T Nation

Dlsmith TRT Log

Hey everyone, I started TRT about 3 months ago and have been reading here for the last month or so. I’ve really enjoyed reading the experiences of others and have learned quite a lot, so I thought my experience could possibly do the same for others. Also, any guidance from this group can only help.

This will be long. My feelings won’t be hurt if you skim or skip all together. I plan on using this as a diary of sorts.

I first started feeling low-t symptoms around 15 years ago, maybe longer (I’m 49 now). At first my main symptoms were lack of motivation and general malaise. An overall feeling of blah. That and a fat body. I went from fairly fit in my 20s (never an athlete, but active) to fairly fat in my 30’s. At 6 feet tall I’ve fluctuated between 210 – 285 pounds for years. I used to joke about being able to gain and lose 50 pounds every year.

Around 15 years ago I started reading about low-t. That was also the around first time I went to my to get my levels checked. Back then I didn’t know about anything other than total testosterone levels, so that’s all I checked until recently.

At age 34 I had my first test and my total testosterone was 205 on a 200-800 scale.

Reenactment of conversation with my PCP.

Me: Doc, that seems really low. Is that what is causing me to feel terrible and continue to gain fat and not muscle even when I’m going to the gym all the time?
Doctor Dummy: Not at all. You are in the normal range. This is not your issue.
Me: Are you sure? I feel really bad and I’ve been reading a lot about how low-t can make men feel like I’m feeling.
Doctor Dummy: (please note, this is a direct and literal quote… seriously) You don’t have to worry about your testosterone, you are in the normal range. Plus, there is too much testosterone in the world anyway.
Me: ….
Doctor Dummy: But, if you are really feeling that down, then I can prescribe anti-depressants.
Me: ….

I’ve always been anti medication (which is why it took so long to take the plunge) and scared shitless of anti-depressants, so I declined and went back to my life. That started years of trying to boost my T naturally. I tried every herbal t-booster on the market (I’ve spent thousands), every workout plan, every diet. I would say I had varying degrees of success. I hit a couple points over the years where I felt pretty good. Well, good compared to when I felt the worst. Now I’m learning that I was in a much worse place than I even knew.

Very long story short (less long), I spent the last decade and a half faking it. I was pretending to be the man I wanted to be, or wanted other to think I was, while feeling completely exhausted and miserable. I had ideas, but lacked follow-through. I started projects, but never finished them. I started workout programs and diets, but never stuck to them. I frustrated my wife with not doing the things she asked of me and put a strain on our marriage. Sometimes this was from lack of motivation, but often from a brain fog driven forgetfulness.

Over that time I went through some stuff. I lost my first wife in a car accident 5 years ago, which led to a couple years of depression fueled poor health choices.

4 years ago I had my T checked for the second time. Just total T again. It was now at 284. Those herbal remedies were really working! My doc gave me a prescription for androgel. I ended up getting nervous and decided to give it one more shot naturally, so I never filled the prescription. You don’t know what you don’t know…

Then I started dating again which lead to a few years of working really hard to look good and feel good. Went a little crazy for a year or so and then somehow met a wonderful woman, now my wife, who is beautiful and fit, which also motivated me (and gave me some insecurities). I felt really good for a while, boosted by the new relationship and renewed sense of hope. I think new sexual partners is the one way that actually increases testosterone naturally, but that method is finite.

Over the past year things got really bad, symptomatically. Worse than ever. The overall funk got harder to fake. Motivation was non-existent. The afternoon slump was nearly unbearable, even with a ridiculous amount of coffee. The brain fog and forgetfulness was almost debilitating. I was having a hard time even formulating thoughts. And, libido went to almost zero, which led to more issues.

Regarding libido / sexual function. When I started dating again I started using Viagra, “just in case”. I have had short bouts of ED over the years, mostly driven by performance anxiety, I now know, so I wanted to make sure my new dating life was successful. It worked great at first. Really great. But then it became a crutch. Instead of just occasional use, I started using it every time and gradually increasing my dose. And then one day, it just stopped working. It turns out that when your libido is so low that you have no interest, the blue pill is worthless. So that led to 6 months of consistent ED, which is not the best thing for a new marriage. That is the thing that finally had me take plunge and start TRT.

