I've been reading this forum for years and years and this is the place with the least nonsense bro-science BS. I'll start with my short story first and include bloods, and other such things.
TL;DR: Always been a mousey lil biznitch, used AAS and felt awesome, got huge, injury took me out later in life, age 36 and just got TRT prescribed due to bloodwork. See bloods and questions below the novel I wrote.
In my younger years I was very slow to develop manly features and late to hit puberty at around 18. I was always the target of bullying in school and was left with using my wit to deter aggressors, which usually left me with a black eye. I didn't have facial hair until well into my 20's. I've always been what my friends call "pretty". I'm mostly hairless across my entire body. Wrists are only 6 1/2", which looked kind of odd with 18" arms. My beard comes in patchy and up until I started lifting my friends ribbed me by calling me "Twig Arms Timmy".
I started lifting at age 26 and got a decent trainer to help me start. I gained very slowly at first. I struggled for a few years even though my diet was decent (not perfect by any means but I wasn't super serious then) but it was good enough to make the gains I wanted. Something was wrong and I craved more, so I got into the pro-hormones after a fair amount of research. My first go at it was with superdrol and I gained a good 10-12lbs and did an aggressive PCT. A few cycles later and I was a 215lb monstrosity at 5'11" and 8%bf. At this point my friends referred to me as "scary".
I looked great. Felt great. But I would consistently struggle with a cervical spine injury that I couldn't figure out. It would pop and I would be in bed for a week straight. I got regular deep tissue massages, frequented the chiropractor, and ate glucosamine/MSM tabs like tic-tacs. I also took a serious back injury from a crappy form leg press. All 600lbs came down on me like a brick house and folded me like origami. I got away with several torn muscles and a L3-4 herniation. I was careful with it and healed it pretty quickly and got back to the gym. I've also struggled with some weak joints.. My shoulders aren't great, and I sometimes have issues with my SC joint of all things.
Fast forward to age 34. I got married and stopped lifting seriously, but kept myself decently big with the help of some SARMS. The wife hated the thought of me doing anything illegal, but there were still some PH's left over from previous cycles so I would sometimes do that, but my PCT's were crap because of the state of the research chemical market at the time. I likely didn't even PCT at all because it was probably bunk. I felt like crap mostly and my libido was floored but I kept on SARMs almost 100% of the time to feel halfway normal.
Age 35 I took another cervical spine injury that left me in so much pain that I stopped all workouts, stopped all SARM usage, and I was like this for a year until I sought out some help. I kept telling myself it would get better. It was so bad some days that I couldn't turn my head, or get out of bed without help. It took months of xrays, mri's, treatment plans and PT before they finally decided to give me two courses of epidural. The tests showed severe degeneration in C4-C5 and lessened degeneration in neighboring discs. I think this is due to the anthrax vax I got in the military in '98, but nobody seems to believe me. The epidural helped quite a bit temporarily. Overall the pain is much less, but it comes back and bugs me sometimes. Nowhere near the same though... for now.
So now I'm 36 (close to 37) and got back into the gym after I felt better and... well... it sucks. Somehow I feel WORSE after my gym visits. I have years of knowledge and research behind my exercises. I was trained by one of the best trainers in the world (not telling who so I won't incriminate). My diet is impeccable. Every time I come back from the gym I'm sore for over a week. I feel like I was hit by a truck every single time. Not just the soreness, but the overwhelming amount of tired I feel afterwards needs some addressing. I lost all the fat I gained when I was on injury, but I have some fat in my midsection that refuses to leave. My body looks sort of pear-shaped... not unlike an untrained woman. So back to the doc. I knew what this was. I'm no dummy and this isn't my first rodeo. My T is on the floor. I know the feeling from so many PCT's. But I haven't cycled anything in over a year. I went to my doc and played dumb. "My libido is so low and I don't even think about sex ever. I can achieve erection but I don't want to use it. I'm tired all the time and feel like I'm walking around in a fog." Several key words were used here and of course my doc responded with exactly what I primed her for. "Sounds like low-t. Let's get some blood work."
I wanted NO ambiguity here. The last time I asked this question at age 34 my T was at around 320-ish ng/dl and the doc at the time responded with "It's low for your age but I can't recommend TRT at your age.". This time I drank a few nights prior, and ate carbs prior to the test which I scheduled later in the day. I did not bother to deprive myself of sleep however. It came back at 157ng/dl. Wowzers that's low. Even with the stuff I did to myself. Doc prescribed TRT and started me at 100mg per month. I gave her a study from the AACE which stated biweekly is preferred, which she happily accepted and allowed 100mg biweekly from the get-go. I will be slowly talking my doc into weekly injections, with dosage depending on bloodwork.
