T Nation

Age 33, Thinking of Starting TRT


Here’s my details

33 YO
191 lbs
~25% body fat right now. (most of it around belly)

normal body and facial hair
Full head of hair, (just a bit of loss around temples)

Problems: fatigue, lack of drive, weak sex drive, no gains in gym, can’t loose fat, no morning wood, all the usual suspects

No drugs for prostate,
Diet: organic ~45-50% carbs, 25% P, 25-30% F
No testes ache;

I’m going to the gym for a few years, never gained any muscle…can’t loose fat either. I’m taking Iodine supplements for thyroid, my temperate is almost optimal.

here are my results:

LH 3.3 IU/L REF RANGE 1.7 - 8.6
FSH 1.75 IU/L REF RANGE 1.5 - 12.4 (just above min.)
FT 8 ng/dL REF RANGE 9ng/dL - 29ng/dL (thus sub min.)
TT 399 ng/dL REF RANGE 219 ng/dL - 906 ng/dL
E2 74 pmol/L REF RANGE 0 - 192
Prolactin 194.6 REF RANGE mIU/L, REF RANGE 86-324 mIU/L
PSA 0.743 ug/L REF RANGE 0 - 1.4
TSH 1.24 mIU/L REF RANGE 0.27 - 4.2

I have read all the sticky’s around here. It’s obiously I have a problem. my TT is low, and my E2 is high as hell, no wonder I feel like shit.

If so I bought some turkish Pregnyl(hcg) from MSD 5000 IU. It has 2 vials inside, how do I use/split them so I can get 250 IU EOD, any idea?

Are you going to a doctor for TRT? Your E2 isn’t that high.

Yes, you’re right…I forgot to make the conversion last night to pg/mL…which is then 20 pg/mL, a bit lower than the 22pg/mL that is recommended around here.

In that case it’s just my TT and FT that are low.

I might go to a doctor but I’d like to avoid spending a few hundred quid for an idiot to tell me to to inject hcg and Test cyp. I’ll also move to another country in 2-3 months so I won’t be able to continue with the same doctor. My thoughts were to try an HPTA restart if possible…and I’m also trying to understand how to inject 250 hcg with the 2 vials that I have (need to understand how to split the doses in practice.)

E2 is lower because less FT for FT–>E2

Your TT suggests that SHBG may be elevated, with more SHBG+T inflating and overstating your T status. SHBG does lower FT as well.

You seem to have secondary hypogonadism, E2 and prolactin are not the cause. A blow to the head can damage the pituitary. Any concussions?

While E2 looks ideal, with FT this low, you are estrogen dominant and this will promote higher SHBG.

Ad 2.5ml BA [bacteriostatic water] water to 5000iu hCG. Must be BA water to prevent bacterial growth - 0.9% benzyl alcohol in water or normal saline. You have to purchase in a rubber stopper vial. The 5000iu glass ampules are intended for injection of 5000iu all at once for fertility work with women and in that case, BA water is not needed as there is no storage time.

Mixed as above, “12.5” on an insulin syringe will be 250iu hCG. You can load multiple syringes and store those loaded and refrigerate. You can load more and do partial injections, swab needle with alcohol prep pad before recapping and returning to refrigeration.

So you need a larger syringe to move 2.5ml BA water, a supply of BA water, insulin syringes and alcohol prep pads.

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.

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thanks Ksman!

I’ve read the stickies, will read them again, I haven’t absorbed anything in 1 read

SHBG is 34.5 nmol/L RANGE 16-55.

blows to the head? Only one around 20 years ago, was very young…felt with my head on the ground while playing football…maybe I’ve never fully recovered? If you say I have secondary hypogonadism should I skip the hcg and start nolvadex as described in the HPTA thread? or should I start with hcg and then maybe add nolvadex?

thanks for the tips, I’ll get the BA water and the rubber stopper vial, that’s exactly what I was looking for.

