T Nation

First Few Months on TRT with Minimal Results

Age 37
Weight 210
Height 5’-11"
Minimal body hair to begin with
A few extra pounds around waistline
Only supplements include - fish oil, multi vitamins, creatine

I have been active my entire life (sports, outdoors, ranching, hunting, weight training etc). I have lifted weights on/off since I was 12 because I am naturally thin and dabbled in AAS when I was younger and dumber using poor bro science. Since then I have ate relatively clean and stayed as active as possible with an office job and family. Last year I started to notice that I was gaining FAT and losing my strength even though I was still working out. I started to eel depressed and lost all of my energy to workout. It was pathetic! Google became my friend and I started researching WTF was happening and how could I fix it. Quickly I came across TRT discussions and started researching. With a family I don’t want to jeopardize my health but I want to continue living an active lifestyle and being able to workout. I read Jay Cambells TRT bible and have been trolling around on various forums ever since. I ended up having my primary dr run basic bloodwork to see where my testosterone levels were and if TRT was a good option for me. This is what the initial results were:

Pre TRT bloodwork 4/4/18
Testosterone 291 ng/dL
Total cholesterol 149 mg/dL
Triglyceride 99mg/dL
HDL 48 mg/dL
LDL Calculated 81 mg/dL
VLDL Calculated 20 mg/dL
BUN 17 mg/dL
Creatinine 1.13 mg/dL
TSH 1.77 uIU/mL
WBC 3.5 K/uL
RBC 4.93 M/uL
Hemoglobin 15.1 g/dL
Hematocrit 43.9%
Platelet Count 159 K/uL

I talked it over with my wife and thought about if for a few months. Obviously my testosterone was low so I asked to try a shot and see if it helped me. My dr didn’t know much in the realm of TRT so he offered to give me a shot of Test C (200mg). I felt amazing for the first week then it started to wear off. I went back and explained my situation and he offered to give me another shot a week later. After a few rounds of bi-weekly injections I asked if I could inject myself at home because after my research I knew that 2x week was a much better routine. He was hesitant at first but ended up agreeing and since February I have been self injecting subQ 50mg 2x week (Monday and Thursday) for a total of 100mg a week. I have been feeling better but honestly not quite enough to justify sticking myself forever so I decided to have a follow up blood panel ran using discoutnedlabs. These results are taken before my injection on injection day which should be my trough. Here are my new results:

Testosterone (free+total) 370.6 ng/dL
Free testosterone direct 11.0 pg/mL
Estradiol, sensitive 19.4 pg/mL
SHBG 17.5 nmol/L
Total cholesterol 160
Triglycerides 70
HDL 45
LDL Calc 101
VLDL 14
WBC 4.3
RBC 5.19
Hemoglobin 16.0
Hematocrit 47.9
Platelets 182
BUN 19
Creatinine 1.06

Honestly I thought my testosterone would be higher and I am getting concerned about the elevated LDL levels. Running a small cattle ranch I have an abundance of red meat but it is home grown with no hormones or antibiotics. I probably have 1-2 meals a day consisting of red meat and the other 2-3 meals involve chicken or turkey. For the past month I have been following the metabolic blowtorch diet using IF 2-3 days per week and I workout the other 3-4 days. Besides the small change in energy levels I have noticed a small change (decrease) in testes size and a small decrease in libido plus weaker erections. These negatives are outweighing the small increase in energy so far.

There are no good doctors in my area that specialize in TRT and like most other people I feel like I am my own Guinea pig with minimal direction. Based on my low testosterone levels still I am considering locating a source online and increasing my dosage but I would like to hear from people with more experience if there is something in my labs that could explain the low test levels still. If I start shopping online I would certainly add HCG and keep some nolva on hand but if possible I would like to keep everything lab grade and legit to avoid injecting myself with garbage.

I am hoping that someone with experience or knowledge can help steer me in the right direction and explain why my levels seem low still. Perhaps with enough knowledge I can persuade my dr to reevaluate my dose. Thanks in advance for your help.

Go to 75mg twice a week.

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Yes what @highpull said but try to get it from your doctor. Show him these blood results that you ran (though HE probably should have ordered some after 6 weeks) and ask for a dosage increase.

Start doing IM instead of subQ, for some it seems like SubQ just doesn’t give the same TT as IM. I’ve seen other experience this, and I did too.

A 1/2 28ga syringe into the thigh works great.

i was low as well and the doc put me on HCG 1000 week and test 120 week (cyp) … but i dropped the HCG after week 2 because the sides were too much. However - my levels have spiked all the way to off the charts in this short time. I went from a test level of 122 to 1500+ (the test cant read it) and my E went from 3 to 66 (high) … So either I am an overresponder or the HCG kickstarted my natural test + the exogenous got my levels back up. Maybe you could look into this protocol? Just a thought …

Follow Hugh pulls suggestion.

