T Nation

My Struggle, My Goals, and My Progress on TRT

I began TRT about 3 weeks ago, on my 35th birthday.
My son was born 4 days later, so my life has changed in many ways. I’m here for guidance and support.

Thank you, THANK YOU for reading my case, and thanks to everyone who wants to come on this journey with me.

SOME QUICK BACKGROUND ON ME:

I’m small. My username is meant to be funny. I have always been short and skinny.

10 years ago I began lifting weights. Heavy weights, low reps, long rest periods.
I changed my diet to a very clean, high-calorie 40-40-30 diet.
Egg whites, oatmeal, chicken breasts, spinach, brown rice. You know.
Since then I’ve grown - very slowly - from 129 pounds to 145.
More about that later.

WHY I’M ON TESTOSTERONE THERAPY:

I have a great doctor - she’s very open, and knowledgeable about TRT.

Unlike many people here, I didn’t approach my doctor about starting TRT - she actually suggested to me.

I went to her in February for a comprehensive blood workup.
My wife and I wanted to have a baby, and I wanted to get a clear picture of my health.
(By the way - we did get pregnant. My son was born 20 days ago.)

When my labs came back, my doc said I had Low T, and she suggested therapy, which sounded scary to me.

I said I’d think about it.

All summer I paid attention to any signs or symptoms that may have been due to Low T.

Fast-forward a few months. My wife was pregnant, our sex life all but disappeared.
In the mirror, my body started looking… bad. No muscle tone, just unattractive.
I felt depressed and bitter, my libido was gone. I was socially withdrawn.

What finally motivated me to go ahead with TRT was a hydrostatic body fat test I did last month.
It revealed my body fat as 20.8 percent.
For a guy as small as me, that means I’m basically bones and fat.

Along with my body fat results, I got a chart.
The chart told me what my body fat percentage would be, if I lost 5 pounds of fat, 10 pounds, etc.

The chart said if I lost 16 pounds of fat, I would weigh 129 and be 11% bodyfat.
That’s exactly where I was 10 years ago.
10 years ago I weighed 129 and was 11% bodyfat.

This means I’ve been working out, eating right for 10 years and I’ve gained no muscle at all.
Or, I’ve lost all the muscle I may have once gained.
This was a shocking revelation to me, and it made me feel bitter and hopeless.

MY CURRENT REGIMEN

I called my doctor and made the appointment to begin TRT.
My doctor basically prescribed the exact regimen recommended here by KSMan (Test Cyp, AI, HCG), with a few differences.

She prescribed 180mg/mL Testosterone Cypionate (it looks like a lot of guys here are on 200mg/mL).
I inject a small amount (.05mL) IM into my quads DAILY.
My doctor says small daily injections eliminate peaks and valleys, and more closely mimic nature’s secretions.
I use a little 30-unit syringe with a 1/2 inch 29g needle.

Along with the Test Cyp, I’m taking 0.25mg of Anastrozole (Arimidex) daily.
This seems to be a higher dose than many guys here.

Twice a week I also inject HCG subQ into my belly fat. I forget the dosage - I’ll come back and update.

LABS

From my original doctor visit in Feb:

Testosterone, Serum 486 ng/dL range: 348-1107

Free Testosterone 8.2 pg/mL range: 8.7-25.1

Estradiol 20 pg/mL range: 7.6-42.6

Additional labs taken before beginning TRT:

Pregnenolone, MS 24 ng/dL

Dihydrotestosterone 29 ng/dL range: not given, although the report says “Low”

DHEA-Sulfate 202.4 ug/dL range: 160.0-449.0

LH 2.3 mIU/mL range: 1.7-8.6

FSH, Serum 3.5 mIU/mL range: 1.5-12.4

PSA 0.5 ng/mL range: 0.0-4.0

My labs also revealed low HDL-2 (the good cholesterol) and low Vitamin D3. I’m now supplementing both daily.

My doctor has recently recommended that I add DHEA and Pregnenolone to my TRT regimen, but I have yet to discuss this with her.

REQUESTED CASE INFO:

Age: 35

Height: 5 feet, 6.5 inches

Waist: 32 inches

Facial hair: I can grow a full beard. Thick, coarse hair.

Body hair: I have fine, sparsely placed body hair.
A small amount on my upper chest, a lot of hair on my lower legs, normal pubic hair, very little hair elsewhere.

