T Nation

Low T - Need Advice for Next Steps


I went to the doctor earlier this week because I have been exhibiting many of the low T symptoms for the last 18 months. My wife was tired of our lackluster (almost zero) sex life, my lack of energy, and lack of drive. She convinced me to “man up” and talk to the doctor.

The doctor ordered some lab work and based on the results (shown below) gave me a prescriptions for a 325 mg iron supplement daily, 50,000 iu Vitamin D 1X per week, and 200 mg Test Cyp 1X per month.

After some brief time reading they called to set up the appointment for me to go in and get a shot. I asked if I could get the shot at least biweekly. The nurse said the doctor does not normally do that, however she would talk to him and get his thoughts.

I am not 100% sure what to do next. I am supposed to have my first injection Monday.

Here is my information:

-age – 36
-height – 5’9"
-waist – 36"
-weight – 176 lbs
-describe body and facial hair – heavy body hair on chest, heavy hair on face
-describe where you carry fat and how changed – I have always been skinny, in last year I have gained fat on stomach and chest

-health conditions, symptoms – in last year diagnosed with colitis (no issues prior)
-Rx and OTC drugs, any hair loss drugs or prostate drugs ever – Lialda (Mesalamine)
-lab results with ranges – See Below
-describe diet – 3 Eggs and fried potatoes for breakfast, no lunch most days, beef, starch and fresh vegetables for dinner. Snacks are usually fruit or leftover dinner. Very little sugar. No gluten.
-describe training – Weights 3x per week until lost energy/motivation. Last 15 months no workout except walking 3 days per week.
-testes ache, ever, with a fever? – never
-how have morning wood and nocturnal erections changed – Have not had any in the last year or so


I’m going to copy and paste a good chunk of another reply I just used because of similarities.

Your testosterone is without question low, but there is typically a cause. Some concerns at the start. You need more labs before injections begin to get a baseline; most importantly e2(estradiol), t4, t3, rt3.

The more fat men carry, usually correlates to higher aromatization/conversion of T (testosterone) to e (estrogen). Estrogen getting too high will negate all effects of T and will make matters worse.

T to e2 can be reduced by reducing T spikes/peaks which is done by more frequent injections of smaller doses of T. Once per month injections is idiotic. Minimum is once per week due to half-life of most T esters. I like injecting EOD or every other day.

If e2 is still high after the above then you either need to reduce T dose or use an aromatase inhibitor. The most common is anastrazole/arimidex. Typical arimidex dose is 1mg/100 mg test.

Are you done having kids? Your testicles will atrophy without hCG.

Also at home you can test your thyroid function by testing your body temps both upon waking before getting out of bed. No talking, drinking before etc. and also around 3 pm as well.

Waking should be 97.4 or above. Afternoon you should hit 98.6. Write these down for a few days for us and your Dr.

Its good that your Dr is willing to treat you with TRT but he doesn’t know what he’s doing from the sound of it. He appears to be operating on antiquated methods and isn’t up to date with modern HRT (hormone replacement therapy) treatments. Youre going to need to educate him, go along on a rollercoaster ride while he learns if he wont listen to you or find a new Dr.

If I were you, I would spend your time and resources finding a Dr who will allow self injection, is open to use an AI if your E2 becomes too high and also hCG to preserve the function and form of your testes.

You can start by using google maps, identifying pharmacies and compounding pharmacies, call them and ask them to suggest a Dr that prescribes T, arimidex/anastrazole and hCG.

When/if you get to the point of self injection, you can use smaller syringes and inject subcutaneously, no need for intramuscular to avoid scar tissue on your muscles over the years.

Report back and good luck.


Your CBC strongly suggests a GI bleed and that your condition is not been managed well.
Have you had an occult blood test?

Insulin control:
Get A1C tested

Find a new doc. You need to inject twice a week.

In the 2nd post of the 1st forum topic, follow these links:

  • advice for new guys
  • things that damage your hormones
  • protocol for injections
  • finding a TRT doc

Where are you located? Someone might suggest a doc/clinic.

Do you get colder easily now?
Your wife feels cold easier now?
Have/had you been using heart burn pills/meds?
Have you always used iodized salt?

Your condition can adversely affect absorption of nutrients and minerals.
Check overall thyroid function by checking oral body temperatures as per the thyroid basics link.

LH/FSH - must be done before any TRT injections
prolactin important
AM cortisol [ 1t 8AM please]

Your doc is in way over his head. He is about to start TRT without any diagnosis. Low T is the symptom, not the disease.