T Nation

Low T, New to TRT

Thank you for taking the time to read this, I am new to the forums and new to TRT. 24 years old and I am a firefighter who is very active and consistently trains in the 4x per week. Despite this for the past 8 months I have suffered from severe day time fatigue, mood swings, foggy brain, and lowered libido, anxiety/depression. Went to the doctor to talk about all of this and look into a prescription for an anti-depressant and to my surprise my doctor wanted to test my testosterone levels and the results were as follows

Total T 380 ng/dL Range (250-827ng/dL)
Free T 54 Pg/ml Range 18-69 Years old (46-224)
E2 Not tested?? Not sure why but I was not educated enough at the time

Protocol 100mg Test C weekly:
I after reading decided to take 100mg up front followed by 50mg 3.5 days later (to reach stable levels more quickly) continuing with 50mg twice weekly every 3.5 days (100mg total)

2.5 weeks in and so far not much improvement. Silght energy increases but libido seems to be the same or not steady all the time. No spontaneous erections through out the day either. Sex right now is not an issue though as I can still achieve a 10/10 erection when getting busy with the Mrs.

My main concerns are the underlying brain fog and mental clarity as well daytime fatigue.

One last note I have noticed from time to time my nipple (right side) is sometimes itchy… not having a baseline E2 is worrisome.

Should I stick with my current protocol of 50mg / 3.5 days or adjust from here?

Thanks to all

It doesn’t matter if you go with 100mg weekly or 50mg twice weekly, Test cypionate half-life 6-8 days steady state in (6 weeks) 40 days. Getting your levels stable and feeling like your old self again, we are talking about completely different time frames.

I usually start feeling the effects of said protocol at 8 weeks, but things can continue to improve for several months. The twice weekly protocol has a better chance of showing good results “if” your pre-TRT estrogen is not already elevated.

If estrogen is elevated as of right now, then you may need more frequent smaller injections.

Thank you for your reply. I do not know what my E2 was as it was not tested for. Should I stick with 2x weekly or an EOD approach? If I do an EOD approach how can I accurately measure the mg in my syringes accounting for wastage?

Do you have any other blood work to share like thyroid values, iron, vitamims,.and etc?

Attached is my bloodwork. I’m a bit confused as to why my SHBG is 30 but free T is so low? 53.3 Pg/ml on a range of 46-224. I read a while back a study of 600 men showed an average free T of 130 pg/ml. How often should I be injecting with a SHBG of 30?

Unfortunately I do not… I am getting a full thyroid panel Which includes * T3 Uptake, T4 (Thyroxine) Total, Free T4Index (T7) and * TSH at the 4 week make of TRT.

It’s low because your total testosterone is also low. Really interested to see your upcoming labs. Try to get free T3 and reverse T3 added.

1ml Easy Touch 27-29 insulin syringes, no wasted medicine. Without estrogen testing nothing is certain, you could have high SHBG, low FT and be a high aromatizer.

@systemlord just posted SHBG is optimal at 30…

@highpull what dosage and frequency do you think I will benefit most from given my optimal SHBG? I agree I am interested to see my Thyroid values. Both my mother and sister take Synthroid for Hypothyroidism… again not sure why my Primary didn’t think of this given my family history and symptoms of low T/Fatigue

Some doctors don’t take things seriously, the brush it off without checking. It also seems like doctors want to prescribe drugs more often and keep the hormonal treatments stuffed in the back of their toolbox.

Big Pharma has a huge influence on what doctors prescribe, statins, SSRI’s and Cialis. When it comes to testosterone or thyroid hormones, “no it can’t be that, your levels are normal” and the discussion is over quickly.

So the doctors prescribes antidepressants for the depression and Cialis for the erectile problems, ok so it’s about the prescription drugs, got it.

It’s funny to me that they will prescribe SSRI’s based on symptoms every day no problem, but most will dismiss the idea of hormonal replacement due to symptoms if you’re inside the normal range. I guess they can’t test serotonin/dopamine so they are OK treating symptoms there but aren’t on hormones. It’s just another oxymoron of the industry.

Another problem is doctors don’t test hormones at baseline before prescribing these hormone damaged drugs to see what normal is at baseline, then you go on the drug which lowers your levels.

Healthcare in this country and in this world is shit when it comes to hormones, only the leading doctors in the fields are competent enough.

Systemlord, withy my SHBG at 30 what frequency do you recommend? Since I do not require a infrequent higher dose to spike T and lower SHBG

It’s hard to tell you what is best without estrogen testing. Your SHBG may very well end up low within the first couple of weeks or months which might change the direction of your protocol because most see a reduction is SHBG after starting TRT.

I’m one of those rare men who see an increase in SHBG on TRT.

Okay I will stay at 50mg E3.5days until further testing at the 4week mark. I will post back here with my thyroid values as well. Thanks again!

The vast majority of men on TRT, whether it be through a TRT specialist or underground, take 150-200mg once a week.

If I am you, I’d start with 150mg once a week.

@systemlord @ncsugrad2002 @highpull

Figured I would update you all. This week has been much worse in terms of libido, brain fog, anxiety, and extreme day time fatigue. I have yet to experience any relief of symptoms since starting TRT 3 weeks ago and if anything I feel worse. At first I felt ok for the first week or so. Could it be that my own natural levels have dropped off and now I don’t have enough T in my system? Maybe my 50mg 2x weekly dosage is too low for me? I am at work as I type this and my brain fog is severe and I am extremely tired like I haven’t slept in days. I have felt this before pre-TRT but that was expected as my levels were so low especially mtyfree T. Can anyone provide insight into what may be happening? I have a feeling the dosage is too low for me.

Your natural testosterone is more than likely shut off and now you’re waiting for the exogenous T to build up in your system. I don’t expect your levels to be sufficiently elevated this early in the game. Three more weeks your levels will be higher, week three is usually the toughest, if dosage is spot on you should start feeling something positive by fifth week.

This could also be the problem, we just don’t know. High estrogen caused me brain fog, fatigue and poor sleep.

You’ll find out in 3 weeks.

I can’t handle this for more 3 weeks and hopefully I wont have too. I understand that this takes time and any change in dosage without labs first is driving blind. However my job performance is suffering as I am a firefighter with very little energy. I am so confused as I thought 50mg 2x weekly was a great starting point. I feel like I am going backwards with libido and energy. Should I just wait this out until I receive my labs in 3 weeks? My upcoming labs will also include full thyroid panel and Sensitive E2.