Where I carry fat:
Apparently everywhere, if you look at that hydrostatic test. Distributed fairly evenly.
I have more fat in the waist and belly.

How this has changed:
I used to just carry fat in my waist, mostly in the lower back. The belly fat is new.

Health history:

I have had, since childhood, a condition which I believe is Levator Ani Syndrome.
Look it up if you wish - it’s basically a chronic painful muscle spasm of the pelvic floor, occurring every 6 weeks or so.
It basically feels like having a painfully full colon.

This summer I began to notice my nails becoming weak and flexible.
I take Biotin and use a nail cream, and this is now not a problem.
My hair is thicker now as well, from the Biotin.

I have had asthma since childhood - not a single asthma attack since beginning TRT.

I have allergies to dust and pet dander. I have pets. I take Claritin daily.

Testosterone related symptoms:

In March (after these labs) I experienced a constant ache in my right testicle for about 2 weeks.

As I mentioned, I’ve been trying to pack on muscle mass for 10 years without success.
I’ve tried many workouts, many supplements and many high-calorie diets over the years.

I noticed, this summer, a MAJOR decrease in the volume of my semen when I ejaculate.

I’ve had lethargy, low libido, little or no drive. I’ve been socially withdrawn and unmotivated at work.

I also have been getting super annoyed by just about any human interaction.
(This is already gone since I’ve started TRT. I’m more outgoing and I’m enjoying people.)

Rx and OTC drugs:
Claritin daily.
Q-Var, an inhaled daily asthma prevention drug, I have stopped using since TRT.
Vitamin D3 5000 iU daily
Biotin, daily
A generic Costco multi-vitamin, daily.
Omega-3 capsules, 1 daily.

Hair loss drugs:
I’ve been using Minoxidil 5% (Costco brand), 1 mL daily, on my scalp for one year.
I have a thinning hairline and crown.
I use the Minoxidil MUCH less often now because I don’t want to expose the baby to it.

Diet:
Breakfast / lunch / snacks : very clean, no junk, no white flour, no sugar, with an occasional cheat.
Dinner: My wife cooks, I eat what she makes without complaint. Sometimes healthy, sometimes not.
No desserts.
Protein shakes, multiple times daily. Optimum 100% Whey Gold Standard.

Training:
2X or 3X weekly, in the mornings. 5-10 min cardio warmup, followed by 45-60 mins of lifting.
Moderate to heavy weight. 8-12 rep range. 2 minute rests between sets.
I supplement with BSN NO-Xplode before workouts for energy and focus.

Testes ache ever: Yes, in March for about 2 weeks.

Morning wood: soft, inconsistent.

Soâ?¦ here’s where I am.

3 weeks on TRT. My personality has improved. I’m more friendly, less withdrawn and less irritable.

I have a more positive outlook - maybe just because I feel like I’m taking control of my body.

Now, about my goals.

I’ve told people that this is about my health, and it is.
I want to feel better, and know that I’m more healthy.

My real, underlying motivation, though, I actually feel a little guilty about. It’s vanity.

I want muscles. I want to look great with my shirt off.
I’ve never had that - I’ve always wanted it.
I’ve looked like the before photo for 10 straight years, with no after in sight.

I’ve felt inadequate my entire life.
Always being smaller, being shorter, being seen and treated as less than a man.
Having the body and the voice of a little boy.

I’m losing my hair now. I have no more muscle tone.
People once saw a little boy, now they see a little man. Weak. Too thin, but with too much fat.

I want to look and feel like a man.
I want to be a superhero to my son, and an Adonis to my wife.
I want to be strong, be sexy, and to truly know myself and my capabilities.
That’s my goal.

Thank you for coming with me on this journey.

  • Nate

Very honest and open post. I am fairly new to TRT as well and will keep an eye on your progress. Best of luck and thank you for posting.

Hey Nate, I really enjoyed reading your story. Your writing style is easy to read,
and I like the way you pepper humor through it. You should be a writer imho.
I think your story is somewhat typical of the avg guy that gets on HRT.

I know my story goes somewhat along the same lines, although, I am an ectomorph (6’3" now 230 but was a skinny 165-185 for years and years) that just always thought I was a “hard gainer.” Tried every diet and training method that I read, or was coached into all with so so and slow to no results. Always
carried a little extra bodyfat, always felt a tad socially withdrawn and awkward (except for those
few years when I was in the rave scene hahah).