I had read enough to know that my PCP wasn’t going to be a good option, so I found a clinic.

Pre TRT blood work:
TT: 326 (264-916)
FT: 7.3 (6.8-21.5)
E2: 30.9 (7.6-42.6)

(They tested a bunch of other stuff, but not SHBG. I didn’t learn of its importance until I started reading here. I will add it next time.)

They put me on the typical clinic protocol. 200 mg test (100 every 3.5), HCG and .25 arimidex with each injection.

10 week post TRT blood work (day before next shot):
TT: 1371 (264-916)
FT: 26.9 (6.8-21.5)
E2: 33.1 (7.6-42.6)

Some thoughts on my first 3 months of this journey:

Overall – I feel pretty great. My head is clear for the first time in so many years. I feel motivated and focused. I feel like a fucking man! I didn’t know how bad I was feeling until I started feeling good. This is truly lifechanging / life saving.

Training – Increased motivation has led to results in the gym. I am getting stronger putting on slabs of muscle, for the first time in decades. After the typical first couple month weight gain, I have now started to shed some fat as well. I’m excited for the changes that are starting and will continue.

Libido – after month 1 it was amazing, like in my teens. Then the next month it fell off again, close to zero. Now I’m in a good place. Not teen levels, but pretty damn good and consistent. If I stay here, I’m a happy man.

AI’s – at first based on listening to Jay Campbell (who I find very unlikable for some reason. Anyone else?) and others, I did not take the AI’s at all. I wanted all those benefits of estrogen that they advocate, unfortunately about week 8 I started feeling really weird. Not pre-TRT bad, but not great either. I started getting really emotional and my libido tanked, leading to an unwelcomed bout of ED again. I took the AI for the last month before my shot (.25 twice a week) and started to feel amazing again. So, I’m not saying anyone is totally right or totally wrong, but it appears the AI helped me. My plan now is to back that to once a week and see how it goes. Ultimately, as I continue to lose fat, I hope to not need it at all. For now, I am feeling really good, so…

So there you have it. I don’t expect many made it through all that, but thanks for reading. I’ll post updates as I go.

You aren’t going to find many Jay lovers around here… guys is cookoo. Literally posts about aliens and other dimensional beings coming to suck our energy away and stuff like that on his twitter (and is serious about it). He’s gone off the rails. The only positive thing is a lot of us found out about TRT and not using an AI, etc. through his older YouTube videos fortunately.

Jay is a wackjob, but I respect him for the attention he gives to TRT and educating people. The AI’s can work for some men, I can’t even handle a 1/8th of a 0.050 anastrozole because I’m an AI over-responder. I over-respond to just about all medications and even testosterone.

Glad I’m not alone!
I didn’t even know about the crazy stuff. I just thought he sounded like a douche.

He’s 100% douche too, haha

Today was weigh in and measurement day. I was surprised to see that I have gained 7 pounds since starting TRT. I have 40-50ish pounds of fat to lose, so that was a bit discouraging. I’ve been hitting it hard at the gym and the diet has been, not totally on point, but much better than pre-trt.

I was much more encouraged when I did my measurements. I lost 1.5" from my waist and 1.25" from my man boobs, while gaining .5" in both my thighs and arms.

Overall I’m pleased to be moving in the right direction. It’s for sure a cool feeling to be adding lean mass for the first time in a looooong time. Now I need to further dial in the diet.

The journey continues.

Your fat is being redistributed and you are gaining muscle.

Congratulations, it sounds as though you’ve hit your dosages. You’ll continue to lose fat and gain muscle.

Hello friends – decided to write a little update, so here are some thoughts and observations 14 week into TRT.

First a reminder of my protocol. I’m on 220mg of TC and 180 of HCG every split into 2 weekly injections. I have stuck with this the entire time. I was prescribed .3mg anastrozole along with each shot, but generally take one every couple weeks. Thoughts on that to follow.

