T Nation

Efficacy of the T-Nation TRT Protocol

[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]

These cases are rather unusual here. Yes, there are guys like this. But we still should not let that change the conversations here.

Criteria for Rx TRT:
Many docs are slaves to lab numbers and don’t consider symptoms. And for most that do consider symptom and labs, very few seem to consider low T to be a symptom that needs to be investigated instead of a condition that Rx TRT will fix. We know that low T can be symptom of some well known causes and most doctors do not consider that there might be another root cause that needs to be addressed. Docs are pushed into some of this thinking by HMO’s etc and insurance constraints, pressures and fears.

Labs for TT:

  • can be misleading as this can be inflated when SHBG is high. That is why we need fT, even though its pulsatile nature makes the fT values uncertain and of course we need FSH and LH as part of this workup. We see docs who Rx TRT and don’t test LH/FSH, because drug reps don’t want to to confuse the issue with facts.

-Some guys need more T than others. A lowish T level might be OK for a guy who has never had high T, levels, little body and sparse facial hair. Take a short stocky hairy beast who grew up on high T and take him to the same lowish T level and he will be a wreck.

Dose: Doctors do not read more than bare minimum and ditto for thinking. Injected T; old grandfathered product literature suggests injecting every two weeks, predating disposable syringes, and thats what docs see, thinking is optional. Anastrozole 1mg/day in a estrogen positive breast cancer context, so prescribe that to males, brain dead.

The things that I complain about with docs are the things that guys report here. I think that words like stupidity, ignorance and malpractice are appropriate. Everyone here can see it without spending years in medical training. Now I am on a tangent!

“Efficacy of the T-Nation TRT Protocol”: What is suggested here, with the suggested follow up labs and dose changing methods and calculations works very well. Drug delivery suggestions reflect the reality of half-life of the drugs. There are the objectives of target T and E2 levels as well as testicular health for those that consider that important. However, in the realities of any case, we may run into other hormonal problems with thyroid/iodine, DHEA or cortisol and these need to be addressed if we keep the objective of health and vitality in mind. We also run into non-hormonal complications such as heart disease, high PB and other “diseases of aging” as well as other pathologies and “battle wounds”, and sprinkle in some depression and adverse life events. But overall, the suggested protocol is the best recommendation or starting point for guys whatever the complications might be with the caveat that in some cases, thyroid and/or adrenal problems may need to be addressed before starting TRT. I am not loosing sight of low HG in some guys, we do not see many cases of that here, or at least recognized and treated, low GH may need to be treated before the expected benefits of TRT can be realized. We have guys who “do everything right” and life is not great. Their docs have not been successful or not helpful. We do make collective efforts to see if we can help. In cases where there is degeneration involves, all aspects of pathology might not be resolvable. But overall, we see many who have life restored with T+AI+hCG.

Who is the “T-Nation TRT Protocol” right for?: The stupid answer is for guys who are self actualized who know that there is more than their docs offer or deliver who have thus landed here. In some respects it is easy to land here with a Google search. The quality of the content here creates very high algorithmic page ratings. I work here because I saw that T-Nation was a better community than the other “muscle boards” out there. Guys who are passive do not land here. For those that do land here, there is a lot to learn so they are proactive and educated. They can very quickly and easily understand more than their doctors in many cases and that really is needed in most cases. However, we do not see guys who are proactive who are getting perfect hormone management from their doctors unless they simply are trying to seek more understanding of there treatment I thought that I was trying to get off of my tangent, but not working.

We are here and this forum exists simply because there are needs that are not addressed/managed by the medical community. We are all about what doctors are not doing. -done!

Who is the “T-Nation TRT Protocol” right for?: The stupid answer is for guys who are self actualized who know that there is more than their docs offer or deliver who have thus landed here. In some respects it is easy to land here with a Google search. The quality of the content here creates very high algorithmic page ratings. I work here because I saw that T-Nation was a better community than the other “muscle boards” out there.

Guys who are passive do not land here. For those that do land here, there is a lot to learn so they are proactive and educated. They can very quickly and easily understand more than their doctors in many cases and that really is needed in most cases. However, we do not see guys who are proactive who are getting perfect hormone management from their doctors unless they simply are trying to seek more understanding of there treatment I thought that I was trying to get off of my tangent, but not working.

We are here and this forum exists simply because there are needs that are not addressed/managed by the medical community. We are all about what doctors are not doing. -done!

So since you arent a doctor and you cant rx any meds. You are all over these boards giving medical advice. How does one get the T Nation TRT protocal? Can KS man rx these meds? Do we take this protocal to every doctor until we find one as smart as those on this forum. I think your posts while helpful mislead many.

[quote]seekonk wrote:
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.
[/quote]

All good points. And I would add that low-T is one of the very few diseases that a potential sufferer wants to have. That is, if one is an overweight/out of shape/unhappy man, you would welcome the news that 1) you’re in this state through no fault of your own (ie, you have a legit medical condition), and 2) there’s a ‘magic potion’ that can make it all better (and make you more virile to boot).

The upshot of this is that most of the men who post on this subforum are predisposed to answer the low-T questions in the affirmative. (It’s worth remembering that the men posting here self-select, and that men who are pleased with their physique, fitness and state of mind do not create ‘I think I have Low T’ posts.) I’m not saying that men who post are overtly lying; rather, I’m suggesting that the fact they hope/want to be diagnosed with low-T influences how they respond to low-T questions. IMO, this predisposition should be taken into account by those eager to offer assistance/advice.