Fast forward to 42, married 2 awesome kids and just grumpy all the time, tired, no zest for life.
Feeling like, is this it ? So, I went to my uro for testing and came back low T 301 and a month later 313.
The practitioner that did the consultation was awesome, took his time, explained ins and outs, As
we discussed my history it became apparent that I always had low t.

Anyway, being on, and tuned is the best I have felt pretty much ever, but I wanted to touch on something you
said about vanity. I wanted to feel better than I did, and I do, but in the back of my mind were
the same thoughts you had. I wanted to be more muscular, more virile, I wanted to be the person that
was noticed when he took his shirt off. I wanted these things for me though, not to impress anyone, but to
just make myself feel better about myself for once, to feel “whole” if you will. I don’t really see it
any different than someone that has a nose job, breast augmentation or other procedure that finally gives someone the chance to feel complete or normal. I think that most guys on HRT have these same thoughts.
I’ve watched many a poster here on T-Nation go from the HRT dose of 100mg of test per week to a blast and cruise cycle of 300-500mg per week for 6-8 weeks, and then back down to the 100mg dose.

Here is a thread I read a few days back that I think you will enjoy along these lines.

Enjoy the ride.

Congratulations on your son! Awesome man! And from the sound of it, you will be an excellent father!

You are not vain, you just want to feel good. When you feel like crap, you think about many things that will make you feel better - especially things that you may have dealt with all your life - like being a smaller guy. And when you look good you feel good too! But the great thing about being a dad is that you CAN be a superhero and it does not matter what you look like. I have four kids - I am their superhero. When I am in shape, I may look the part. But even when I am out of shape (and I am bald), I always play the part. Love your son and be an involved caring dad. Be strict and have high expectations, but love him greatly and you will be his superhero (I think I am changing the name of this site to E-Nation - sorry!).

But back to your low T - feeling better will help you do all of those things better. It is what brought me here. Did you do any research in to what is causing your low T? Your TT and FT are low, but their not in the pits (but they may be very low for you). Your FSH and LH are pretty low. I had low T tests (375, same range as you) for several years. I finally started TRT and then after learning a lot more about it backed off after about 6-8 weeks of injections. I am focusing now on the cause before I commit to TRT - once your are all in - you are all in!. I was never as low T as some of the guys on here and my symptoms were never as bad. And plus - its amazing what a pregnant wife can do to her husband’s body!

I am in the middle of a SERM restart - a kickstart to my pituitary to produce better amounts of LH and FSH. After a month my LH and FSH are up and my T and FT are through the roof! I feel great and am lifting great. After I finish I will see if my body will maintain better production of all hormones involved.

That was some scrambled info, but here is my point - you are young and if you have not aggressively investigated the cause of your low T, I would back off the T since it has only been about three weeks. Try and find the cause of your low T. Try a SERM restart before you commit to TRT. And if all else fails, you have a great doc if you go forward with TRT.

–And to change the subject slightly - read the rest of this website outside of the forums. You will find awesome info on training - AWESOME INFO! Great articles, great videos, great training plans, etc. This will also help you meet your goals!


Like PKNY said- I enjoyed reading your post. Everyone has had great responses thus far too.

I felt like we had a lot in common. - I’m 5’10 and always been a scronny 150 - till 2 years ago. I gained 30 lbs in year. I turned into a skinny fat guy. My patience with my wife and everything else went away.

My lack of motivation was the hardest thing to deal with. I was used to always working 10 hour days and then getting things done around the house after work. But suddenly I couldn’t focus or really get into anything. It took almost a year to get all of the RXs I needed. I finally am starting to feel decent.

You are in a good spot because youre doc sounds great. She is willing to prescibe what is needed and sounds like she knows how to best treat low t issues.
Question: why did she put you on DHEA? (My new doc just added that to my regiment and I dont know why.)

Like beerman said your LH is low. That is an indication of secondary hypogonadism. (meaning the problem is with your HPA axis, not your testicles)
Im in the same boat. Let us know if you have questions about that. There are so many knowledgable people here.

Im excited for you to be a dad. As you know, being a dad is the greatest thing in the world! It gives new meaning to everything you do.

