T Nation

Efficacy of the T-Nation TRT Protocol


#1

I, with a little help, derailed a recent thread on using the KSMan recommended TRT protocol. Eyedentist is not a fan of self-administered TRT and is fairly suspect when it comes to the advice given here in general. I'll let him get further into his feelings on the matter, but, in short, I don't share his opinion.

When I travel for work, I don't let the company travel person choose my flights or book my travel. The reason is that no one cares more about that trip more than I do. I make sure that the departure and arrival times fit my schedule. I make sure that I chose the seat I sit in (it makes a difference). I make sure that have my F.F. status registered (potential upgrades, priority boarding, etc.). What I've learned over the years is that no one cares more about all those 'little things' than the guy whose butt is in the seat. I travel a lot, so these little things will often turn into a big deal. The obvious continuation of this analogy is the question, "Do you fly the plane?". No, I don't fly the plane, but I do reserve the right to choose to drive, so in the end, I am in control of the ultimate path I take to get to my given destination.

Health care is a similar matter for me. I don't take a doctor's word as gospel truth. I make no apologies for questioning these professionals. It's called self-advocating, and I think it's something that all responsible patients should do. In my experience, the more confident and competent a doctor is, the more they are willing to engage in a meaningful conversation.

In the previous thread I made an reference to a large surgery I had several years ago. When I was told I needed it, I completely immersed myself in the literature. There were several ways to address my particular condition and they all had compromises. I wanted to figure out which was the best for me. I eventually arrived at the same surgery my specialist recommended. The first surgeon I saw was against it. The second surgeon I saw, who is world-class in his field, said that it would be irresponsible to give me any surgery other than the one I wanted. What I came to understand that it wasn't that I was a poor candidate to receive the surgery I wanted, but rather the first surgeon was a poor candidate to administer the surgery I wanted. It was a more complicated procedure than what he recommended and he simply wasn't up to the task.

I think this is often the case with TRT. Doctors often see reasonably healthy guys looking for TRT that could potentially benefit from it, but they don't necessarily need it. Their level, while low, still fall in the 'normal' range and they can have sex and be generally productive. Adding TRT successfully to their lives may help them, but it also might be a pain to administer properly and there really isn't a lot in it for the doctor. If the doc has tried 1/2-assed protocols previously, then he may very well believe that TRT is much ado of nothing or an overall negative. Keep in mind, this is just shoddy doctoring, not a meaningful appraisal of TRT.

I've personally read a lot of Pubmed articles on TRT, testosterone, HCG, A.I.'s, SERMS, etc. Like I've said before, I don't have an endo's understanding of the hormonal cascade, but I'm not uneducated on it, either. I understand the effect of the 1/2 life of different T esters. That alone seems to be a hurdle that many doctors fail to clear! At the end of the day, I have nothing close to a doctor's macro view of the human body, but I have a much better understanding (and, frankly, a lot more interest) of how I feel, my life situations and my overall health.

Is TRT an 'easy' way to lose fat? Who cares if it is? Regardless of my screen name, I've always been lean and have been athletic my entire life. This really has little to do with me, but I find it staggering that a doctor would want their patients to take 'the hard way' to getting healthy. Diet is something that should be addressed by everyone regardless of weight, and twice in the last week or so I've told people this in threads.

Many obese men don't react well to TRT because they can't control estrogen. Of course, many doctors won't even test E2, so they don't know this. There are a large portion of men that do react very well to increases in testosterone and shed fat because of it. They often don't lose that much weight because as fast as the fat is coming off, muscle is being added. This is not a bad thing. While we may not see large differences in BMI, that's not the holy grail. We've all heard the stories of body builders at 8% body fat being told they're obese because of a high BMI. The truth is that men who carry more lean muscle into their later years are more active, live longer and live better lives. Why would we want to limit this?