Thoughts and observations:

Overall mood and feeling of wellbeing:

I was sad to learn that TRT does not erase all the stress of life and put a permanent smile on your face. It turns out that life has ups and downs that have nothing to do with the sweet sweet T running through your veins. Bummer…

However, it also turns out that quite a lot of my struggles and mood swings and overall funkiness were a product of my low testosterone. Overall, even though my life is at a difficult point right now, I feel the best I have felt in many years. Something I have really noticed is that I am able to get past things much more quickly, rather than endlessly obsessing and ruminating.

My protocol:

I started at 200mg and felt pretty good, but not amazing. So I decided to bump my dose up a little. 220mg has me feeling overall pre-trt symptom free. I have noticed that I get a bit irritable around 12 hours after my injection, but that goes away by 24 hours in. I don’t love this feeling, but since I’m aware of it I am able to acknowledge the reason and keep myself from reacting.

A side rant – I’ve noticed there are a hand full of posters here that like to tell people their dose is too big without any legitimate reasoning. It’s one thing to recommend a lower dose because of symptoms or side effects. That’s cool. But it’s another to just blindly say it’s too much because of some bias. We are all different. Our genetics, age and body composition are different.

AI’s – I’ve gone from taking one with each shot to only when I’m feeling symptomatic. For me that is when I start feeling moody and emotional, which seems to happen every 2ish weeks. I feel best overall when I minimally control estrogen. That said, I think I would probably not need to worry about it if I did 2 things. First lose fat (working on it). I have around 50 pounds of fat to lose. Second, inject more frequently. I know that is probably the route I should go, but I’m hesitant to make a change since everything is working fairly well and I really don’t want to take a step back while I adjust for 8 weeks. At least not yet.

Any thoughts on the impact of extra fat while on TRT? As I lose fat, there will be less conversion to estrogen and therefore a larger free-T impact, right? Meaning maybe the dose I’m on now to feel good will not be necessary… As stated above, I have no problem taking as much as is necessary to feel good, but I am curious about the impact of body composition on dosing.

Mental clarity / brain fog:

Night and day difference here. I was basically a zombie before TRT, now I’m feeling a clear headed as I can ever remember. This alone has been worth the price. This has been especially beneficial at work, where I feel my career is on the move again for the first time in a decade. Pretty cool.

Training:

This is the best I’ve felt in the gym in… ever? Yes, ever. I feel amazing. I was stronger when I was younger, but I can feel those PR’s coming. Recovery is amazing and energy is through the roof, even at 5:30AM when I get to the gym. Training is fun again. I’ve also noticed a big cardio boost on weekend mountain bike rides. I can’t even imagine how good it will feel when this fat is gone.

ED:

It’s quite possible that TRT saved my marriage. The ED issue had gone from an every once in a while thing to a 9 out of 10 tries thing. It was a nightmare. Especially for a newly married couple. The worst started about 6 months into our marriage. Great timing! Low T led to low libido, which led to forcing it, which led to failure, which led to embarrassment , which led to obsessing, which led to performance anxiety, which led to a really shitty time.

A note to anyone dealing with this. TRT may be the answer, but it takes time and some mental work may need to be done also. After 3 weeks I had successful sex 2 nights in a row and thought the problem was gone, then that mental loop started back up and the next few times were not successful. Then, after some talks with the wife and mental work and repeated sleep dick workouts (that’s sleep and morning wood. Your dick is going to the gym), everything started to work again. I had more sensitivity, more confidence, and more successes. Now we seem to be on track. 4 weeks with no issues at all with performance. Hopefully that’s the new norm! So, if you are struggling, hang in there. Good times are coming.

Side effects:
Not too much to speak of. No acne or gyno, etch. Just the irritability 12 hours after injection and occasional moodiness when my estrogen gets high (I think). I would like my libido to be a little higher. Performance has been good, but I would like to feel the ‘want to’ a little more. Thinking about fluctuating doses, maybe 200 / 240 every other week instead of 220. Any thoughts?

That’s wordy. Until next time…

This might be a sign that your body is responding to the peaks and troughs of these large injections, splitting the shots into two shots per week should eliminate this feeling 12 hours after your injection and you should notice feeling more consistent.

The every other week protocol is a bad idea, this will make the peaks and troughs even bigger and leave you will overall lower testosterone levels. We refer to this protocol as the hormonal rollercoaster.

