T Nation

Dr Put Me on TRT with No Help


#1

Hi all. I have been doing a lot of research and i want to make sure that trt is right for me. I’m 38 years old and pretty much feel like crap all the time. Had my test and test free tested and the numbers where
Test 373
Test free 36.8
Also had my fsh and lh tested and they came back as
Fsh 4.1
Lh 2.5
My Dr put me on testosterone cypionate 100mg with 1ml injections every 2 weeks.
I took my first injection about 7days ago now and I have to say I’m feeling much better now except for a weird side effect of a dull ache with my nut sack for the last 2 days.
Anyone else get this weird pain? Also is there anything else I need to do or follow to help the trt?
Is the trt something I am going to cycle in and off with it am I on it for life?
Sorry for the questions but my Dr is not much help with this and I am going to try and find another one soon.
Thank you for the help.


#2

Yes, trt is supposed to be for life, unless you find the reason that your LH is so low. It could be a pituitary tumor, of which an MRI could find. Or it could be hereditary. For whatever reason, it looks like your pituitary gland isn’t sending enough signal to your balls to produce testosterone. Called secondary hypogonadism.

If your dr has not looked into an MRI or other reasoning of why your LH is low, I believe it’s borderline malpractice. And I think it just plain sucks he try TRT prior to doing so.

100mg test every 2 weeks is dreadfully low. My original dose was 300mg every 2 weeks. Regardless, the every 2 week protocol is awful. Push your dr for AT LEAST every week injection or, better yet, insist he teach you how to do home injections, that way you can find what works best for you.

That protocol your on shows your dr has zero idea of what he’s doing and is severely outdated in his approach. You will feel worse than NOT being on anything with that protocol.


#3

That’s a terrible protocol for a hormone with a halflife of on average 8 days, lower if SHBG is low. You don’t have the proper testing to determine a protocol for success and most doctors don’t know what to do. Almost everyone who comes here, comes here with a story exactly like yours.

You need to find a doctor that does hormone replacement on a regular basis and not some doctor who doesn’t specialize in TRT and only treats guys coming into his office on occasion because you’re simply there in front of him. Most men inject their doses twice weekly, others more frequently do to low SHBG.

Injecting once weekly will induce highs followed by lows, levels will peak within 48 hours, then start falling, by the end of the week levels will be low, we call it the hormonal roller coaster. You may not notice swings in levels now, but in time you will. Be prepared because a lot of doctors just don’t specialize in TRT, I went private to find someone with more experience and made a world of difference.


#4

@systemlord

I personally think you should remove the “injecting once a week” is awful, etc. from your responses. Some respond great to this frequency given SHBG and e2 results. It’s not a total write off.

Now the e2weeks protocol, yes, horrible.


#5

Hi Good too meet you Brother @rholden38 I am finally going on Injections too myself i have been on a 10% Compounded Testosterone cream, and its failing now as i am back to being TIRED lots and almost Falling asleep in the afternoon. I will be on 125mg Per week Split into 2 Injections. 62.5mg per shot. is a very Good Protocol. and stable one.


#6

Thank you all for the help on this.
do you all think i should have my dr rerun my labs. Going thru my last labs i don’t see anywhere that shbg was run. What else should i have her do?


#7

You can’t really re-run your labs to get a baseline anymore since you started on test injections. You can’t retest FSH/LH anymore and your injection is going to ruin whatever baseline E2 you had. If you’ve only taken one injection you could either stop now, wait a couple months and retest: TT, Free T, E2, SHBG, FSH, and LH at a minimum. Otherwise, you could continue with TRT and see where you stand in about 4-6 weeks but you would be better off changing your protocol as others have said. 100mg/wk either pinned once or preferable split and pinned twice.


#8

Honestly your dr. doesn’t know what she’s doing.

Personally I would first ask if you can make the dose at least 100mg per week. Ask dr. to allow you home injection. Then run blood tests a month later.

If she won’t let you do the above, I’d not go back for another injection. You’re going to be worse off than before in a few weeks.

I would also ask this “doctor” why she hasn’t run another series or two of testings? One test isn’t a good indictor of low T. I’d want to see numerous tests to verify and confirm.

Did she make a diagnosis? It likely is secondary hypogonadism. And if so, why isn’t she asking for a MRI?

“doctor”. Right.


#9

You have less than 1% free testosterone, your SHBG is likely higher. Ideally, 2-3% of your test should be free. You should be fine with a weekly dose, but as mentioned, you definitely do not want to go longer than that between injections.

Did your doctor run any other tests? SHBG? Prolactin? Estradiol? IGF-1? DHEA-S? Thyroid tests?


#10

I did have blood work done in january of this year however I do not see any of the things you guys are saying on the test except for thyroid
TSH was 1.76
T4 was 1.3

I was able to do the injections at home so i am thinking i will do weekly starting now.


#11

HighPull what number is 2% free test or 3% free testosterone, what result would one need to get?


#12

No particular number, it’s a math calculation. For example, my most recent levels were 900ng/dL total testosterone and 202pg/mL free testosterone. Converting pg/mL to ng/dL yields 20.2 for the free test. When divided by 900, it is 0.02244 or 2.24% free. My SHBG runs in the mid 20s.

One with a high level of SHBG would need to, at least initially, run his total test pretty high to get his free testosterone level optimal. On the other hand, one with a very low SHBG level will do fine with lower total test levels, as their corresponding free test will be higher, for example, a guy with 600 total test and 200 free, 3.33% free. They get more bang for their buck.


#13

so in 4 to 6 weeks when i have my levels retested so i do it before or after injection? or does it matter when?

thank you again for the help with this. i am close to the Las Vegas area (about 80 miles out) so i am looking for a good trt Dr in that area.


#14

It does. Get your blood drawn on the day of an injection, and before the injection. Be consistent with that. You’ll want to see what your levels are at their lowest.