"So since you aren,t a doctor and you cant Rx any meds. You are all over these boards giving medical advice. How does one get the T Nation TRT protocol? Can KS man Rx these meds? Do we take this protocol to every doctor until we find one as smart as those on this forum. I think your posts while helpful mislead many. "

The subject drugs simply need to be Rx by a doctor. If one cannot find a doctor who will do this, that does not in any way lessen the value of the suggested protocol. I don’t mislead anyone. Doctors are the problem, not the drugs or the suggested protocol. Can one get by on less that the protocol? Yes, a few do not need anastrozole and with the suggested actions based on E2 lab work, one may get to using no anastrozole. And a few report no testicular shrinkage or 24x7 aching who do not use hCG. Feel free to find what works best for you. There is nothing magic about the protocol and there is nothing magic about doctors who will not do anything more than Rx T.


We see many who come here who are simple minded that fixing their low T will make life perfect. This tunnel vision comes from TRT drug ads and other hype. The T tunnel vision blinds them and most doctors to ignore low T as a symptom that can lead to finding and resolving the root cause and other health issues. So its not just the guys with this issue. Part of the problem is the advancement of low-T as the disease and Rx as the cure. The drug reps don’t want to complicate the message to guys or docs with all of the issues that we come across here that go beyond T delivery. When you look at the content of typical posts here and the stickies, very little is about T delivery issues, and most of these things are not addressed by most of the docs of guys reporting here. Even with docs who never test LH/FSH who Rx only T, we do have the idiots who prescribe and deliver injections every two weeks and some times longer. Why do injectable T products suggesting that injecting twice a week is OK. Because at the end of two weeks, if TT is at 301 [bottom of the ‘normal’ range, one is then ‘normal’ and the objective is obtained, crashing to TT=300 is the medical solution to your problem.

I can’t wait to see the new and improved t-replacement sub-forum.

-I’m so glad you stopped in for feedback concerning your medical condition. You probably hoped that you would find men in similar situations to help and support. Boy were you wrong. We recommend that you look straight into the closest mirror and face the fact that you are a middle aged, fat, unhealthy, unhappy loser. You have no doubt done this to yourself and pray daily for a disease to blame it on. Don’t bother trying to understand your medical problem, I know, with absolute certainty that your doctor, whomever they may be, is most qualified to deal with this. Don’t even consider attempting to locate a more knowledgeable healthcare provider or we will slap another degrading title on you. Please read the new and improved stickies…

Stickies-

-why you are a middle aged, fat, unhealthy, unhappy loser
-protocol for suck starting a shotgun
-doctors are perfect, why you should care
-ophthalmology and trt

Some great dialog here that I have enjoyed reading. I can tell you I didn’t just wake up one day with low T. But one day I decided to face the fact that I didn’t feel right any more. Something was different now and I wanted to know what had changed. My family was the same. They were happy and healthy and achieving great things.

My profession was the same and my success in that profession was improved. I still enjoyed the work. There were no tradgedies or life altering events. I could think of no reason why I wouldn’t feel as energetic, motivated or enthusiastic. I was more willing to sit and less willing to do. Things are more grey and less bright. I am more pessimistic and moody. This change didn’t happen over night. It took years and crept in slowly. It’s not something I noticed and tracked, but realized over time. I believe I started to notice it in 2007.

In 2011 I went to my Dr. We talked about what was going on, no tests were done, and it was depression due to some changes at work. So I was put on anti depressants for nine months. That didn’t work. So I got off those. But things were still not right. So exercise and a clean diet became my focus in 2012 and 2013. I worked hard and stuck to the diet and gains were so slow compared to a 5 or 6 years back. Things just didn’t add up.

In 2013 I started looking into how to boost my performance in the gym. That led me to investigate steroids which led me to learn about TRT. So finally in the last quarter of 2014 I got tested and my T was diagnosed with hypogonadism. I went to an endo because of their specific training. I wanted a guide through this. Someone to partner with and talk to about options. I told him what I had read and what I wanted and why.

The dr disagreed but couldn’t give any reasons why other than HGC and AI was not FDA approved. Some advice I got here suggested I should short circuit that and jump directly to what I want. I decided to stay with the dr and build the trusting relationship I was looking for. He prescribed T and we waited a month for results. I felt good for about 3-5 days between my first and second week of treatment. I now have small balls, mid range T and my E2 has doubled. The dr still refuses to prescribe AI or HCG and can’t express why.

He is confused about dosing and when questioned reverts to “not FDA approved” and a paternal attitude. This man is supposed to be an expert, he is not stewarding my health, he is not guiding me, he is not partnering with me. He is a lazy dr who in my book is an idiot. The advice offered on this forum is not dictated but offered. What I have read here has come true. It makes the most sense I have read and I want to try it to see if it works. Now I have to find the right dr to partner with.
The suggestions that people are looking for an excuse for being fat and unhappy, or a magic pill to return them to their 20s is bunk. It is not the case with me and I wouldn’t presume it on anyone else. I for one have not been mislead but educated in the matter by this sight.