Mild/moderate doses of testosterone that keep a man on the higher side of a physiologically 'normal' blood values can do people a hell of a lot of good. It is important to take precautions to not induce problems that might be caused by the addition of testosterone, but those concerns can usually be addressed without too much drama. At the end of the day, I really don't care if a doctor wants to pass some sort of moral judgement on me. Honestly, he can pack sand. I'd love to have a smart doctor to bounce ideas off of and speak freely to, but until the day that I find that guy, I'm stuck on an internet forum with people who are often in a very similar situation.


#2

Doctors today are supposed to be trained to view the client differently and abandon the paternal model. Patients like yourself that are motivated to educate themselves and are actively trying to manage their own health sadly are a minority. Even though when client leave the office they’re going to do whatever they want, the docs still feel like they should have some control.

I think building the kind of relationship that you’re seeking from your doctor takes time and a lot of respect. Since most people are absolutely clueless or even worse ‘google informed’, its really no surprise. To manage your own health practically does require a macro-view of human physiology.

It’s a bit of a battle getting that kind of respect from a doctor but when they’re willing their patients are at a huge advantage over the paternally led. Most doctors will leave patients with more questions and a lower self-esteem than before they saw the dr. but it’s those rare ones that are willing to trust in you.


#3

Fat Boy - I appreciate your point of view, and in my particular case am that point of view worked for me. I could’ve gone a couple of years trying to go through GPs and Endos to MAYBE get proper medication, when the answers were staring me right in the face after my first set of labs. I chose to go the Wellness Clinic route to get started, and ended up switching to a great doctor at DefyMedical for even better treatment.

However, I think folks like EyeDentist and C27H40O3, and even The Myth, offer some very good opposing viewpoints to those generally accepted as gospel around here, even when Im in total disagreement with them. I would never want to NOT have those opposing viewpoints, as sometimes I agree with them as well.

The T-Nation guru is not always right. All doctors/endos are not generally idiots. People don’t always need to rush to iodine replenishment, and sometimes low temps are just that person’s normal resting temperature. Also, the T-Nation TRT protocol is not proprietary, and was not invented somehow only by members on this forum. There are many other forums, such as ExcelMale, which give great value and insight by folks such as Nelson Vergel, who is a recognized/published expert in the field of TRT. There are also some great doctors that are very good at evaluating low TRT symptoms that never had to come to T-Nation to get the answers.

Again, I think your post is great and I respect your opinion. I’m just not in total agreement with it, and value the opposing viewpoints.


#4

Well said Friedman.


#5

Do you honestly believe that doctors don’t want to help people? Why do you think doctors don’t prescribe it more freely? Why does a healthy male need TRT? Insurance companies have overrun medicine obamacare. Doctors reimbursements come from insurance companies. Insurance companies don’t want to pay for a in range symptomatic pt to be on TRT for life. Insurance companies do not care about your quality of life they care about cost containment. We the American public voted for this health care mess now we get to lie in it. Personally I don’t think insurance should pay for most TRT. If you have cash get away from doctors who work for the insurance you bring in to them. I’m on TRT I went to Vegas my protocol is beautiful. My dad went to a local doc gets 100 mg once per 2 weeks. You get what you pay for or don’t…


#6

Living in Canada, I pay for 100% of my HRT medications. The labs and physicians are covered though. Is Medicare in the US paying for medications?! If someone has extended health benefits that cover it that’s an entirely different matter.


#7

I got too heated in the previous thread. I wanted this one to be more conversational. I completely appreciate that everyone may not agree with my approach. I don’t think you have to share my opinion for yours to be valid. I would like to understand the criticisms that people have, because I think there is a good opportunity to learn. Thanks to all of you that have added to the mix.