If your levels are high normal and you feel good, it shouldn’t matter if its 200 or 350mg.

Maybe. It has happened. Over time, if SHBG goes down, more free T. As belly fat diminishes, less aromatization, less E2.

Some TRT doctors recommend this.

maybe I wrote in a confusing way. It’s 220mg each week every 3.5 days, so I’m taking 110mg each shot.

Thanks. I think I’ll start now. This week 200mg, next week 240mg.

Quick update. Everything is going well, for the most part. Thinking clearly, strong at the gym, improving body comp, healthy libido. Still struggling a bit with irritability. I think either lowering my dose a bit or going to smaller more frequent injections may help, but I’m nervous to make a change since overall I’m feeling so much better than before.

Onto the more uncomfortable topic…
My libido is strong and for the last couple months I have had no issues with ED, however performance anxiety reared it’s ugly head again the last two attempts. I’m concerned that this is going to snowball. I’m confident that my issues are not physical, as I’m am hard as can be until right before entry. I notice it also only happens when I’m on top (TMI probably) and not when she is driving. Anyway, has anyone reading this been able to overcome this sexual performance anxiety for good? Can you recommend any strategies?

Hello to anyone that reads this. I thought this would be a good time for an update since I just turned 50 a couple days ago. The big five-oh shit my time here is finite and I’m most likely well more than halfway through this ride and that’s really weird! But, I feel the best I’ve felt since I was 35 and I’m becoming more encouraged by the realization that there is more time to thrive than I ever would have guessed.

Some thoughts on where everything stands 5-6 months in (the previous low-T brain fog keeps me from remembering if I started in August or September).

Libido: May as well start with the big one (not to brag). My last post was lamenting over the issues I was having with psychological ED. I’m happy to say that I believe I have gotten past that. No issues in the last few weeks and several successful events including some very quick turn arounds. The wife is happy, though probably a little sore (not to brag). It turns out that when people say the real benefits of TRT come after several months, they are right. So, while I have been doing some mental work (meditation, visualization), I think it was just taking my body some time to catch up. I was definitely dealing with some performance anxiety, but I think that the physical and mental issues related to the years long low T, just took some time to work themselves out. Now it seems that my physical response is just stronger than the mental anxiety loop.

Body Comp: This has been interesting and unexpected. I think I was expecting quick weight loss simply because I had more testosterone, but it turns out that is not how it works. I started consistently lifting pretty much immediately after starting. I lift 4-5 days each week before work, walk the dogs for 2-3 miles 3-4 days each week and mountain bike or hike on the weekends. The first couple months was difficult and I half assed workouts, but now I’m addicted and feel terrible if I miss training for a day. The diet is good, but not as consistent as training. I still struggle with the occasional binge. At my heaviest, around 3 years ago, I weighed 305. When I started TRT I was at 241 and I’m guessing 30% bf. As of this morning I’m 247, but I have lost 3.5 inches around my waist, 3 inches on my chest, gained 3/4 inch on my bicep and 1/2 inch on my thigh. Still a long way to go, but I’m getting compliments frequently and look noticeably more muscular. I wasn’t expecting to put on this much muscle this fast and I also wasn’t expecting to look better at a higher weight.

Brain fog: gone.

Motivation: At an all-time high. I rarely sit still. House projects are getting done, my career is moving forward for the first time in a decade, I’ve started playing guitar again after putting it down for 15 years. Truly remarkable if you know where I was for most of the last 15 years.

Negative side effects: 6 weeks ago I went from 220mg/week (2 injections)to alternating 200 & 240 every other week to help with libido (which it did), but that came with my first sides. A small amount of acne on my chest and back, and irritability 12-24 hours after injections (not every time, but often enough to be a trend), especially on the 240 weeks.

AI: I’ve been taking .25mg/week, but based on all I’ve been reading around here and elsewhere, I’m going to ditch it and see what happens.

New protocol: I’m feeling really good right now, but I do want to see if I can get rid of the AI without having to deal with the irritability that I seem to get when I don’t take one, so I’m going to go to 3 injections / week at a slightly smaller dose. 210mg/week split into Monday, Wednesday Friday injections and no AI. I’m hoping the smaller spike helps, while keeping everything else in check.

