T Nation

Looking at Going on TRT, Advice?


#1

-age: 32
-height: 171cm
-waist 95cm
-weight 79KG
-describe body and facial hair: Cant grow a proper beard, patchy, light chest hair.
-describe where you carry fat: abdomen and lower back/glutes
-health conditions, symptoms [history]: Fatigue in general, a lot of fatigue after exercise, easy to store fat, hard to put on muscle. surgery for a twisted testicle
-Rx and OTC drugs: zinc, probiotics
-lab results with ranges- cant find right now, will find and add later.
-describe diet basically a paleo diet.
-describe training: resistance train when I can (fatigue/injuries), surf occasionally, again when I can.
-testes ache, ever, with a fever? Nope
-how have morning wood and nocturnal erections changed: I dont really get them and havent for a very long time (10 years??)

Okay first Ill start by saying, Ill do my best to give enough info and keep to the point and thanks for any advice anyone can give.

My Dr put me on TRT at the beginning of the year, I was put on due to the symptoms I had my test was low but not low enough to be considered for PBS in Australia (Im from Australia by the way).

I was put on 250mg Test-e, once every 2 weeks. After my first injection I felt great, I hadnt slept so well in a long time, I was able to get up out of bed so much easier, I was able to exercise without sleeping for a day and I was definitely interested in sex again.

After my second injection I started to gain a bit of wait around my waist, feeling bloated etc, Im guessing sides from E?

I had ups and downs, blood pressure increased slightly 146/85, usually 110-120/70, I still felt good training wise etc but wasnt as energetic waking up in the mornings.

I was due to go on holidays so after a discussion with the Dr he thought it best to stop for now and try again once I got back, so we had time to make sure everything was okay.

I stopped cold after about 7 weeks. My hormones appeared to come back to normal once I had gotten back from holidays.

In regards to weight, before starting TRT I was 69kg, while on TRT I went up to 74kg, this is while I was actively trying to lean down. I then went on holidays at that weight, got sick, once I came home my diet went to shit( compared to my normal diet) and I went up to 84kg, I found it very difficult to control my weight and to lose weight at this point, I am now back down to 79kg.

Hopefully that history makes sense.

Here are my questions.

In Australia, from my experience doctors wont prescribe multiple smaller shots per week, they will stick to the 250mg every 2-3 weeks. They also wont prescribe an AI or SERM.

Before I make a decision, I am planning on dropping back down to about 74kg, so that my body fat is a lot less when I start.

I essentially have 3 options.

  1. My GP, will prescribe Test-e 250mg every 2 weeks, will not prescribe an AI or SERM/hcg.

I know after reading the stickies in this forum, this is not ideal.

The injections are given in rediject pens, loaded with 250mg/1ml. I could transfer all of my rediject into a sterile 10ml vile, I would rather not do this as Im not sure how safe it will be regardless of how careful and sterile I try to be.

  1. Another Dr that deals more with TRT, will give 250mg sustanon per week, with weekly injections, will prescribe a SERM if it is needed, no AI, and will prescribe hcg.

I have read sust250, is pretty bad to be on as levels are up and down, also due to the long ester, when coming off it stays in your system longer and makes HPTA/PCT harder.

The doctor recommends coming off once every 12 weeks for a period of time, but this is ultimately up to the patient.

This option is the most expensive, at $600/12 weeks.

  1. I know someone that can supply me with Test-e, I cant guarantee the powder but I know and have seen the stuff work.

I can also access from what I am told is a reliable source for medications, Nolva, arimidex and hcg.

However, this is not through medical channels and I am not sure how I feel about this.

This is the only way I can give myself smaller more frequent injections and have the other medication to go along with it.

Im looking for advice on

is sust250 really that bad to be on as a once a week injection?

would any one here be comfortable getting what they need from non medical sources?

or, should I just not do TRT if I cant get it done through doctors properly?

Im not sure what to do.

Hopefully I have provided enough information.

I appreciate any help/advice I can get.


#2

What are your current labs since returning from holiday? What are your baseline labs with ranges? Please read the stickies.

Now with that said Test E 1ml of 250mg bi weekly is a great TRT dose. It just will likely be needed to be split to weekly or twice weekly injections but 250mg bi-weekly is a reasonable starting dose. As for the need for HcG that is up to you and your fertility concerns and that is something only you and if your married, your spouse can answer. As far as using a SERM in place of an AI, you can use Nolva for that…Its just not as easy to dial in from what I have been reading on here.

As for sustanon yes it does have a longer half life. It is a mixture of different esters taking a rough guess without to the math its weighted halflife is 15-18 days compare to Test E of 7 days. So simply put that would just be a factor for calculating either an extended start date of extension of use of a SERM for PCP aka restart.