#8

[quote]Ryancoburn wrote:
Do you honestly believe that doctors don’t want to help people? Why do you think doctors don’t prescribe it more freely? Why does a healthy male need TRT? Insurance companies have overrun medicine obamacare. Doctors reimbursements come from insurance companies. Insurance companies don’t want to pay for a in range symptomatic pt to be on TRT for life. Insurance companies do not care about your quality of life they care about cost containment. We the American public voted for this health care mess now we get to lie in it. Personally I don’t think insurance should pay for most TRT. If you have cash get away from doctors who work for the insurance you bring in to them. I’m on TRT I went to Vegas my protocol is beautiful. My dad went to a local doc gets 100 mg once per 2 weeks. You get what you pay for or don’t…[/quote]

  1. I honestly believe doctors are so beat up by malpractice suits that if someone is marginal then it’s probably too much of a chance for them to intervene.

  2. See answer #1.

  3. Define healthy male. It’s an upside down U-shaped curve. More testosterone is good to a point and then it starts to cause problems. I think if you’re on the low Test side, but generally healthy, most are not going to prescribe Test because they don’t see the risk/reward ratio being favorable. This opinion about risk/reward may very well be skewed due to previous experiences with ineffective protocols and/or a lack of knowledge/recent research.

  4. Yes, the medical system here is jacked. It was jacked 10 years ago and it’s jacked now. Follow the $$$.

  5. How about helping your dad out with a little advice?


#9

My dad knows the ideal protocol. Honestly he skips his injections he is not compliant. My mom could walk in and get estrogen with no labs. If your a male your treated a lot differently there is no doubt about that.

A healthy make to me is healthy physically, mentally. TRT in my mind should be a last resort after having exhausted all natural ways. I have no doubt if many put the same effort into there diet and training as they do into finding the ideal TRT doctor program some not all would find they are better off naturally.

I see to many people on this site abusing TRT running cycles then trying to manipulate there labs. So there doctor doesn’t kick them off. Its one thing if someone becomes there own doctor but I think it makes it harder for the rest of us when people are gaming there doctor. Either let the doctor be the doctor or be your own.

I can understand EYE dentists perspective trying to separate the abusers from the people who really want help is hard. I’m a dentist and its a struggle just trying to weed out the narcotic abusers and people who need help. Doctors all went to school to help people. Some im sure have been burnt enough times by abusers that they may be more defensive. I guess that’s the rub I know doctors want to help. I want to help my pts its the abusers who ruin it. Bringing in a protocal and handing it to any ethical doctor will raise red flags and put them on the defensive. The Internet has created a group of people who think they have more knowledge than practicing MDs. How would you like to be mechanic and you open the hood and see it’s the transmission that needs replaced but the customer is adamant he read something on the Internet that it’s just his coolant system. Would a ethical mechanic replace the coolant system because the paternal model is dead? Or would he act like the professional and decline becuase he doesn’t want to waste your money?


#10

[quote]Ryancoburn wrote:
The Internet has created a group of people who think they have more knowledge than practicing MDs. How would you like to be mechanic and you open the hood and see it’s the transmission that needs replaced but the customer is adamant he read something on the Internet that it’s just his coolant system. Would a ethical mechanic replace the coolant system because the paternal model is dead? Or would he act like the professional and decline becuase he doesn’t want to waste your money?[/quote]

Great analogy Ryan. Being both a mechanic and a healthcare professional I can totally relate to this.


#11

There are def patients who feel informed after 30 minutes of Google search. I can see how frustrating that would be for the doctor.

Agreeing with that, one must also agree that there are shitty doctors who prescribe wrong treatments. My first doc wanted to put me on a 150mg shot per month. A good man and probably a good doc in other fields but fuck, he should know better before throws a treatment like that.

Patient should be wary and willing to question but should also know when to shut the fuck up once it goes above their head. Same goes for the doc, if he’s never done TRT, he should be a man and admit his ignorance or consult one of his professional colegues.


#12

Most guys on this forum are not trying to abuse TRT or deceive doctors. So we should not go on that tangent.

