T Nation

Just Started TRT, Concerned and Confused

Hello everyone.

I am a 27-year-old male, 5’7" at 189 lbs.
Lots of thick, dark, fast-growing facial hair.
Plenty of hair on my head. Plenty of hair on my body.
Tons of fat in the belly (sides and front) and chest area. A relatively small amount in cheeks, neck, butt, and thighs, and almost no visible fat anywhere else. My biceps, triceps, forearms, shoulders, thighs, and calves are hard as a rock when I flex.
No idea what my bf % is, or what my waistline is.

I drink maybe once every few months, if that, in case that is relevant.

Doctor only tested for total testosterone, which was at 218 out of 280-900 ng/dL.

I have experienced depression, anxiety, insomnia, fatigue, lack of sexual interest, adult ADHD-PI, for many years.
ADHD meds have only been destructive, so I do not take them.
Benzos helped anxiety and sleep but destroyed memory, worsened fatigue, etc.
SSRIs helped anxiety and depression somewhat, but completely destroyed all interest in sex.

Ditched my psychiatrist about a year ago because he only seemed to make everything worse.
Went to GP a couple weeks ago, and he wanted to test my testosterone levels, which seemed out of left field to me.

Test results came back with the results reported above (218 ng/Dl out of 280-900 ng/dL), and he immediately wanted to put me on TRT. He pushed hard for injections. I obliged, but insurance would not cover it. Now I am on 5g/day Androgel 1%, and this is day 3. I have considered going back and asking for more hormone tests, but I am tight on cash and do not want to keep paying copays etc if it is unnecessary.

I have felt some very mild improvements in mood and energy levels, but not much else.
I know TRT can take a while to be effective, so I am not tripping on that.

What I am tripping on is the speed and ease with which my doctor’s conclusion was reached. No free test measurements. No other hormone measurements.
Just total T, and I have a prescription. Is that normal? Adviseable? Safe?

I used to lift quite a bit. Went through a 2-year stint of 5x/wk splits. Body looked alright, but my lifts never impressed me even after 2 years. I could not even put up 170 lbs on the bench, which at that time was the only lift I truly cared about (though I did many more).

Late last year I got back into it with full body workouts similar to SS. After 6 months of 3x weekly full body progressive workouts, I could only complete 3x5 squats at 185 lbs, 1x5 deadlifts at 215 lbs, 3x5 benches at 165 lbs, 3x5 overhead press at 115 lbs. This is with daily creatine, beta alanine, and plenty of protein shakes and protein-rich meals.

Progress ground to a halt, and the pain/time/fatigue hardly seemed worth zero gains and maintaining such a low strength level. Most men I know who barely worked out at all had similar, or in some cases, better performance. So I dropped it a few months back.

Is all of this pretty typical of low T? Am I putting myself at unnecessary risk by accepting TRT based on total T alone?
Will 5g/day do anything other than shut down endogenous production?

Do you think it would be enough to help me get past the limits I previously mentioned in the gym?
I loved working out but putting in so much effort only to be at what seemed to be a near-baseline level for most men really put me off.

I would also appreciate any general advice. At this point, I am completely lost as to whether or not this is a good idea, what benefits I can expect, what drawbacks I can expect, etc. There is a lot of info on the web, but a lot of it is very conflicting.

If TRT is the right choice, are there any ways to get around non-coverage for injections of Test C, which is what my doctor really wants me on anyway? The pharmacy’s price was completely outrageous. To pay it with the dosing schedule my doctor wanted would be much more expensive than making payments on a brand new car. Not an option…

I pay $100 with no insurance from popular chain drug store for a 10ml vial of T cyp 200mg/ml - I take 100mg weekly so the vial lasts 20 weeks - I do self injects 2x weekly - try to use one of the generic rx cards you find laying around or on net .

I apologize in advance if this is poor etiquette, but do you actually buy in South Africa?
Wondering what the chances are that I could find a similar deal in the USA.
The popular chain drug store I went to wanted substantially more money for substantially less testosterone.

Do not start TRT, you need a diagnosis. Low T is a symptom and you do not know the cause.

You must test LH/FSH before TRT, too later later.

Waist? What size are your blue jeans?

This is standard advice maintained here:

There is a huge amount of knowledge in the stickies. Please study these. Start with the advice for new guys sticky.

There is a lot to read there, so read carefully. There are suggestions for things that are root causes of low testosterone [T]. Low T is a symptom, not a root cause itself. But low T itself is a root cause of many of the symptoms one experiences. Note that other things cause the same spectrum of symptoms, so do not have T tunnel vision. Many docs are guilty of that and they only treat the symptom [low T] and do not attempt to find the real problem. If you go to a clinic that specializes in low T, you will get T tunnel vision for sure.

Post info about yourself as suggested in the above sticky. We need labs, almost all of your labs, not just hormones. We also need the lab ranges.

We see a very high number of thyroid issues in the population of guys that show up here. So there is a strong focus on that. Most people are iodine deficient to some degree. Your history of iodine intake from iodized salt and vitamins that list iodine is important. If you become iodine deficient, the RDA [recommended daily allowance] is inadequate for recovery of iodine stores. Please see the thyroid basics sticky for more information.

You do not want to suffer from subclinical hypothyroidism or get Rx thyroid meds to treat iodine deficiency.

If you are injecting T or contemplating that, read the protocol for injections sticky.

There are stickies for finding a TRT doc, estradiol [E2] and lab work.

Do not place your history or treatment details in the stickies! That belongs in your thread. Keep all of your posts in your thread so we can have a clear picture of your situation and needs.

Thank you for the thorough and direct reply.

I will scour the web for info from doctor-friendly sites, print it out, and take it back to my doctor. I have been on the gel for 3 days, but I will stop applying it immediately. I have been through the ringer trying to get these issues worked out, and testosterone seemed like such an easy fix that I wanted to believe I could just jump right in.

But permanent changes to my body are not to be taken lightly, and I need to just back off and handle this correctly. I have lived with these problems for over a decade… what’s another month or two? Thank you for confirming my suspicions with honest information.

And FYI, my temp has always been normal, which is quite unfortunate on days when I really want an excuse to stay home from work.
Below normal temps extremely rare for me even in the mornings, and I do not run hot unless I am sick.

My pants are 38-40, but many have ripped due to weight gain over the past 3 years. But I have lost some weight since then and have not had any new rips. So I would guess that 38-40 is still a relatively good number.

I had general bloodwork done about a year ago, and the only thing the doctors found was something indicating that I do not drink enough water, although at the time, water was pretty much all I drank, and more than pretty much anyone else I knew. I will see if I still have it filed, for specifics.

I’ll look into iodine. I started using sea salt about 5 years ago. I was aware of the missing iodine and even strongly encouraged everyone in my home to take multivitamins specifically to make up for it, but I never considered that the RDA might not be enough.

Thanks again. I will check in when I know more.

When I signed up on this forum I accidently hit S Africa - I am actually in Wash DC