what gets the job done and it regulates mitochondrial activity, the source of ATP which is the universal currency of cellular energy. This is part of the body’s temperature control loop. This can get messed up if you are iodine deficient. In many countries, you need to be using iodized salt. Other countries add iodine to dairy or bread.


The issue is definitely testes related. There might have been some damage, as I had some pains in them, but ignored it, since I was young and stupid. I will check them out soon. About that salt, using iodized salt is pretty common here, so I don’t think it’s really an issue.

height= 178cm, so not tall
weight= 80kg, fat mostly stored on the waist but not a lot of it, rest of the upper body and legs are fairly lean.
waist size= 85cm

I will also look more into thyroid issue if the AI doesn’t help and I’ll look into the sticky now. Thank you for your posts, all of you. There might be some hope after all.

Found my old TSH and ionogram bloodwork: It’s from 20-10-2015.

TSH: 2.11
Sodium: 138.8 (ref. 135 - 148 mmol/l)
Chlorides: 99.6 (ref. 98-107 mmol/l)
Potassium: 4.26 (ref. 3.5 - 4.9 mmol/l)
Don’t know how that helps.


Arimidex would be a safer bet I think.
As far as I know it only supresses not kills it like Aromasin or Letro. I don’t want to crash myself on top of that.


Thyroid is not a minor issue!

Please check salt package to see if iodized.
TSH should be closer to 1.0

Your body temperatures are very important.

If you postpone this, I may not be able to follow up.


I’m not gonna postpone anything. I’ve been struggling for years now, so I want this to be over as quickly as possible.
I’ll start with temperature check in the morning and will report back. I checked the salt and it seems we use mostly “normal” one, but I also have iodized one on hand. I’ll start “supplementing” it when I check the temps first.
Going to the andrologist will take some time, but I’ll report back once I know more.


I think that you should get the non-iodized salt out of the house.

Empty salt shakers and fill with iodized salt.

I have seen so many problems caused here by not using iodized salt. Thyroid hormone fT3 regulates your energy levels and your body temperatures. Low thyroid function very easily makes guys feel bad even with high T levels.

Iodine deficiency often affects everyone in a home. You can check body temps of others there.

You need to focus on thyroid and E2 levels. Getting enough iodine is something that you can correct.

TSH=3, should be closer to 1.0
Your TSH can be elevated by a lack of iodine. There can be another cause if rT3 is elevated. rT3 can be increased by stress, accidents, illnesses etc. Your fT3 is good. If body temps are low with good fT3, we need to consider that elevated rT3 is interfering with fT3.

Are you self injecting T?
Injecting every two weeks is not good. For anastrozole to work, it is a competitive drug, it needs to be balanced against your T levels. You need to inject every week or twice a week. Anastrozole needs to be dosed twice a week, at time of injections. Proper E2 management is very important for you.

Is T sust in glass ampules or multi-dose vials with rubber stoppers? You can fill multiple syringes if glass ampules.


I’ll try with the salt and the AI.
Yeah, I’m doing self-injections. I’m at 125mg once a week now, which gives me:
Total Test: 664.55 ng/dl
E2: 58 pg/ml (ref range up to 39.8)
(Test would be higher if I used AI, I’m aware of that)

They’re glass ampules 250mg/ml.
250mg/2 weeks protocol clearly didn’t work.

I also tried using only 75mg a week, but all it got me was:
290 ng/dl of Total Test(so like pre-TRT) and E2 at: 44, which felt even worse.

Thank you for your time. I’ll report back once I know more.


A little update from me. It might be a little emotional and “cunty”, but that’s because I am.

97.3F first day in the morning
97.5F second morning
97.7F third morning
It varies, sometimes I get 95F in the middle of the day, even though it’s hot on the outside.

I went to the doc and I think he actually hates my guts or doesn’t know anything at all. He prescribed me more Test of course, but instead of Arimidex or any AI at all. - I got Clostilbegyt aka Klomifen. Why? I don’t know. He simply said “pills for the breast cancer won’t do me any good” Jesus Christ, the state of this country.

What should I do now? High E2 literally kills me and any hope for a better life or at least enjoying any form of life along with it.

Edit: I’m still waiting for my visit with Andrologist. It will take some time of course.


E2=58 is horrible, you need E2=22pg/ml

FT would be higher is you used an AI and TT might be lower with an AI as there would be less SHBG+T in your TT.


I think I’m gonna buy “underground” Arimidex. No doctor will prescribe me AI here, it seen as “breast cancer remedy” here, so it’s pointless to look for another doctor. I already feel f*cked for life and want this to be over as quickly as possible.


That will work.


Little update.

So I’ve finally got my hands on Arimidex, it’s not prescription obviously, I bought illegally.

I did 0.25mg 1/4 tab every day from 20th June to 29th June, but quickly switched it to 0.5mg 1/2 tab every day, like the desperate idiot I am.
The reason I did that is because, like I said. I was desperate and wasn’t sure it would work as I didn’t feel anything getting better. In total from 20th June to 29th I’ve used 4mg of Arimidex which is obviously absurd dose, but on 29/30th(maybe before that) I felt similiar symptoms to high e2, but something new came also.
I was:
-sleeping a lot more during the day, but couldn’t sleep at night
-night sweats, more oily than with high e2
-my penis was cold just as during high e2
-i hard morning wood, but no desire for sex
-blunted emotions, like i didn’t care for anyting at all
-paranoia, attacks of panic and very suicidal thoughts
So my bet was that it’s low E2.

I did a shot of 125mg of Sustanon yesterday(Monday 3th July) along with 0.5mg 1/2 tab of Arimidex and did blood today(4th July), it came back as following:

Total Test: 1356.94 ng/dl (ref. 241-827)
E2/Estradiol: 30.63 pg/ml (ref. 11.8-48.9 / mediane: 22.7)

I still feel like crap, no libido and getting “cold dick”, but I think I’m on a good path now. I’ll continue to use 0.5mg of Arimidex on Monday with injection of 125mg of Sustanon and 0.5mg on Thursday, making it 1mg/week only.

Btw. Here’s the product.

Is this legit?
I think it might be underdosed, or maybe I’m just so prone to Estrogen.


I can’t see that you tested FT?

We need oral body temperatures when you wake up AND MID-AFTERNOON.

Your SHBG was very low. As that can be a symptom of diabetes some times, you need to have glucose tested after not eating for 12 hours. A1C lab work is also very useful.

With low SHBG, FT can be very high and there is less non-bioavailable SHBG+T and then TT understates your T status. So there can also be more FT–>E2. So that is part of the reason that you need more anastrozole, but your anastrozole might be the problem too.

You need a fixed/steady T and AI protocol for a week for your labs to reflect your dose.

Many with really low SHBG have problems getting balanced and may need lower T dosing.

I don’t know how much T you use per week or how often.


I’m gonna check the other things too. Seeing how much trouble everything causes, I wish I never had to use the T in the first place.

I’m on 125mg of Testosterone/a week only. Nothing more, nothing less. I’ve been on the same dosage for a long time.

I think I’ll lower the dosage to 80mg of test/week with 1mg of Arimidex/a week? Maybe that will work.

The last time I did 75/80mg a week it returned 291 ng/dl of total test, with 40 pg/ml of E2 four days after the injection. I didn’t use any AI back then though.