Thanks for reading.

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Instead of slowly weening off the AI I have decided to go cold turkey. None for, I think, 2 weeks. So far I notice an increased libido and better sleep. On the the negative side I’m getting that irritability that has previously sent me back to the AI. Going to fight through it this time and see if it goes away with time.

Also, this is my first week on 3 injections instead of 2. I’m doing Monday, Wednesday, Friday.

One year on TRT. Update and what I’ve learned. I think this will be long, but I don’t post often and a lot has happened in my first year, so I hope this helps someone.

TRT is not a magic bullet. It won’t solve all of your problems, but if you are willing to put in the work it could help. I started TRT because of ED issues, body comp issues and debilitating brain fog. The brain fog went away pretty quickly, but the other two took time and real effort beyond TRT… but TRT helped.

My program started at 200mg/week split into 2 injections subQ along with HCG and an AI (on and off. More on that later). Now I’m on 180mg/week split into 3 injections IM, HCG in cycles and a low dose AI every 5 days.

Improved body composition. I’m 6 feet tall. When I started TRT I weighed 240 pounds and I’m guessing by body fat % was in the 35% range. When I started I lifted hard and ate harder. A few months after starting my weight was up to 255. I’m sure I added a few pounds of lean mass, but it was mostly fat and water. I ate like a pig. As it turns out, you can’t out train or out TRT a bad diet, and the water weight gain is a real thing. I looked like a water balloon. Then I got my shit together. I have tracked every calorie since April, staying around 2500/day, focused my efforts on fun cardio (mountain biking, swimming and kayaking mostly) and lifted just to maintain (1-2 full body days at the gym plus some kettle bell circuits at home). I’m now at 202 pounds and the leanest I’ve been in my adult life. I’m guessing between 18-20% BF% based on online photos. I can’t see defined abs, but I can the outline of them. I’ve been 50-75 pounds overweight my entire adult life, so I’ve got some extra skin that will probably keep me from seeing abs, but my biceps, forearms and calves are pretty vascular. For me, the 2500 calories is really easy to maintain so I will get as lean as that will allow. I’m guessing this level of effort will get me to around 15-17% BF, which is pretty perfect for me. I get comments constantly about the changes and it feels really good. In addition to the appearance changes my health markers have improved drastically. The biggest impact was in blood pressure which went from 156/95, pre-TRT and similar during the first 6 months of TRT, to 128/80 at my physical last week. It’s important to note for others in my similar situation that these positive changes did not happen until I became hyper focused on my diet. I’m sure TRT helped some with maintaining/gaining muscle as I cut fat, but it did not lead to the fat loss and health improvements. In fact, my health got worse in the first half year on TRT. The improvements are almost entirely the result of improved diet and increased cardio. I have a goal of 195 pounds and I will post before and after pics at that point.

ED issues. This is what got me to finally start TRT after years of trying to increase it naturally. I’ve had the occasional issue with this over the years, but it became a real and frequent issue about a year and a half ago, which was also about 6 months into a new marriage. Fun! In retrospect I believe my issue was about 30% physical (overweight/low T) and 70% mental. I should say that it may have started off a physical/health issue, but it became very much a mental issue. Those that have or are currently dealing with this are familiar with the “mental loop” that happens and actually ensures failure regardless of physical health and libido. When TRT didn’t fix the problem right away the mental loop became stronger. It goes something like this. You are in the mood and at attention, but as you get closer to the act the voice in your head starts saying things like “please don’t let it happen again. Just relax, you got this. Please don’t let it happen again. Shit, it’s happening again! Please don’t happen again, not now. It’s happening. Fuck!” once that mental dialog happens, it’s over. There’s not enough Viagra in the world to overcome that dialog. It’s embarrassing and depressing. You wife or girlfriend thinks it’s from lack of attraction and can’t understand it’s got nothing to do with them. The good news in my case is that I seem to have totally gotten past it, finally, and my sex life is the best it’s ever been. It took some serious work that I will detail in the next paragraph so that I can hopefully help others that are dealing with it.