No, others may, but personally no way

If you get hormones from or GP or a TRT doctor it is still hormones. Medical need is based on lab results that are not provided with nearly enough detail for anyone here to make an educated opinion.

With the information you currently have a decision would be a guess. Get new labs, read the stickies for what to request. For example a CBC, TT, FT, FSH, TSH, FT3, FT4 etc…

Myself and many members here enjoy helping greatly. But to give the best advise any of us can we need (and so do you!) all the information we can get.


#3

Doctors won’t prescribe an AI and recommend coming off your replacement therapy every 12 weeks, it doesn’t sound like these doctor really understand male hormones at all! Your problem is you went to your GP for testosterone treatment, that’s usually the first mistake people make. You need a doctor that understands male hormones, you would no more take a break from thyroid meds than you would TRT.

A lot of people gain weight (water retention) at first when beginning TRT, it’s not permanent as you body is going through body composition changes and you’re gaining muscle at the same time. Injecting every 2 weeks causes you T and estrogen to fluctuate wildly and leaves you hypogonadal for the latter half of the second week, once a week does the same to a lesser extent. Twice weekly is becoming more commonplace since it keeps you levels super stable eliminating the peaks and valleys.

These forums are a great place to get advice regarding dosing (AI’s) especially when your doctors are resistant do to inexperience. You need to find an endocrinologist that knows male hormones.


#4

Are you using iron fortified salt [iodized]?

Have you had thyroid tests?

Low thyroid function will take away energy and make you fat. See below to eval overall thyroid function via oral body temperatures.

Please read the stickies found here: About the T Replacement Category

  • advice for new guys - need more info about you
  • things that damage your hormones
  • protocol for injections
  • finding a TRT doc

Evaluate your overall thyroid function by checking oral body temperatures as per the thyroid basics sticky. Thyroid hormone fT3 is what gets the job done and it regulates mitochondrial activity, the source of ATP which is the universal currency of cellular energy. This is part of the body’s temperature control loop. This can get messed up if you are iodine deficient. In many countries, you need to be using iodized salt. Other countries add iodine to dairy or bread.

KSman is simply a regular member on this site. Nothing more other than highly active.

I can be a bit abrupt in my replies and recommendations. I have a lot of ground to cover as this forum has become much more active in the last two years. I can’t follow threads that go deep over time. You need to respond to all of my points and requests as soon as possible before you fall off of my radar. The worse problems are guys who ignore issues re thyroid, body temperatures, history of iodized salt. Please do not piss people off saying that lab results are normal, we need lab number and ranges.

The value that you get out of this process and forum depends on your effort and performance. The bulk of your learning is reading/studying the suggested stickies.


#5

Forgive the way I have replied to this post, havent quite figured out how to do it inline like you did.


#6

I also havent met anyone (male) that has been prescribed an AI by a GP or an endo. An endo usually wont help unless T levels are under 8nmol/l and I think it has just recently been changed to 6nmol/l. Theyre the lvels considered by the Australian government to be eligible for PBS (cheaper medication).


#7

Thanks for the reply, I have recently moved and cant find my test results at the moment, but I will keep looking for them and post them up here when I find them.


#8

Best of luck sorting it all out mate, I’ve been through these issues with the docs here in Oz too, ,makes it very tough as I don’t qualify for the PBS cheap meds either as my levels were just over by a bees dick and the doc says they keep moving the goal posts and making it harder to get. My doc writes a private script for the compound cream, at first it was that gel stuff, but I hated it, the shit stinks and seems like there is a bucket of it each day to spread around. The cream in comparison keeps everything very stable, it’s cheap and only needs a small application area.


#9

Thanks man.

This forum and ones like it are a great resource but sometimes I think there is a bit of disconnect on whats optimal Vs whats available.

Are you happy with the cream?

Have you tried injections?


#10

Haven’t tried injections, doc won’t do them, a
Cream seems fine, been on it for a while and it’s cheap too, only 50 bucks for nearly 2 months worth


#11

Finally got my blood test results back, also I checked my temp in the morning, I ranged from 35.8deg C-36.3 deg C.

LH 2 (<9)
FSH 2 (<10)
-TT 17.7nmol (11-40nmol)
-FT 363 pmol (260-740)
-E2 56pmol (55-165)
-Prolactin 172 mIU/L (<500)

Shbg 38nmol (10.0-70.0)
-DHT
-PSA 0.92 (0.2-2.1)

TSH 1.0 (0.3-3.5)mlU/L

ft3 4.2 (2.6-6pmol)

Ft4 11.6 (9-19pmol)

Rt3 261pmol (140-540)

DHEA-S,


#12

Bumping up for a response.

Thanks


#13

Bumping again, hopefully get some advice or I might just start a new thread with all the info