T Nation

29Y/O. Dr Wants to Put Me on TRT


I’m new to the scene but have been reading up as much as possible. Started last week with a testosterone blood test that came back at 364. Dr said that was low for my age and wanted to run it again and confirm it. It came back at 161. I have an appointment with the urologist Tuesday.

I’m starting to think I’ve suffered from low T for years. I workout a lot with crossfit and have a hard time with it and putting weight off. I have been diagnosed with GAD, anxiety, and insomnia several years ago. I’m hoping all of this is just a result from the low T and I can kick the anti depressants to the curve.

Total T first test 364, latest test 161 (195-1138)
He tested free T but I don’t see it on my charts, will ask urologist.
LH- 4.3. (0.6-12.2)
FSH 3.3 (0.95-11.95)
PSA 0.59 (0.0-4.00)

I still don’t understand all the blood work and would like to be able to look at it and interpret everything.


Can you add reference ranges to your test results? Did he test SHBG and albumin? FT can be calculated from those. You also want a thyroid panel including TSH, FT3 and FT4 to rule out any thyroid disease.

When did your insomnia start? How’s your stress and anxiety levels - are they justified with a stressful home and work life? Are you taking any OTC vitamins/minerals? Caffeine?


Only other test he ran was a full CBC with auto differential only bc my iron came back high on a previous test. I’ll ask for the thyroid panel when I see the urologist. Insomnia started late teens early 20s, so maybe 10 years ago. Pretty much when everything started. I don’t think I’m stressed much more than others, I have been moody and getting worst according to my wife.


Free test is at 2.7 (5.1-45.1)


Leaving the Dr now. He gave me a 300 MG shot. Wants me to come in and get 300 every 3 weeks. Nurse gave me a prescription and I convinced her I can do it myself at home. So was just going to administer 50mg x2 a week myself. Question is what should I do for next 3 weeks and how long before I start feeling like crap again? I have a prescription for test cyp 200mg/ml MDV 10CC 5 refills?


No AI? You should be tracking your estradiol while on TRT as well. Make sure to discuss that with your doc.


He does not want me back until 5 months for more labs. Asked about hcg he told me I could not be on it while on test.


He doesn’t know what he’s talking about… HCG is fine on TRT to keep fertility and make your balls not shrink. It’s optional though. Aromatase inhibitor like arimidex is required if your estradiol gets too high – your estradiol needs to stay around 10-30ng/dL or you’ll have all sorts of problems


Will I be fine the next 5 months before my next lab?


Maybe. If I were you I would call your doctor and ask for a blood test next month which includes T and estradiol. If he refuses, try to find a new doc. You can also order your own labs online from Discount Labs or Private MD. If you start getting moody and have a crashed libido then esteodiol is a likely culprit. Sounds like you should start searching for a new doc anyways.


My general doctor said he would treat me with TRT if I didn’t like the urologist. Will talk to him next month. So someone correct me if they think I should do different.

I got a 300mg a shot today and I know by next week it will be wearing off if not sooner. He wants me 300 MG every 3 weeks but I plan on breaking it up to 50mg bi weekly. So I just plan on starting next week the 50mg twice a week. Should I do injections on Monday morning then Thursday afternoon? Is there a better recommended schedule?


It’s been 36 hours since my first shot, and I feel amazing. I truly believe I’ve suffered from low levels for years now. I’m sharper, no mental fog, better mood, more energy, etc… I just hope this last and am grateful if it truly does only get better.


This is wrong. Should have screened for high prolactin and E2. At your age, low T is the symptom and not the disease and a diagnostic effort to find the cause has been missed.

300mg T will sky rocket your E2 and that will mess with SHBG.

Eval thyroid by last paragraph in this post.

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

  • advice for new guys
  • 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.


50mg T twice a week
0.5mg anastrozole at time of injections
250iu hCG SC EOD to preserve your testes and fertility

Without hCG, you fertility is in real danger.


Thanks Ksman, will check oral temp throughout the day tomorrow. Few questions.

Is there a sticky for all the recommended blood work panel, if not would you mind posting what I would need and an online lab you might recommend if my dr/insurance refuses.

Also does the anastrozole and HCG need to be prescribed or can be bought online.

Thank you, you a truly a godsend on this forum.


Update: By day 6 I felt nothing anymore and was slipping back to my normal depressed self. I kept my head because I knew on day day 7 I was starting 50mg biweekly SubQ. Injection day came did subQ 50mg in the abdomen using a 29q 1/2 inch. Was so easy, no bumps or any sides. But I feel nothing, absolutely nothing. It’s been 3 days and I’m suppose to do my other SubQ tonight but i want to try 50mg IM and see how I feel. I feel worst than I did before I got my initial shot.

I called my urologist and was picking his brain about hcg and anastrozole and he told me he doesn’t prescribe those medications. So going to see my general DR Tuesday and hoped get some labs.


I’ve heard that there can be a hit of dopamine when you start on TRT, and that might explain your initial high.

It takes a few weeks for the effects of TRT to come through. There’s a tool on the Nebido site that shows their onset, and the starting time is between a few weeks and several months for most things.


I’d be inclined to give it a few weeks before you start messing around with the programme.


Hard to know what is going on. E2 is a frequent issue.

Response to T involves changed gene expression, different proteins created, cellular changes, bulk tissue changes, metabolic changes, brain tissue and pattern changes. It all takes time. And everyone is different to some degree.

You have had two hints re thyroid issues. Low thyroid function can hold down guys with perfect T and E2 levels. See last paragraph in my first post in this thread. Do not have T Tunnel vision!


I know just picked up an oral thermometer. Will take it in the morning while laying in bed still and through out the day.

I did a deltoid IM injection 3 hours ago and right away could tell the difference just like my first IM. Feel great again. I see the dr Tuesday and will not inject Monday and wait to give blood Tuesday morning and inject Tuesday afternoon.


OK heres my latest update with labs. My oral temperatures were all in range 7am 98.2 and stayed above 97 through out day with a 97.8 at 10pm.

scroll up yo see pre TRT labs

TT 840 (348-1197)
Free T 12.7 (9.3-26.5)
E2 19.1 (7.6-42.6)
LH 0.2 (LOW) (1.7-8.6)
TSH 2.59 (0.450-4.500)
Prolactin 8.4 (4.0-15.2)

ALL CBC was normal and in range.

I feel a lot better with only a few issues.

1.) Dr. says my levels are to high and I disagree and wants me to try androgel as he thinks I will be more steady.

2.) I have had a red flushed face around the cheeks mostly and it looks bad ever since starting trt. I was convinced it would be E2 or RBC count but everything checks out. Any help would be appreciated.

I started seeing a new dr since I started this thread. A urologist who actually seems very knowledgable at least more than the other two. He’s just very old and set in his ways.

I have been on 120mg a week divided up into 2 shots. Monday and Thursday. I took my blood work Monday morning before my shot. Dr thinks I am on 100mg a week and told me to take my single 100mg shot on Friday and blood test on Monday. So he thinks 840 is to high three days after injecting 100mg.

I might try the gel but I doubt I will stay on it as I can get Cyp so much cheaper.

Please let me know your thoughts esp on red, flushed face.

Thank You