T Nation

28Y/O Male. Approved TRT from Doctor


#1

So heres the story.

Primebody sees my T at around 360 and swoops in to say yes to TRT.
i went through the proper channels before with PCP and endo, but because i have size on me, they think TRT wont be a fix.

we looked into maybe thyroid, but im being brushed away.

Symptoms in order of concern:

  1. low ass mfing libido. like…no morning wood, no desire.
  2. fatigue. i uses CPAP and have done so for a while, but the fatigue set in way before that.

everything else is gravy.

i get tests done with the following results:

Test (ng/dL): 382,395, 326
Test Free (ng/dL): 12.4, 11.7, 104
Test bio (ng/dL): 144, 138.7
LH (mIU/mL): 4.9, 6.6, 4.6
FSH (mIU/mL): 4.4, 5.9, 4.7
Prolactin: 27.5, 11.77, 15
SHBG: 12.9, 18.3
IGF-1 (ng/mL): 257
e2 (pg/mL): 37.7, 27.1, 23 (10-50 range roughly)
TSH (uIU/mL): 3.63, 4.47
T4 free (ng/dL): 1, 1.1
T3 total (ng/dL): 103
Hematocrit: 43.6%

Note, the bloods come from (stanford, stanford, labcorp) and in order of results shown, eg, labcorp last result.

I had to go to LA, from SF, to see the doctor, and there he gave me hCG subQ and T IM(glute).
100mg/mL T, 350IU hCG.

I have noticed that morning wood is back, not in force, but back. Nothing else changed, but a few days after my first pin i occasionally smiled (im not a very…happy…person. not depressed, just realistic).

that was the 24th of June, and my Rx is slated to come in tomorrow.

My script is:

  1. 200mg/mL Test Cyp, split into 2 doses a week - IM
  2. hCG - 0.5mL split into 2 doses, subQ
  3. AI (ana) 1 cap @ 0.5mg a week, which i would probably split in two.

So here are my questions:

  1. do my bloods warrant me to be on TRT? are other factors to be aware of? doc wont do MRI for pituitary issues due to great chance to false negatives. i got a concussion a few years back but i dont think it changed much /shrug.
  2. how is the dosage - does it fit the bill? some people say 200 test is close to running a cycle and is the upper limit, and some even say 100/week is fine. Do i take what the doc says or should i start conservatively?
  3. i feel a little heavy in the chest and sluggish, is that normal? is it also true that it takes about 2-3 months for my hormones to stabilize, in which case THEN i will feel effects?
  4. im deathly afraid of needles, but if subQ is slower release and more ideal, then i would rather do subQ for both pins vs subQ + IM as i would freak out over quad bleeding. what needles would best suite my needs? im not sure if its a long or short esther, but would it matter if the Test went subQ?
  5. doc wants bloods in 6 weeks after first in home pinning, but i ordered bloods now too just in case so i can get a baseline of what his 100mg test did to me and if my blood is sewage thick. im really concerned about slushy blood.
  6. my brain is a wreck, especially after reading the COUNTLESS awesome articles here. any further advice is super welcome.

Thanks all!


1 Month In, Need Help Honing My Meds
#2

First off, good luck in whatever you decide, I know all the thoughts flowing through your head and just know there are other people out there going through the same thing.

do my bloods warrant me to be on TRT? are other factors to be aware of?

Your levels are low. They are low enough to adversely affect your life. Frankly if your levels didn’t warrant being on TRT, the doctor wouldn’t give you the script. There might be any number of reasons why it is low, and I don’t know if you will ever find the root cause. I’ve been on TRT for 4 years and we never found a reason why. BUT the treatment has helped me tremendously.

how is the dosage - does it fit the bill? some people say 200 test is close to running a cycle and is the upper limit, and some even say 100/week is fine. Do i take what the doc says or should i start conservatively?

First, 200 isn’t even close to what people take for a cycle. 600/week seems to be about the minimum for a proper cycle. You can always come down later. I’d take the 200 if that’s what your doc prescribed and if your tests come back too high, he/she will bring your Rx down.

Re: how you are feeling now

I wouldn’t take any feelings after one dose too seriously. It took me months to feel steady. Once everything balanced out, I felt much better.

Re: needles

Personally I use 1ml TB needles (25g x 5/8). I use them in my quad, but they are small enough for subq. Because they are so small, drawing the liquid takes forever, but I never wanted to use a different draw needle like some people do. Talk to your doctor about IM v. subq. It might not matter for a while, since you are just starting and haven’t tested your results.

doc wants bloods in 6 weeks after first in home pinning, but i ordered bloods now too just in case so i can get a baseline of what his 100mg test did to me and if my blood is sewage thick. im really concerned about slushy blood.

IANAD but one dose of 100mg test isn’t going to turn your blood into motor oil. I’d follow the doctor’s advice and do your bloods in 6 weeks. Of course if another test now makes you feel better than go for it.

my brain is a wreck, especially after reading the COUNTLESS awesome articles here. any further advice is super welcome.

Try and relax. I was where you were and I know how you are feeling. Just know that it is a long process, but you will start feeling much more energetic and normal. The nice thing about being on TRT versus a cycle is you are going to stay on forever, so you can play with dosing depending on your bloodwork and how your body responds. If you get side effects, you have a doctor who can help you with it.

