T Nation

32 Yrs Old, Low Test. TRT or Cycle?

T Replacement
#1

Hey guys im new here…im 32 been lifting since i was in high school. Went through some shit few years ago that made me put myself to rock bottom(death, alcohol and drugs).

long story short im back in a good place and drug and alcohol free for close to 2 years now. in that time ive been hitting the gym but im lacking the energy and endurance i once had previously.

Ive had hormone tests recently and my test is low real low…
https://imgur.com/a/cdJMPHa

Im looking at either starting trt or go with a cycle first then onto trt. also i have purchased test e 250, hcg and aromasin all of which are self addministered.

My questions are:

If trt should I start with 200mg twice weekly of 100mg, hcg twice weekly 250iu and aromasin 12.5mg eod.

If cycle should i go with 500mg, 250 twice a week, hcg 250iu twice a week, aromasin 12.5mg for 10-12 weeks. Then followed by cruise trt dosage.

whats your thoughts, advise, recommendations?

#2

If you’re looking to go on TRT with the goal of staying in the therapeutic normal ranges, 50mg injections twice weekly would be a good starting point. I prefer to start TRT in isolation since there are less moving parts to analyze, adding HCG can complicate dialing in process.

You can always add HCG later and see if it provides benefits or not. TRT is for the long haul because your testosterone levels don’t increase as you age, they decline so going on a cycle to preserve levels in the geriatric ranges makes no sense.

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#3

LH + FSH of 1 indicates secondary hypogonadism, aren’t you interested in knowing whether there’s a cause of said secondary hypogonadism (pituitary injury/ abnormal pathology), because something clearly isn’t firing correctly.

Do you take prescription medications (if so would you be comfortable sharing), any history of recreational drug use?

#4

Medications I’m on are lexapro 5mg daily and temazapam 10mg most nights also nexium for reflux. Ventolin for asthma.

What’s your recommendation?

#5

annnnnnnnnnnnnnnd you have you’re answer. But more likely the tamezepam

Is the temazepam for sleep, chronic pain or anxiety? Benzo’s generally aren’t the best treatment for insomnia.

#6

For sleep mate. Also forgot to add I take low dose clonazepam .25mg when needed for anxiety

#7

The benzodiazepines are probably the issue, however if you need them you need them, TRT would be the route in that case. You can start on 100 or 200mg/wk, 200mg/wk will probably get you slightly over therapeutic levels into mildly pharmacologic (though not outright supraphysiolgic) ranges, over time HCT might start to creep up and you might experience more side (or not, depends where it gets you to). 200mg, being a higher dose will give you a more immidiate increase in muscle mass than 100mg.

#8

Thanks mate I’ll start on 200mg and see how I go. I’ll get bloods in 5 weeks and keep you posted. Thanks for you input mate appreciate it.

#9

thanks man, can you elaborate on my bloods for me if possible e2, cortisol etc? Also shoul i go with aromasin on trt or leave it out? (i was prone to gyno through puberty)

cheers

#10

Wait, so are you doing a smaller cycle or long haul TRT? 200mg a week is a lot to start with imo. You’ve never done a cycle or messed with anabolics before? Your FSH and LH are low, SHBG is 25. Have you investigated with a medical professional why FSH and LH are so low? You’d probably need a lower test dose with a lower SHBG like that and more frequent injections. You will run into E2 issues if you don’t.

Aromasin is very powerful, as is Arimadex, but Aromasin permanently bonds to aromatase. This means if you overdo it you’ll be on a world of hurt for a while. However, some have better luck dialing in with Aromasin vs Adex. I only know about these through reading, no personal experience, hopefully others will chime in.

#11

Clonazepam is the reason why I need TRT, it messed up the LH signaling in the pituitary gland. Sure they might help with anxiety, but they cause other dysfunctions in the brain and are bad for hormones production. Withdrawing from these drugs can be very difficult.

A lot of men find out after the fact that the real reason for the depression and anxiety was low testosterone and or low estrogen and were instead treated with these mind altering drugs that worked for awhile, but then cause hormones to drop even further down the road and the medication can no longer mask the severe symptoms.

Estrogen and cortisol look fine.

#12

when addicts (abusing) benzos quit cold turkey, the withdrawl can literally be fatal!!! seizures… I’m trying my best to not get them prescribed or have to use them, I have terrible anxiety.

#13

Even a slow 10 months taper is dangerous, my blood pressure was in the zone where heart attacks happen.

I had no help from any of my doctors, there’s no profit in getting you off prescription drugs.

#14

Have you tried L-Theanine? It’s short acting but worked really well for me. Ashwagandha works too, reduces stress all around.

TRT didnt reduce your anxiety? It was working for me decently in that regard until just a few days ago.

#15

FWIW, using a cycle would mean relapsing back into drug use. I’d suggest using doctor-supervised TRT, if anything at all.

For context, what’s your current height, weight, and general bodyfat?

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#16

Yeah it’s not easy I don’t want to be on them but I’m trying.

#17

Cortisol 178nmol/l

#18

Reference ranges, before 10am 110 - 550
After 16:00pm 70 - 400…Cortisol 178nmol/l