An answer to my previous question please? Thanks.

HPTA restart has a phase where one is getting the testes to recover form and function. That can be hCG or SERM. If starting on a SERM, that also gets the pituitary involved. If starting on hCG, you later switch to a SERM to get the pituitary involved. So one can do this with hCG then SERM, or only a SERM.

Does that help?

that’s perfect. I thought SERM is only for pituitary, not for the testes as well (guess I was wrong).

Since you said that I have secondary hypogonadism do you think I should only use a SERM? or start with hcg then SERM? I’m ok with either option.

Both are valid.

SERMs hide E2 from hypothalamus, hiding the negative feedback signal in a dose dependent manner. Docs typically use Clomid. A few guys feel horrible on Clomid. Nolvadex works well, but does not have those nasty side effects that some experience. So you can use the hCG you have, then switch and proceed.

SERMs cause the hypothalamus to stimulate the pituitary that then releases LH and FSH in typically lab-similar amounts.

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started taking Nolvadex (tamoxifen) today because I couldn’t find HCG in the form I wanted. I’ll purchase BA water and a rubber stopper vial, (just in case) but that might take a while longer due to shipping.

I’ve been taking tamoxifen for 2 weeks, haven’t noticed any change so far. Is there any point on continuing?


Known good product?

Testes need to start changing gene expression, tissue changes need to occur, size needs to recover. Later, lab test TT, FT, E2, LH/FSH to see what is going on. Note that guys who start injected T often do not have things kick in for 4 weeks or more, because the T needs to start changing gene expression, tissue changes in the brain and brain patterns need to change. Two weeks? Chill out and get some labs scheduled.

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I’m currently taking 20mg EOD Tamoxifen from Wockhardt. is this a good product?

thanks, I’ll chill and run some tests in 1-2 weeks.

Also I feel that my temp is going down again. Do you think this is possible from increasing the iodine dose maybe?

I’ve started reading about HGH therapy and it looks like that might improve testosterone as well + some other benefits. Although it’s a lot more expensive than TRT.

Any thoughts on this @KSman ? HghRT vs TRT ?

so after 1 month of Tamoxifen my results are the following:

LH 4.64 IU/L REF RANGE 1.7 - 8.6

FSH 2.46 IU/L REF RANGE 1.5 - 12.4

FT 11 ng/dL REF RANGE 9ng/dL - 29ng/dL

TT 587ng/dL REF RANGE 219 ng/dL - 906 ng/dL (from 399)

E2 17.5 pg/mL REF RANGE 0 - 52.3pg/mL

TSH 1.54 mIU/L REF RANGE 0.27 - 4.2

FT4 23.81 pmol/L REF RANGE12-22pmol/L this was a bit outside range(maybe from too much Iodine? I doubled my doses for a while)

SHBG is 44.5 nmol/L RANGE 16-55


hGH will cost you at least $6000 US$ per year.

Not a great result. But testing LH/FSH might have told us more.

Do you feel anything?

You could take 20mg every day and note changes.

This might not be a viable solution for you.

Cold? You have not posted requested oral body temperatures.
TSH has increased, you might be colder.

not a great result, but I have to say I felt better than before. I actually felt a difference in mood, I also lost about 1.5 Kg fat in the last month. TT increased by almost 50%. I’ll start with 1/day now.

what do you mean “LH/FSH might have told us more.”? what did they say, I’m trying to understand this.

Temp at 8pm: 97.8

Thanks for the help!

Temp at 08:30 97.5F
Temp at 19:00 98.2F

Temp at 08:45 97.5F
Temp at 19:15 98.0F (was crazy hot today though)

ps: my feet don’t feel so cold as they used to after starting Iodine supplements.

after taking 20mg ED, how long should I wait before taking another blood test, 1 month?

also regarding GH, I’m thinking of trying some generic ones…and run some blood tests to see if they’re good or not, what do you think?