You can find a doc that will prescribe trt with much less of an issue but you are lucky to of started. You Must Be a good sales man

:slight_smile:

Most telemedicine clinics will ship meds to you. You can also fly out to see others and they will prescribe you after a one time face to face consult. For me I had to fly to Chattanooga and was able to return back to houston with a 6 month supply.

We are all so Different and everyone likes a different levels. Some higher and others mid range. When you find the right dose and feel well consistently take a new boood Test and that is your level and dose.

Thanks for the replies. Is there an ideal trough test level? Obviously everyone is different and one person may feel great at 500 while another person may need 900 to feel the same way but what levels should i expect with a 75mg 2x a week? Also, from everything i have read subQ injection is more beneficial so how could an IM shot improve the resulting levels of test i am seeing? Lastly, how concerned should i be with my LDL levels?

Most on here would like to see free test more than total. If you have total of 700 but only have free in the bottom half of the range, your 700 number doesn’t mean much. Most seem to think you should be in the upper half of the range of free T which I believe is 20-25pg/ml.

To clarify I don’t mean your free t number higher than your total, but that your free T means more.

Subq and IM: try one and the other to see what works best. Your estrogen is low and that’s awesome. Usually subq is more potent and slower consistent release. Some Prefer IM because of a faster release into the blood stream, but you should be doing eod or e3d. Nothing wrong with trying one or the other to see what suits you the best.

You are looking at total Test. Think free t levels. 20+ for most men . Do not be scared to go 25 or 28. Everyone is different.

Current doc might not dose you to top Of ranges. I would find a trt doc before this happens.
Not guaranteed but be ready for it.

I was doing IM for the first 4-6 weeks at the doctors office and thats when i really started to notice the decline in well-being likely due to the extended period between injections. That decrease in how i felt was one of the main reasons i asked to do it at home and modify the routine to 2x a week. Although i feel better now with 2x a week compared to the every two weeks, i am still a long way from where i felt after the first injection. Like i said before there arent many options for a knowledgeable trt dr in my area. Most of the endos around me are female and i doubt they will have in depth knowledge that a good trt dr would have. Thats why i am using my PCP because i thought that he would understand better being male but so far i was wrong. I am going to schedule a follow up with him and see what he is willing to do but i am worried that he will be upset that i modified his piss poor injection routine. Is it worth even telling him that i modified his routine?

Don’t even mess with Sub Q If you are getting too low total test. I did sub q for so long and i felt the same way. Just bleh.
Soon as I switched to IM I feel it so much more clearly.

There is no question what works better for me.

Your LDL are fine, your total cholesterol is nothing, but your HDL’s are low. You need some Omega 3’s in your diet. And up your dose, 75 is probably a good number to try.

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OP is like me, he needs injections minimum EOD or everyday do to low SHBG. SHBG binds androgens and when low your kidneys can excrete testosterone very quickly and that’s why your levels are low at trough injecting twice weekly.

I didn’t do very well on sub Q injections and testosterone is lower, testosterone levels are higher on IM converts less testosterone to estrogen for me.

I only need a Total T of 500 to have Free T high normal or higher.

Like we said above you can find a telemedicine clinic in one phone call and stop wasting your time with a pcp who cannot help you dial in the trt.

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Well i had my follow appointment and got my pcp to increase my dose to 150mg/wk. i have to find a new doctor because he was upset when i told him i starting injecting 2x/wk and he questioned the validity of my labcorp results since he didn’t authorize them. This is so frustrating dealing with a doctor who doesn’t know his shit. I am unfamiliar with telemedicine clinics. How do they work and how do you know if you get a doctor knowledgable in trt?

Good job! You got the test. Not don’t worry to much about Dr.
Inject on your schedule. Do the 75 mg 2x a week. After a couple months run
CBC(or just hct and hgb) total and free t, estradiol. Your lipid profile should improve over time with your hormones in a better range.

Over the phone with the doctor and they ship your meds and do labs for you. It’s better than what you hve. Cheap to.

Cal defy unless in Cali you can call my doc.

Your doctor is upset because you didn’t trust him and with good reason, sounds like a Mr. know it all.

Defy Medical requests a physical before they will schedule a consultation, then the consultation occurs, medicine is prescribed and filled at Empower pharmacy and shipped to you. Cost is $1200-$2000 years pay as you go, not all up front.

Dr. Saya is the medical director, Dr. Calkins is the right hand man and Mike the PA can run circles around ordinary so called TRT specialists.

I was looking at defy but their costs seem high although their price breakdown included Ai and hcg. Right now my insurance covers most my costs, except for the headache of dealing with my pcp. The test is fairly cheap reasonable also, about $12 for 2ml of 250mg test c. I still need to research more but from what i started reading, you have to buy the meds from defy. I will probably call them and get a clearer idea of total costs and see what if anything my insurance would still cover. I am most curious to know if you have go through all the initial checkups and such if you are already on trt.

If you had labs done within the last 90 days and your consultation is within that window, you could skip a lot of testing and save money.

Don’t start out on HCG, start TRT in isolation, dial-in and add the other stuff later if you wish. This way you’ll have less moving parts to analyze.