Advice/Opinions, Start TRT or Not?

Hey guys, first time poster…39 years old next month.

I’ve been getting bloodwork done each year for a long time…i first had my Total and Free testosterone etc checked about 6 years ago. Back then, my reading was mid 400s for total t…it has steadily gone down each year and finally this year was mid 250s and free t in the 50s and estrogen of 29.

I’ve been hesitant to start TRT, even though my doctor has willingly prescribed it to me for whenever i decide to use it. Over the past 6 months, ive lost about 20 pounds (i’m currently 6’5 250s), i’ve brought up my D3 levels and B12 levels (they had been low). I’ve focused on better sleep, lifting heavy and eating better… i was retested on Monday and my results were:

Total T - 315 ng/dl

Free T - 62 pg/ml

SHBG - 28 nmol/L

Estrogen - 26 pg/ml

DHEA-S - 187 ug/dL

Free T3 - 4.13 pg/ml

Free T4 - .96 ng/dl

TSH - 1.120 uIU/ml

PSA - .71

With all of that said, i need advice and opinions… should i try to keep boosting it naturally and hope for the best, or should i go ahead with the 100mg testosterone cypionate per week that my doctor has prescribed? He has left it up to me on if/when i start and how often i inject as well as if i go IM or SubQ…he just wants me to let him know the day i do start if i do, and to not go above the 100mg / week that he prescribed.

I have all of the normal low T symptoms, (low energy, fatigue, no motivation, brain fog, muscle n strength loss etc) except i do get frequent morning wood…just no real desire to use it!

Should i take the plunge? Should i go IM or SubQ? if i go SubQ, what size needles should i use? (Gauge and length) what dose has been successful and what are your levels?
I would like the lowest dose to bring me to normal levels and that make me feel my best…prefer no AI or HCG, just testosterone, if possible.

Any and all opinions, advice, questions etc will be greatly appreciated.

I think most guys here would offer the same advice. Start low (100 mg is good), use a 27 - 30 ga needle. The length depends on where you want to inject and if you want IM or Sub-Q. Pick one, go with it for at least 6 weeks, it really doesn’t matter which one you start with. Start with just Test. Avoid AI’s, they should be considered last resort for real issues, and you won’t get gyno in the first 6 weeks no matter what you think about how sensitive or itchy they suddenly are. HCG is an individual decision but dial in the Test dose first, and remember that your E2 and other levels are going to jump around a lot for months, ride it out, be patient.

I would take 150mg per week (I know, you can’t) once a week IM, 23g 1 inch needle. No hCG or AI. I take 200mg once a week with trough levels at 880-920 total and 200-270 free.

Testosterone starts declining after age 30 and you have been experiencing a decline for almost a decade, your levels are not increasing, levels are decreasing.

You can fight to holding to what you have, but you are not going to be seeing significant increases in testosterone, not unless you have found the fountain of youth.

I inject 7-10mg daily IM in shoulders and quads using 29 gauge insulin syringes. TRT will decrease your SHBG forcing you to make changes to your TRT protocol, in 30 days time you may very well have low SHBG.

You will more than likely need very frequent dosing.

I’ve already planned that if I DO start, I’d rather do small daily shots…was planning to start low, but didnt know how low. I dont do any stimulants, not even caffeine…I dont want that “rush” that some guys get…I just want a smooth ride and to feel my best with the smallest dose that gets me there!

It seems like it’s probably going to be inevitable to me and you already have the symptoms so I’d go for it.

I’d do the 100mg a week he prescribed. Would he be willing to go higher if needed or is that it no matter what?

If you want smooth and steady, I think daily subQ is the way to go. Get you some 29g 1/2” needles, inject in your delts shallow IM and it’ll be painless.

I had super high shbg and found 3x a week IM worked better for me but I think I needed the extra boost to overcome the high shbg, which isn’t what you have

I would not hesitate. I had the same symptoms and was debilitating and affecting my family and I was headed for a divorce. 2 months in at 100mg a week subq 50mg e3.5 and my life did a 180. No longer fly into a rage at the drop of a hat or get depressed for no reason. Now I’m up at 4am working out 6 or 7 days a week and mood is very stable. ALL aspects of your life will eventually improve. You are very fortunate that this was diagnosed at 39 and you have the opportunity to address it and not suffer needlessly.

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what was your bloodwork like before you started, and what is it like now, since you’ve been on for a couple months?

Thanks for the reply!

Here’s what they were 2 months ago. Not sure now as I have not had updated labs done yet. But anything is an improvement from what I was. I was questioning trt for a while because I didnt want to be on it for life, and what if it didn’t work? And…needles scared the shit out of me. I thought I was broken and was beyond hopeless. Now I look forward to injecting (I’m sure that feeling will pass lol !) A minor inconvenience is well worth a better life theres no question about that.

Yeah, the “what if it doesnt work/what if it somehow makes me feel worse” has been in the back of my mind for a bit… what size needles and what locations do you use for your subQ shots? My gf is a diabetic and does insulin shots subQ, so i’ve seen it done daily…just curious what you use for your testosterone, since it is thicker?

Haha yeah you sound just like me. I went like 5 or 6 inches or so to the sides of my belly button with a 27 gauge. It’s literally just a slight pinch and takes just a few seconds. Also in glute with .5 in 28g and that’s completely painless. Theres no guarantee anyone’s living till 100, or even next week for that matter so why not try it and see what happens…lifes too short to be miserable. Your T is not going to improve with age.

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You can use 1/2” insulin needles to do shallow IM on your delts as well if you wanted to try that. Painless also.

Hey man, keep us posted on your decision. Theres a whole community of people here that are all here to help and been in your shoes. You’re not alone, good luck!