T Nation

Advice Needed to Self-Medicate TRT

Im a 26yo male from germany, 75kg, 178cm, good beard growth, thinning hair, bodyfat around 20%, training since 10 years, and noticed weakness and all the other low t symptoms 3 years ago. My total t back then was always around 7,5-8,5nmol/L. So i went to 4 different doctors, and only one of them prescribed me testosteron gel. But i never used it, because i was scared of starting trt at such a young age, and heard bad stuff about the gel. So the last years i made 0 progress at the gym, even though it is my biggest passion. Every time i’m in the gym, i have no pump or drive, feel anxious and can not increase my weights.
When I was 20 years old, I had made extreme progress in no time, now it is total different.
My total t is at the moment: 12,8nmol/l
Free T: 42.8pmol/l
shbg: 24,9nmol/l
fsh: 2,6u/l
lh: 2,4u/l
E2: 82pmol/l
I wanna start self medication, with 150mg Enanthate e5d (subq injection) and a calorie reduced diet. I also have Arimidex on the hand, if i feel some increase in E2. Dosage would be 0,25mg 2 times per week. Do you guys think i could benefit from a trt, or would I have to go on a real cycle (250mg e5d) with my current values, to notice any improvement at all? btw sorry for my bad english

First. you need to add ranges. Second, Total T of between 350 and 400 (converted) and an E2 of 22 (converted) are indicative of a problem. Your T is low. Has any doctor given you a reason for the low T? 150 E5D would be a little high for a starting dose. Try starting with 100 a week, or maybe 50 -60 twice a week and see what happens. If you want to run a cycle, go to Pharma and ask. 250 E5D isn’t much a of a cycle, IMO.

50mg twice per week would be best, even better 25mg every 2 days, once weekly can induce spikes in T & E2 and levels are high the first couple of days and by the end of the week levels are lower.

TRT will lower SHBG and make more frequent injection necessary, SHBG binds androgens so lower values, less binding of androgens and faster excretion and this means lower levels 4-5 days after an injection.

You likely have a problem with your estrogen once you elevate your levels high enough since estrogen is already at a healthy range, you may need more frequent injections to mitigate side effects.

I only have 250mg per 1ml ampoules, so i need to go on 150mg e5d trt, or a 250mg e5d blast, and then during winter trt dosage cruise. Since summer is coming, i would like to start with the blast, but my bodyfat is 18-20%. Could my bf% be to high for a 250mg blast (e2 risks)? Should i take “Arimidex 0,25mg 2 times a week” right from the start, or wait till i fell side effects? Any tips, on how i should start?

Problem is, we don’t know the cause of you’re hypogonadism. Given labs it appears secondary, it’d be good to figure out if there’s a root cause, if you can’t figure one out then TRT may still be nessecary. What’s you’re BF Like

How’s sleep patterns, diet, alcohol and recreational drug intake (specifically ones known to lower testosterone like opiates, alcohol etc), prescription med intake, adrenal function. Any labs for prolactin? Thyroid function?

In my opinion you don’t require frequent injections of long estered T due to the fact that it’s given half life makes such frequent shots intrinsically worthless unless you cleave through the ester and metabolise + excrete testosterone at a ridiculous rate, more frequent injections over time will equate to more scar tissue build up.

Adex isn’t needed, estrogen is important for cholesterol and glucose management, production of NO (pivotal for erections), neurotransmitter balance, bone density and more.

I can’t advise you to cycle, as it’s a risky decision that you yourself have to make, but given you’re current situation you could try 200mg/wk it’d likely push you slightly above therapeutic thresholds and will give you some of the accruations of muscle mass you desire at minimal risk, then back down to 125-150mg/wk.

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Listen to this^.

Thanks for the advice!
I had very high levels of prolactin at my first blood test a few years ago, after which the doctor examined me for prolactinoma, but did not find anything. He told me the high scores came from the stress of taking blood at the lab. I’m a bit overwhelmed with the estrogen theme, as there are many different opinions. The renowned Dr.rand, for example, prescribes each of his patients from the beginning on arimidex to the trt. Other people say you should take an ai only at too high values.
My body fat percentage is currently at 20% (especially belly fat), but the T levels are higher than they were at 12%. Am I in a risk area as far as estrogen side effects are concerned? In addition, I’m considering taking 1mg of finasteride ed because I am suffering from genetic hair loss, and that will be much stronger under trt.
How do you rate my T levels? Will I be able to draw a big physical and mental benefit from 200mg e5d? I’m a bit overwhelmed with everything, and afraid to make the first injection. Since 0,8ml is to much for one subq injection, i would split the injection in 2 shots on each belly side. should i switch the needles, or stay with the same?