My wife and I had difficulties getting a healthy baby here and then 6 months ago she delivered a studly little man. That experience has given me a greater appreciation for life and being fertile. (hope I still am)

The thing Im realizing is that no matter how bad I want to be his hero, he is my hero and doesnt even try.

Here is a photo of my hero and his sidekick.

Good luck. Keep us updated.

Joe

If he could grow hair he would look like Daniel Craig.

Hi guys,

I’d just like to say thanks so much for reading and for your great responses.

I saw my doctor today and I’m doing another hydrostatic body fat test tomorrow.
I had blood drawn on Monday, which was the 3-week mark.

Beerman, thanks for your kind words, I took them to heart.
I asked my doctor about the LH/FSH levels.
She said that the variation is so great in these tests that she wouldn’t advise any treatment based on them.
She also said higher muscle mass places demand on the pituitary to stimulate Testosterone production.
Since I have low muscle mass, there’s no demand and so my LH and FSH levels will be low.
Vicious circle - no muscles, no testosterone, no muscles.
We’re going to test LH/FSH again in 3 months. In the meantime I’m comfortable proceeding with TRT.
My doc says I’m responding to it extraordinarily well.

I’ll share my 3-week lab results tomorrow after my bodyfat test - I hope you’ll find them as interesting as I do.

Nate

Well, bad news today - I couldn’t get my body fat test (I have this done at a mobile testing lab, and the truck broke down).

So here’s some good news. Yesterday my doctor gave me my testosterone and estradiol levels.

Testosterone: 1200 ng/dL
Above range! My doctor said my levels were “super-physiological”.

Estradiol: undetectable levels.
Zero is probably too low for an E2 level.
My doctor is backing me off of the Anastrozole, to 0.25mg EOD.

So here I am, suddenly with Hulk Hogan levels of T and no estrogen in sight.

How do I feel?

My appetite is crazy. I’m so hungry. On workout days I get so hungry, I get the shakes.

I am horny. A lot. Remember my wife just had a baby, so we haven’t gotten down in quite a while.
You know those tv ads that say “Ask your doctor if you are healthy enough for sexual activity”?
My wife’s doctor said “no”. She’s still healing from the C-section.

I want to work out. Just about any time I’m awake, and not exhausted, I want to be in the gym.

I have some acne - something I haven’t had in years.

I think overall these are good signs, even the acne. I can buy some nice face wash and knock that right out.

I am anxious to see physical results, and I’m hitting the gym tomorrow.

1 Like

You are probably an anastrozole over-responder. You can search for that here. If so, you will need 1/4th of the expected dose which for your T levels would be 1-1.25mg/week, so a forth of that. A liquid product is really the best, you can break tablets for such small doses.

LH/FSH will be zero with TRT. So testing is a waste of time and money. Only exception is a one time test. If FSH is not near zero, that an be a result of a FSH producing testicular cancer.

You can inject EOD and get the same benefits, and take anastrozole at the same time. If you start hCG, you would do that at the same time as well.

Note that E2=0 can also be the result of lab errors, seen quite often here with labcorp. With low E2 one feels terrible and depressed, libido gone etc. So your labs and how you feel create a conflict, so perhaps the labs were in error. Labs do not usually report E2=0, they would typically report E2<7 or E2<14 etc. Did you see the actual report?

Thanks for weighing in KSman, your sticky posts have been very helpful.
I’m moving my anastrozole to a dose of 0.875 mg/week, down from 1.75 mg/week.

My doctor said the same as you regarding LH/FSH - that it should be zero on TRT.
With my insurance I don’t pay for labs, so we’re going to include the one-time LH/FSH test on my next round.

As for Estradiol levels:
I do not feel terrible/depressed, and my libido is sky high at the moment.
I will get the full report when it is available later this week, and I’ll post actual numbers.
The word my doctor used to describe my E2 level was “undetectable”.

I’m getting some gym results together for my next post.
In the meantime if you need me, I’ll be ripping some phone books in half.

Thanks!
Nate

There is not difference between undetectable and a lab failure, you need more than one test.

Labs do not report the actual levels when very low as there resolution is poor, so they say less than something. You need to get a copy of the lab reports!

Just a brief update to say, my doctor has added Pregnenolone and DHEA to my regimen.