I’ll assume your TRT is dialed in and you are experiencing morning wood. TRT got me to this point. I’ve also tried the daily low dose Cialis at times and still do when on vacation or at times where I want to get it on more than usual, but no longer every day. I recommend it if morning wood is lagging. A small dose before bed will give you a good workout during the night and generally have you at attention in the morning. At least, that is my experience. The most important step in getting past this issue is an honest conversation with your partner. Without their help, it will be very difficult to get past this. It took a couple months of failures followed by honest conversations with my wife to finally get her to understand that it wasn’t her or my attraction level that was causing the issues and that I needed her help to get past it. I should repeat that. You need their help to get past it. They need to understand that when a failure happens the absolute worse thing to do is get dressed and give up. Things changed when my wife finally understood what was happening and when it happened asked me to make her feel good in other ways. Knowing she could still get where she needed to, even when I wasn’t working, was a game changer. It gave me my pride back and really allowed me to relax. Often the process of turning my attention to her body, took it away from mine and got me back to full function at some point during the process. This was probably a six month process that included times where I thought things were better and then they went back again. I’d go 3 times in a row successfully followed by the next 3 being failures. Funny thing is that as time went, this became lest embarrassing and almost became a playful time. That can only happen if both parties get to where it’s not taken personally. I could talk about this forever, but the most important takeaway is that if the issue is mental, and I believe most are, then it has to be a collaborative effort. During this time I also did a lot of meditating and visualization that I believe helped with relaxation during the act. The issue went away completely over the last few months as I have lost fat. The confidence that comes from an improved body is truly amazing. If you are embarrassed with how you look naked that will greatly effect that mental loop. So, do the mental work, but also quit being fat!

The AI debate. I think this is an important debate to have and I’m not informed enough to speak to it overall, but I can tell you my experience. First, I started just doing what my clinic said, which was .25 of an AI twice a week. I felt good on that, but I started reading and watching all the anti AI stuff and decided that I wanted to avoid it. I have a few posts here where I talk about quitting being a good experience with regards to libido, but struggling with some moodiness. It was good at first, but I also went from 2 injections / week to 3 and from subq to IM at the same time, so I think some of the improvements may have come from that. My mistake changing multiple things at once, but I did stay consistent and unchanged for months after that. Anyway, I went 5 months without an AI and I was dealing with some sides (extreme bloat, painful acne, inconsistent libido and mood swings). I also quit HCG and did only test for the last 10 weeks of this. I gave a real effort, but the moodiness and acne were becoming an issue, so I decided to add back the AI. I now take .25 every five days. That seems to be the sweet spot for me. It keeps my E2 around 45-55 and I feel completely dialed in. I have zero issues now. In fact, I can’t imagine feeling better. No bloat, very little acne, strong libido, steady moods, positive body comp changes. Ultimately I would like to not take an AI and plan to try dropping it again now that I’m much leaner, but I do feel great as is, so it’s hard to make a change.

This is getting long, so I will wrap up with a little advice based on my experience.

It takes a while for all the benefits of TRT to materialize. I felt marginally better pretty quickly, but I didn’t feel amazing for almost 6 months and not perfectly dialed in until the last few month. Be patient. Reading this it probably sounds like I made a lot of changes over the year, but I really didn’t and any changes I made were done slowly and for months at a time. For my first 6 months I tried a few different amounts. I started at 200/week, went to 220/week for a little while and then ultimately ended up at 180/week IM which I’ve been at since April.

Increased libido is fun, but even on TRT it will be effected by sleep, stress, diet, etc. Don’t have unrealistic expectations based on a few commenters who may or may not be telling the truth about their experience.

TRT, as well as all other things, work better if you lose the fat. Don’t use low T as an excuse for poor habits like I did. If you are having a hard time losing fat, start counting calories and increase your cardio. It’s really that simple. Also, there’s a difference between eating for health and eating for weight loss. Fats are good for health, but they aren’t satiating, so replacing some fat calories with protein and fibrous carbs makes it much easier to eat fewer calories without feeling hungry all the time. Also, cardio is really important. I avoided it for years, but now love it. Pick something fun and do some cardio.

Thanks for reading. All the best on your journey!

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