T Nation

Galgenstrick’s TRT Log

I wanted to share my progress so far. As well as update this log in the future.

33y/o
6’ tall
190 lbs
Probably 25% BF

Here are my pre TRT numbers:

Total T: 477 (264-916)
SHBG: 47.5 (16.5-55.9)
FSH: 3.1 (1.5-12.4)
Estradiol: 15.4 (7.6-42.6)
LH: 4.8 (1.7-4.6)

Before starting, symptoms were declining libido, no morning wood, depression, lethargy, no motivation, suicidal thoughts, anger, irritability.

I started TRT 8 weeks ago. Protocol is Test Cyp. 125mg/week, split E3D. Test only, no AI.

Here are my labs from today:

Total T: 772 (264-916)
SHBG: 38.1 (16.5-55.9)
Estradiol: 23.6 (7.6-42.6)

I was feeling great for the first 6 weeks, depression lifted and so did brain fog. But the last 2 weeks I’m starting to relapse, and my old symptoms are coming back. All except libido. I’m doing pretty good in that department now.

I have Hashimoto’s thyroiditis. I’m taking T4 only and have had pretty good lab results from that. 125mcg levothyroxine.

Here are my current thyroid labs:

TSH: 0.815 (0.45-4.50)
FT3: 3.2 (2.0-4.4)
FT4: 1.44 (0.82-1.77)

I would really like to improve my mood and energy. Suggestions are welcome.

Edit: All labs above were measured at trough, including thyroid.

You probably need a higher dose. The first month or so of TRT you still have natural production. Once that goes away you are left with just the amount you inject. My SHBG is the same as yours and I didn’t get much from TRT until I got to 160+mg/week. The people on 125mg/week that are good at that dose are mostly the ones with really low SHBG. Most guys are on 150-200mg/week and thriving.

Your T3 is lower than mine and I don’t take thyroid meds. My dad has hashimotos and T4 only didn’t do shit. When he switched to Armour it made a world of difference.

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I expect my doc will increase my dose. It’s a TRT clinic and they like to keep patients at the high end of the range. If not, I have enough T to increase it myself. I am also thinking 160 or 180mg is a good next step. I’m also pretty surprised my E2 is so low without an AI.

I’ve tried Armour before, and I couldn’t get my levels right for the life of me, there was too much T3 in it for me, so I kept swinging between hypo and hyper. I’ve thought about adding in T3 only to boost that a little, but I’m not convinced it will have an effect, and I’m not sure where to get it. But I can be persuaded to give it a try.

We really need to see where FT levels are currently. It could by the time your body got used to and adapted to these hormone levels, it was no longer enough. I also noticed some guys go on TRT and do really well for awhile, but start relapsing because of other dysfunction within the body and/or brain.

Mark Gordon touched on this in one of his videos, he said why men feel good temporarily on TRT protocols is you’ve burnt out a 5-alpha reductase enzyme which allows for the conversion of progesterone and allopregnanolone and therefore you would experience mental side effects, allopregnanolone stimulates Gaba.

The one thing I noticed 15 weeks after starting TRT injecting every 3.5 days is I started feeling unwell at certain times of the day, I could feel many fluctuations within a 24 hour period, it turned out I was sensitive to hormonal fluctuations, the more times passed, the more I felt these fluctuations.

Either you have low FT levels or you have other deficiencies/dysfunction and this could be why you have low testosterone in the first place.

Can’t you simply calculate FT from TT and SHBG? Or is direct a better measurement?

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You can but it assumes you bind androgens the same as everyone else. It could be that SHBG hasn’t found a new level yet, it’s only been 8 weeks and I’ve seen it take months for SHBG to find a new level in some men.

These calculators aren’t perfect either.

Both provide better insight because once you understand how you bind androgens, for instance I know my FT levels at certain TT values. I know my FT is midrange when TT is round 400 ng/dL and FT at the top of the ranges when TT is at 500 ng/dL.

I had similar symptoms as you. But the one thing that made a difference before starting trt and while on trt is 2.5-5mg of Cialis daily. It has an antidepressant effect on me, and a couple of friends of mine. It has truly changed my mood, and Im able to notice the difference. So even though this is not a trt protocol, its a detail that could make a difference. More blood flow to the brain can make you feel better, clear minded and calmer. Just my 2 cents.