Also look on this bright side, in about 6 months you’ll for sure no longer be afraid of needles :wink:


#3

well, its primebody not my endo or PCP that gave me the script, so they have an incentive to accept a larger audience - my docs laughed me out of their room lol.

re: cycle

good, i was glad. some people were saying 200 was close to starting - my other concern is, if i take 200 and its too much, i feel greedy to use like 100. the way i see it is, im already starting on max dose, so they only downregulate me to a lower dose. if i stay at a low dose, they wont complain and take me off TRT cuz my numbers arent good - they get paid the same and i still get my TRT. is that a bad thought process?

re: feeling

wierd, maybe its confirmation bias or unlucky chain of events (too many bbq, too little sleep) that made me feel foggy and sludge blood. apparently i took a bayer yesterday evening and i feel great today /shrug

How often do you pin, EOD, E3.5D? how do you split 200/mg over EOD? sounds like one week would be a better week than another, but i guess it averages?

its it 200mg/3.5days[7days/every other day] ? that 57.14mg lol.


#4

You can/should inject T and hCG with #29 1/2" 0.5ml insulin syringes. Not 1.0ml and separate injections. Inject over upper leg were you can see what you are doing. Pinch some skin up a bit and inject into end of fold with needle parallel to muscles below. T will be slow to load, injections are fast enough. hCG is fragile, never shake, load and inject slow. hCG should not be shipped to you wet.

You will find that you will hardly feel the injections. Avoid veins.

Your hCG dose is 500iu twice a week. Please do not discuss in volumes as potencies are not standardized.

200mg T per week is often a bad idea.

Anastrozole 0.5mg/week will not manage 200mg T/week, or typically not even 100mg/week.

TSH is horrible, should be closer to 1.0
suspect that you have not been using iodized salt and are iodine deficient.
This lowers your metabolic rate, making you feel tired, depressed etc and prone to fat gain.
Low thyroid function can deny you most/many of the benefits of TRT.
SEE LAST PARAGRAPH.

Many aspects of how you were feeling were thyroid related.

fT3 is the active hormone and should be tested.

Please directly edit your post and add lab ranges.

Should you be on TRT? We do not even know your age…

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.

KSman is simply a regular member on this site. Nothing more other than highly active.


#5

well, its primebody not my endo or PCP that gave me the script, so they have an incentive to accept a larger audience

Okay, I assumed it was from a doctor. I don’t know anything about primebody, so I won’t really comment on your dosing. I’d start low and see where you get in your blood tests.

How often do you pin, EOD, E3.5D? how do you split 200/mg over EOD? sounds like one week would be a better week than another, but i guess it averages?

I pin twice a week, typically on Sunday/Thursday.


#6

Thanks for the above on pinning <3
why is 200mg a week bad? im a little apprehensive because wherever i go, people are saying 200 is the max, so i assume my doc wants me to load up and taper me off as time progresses. i read your other sticky on the standard protocol (hell, most of what i have been reading has been from you and im stoked you replied! )

based on your calculations, assuming my average e2=29, is 1.31x2 AI right? so 2.5 AI caps a week?

i was originally thinking thyroid, was leaning toward hypo since i have trouble standing up fast (read: deadlifts. (even accounting for hip angle due to long torso and hydration)). Doc wont even scan for pituitary issues…and hes my endo. he felt my neck and my other lymphnodes and said im free of thyroid issues.

in regards to cold, i get cold SUPER fast, its always been a thing for me since i was a kid. if i run away and sweat and cool off without wearing a jacket, i will quickly get gas and diarrhea lol - my parents said it was cuz my stomach/intestines were frail :frowning:

ill be honest, the only reason im even ON trt is because i am trying to eliminate variables. since my doc wont entertain thyroid, i will have to eliminate low T since thats even LESS of something he would test for. assholes billed me nearly 600 dollars for a string of e2, thyroid, and other T tests.

Ill have to look into salt, i keep seeing that in all your posts - i use kosher and home and minimal at that as i dont really care to heavily salt foods like americans (even though im from california lol)

edit:
based on this:https://www.thyroid.org/iodine-deficiency/

i feel, anecdotally, that i SHOULD be (whether or not i am is a diff story) getting enough iodine.

my multi has 150mcg (as potassium iodide) (but i not consistent with it), i drink lactose free whole milk at home at least 3x a week, i have an occassional ice cream at night, maybe one a week, i eat seafood 2xweek, and have a chobani drinkable yogurt at work most of the week.

exactly this - ive seen this elsewhere too so part of my testing with the TRT protocol is to see if i notice a significant change. little to no change to TRT protocol for 6 months? i would hop off and investigate elsewhere.

im 28, its in the title :slight_smile:

ill clean up original post and edit ranges too, since they were from diff docs.

thanks @KSman, im actually really excited you saw my thread!


#7

i was gonna start at 100mg/week T with maybe 500IU hCG and 1 cap (.5) AI.

some people were saying the high hCG would make my T numbers super high.

the lull before thursday pin is not an issue? so its E3D for you not 3.5 right? a la sunday night thurs morning or something?

Id like to avoid EOD and pinning so much, but if thats what will help stabilize my E2…