I’m seeing strength gains in the gym, and I’ll make some size measurements this week.
I’ll also be receiving my full lab report from my last test (the “no estrogen” results) sometime today or tomorrow.

Thanks for reading, and for staying interested in my case.

Nate

LABS from 10/15

Testosterone, Serum: 1211 ng/dL range 348-1197
Free Testosteroned (Direct): 28.1 pg/mL range 8.7-25.1

Pregnenolone, MS: 30 ng/dL range: <151
DHEA-Sulfate: 152.4 ug/dL range: 88.9-427.0

Estradiol: <6.0 pg/mL range: 7.6-42.6
Roche ECLIA methodology

PSA: 0.6 ng/mL range: 0.0-4.0
Roche ECLIA methodology

SHBG: 33.5 nmo/L range 16.5-55.9

Test looks great. You could try adding some DHEA.

E2 is too low. You may be an anastrozole over-responder. If so, you would take 1/4th of the expected dose after a 4-5 day washout.

You did reduce the dose on 10/22. So labs do not reflect that. Your dose reduction probably not enough.

hey nate u forget to mention whats ur hcg does. and for how long u will b on this trt programmme?if m right its almost a month to u on trt can u tell pls how r u feeling now? hows ur libido and when it started to improved while on trt. i mean on which day?

Hi xsunnyx,

My HCG dose is hard for me to calculate without looking at the bottle- since there’s different milligrams per milliliter.
I’m taking 0.11 mL twice weekly, injected subQ into the belly. I’ll get you the dosage strength and post it tonight.

My doctor said she would safely take me to a total T level of 1800ng/dL, at which point I assume we’ll be tapering off.

It has been over a month (I began September 23), and I feel great.
My libido improved after the first 2 weeks.

I will tell you that my libido has decreased slightly, beginning in week 7.
Honestly that’s not a problem. A raging libido does not fit into my current lifestyle.

Being a new dad with a wife who currently stays at home, opportunities for “release” are few and far between.

I was waking up with rock-hard erections, and also getting random “hello there” erections throughout the day.
I have found myself unable to concentrate at work because I was thinking of sexy ladies all day.
I have been strongly aroused by my wife’s curvy body, even though she’s still carrying 30 extra pounds of baby weight.
It’s been actually detrimental to my marital relationship, as my wife is NOT feeling sexy right now.
The libido is still there, and I can feel it, but it’s not as strong. Morning wood is a little softer. That’s ok.

I expect, once my E2 levels get back on track, the libido will return, and maybe by that time, my wife will be ready to get on board.

hey nate thanx for ur reply mate hope u will remain active and keep posting about ur progress throughout ur treatment and even after ur issue is fully sorted. i really wish u all the best for that u will do sort soon. as many people dnt post thn they keep posting till they suffer but once they all well they forget to mention anythng later on.

as im suffering from low T as well. i must say u r lucky u r in hands of good doctor who has knowledge in this stuff. right now where im living i cnt find anyone expert in this field iv went to many docs they all say all in ur head nathng wrong with hormones and they prescribe viagra etc. but im not able to get erections with viagra as well. regarding my libido im able to penetrate at day time but at night time i dnt even get a bit of erection even after taking any pill. at day time i dnt even need any pill…im suffering from this kind of libido past 1 year. i know its due to testosterone because they high at morning time and lower at night time. but stupid doctors around here dnt know that. i hav to strt treatment as soon as i can but finding a right doctor who have knowledge in it specially with hcg,testosterone and estrogen inhibitor is really a problem with me… i hope tht u will keep posting about ur progress and be in touch later as well. can i know addres and name of ur doctor? do u know if she can treat distant patients by internet? when r u going for ur test again? would thankful if u will keep posting about ur results and progress :slight_smile: please do…

whycantyoumakeyourfuckingpostsreadable

Hi Ksman… from past one year, I am not able to have erections at night time, Even after taking different kind of pills like Viagra etc. But, At Day time, I have no problem in getting and maintaining a erection, I can do that even without taking a pill for sex.I went to see many doctors, They all say its all in your head nothing really wrong with me.

my test results are:-

Testosterone, Serum 324 ng/dL range: 250-1000

Estradiol: 24 pg/mL range: 7.6-42.6

My Question is Why there are erections at day time only?

hope you can read now brother?