Have you changed protocol?

I dont have experience with playing with levels, but a fiend of mine who feels awesome at around 1000-1100 got one batch of fake testosterone(he didnt know of course) start to feel bad and he tested his levels - the total t had dropped to around 720

I have not officially changed protocols, but will start 160mg tomorrow unless doc wants me to go higher than that. I should hear from him this coming week.

I don’t think my test is fake, I am going to a legit doctor and receiving it from a legit pharmacy.

Thanks, I will keep this in mind.

Didn’t you mention that your doctor only use the Tru-T online calculator to measure your FT @systemlord?

Edit - link to the thread - Accuracy of Calculated Free Testosterone Formula in Men

That’s correct, my endo tests TT and SHBG to get my FT numbers.

Doc wants to bump me to 140mg/week. Does that sound reasonable with my numbers?

Doesn’t seem crazy but I haven’t read your whole thread. I’d probably do at least 150 if you’re already at 125

Do you guys just back off on your dose before blood test time? Or find a doc that will bump your dose higher?

The latter. If that’s what’s needed. Not everyone needs as much.

Quick update here. I feel like I respond pretty well to dose changes. I don’t feel a whole lot while my body is regulating.

I am quickly finding out that TRT doesn’t do a whole lot for the stress in my life. And I can still amp myself up with negative emotions and spiral down hill fast. I do notice is that my baseline mood and focus is definitely improved which is a big plus.

Libido is at 200%.

Doc prescribed me a compounded thyroid med of T4+T3. but overall he wants to lower my dose to increase my TSH a bit, which I’m not happy about. So I think I’m going to stick with what I’m doing and see if I can get some T3 only to add in as needed. At least that way I can dose T3 twice a day.

Edit: forgot to add that my motivation is still extremely low. The thought of working out pretty much disgusts me. I was really hoping that would improve. I think it’s because I’m so burned out with work. 10-12 hour days makes me want to sleep in as much as possible in the morning, and just want to melt my brain with TV at night.

@galgenstrick
How has the addition of the thyroid meds effected you? Thinking about trying some myself later this year (more to experiment with optimizing thyroid).

I actually haven’t followed up on it. Mainly because I’ve been doing better and better on my T protocol. My Thyroid levels seem to be stable, and I had bad results in the past with Armour thyroid.

I’m a little cautious about going with another full trial run. The compounded meds are pricy out of pocket and getting levels right takes a long time.

Besides that, I’m still making adjustments to my T protocol. Currently on 150mg/week. I would like to see how I respond to 200mg, but I might need to find a new doctor for that.

Got some new bloodwork and things are looking good.

Protocol has been 160mg/week Test-C split into E3D injections

Total T: 874
LH: < 0.2 (1.7 - 8.6)
FSH: 0.2 (1.5-12.4)
Estradiol: 48.1 (7.6 - 42.6)
SHBG: 22.1 (16.5-55.9)

Measured at trough

Seems like my SHBG has gone down considerably.

So far things are doing great. A few things could be better (energy and willpower), and I know I have some improvements to make with diet and exercise. I am going to work on that now that I have some time off of work due to coronavirus. I have a full home gym and really no excuses now.

My biggest problem at the moment is that my doc is pushing anastrozole. He really wants me to take 0.25mg/week, quoting prostrate cancer as an issue with high E2. So I have decided to inject EOD and see how that goes. If he is not happy with the results of that I might need to find a new doctor. I am just not interested in taking am AI yet.

New protocol will be 175mg/week split EOD.

Suggestions and recommendations are welcome as always.

BTW I’ve completely switched to injecting in the delts with a 0.5” insulin syringe, recommended by @dextermorgan. It could be shallow IM, but I don’t care; It works awesome and is completely painless compared to thighs. So big thank you for that advice!

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Ask him for studies proving what he’s saying about estrogen. He either won’t be able to provide them or there will be a pretty big flaw in the study he provides, and people here will be able to point our exactly what that flaw is. Maybe you can be the one that changes his mind.

Optimistic, I know

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