T Nation

Expecting TRT to Work

Hello Folks,

I have been diagnosed with low T one And half year ago, I was prescribed TRT, sustanon 100 once in a month I did not start the treatment anyway considering its sides. I was suffering from all Low T symptoms but after a long Time I finally decided to start the TRT but not as prescribed by doctor I met with Two doctors and one of them prescribed sus 100 once in a month and another one prescribed cernos 1gram once in three months. As I researched on internet and found the perfect dose must be 150 mg once in a week and I started the same first week I had shot of 100 mg after that I have been taking 150 mg every week and tomorrow on Sunday I am going to take my sixth injection but I am very disappointed to note that TRT has not provided any benefit to me my libido is non-existent, no erection always fatigue no motivation. Firstly, I thought I am taking fake sustanon because it hurts too much for five days after injection I don’t know what is the reason behind it (if anyone can help in this regard that would be great) and when I got my T level checked this week it was 7.22 ng/mL and now I think it must not be fake and I have to bear that pain if no remedy was found.

My question is why TRT, even slightly, is not working to me is there anything I can do to get it working?

My blood work

Before TRT.

Test Total = 1.32 ng/ml (2.6 to 10)
E2 = 30.83 pg/ml (10-50)
TSH = 0.022 µIU/mL (0.550 – 4.780)
Free T4 = 1.600 ng/dl (0.800 – 1.800)
Prolactin = 55.67 Ng/mL (2.1 – 17.7)
Hemoglobin = 13.6 g/dl (13-17)
PCV Haematocrit) = 41.0 % (40-50)
LH = 3.35 mIU/ml (1.5 – 9.3)
FSH = 3.66 mIU/ml (1.4 – 18.1)
Glucose fasting blood sugar = 93 mg/dl (74-106)
HBAIC – Glycosylated = 5.0 % (<6)
Estimated Average Glucose = 96.8 mg/dl
Glucose post prandial (PPBS) = 97 mg/dl (<140)
Cholesterol total = 127.0 mg/dl (<200)
Triglycerides = 100 md/dl (<150)
HDL =31 mg/dl (40.0 – 60.0)
LDL = 72.69 mg/dl (<100)
VLDL cholesterol = 20.0 mg/dl
25 Hydroxy Vitamin D = 7.57 ng/ml (30-100)
PSA = 0.589 ng/ml (0.00 – 4.00)
Bilirubin total = 0.70 mg/dl (0.2 – 1.3)
AST / SGOT = 52 IU/L (17-59)
ALT /SGOT = 103 IU/L (21-72)
Alkaline phosphatase = 93 U/L (42 – 98)
Protein total = 7.3 g/dl (6.3 – 8.2)
Albumin = 4.4 g/dl (3.5 – 5.0)
Globulin = 2.9 g/dl (2.0 – 3.5)
A/G ratio = 1.52 (1-2)
GGT = 36 U/L (12-58)

After TRT

Test Total = 7.22 ng/ml (2.6 to 10)

I only got Testosterone checked to verify whether I am injecting fake test or not, as there are good value I think it shows I am using good test now I have to get checked E2, Haematocrit I will update on the same.

I have another question I have High prolactin can it cause low libido and ED? As My doctor says only test is responsible for that.

Any help is greatly appreciated.

You’re way too early in treatment to notice much of anything, it’s going to take several months for you to start feeling significant changes. It took my 6 months to really start feeling it and will likely take a full year to reach 100 percent. It takes time for testosterone to repair all affected tissues in the body, this is why it take so long. A lot of guys immediate results and fail to understand that once you pituitary gland see you’ve got testosterone in your blood it shuts down your natural production, then you must wait for the tissues and your body to adjust. You need SHBG tested, lots of doctors fail to run this important test, it will determine how often you require injections. You probably don’t have access to this test because of where you’re located. I’ve spent a lot of wasted time injecting once weekly, and less than a week ago went to injection EOD and am feeling it already. I always felt things were happening to slow and now I know why weekly and even twice weekly just didn’t work out well enough for me do to my low SHBG.

Elevated prolactin could be behind the cause of your symptoms. You need to run that down. I would also have those liver enzymes re-checked.

Did your dumb shit of a Dr notice your non existent TSH indicating potential hyperthyroidism, elevated ast/alt and prolactin levels? You likely have something more serious going on that’s leading to your low T, which is also acting as the limiting factor, preventing trt from making you feel better. You’re also deficient in vitamin d. Buy vitamin d3 5000 ius and take daily to address that simple deficiency. I don’t know enough about low tsh or elevated prolactin to provide authoritative help in those topics, but they need to be addressed asap.

Your elevated ast/alt indicate liver markers. They can and will be elevated if blood was drawn close to a heavy lifting session. If that’s not the case, your liver may not be functioning properly either.

Thanks systemlord, I missed to mention my SHBG which is 45.3 nmol/L , what do you think my dose frequency should be?

A moderate dose twice weekly should do you well when considering that your SHBG is getting near the top of the ranges. If your SHBG was significantly higher an even larger dose would be needed, some guys can get away with larger weekly doses.