Of the reports that we get about endocrinologists and urologists, they seem to be very incompetent. You would need to be reading threads here for years to appreciate the issues reported here. Doctors are not equipped to deal with TRT issues. GP’s can understand that there are issues that they need to understand and can be in learning mode. The reports about the specialists seem to indicate that they have no need of learning anything new. Are there specialists who do everything that should be done? I don’t know, we rarely get reports of that nature here. [We have also seen some bad stories about pharmacists too, not many.] Overall, we see stories here about doctors who don’t know much about hormones and have strange ideas and make things up to fill gaps in their understanding and ethics. So what is wrong with been judgmental? The biggest problem in TRT is not the drugs or the science, its the doctors. Thats why we have a ‘finding a TRT doc’ sticky. If the doctors, seen by the guys who post here are not delivering effective care, then the best we can do here is providing information that guys can do to allow them to attempt to manage their own healthcare by not been passive.

The protocol that I have promoted seems to be slipping into the mainstream, with docs who are trying, from reports that we increasingly get here. Nothing magic. Just makes sense to have steady T levels; then a competitive AI drug can manage E2 levels by matching steady T levels. The protocol exists to make a well founded suggestion to others. Creating the protocol for injections sticky was done to save my self a lot of work VS spelling things out over and over again in each guy’s thread. What is unique here was the calculation for correcting anastrozole doses to achieve a given E2 lab target. I thought that that should work and with my own labs it proved to work very well. And one can change ones T dose and make same change to AI and maintain E2 target or combine both calculations at the same time. I also explained why young virile guys taking 1mg anastrozole per day do not get very low E2 levels. Also explained why large dose hCG or SERM’s can lead to high E2 levels that cannot be managed by anastrozole. So I have delivered some original insight and finding here. I don’t apologize. No one hangs guru on me unless they are critical or resentful about something.

Lab values and ranges: We also need to challenge the infrequent injection lab mindset because the labwork is then rather meaningless and effective E2 management is then a joke. Thyroid lab ranges are stupid and doctors lack enough critical thinking, deductive reasoning and education to see that the ‘normal range’ does not mean “you are normal, your thyroid is fine etc”

Doctors are trained in med school and by drug reps to be in the disease management business, not health care. That is the root of the problem. If you don’t have disease, they can’t help you.

Part of the problem is the “criminalization” of steroids. Testosterone is a schedule III drug that is a natural hormone in men and women.


#13

Lots of great points being made on this thread. The collegial tone is much appreciated. Busy at work at the moment; will chime in later when I have time.


#14

[quote]C27 H40 O3 wrote:

[quote]Ryancoburn wrote:
The Internet has created a group of people who think they have more knowledge than practicing MDs. How would you like to be mechanic and you open the hood and see it’s the transmission that needs replaced but the customer is adamant he read something on the Internet that it’s just his coolant system. Would a ethical mechanic replace the coolant system because the paternal model is dead? Or would he act like the professional and decline becuase he doesn’t want to waste your money?[/quote]

Great analogy Ryan. Being both a mechanic and a healthcare professional I can totally relate to this.
[/quote]

I’ll chime in on this analogy. I’m not a professional mechanic, however, I do design all sorts of automotive equipment. Any of the things a mechanic is apt to work on for me I have complete knowledge about. They are often just plain wrong in their assessments. I’ll often have to step in and say, “No, we’re going to do A and B, but not C.” They very rarely want to hear my logic and I very rarely share it.

The local guy I use now knows my background. I go in and we have a discussion about what I want done and he does it. If he has a recommendation, it’s usually a good one and I’ll go with it. He doesn’t try to sell me muffler bearings and I don’t bitch about hooking the car up to the diagnostic computer. We work well together.

I’d love to have this type of a relationship with a doctor, but I haven’t found one. The one GP I had who I really liked is out of my HMO network, so he’s a no-go. While with him, I took his recommendations to heart. It was with him that I tested under 300 on TT. I was doing a lot of endurance training and he recommended I reduce that and start lifting weights. I’ve done that. It’s not an easy thing weaning an endurance guy off long runs, but I did it on his recommendations. I’ve always had a ‘clean’ diet, but for the last 2 years or so I’ve been on a Paleo + dairy program. My lipid panels and overall health is really good. If anything, I’m probably a bit low on cholesterol (~170 total). That’s with a diet that is probably 50% fat.