Did I just fry my HPTA, was I just made this way, or is this mild Cushing's due to epidural? Sadly I don't have any cortisol levels in my bloodwork so I'll request it on my next test on the 5th. I honestly want to be on TRT. I always felt like I was missing something until I started using "things", and then it all clicked into place. I felt like I should have been that way all my life. I'm not too sure I want my cortisol checked so the doc won't deviate from my current TRT plan.
My main question is this: How can I make sure that I get optimal dosage and timing from a doc that is clearly uninformed on normal practice of TRT? She's easily manipulated, but I worry that I'll push too far. This also means she likely knows nothing of using AI and HCG if needed. I've always been able to keep gyno in check in the past, but I definitely am prone to it. Also this 100mg I just got 5 days ago feels like it totally shut me down right away and I feel like utter garbage. Feels like I'm walking through water. Extra tired. Super brain fogged.
RHR: 89 (I'm working on my cardio don't judge me)
Bloods (nonfasted) - Cholesterol looks slightly off, but pretty good for nonfasted:
TESTOSTERONE, TOTAL 157 ng/dL 250 - 827 ng/dL
TESTOSTERONE, FREE 37.8 pg/mL 46.0 - 224.0 pg/mL
GLUCOSE 92 mg/dL 65 - 99 mg/dL
Fasting reference interval
Urea Nitrogen 14 mg/dL 7 - 25 mg/dL
Creatinine 0.98 mg/dL 0.60 - 1.35 mg/dL
eGFR, Non-AA 99 mL/min/1.73m2 > OR = 60 mL/min/1.73m2
eGFR, AA 114 mL/min/1.73m2 > OR = 60 mL/min/1.73m2
BUN/Creatinine NOT APPLICABLE (calc) 6 - 22 (calc)
SODIUM 142 mmol/L 135 - 146 mmol/L
POTASSIUM 3.8 mmol/L 3.5 - 5.3 mmol/L
CHLORIDE 108 mmol/L 98 - 110 mmol/L
CARBON DIOXIDE 24 mmol/L 20 - 31 mmol/L
CALCIUM 10.0 mg/dL 8.6 - 10.3 mg/dL
PROTEIN, TOTAL 6.8 g/dL 6.1 - 8.1 g/dL
ALBUMIN 4.7 g/dL 3.6 - 5.1 g/dL
GLOBULIN 2.1 g/dL (calc) 1.9 - 3.7 g/dL (calc)
ALBUMIN/GLOBULIN RATIO 2.2 (calc) 1.0 - 2.5 (calc)
BILIRUBIN, TOTAL 0.7 mg/dL 0.2 - 1.2 mg/dL
ALKALINE PHOSPHATASE 38 U/L 40 - 115 U/L
AST 22 U/L 10 - 40 U/L
ALT 30 U/L 9 - 46 U/L
Total Cholesterol 211 mg/dL 125 - 200 mg/dL
HDL CHOLESTEROL 63 mg/dL > OR = 40 mg/dL
TRIGLYCERIDES 70 mg/dL <150 mg/dL
LDL-CHOLESTEROL 134 mg/dL (calc) <130 mg/dL (calc)
Desirable range <100 mg/dL for patients with CHD or
diabetes and <70 mg/dL for diabetic patients with
known heart disease.
Cholesterol/HDL Ratio 3.3 (calc) < OR = 5.0 (calc)
NON-HDL CHOLESTEROL 148 mg/dL (calc) mg/dL (calc)
White Blood Cells 9.7 Thousand/uL 3.8 - 10.8 Thousand/uL
Red Blood Cells 5.64 Million/uL 4.20 - 5.80 Million/uL
HEMOGLOBIN 16.1 g/dL 13.2 - 17.1 g/dL
HEMATOCRIT 49.1 % 38.5 - 50.0 %
MCV 87.0 fL 80.0 - 100.0 fL
MCH 28.5 pg 27.0 - 33.0 pg
MCHC 32.8 g/dL 32.0 - 36.0 g/dL
RDW 13.0 % 11.0 - 15.0 %
Platelets 264 Thousand/uL 140 - 400 Thousand/uL
MPV 9.3 fL 7.5 - 12.5 fL
TSH w/ Reflex T4
TSH 1.50 mIU/L 0.40 - 4.50 mIU/L