Just do it. You will never know till you try.

pfff, i have been on that road for 10 years, no bloodwork except for when i went to a endo, but maybe you’re a bit smarter then i was.
this is just my 2 cents, think this through and when you do make sure to do regular bloodwork…another problem you’re gonna walk in to is the product…yeah, maybe now you’ve got a great source, but when thats gone you will end up online, been there done that and lost a lott of money that way…Always with western Union, or now bitcoin, when your shit gets seized then they will keep your adres on a blacklist, and the times you get scammed, fake products or no delivery…think this through or seek medical help.
i lived in Germany for 3 years, and my god…doctors here in holland suck but Germany…pfff we are neighbours, but the difference in culture is huge, thats why we left as soon as we came, and how strange it is, we pay these doctors but they decide if they even want to help you. I have other issues now after 10 years when looking at my bloodwork then and now…my testosterone now looks fine but my SHBG is of the charts, and like Always…no doctor sees a problem, but i feel like shit…and thats putting it lightly.
maybe you should think about the gel they gave you…try it for some time and if shit doesn’t work out fine then you could Always pressure your doc some more.

I am still not sure, if i should start my trt, or if it will be a big mistake. Are my T levels really to low, and would the benefits of a high end level be worth the risks?
I wanna progress with my bodybuilding goals, so i need a good T level. 150mg e5d should be good to start? Or directly 200mg e5d?

Are you treating the numbers or are you treating symptoms?

If you look at only the numbers, levels are very low like an old man.

Low T can cause a lot of indecisiveness.

Its just strange that my free T is at a average level, and total T really on the bottom of the scale. Would trt bring me enough positive effects, even though my free t is not too low? I wanna start with 200mg e5d, but im scared of E2 side effects, since my bodyfat is at 20%. So should i start with 150mg and then up the dose?

The average man these days is quite pathetic, obese, poor diet and lack of exercise. I believe based on your pre-TRT estrogen labs, suboptimal T levels and 20% BF that large infrequent injections is the wrong way to go about it.

You current protocol suggestion is going to fail, seen it a dozen times. If I were you I would start at 50mg twice weekly or 25mg EOD if you want estrogen lower and more stable levels.

You are asking if your T levels are low, if you have the symptoms of a low T, then compare your Total T number to this study.

Testosterone Threshold for Increased Cardiovascular Risk in Middle-Aged and Elderly Men:

The locally weighted regression showed that total testosterone levels of 440 and 480 ng/dL were associated with increased Framingham CVD risk and an increased probability of increased hsCRP, respectively. Men with sexual dysfunction (poor sexual performance, decreased morning erection, and loss of libido) had significantly greater CVD risk.

As @hardartery pointed out,

your Total T of between 350 and 400 (converted) and an E2 of 22 (converted) are indicative of a problem.

This leaves little doubt.

There are no multi vials in my country, only 1ml ampoules with 250mg test E.
So you think my E2 could raise very fast and high, with 150mg e5d?

A lot of EU countries have no access to multi dose vials. That is no excuse. You can input in the search box “sterile vials” and you would probably get 10 posts with sources in no time. eBay.co.uk has them and so many more

I can only buy 250 mg/ 2mL amps here. I just preload several needles at once. It’s not a big deal.

By the way finasteride is so dangerous and shitty thing, that if you get the symptoms of post finasteride syndrom there IS NO TREATMENT for that. Nor TRT will fix you nor anything. The biggest mistake you can do in your life is try to block the conversion into DHT. Take a look at this site:

https://www.pfsfoundation.org/

Agreed. DO NOT mess with finasteride. Bad bad stuff.

Why do you keep saying that your only option is 150mg or 250mg? If you only have 250mg/ml test E available in 1ml amps, then .5ml (half of that) would be 125mg Test, not 150mg. Preload one syringe with .5ml and inject the other (e5d protocol).

You could even preload 3 syringes with .25ml (62.5mg test) and inject the remaining .25ml (e3.5d protocol). You have options man.

@hardartery already explained this I believe.