I’ve taken tribulus, DAA and other test ‘boosters’. None of those had an effect. HCG definitely had a real effect. My T came in at almost 450 on 300iu EOD. That’s low, but it’s a 50% increase from what I had previously. Being on 125mg/week of T Cyp. has been a game changer. I feel strong physically and strong mentally. I want to be a better husband and father. It easier for me to keep calm when kids are running around that shit is going hay-wire. I’m better in the sack with the wife. I’m happier.

Sorry guys, I’m registering absolutely zero remorse for my actions. Was this my first action for changing my life, no. Is this my ‘last ditch’ method for changing my life? No, I’m sure there’s all sorts of other things I could have done. Would they have worked this quickly or been this pronounced? Probably not. So am I cheating? I don’t care. I’m not in the Olympics or playing Pro Hockey. I’m just an ordinary bum on the street trying to get through life. Over 10% of all Americans are on some sort of anti-depressant and something like 70% of all Americans are on some sort of prescription medication. Maybe the end game is that we, as a society, need to get our shit sorted out. I’ll certainly buy into that. Until that happens, though, a shot twice a week is the best solution I have.


#15

Sorry guys, I’m registering absolutely zero remorse for my actions. Was this my first action for changing my life, no. Is this my ‘last ditch’ method for changing my life? No, I’m sure there’s all sorts of other things I could have done. Would they have worked this quickly or been this pronounced? Probably not. So am I cheating? I don’t care. I’m not in the Olympics or playing Pro Hockey. I’m just an ordinary bum on the street trying to get through life. Over 10% of all Americans are on some sort of anti-depressant and something like 70% of all Americans are on some sort of prescription medication. Maybe the end game is that we, as a society, need to get our shit sorted out. I’ll certainly buy into that. Until that happens, though, a shot twice a week is the best solution I have.
[/quote]

It wasn’t my intent to make you feel remorse or guilt. My point was directed to those sitting on the fence. Or too those who think test will transform there lifes into a nirvana. There is no doubt in my mind however of the beauty that reentered my life when I balanced my hormones. I also had tried a lot of natural ways and for those TRT may or may not be the answer. For me it is amazing my wife loves the new me. I also love the new me.


#16

KSman here is a thread there are lots more. Just google cycling while on TRT you will see mounds of information. These people are all being treated by someone and abusing the whole system.


#17

[quote]Ryancoburn wrote:
KSman here is a thread there are lots more. Just google cycling while on TRT you will see mounds of information. These people are all being treated by someone and abusing the whole system.

[/quote]

That thread is in steroids not t-replacement. My observation is that when people post threads about running cycles or aiming to achieve very high test numbers, they promptly receive a friendly referral in that direction. If they stay the thread is a very lonely place.

It’s difficult to find anyone in t-replacement recommending a higher dose of Test, HCG or AI. Almost daily you find threads where a guy mentions that his Doctor put him on an insane dose, administered every two or four weeks. That’s what gets me about the claim that the information shared here is dangerous. Most often it’s the voice of temperance that is shared by the majority of the contributors.

After a few bad experiences with Doctors, I now have a great PA. I send him articles and studies, he considers my points and ultimately decides what will work best. I do as he instructs.

200mg’s of cyp every two weeks, in office. 4500iu’s of HCG per week. Yep that was my protocol. After lots of brain storming and sending information back and fourth, it’s now very similar to what is laid out in the stickies and self administered. Long story short, he was open minded enough to learn with me. Most are not so lucky here.

Without a doubt, this sub-forum has been invaluable to my health. Not to mention every guy on hrt at my Doctors office.

At the end of the day, painting folks with a broad brush is pure fallacy. There will always be Doctors with poor understanding and bad health information passed out on the web.

My personal opinion is that t-replacement is a place where men generally help each other with solid understanding, personal experience, sharp minds and conservative recommendations to discuss with your own Doctor.


#18

[quote]Fat Boy 33 wrote:
I, with a little help, derailed a recent thread on using the KSMan recommended TRT protocol. Eyedentist is not a fan of self-administered TRT and is fairly suspect when it comes to the advice given here in general. I’ll let him get further into his feelings on the matter, but, in short, I don’t share his opinion.

When I travel for work, I don’t let the company travel person choose my flights or book my travel. The reason is that no one cares more about that trip more than I do. I make sure that the departure and arrival times fit my schedule. I make sure that I chose the seat I sit in (it makes a difference). I make sure that have my F.F. status registered (potential upgrades, priority boarding, etc.). What I’ve learned over the years is that no one cares more about all those ‘little things’ than the guy whose butt is in the seat. I travel a lot, so these little things will often turn into a big deal. The obvious continuation of this analogy is the question, “Do you fly the plane?”. No, I don’t fly the plane, but I do reserve the right to choose to drive, so in the end, I am in control of the ultimate path I take to get to my given destination.

Health care is a similar matter for me. I don’t take a doctor’s word as gospel truth. I make no apologies for questioning these professionals. It’s called self-advocating, and I think it’s something that all responsible patients should do. In my experience, the more confident and competent a doctor is, the more they are willing to engage in a meaningful conversation.

In the previous thread I made an reference to a large surgery I had several years ago. When I was told I needed it, I completely immersed myself in the literature. There were several ways to address my particular condition and they all had compromises. I wanted to figure out which was the best for me. I eventually arrived at the same surgery my specialist recommended. The first surgeon I saw was against it. The second surgeon I saw, who is world-class in his field, said that it would be irresponsible to give me any surgery other than the one I wanted. What I came to understand that it wasn’t that I was a poor candidate to receive the surgery I wanted, but rather the first surgeon was a poor candidate to administer the surgery I wanted. It was a more complicated procedure than what he recommended and he simply wasn’t up to the task.

I think this is often the case with TRT. Doctors often see reasonably healthy guys looking for TRT that could potentially benefit from it, but they don’t necessarily need it. Their level, while low, still fall in the ‘normal’ range and they can have sex and be generally productive. Adding TRT successfully to their lives may help them, but it also might be a pain to administer properly and there really isn’t a lot in it for the doctor. If the doc has tried 1/2-assed protocols previously, then he may very well believe that TRT is much ado of nothing or an overall negative. Keep in mind, this is just shoddy doctoring, not a meaningful appraisal of TRT.

I’ve personally read a lot of Pubmed articles on TRT, testosterone, HCG, A.I.'s, SERMS, etc. Like I’ve said before, I don’t have an endo’s understanding of the hormonal cascade, but I’m not uneducated on it, either. I understand the effect of the 1/2 life of different T esters. That alone seems to be a hurdle that many doctors fail to clear! At the end of the day, I have nothing close to a doctor’s macro view of the human body, but I have a much better understanding (and, frankly, a lot more interest) of how I feel, my life situations and my overall health.

Is TRT an ‘easy’ way to lose fat? Who cares if it is? Regardless of my screen name, I’ve always been lean and have been athletic my entire life. This really has little to do with me, but I find it staggering that a doctor would want their patients to take ‘the hard way’ to getting healthy. Diet is something that should be addressed by everyone regardless of weight, and twice in the last week or so I’ve told people this in threads.

Many obese men don’t react well to TRT because they can’t control estrogen. Of course, many doctors won’t even test E2, so they don’t know this. There are a large portion of men that do react very well to increases in testosterone and shed fat because of it. They often don’t lose that much weight because as fast as the fat is coming off, muscle is being added. This is not a bad thing. While we may not see large differences in BMI, that’s not the holy grail. We’ve all heard the stories of body builders at 8% body fat being told they’re obese because of a high BMI. The truth is that men who carry more lean muscle into their later years are more active, live longer and live better lives. Why would we want to limit this?

Mild/moderate doses of testosterone that keep a man on the higher side of a physiologically ‘normal’ blood values can do people a hell of a lot of good. It is important to take precautions to not induce problems that might be caused by the addition of testosterone, but those concerns can usually be addressed without too much drama. At the end of the day, I really don’t care if a doctor wants to pass some sort of moral judgement on me. Honestly, he can pack sand. I’d love to have a smart doctor to bounce ideas off of and speak freely to, but until the day that I find that guy, I’m stuck on an internet forum with people who are often in a very similar situation.[/quote]

There are a couple of issues here which you haven’t addressed. Allow me. You may have read PubMed articles, that doesn’t address your lack of understanding of human pathophysiology and basic human physiology. We aren’t talking about just the Axis here (if you have read well enough you know what this is … if you haven’t … stop administering your own drugs), we are talking about how the rest of your system will react to having exogenous stimuli.

What about your bodies ability to re sculpture bone as you age? If you are younger when you need TRT this isn’t an issue. If you are older, it is. What about the increased cellular reproduction increasing your risk of a reproductive disease such as cancer? There are many more issues going through your physicians head than “does my protocol agree with T NATION’s protocol?”.

That said, there is a lot to be understood by a patient before heading into a Dr’s office. Patients SHOULD educate themselves as best they can before accepting a treatment or being denied it. Looking for a dealer isn’t what you need. You ned a good doctor, even if they disagree with what you would like to happen!


#19

Consider the following hypothetical poster:

He’s your classic ‘low-T’ guy–middle-aged, overweight/out of shape, unhappy. He answers every low-T-related question affirmatively; ie, he has brain fog, low libido, irritability, etc. He posts all of the ‘required’ labs, and other than the testosterone-related ones (more on this below),they are all satisfactory–ie, not only are they in-range, but they are reasonably close to what you consider ideal.

As for his testosterone-related labs (and these can be whichever lab[s] you feel are most germane regarding T status–TT, fT, etc)–they come back in the normal range, but at the 10th %ile. (I’m using %iles so we can avoid getting bogged down on specific numbers). Question: In your opinion, does this man have low T, and would you support/encourage his pursuit of TRT?

Now consider the same poster, but his T-related labs come in at the 20th %ile. Same questions: Does he have low T, and does he ‘need’ TRT?

Now consider if his T labs came in at the 50th %ile…75th…90th…

You see where I’m going with this. So the question becomes, is there an endogenous T level at which you would respond to such a poster by saying ‘Sorry bro, but in my opinion, you do not have low T, and should not pursue TRT’? Or do symptoms always trump labs?


#20

[quote]EyeDentist wrote:

Or do symptoms always trump labs?[/quote]

The problem with the symptoms of “low T,” in my opinion, is that they are also symptoms of a host of other conditions, such as obesity, metabolic syndrome, diabetes, sedentary lifestyle, inflammatory/autoimmune conditions, etc. Since TRT can cause irreversible (or at least difficult to reverse) damage to the HPTA, TRT is seldom the first thing that should be tried. Yet there is an industry today that will provide such “cosmetic” TRT to pretty much any guy who asks for it, almost irrespective of his natural T levels.

We see that here with guys who have TT in the 500s-600s being offered TRT, when low T is probably not even remotely the source of their symptoms. Of course they will feel better when their T is raised and they feel some dopamine and gain some muscle - everybody does - so the diagnosis of “low T” becomes self-fulfilling.

I am partaking of that industry and so I feel I can criticize it - I got on TRT due to symptoms that looked like low T but eventually turned out to probably be due to something else (an autoimmune condition that is now treated), and I haven’t wanted to go through the hassle of coming off TRT since, so I am still on it. While my T wasn’t really that low, increasing T did make me feel better while I was dealing with the untreated symptoms - however, TRT for me is not without side effects. I probably wouldn’t have needed it if I had been treated for the underlying condition from the beginning.