T Nation

New to TRT and Looking for Guidance


Hello all!

I’m new to taking Testosterone and need some guidance if you would be willing to share your experience and guidance. I’m a 42 year old man and I’ve been suffering for a year with depression and really bad anxiety / fear. Which I never had 2 years ago or in my lifetime. I was a high performing sales manager and I’ve basically been sick for about a year and a half. I haven’t been able to work for a long time now. I’ve had low T the whole time and am now addressing (probably should have done this first). I tried a variety of different medications and am also 4 months off of a Benzo that I was prescribed to take for 1.5 years (which almost totally destroyed me). Anyway, my Dr. prescribed 200mg Testosterone Cyp. once every two months. I know that’s absurd (from what I’ve read) and will be seeing him on Tuesday to change it. I’m also requesting a referral to see an Endo. Based on what I’ve read, I started with a 100mg dose a week ago (last Friday Feb 17th) and then took 50mg every 3 days. I felt good after the first dose for a couple of days but haven’t had any really good days since then. I’ve taken a total of 200mg in 7 days. I’m going to continue on 50mg every 3 days if he will work with me in that regard. Is that a good dosing schedule?

Also, has anyone suffered from the same afflictions and if so, did TRT help you? And how long did it take before you noticed any mental repair?

Thank you so much for your help and guidance in this regard,


I’ve been on TRT for 7 years now. KSman can guide you through the medical end of TR. he has links for you to help guide you. As far as Testosterone goes, it is every thing to us men. I’ve watched many men just wither away and refuse to help themselves, even after I tried to get them to get tested for Lo-T. There mental heath is the worst thing to watch deteriorate. They eventually die way to soon. Take your physical and mental health serious. I’ve been through some serous mental health problems from PTSD and low -T . And I’m a big believer in a good Psychiatrist. They can handle physical as well as the mental problems. A good Endocrinologist would be good to have. As well as a great GP. I have a whole team of team of great doctors who got me out of that black hole and back to having a good productive life. I wish you the best and don’t take no for an answer.


Thank you for your reply. Unfortunately my GP and a Psychiatrist got me into this mess with a whole bunch of medications that I didn’t need (and didn’t work). It turns out that I was most likely (according to a specialist I saw) just going through inter-dose withdrawal from the Benzo regiment I was prescribed. And then of course full blown withdrawal… from a medication that was supposed to help me. Anyway, I really don’t want to try anymore psychiatric medication at this point and I’m really hoping that if I boost my low-T (natural T is 193 1.5 weeks ago versus I think 700 where it’s supposed to be), it will help alleviate some mental challenges I’ve been suffering with. And possibly bring back some good energy… not anxious energy. So if there’s feedback that this TRT is going to bring on additional anxiety, I don’t think I can stay on it. But if it’s going to help my anxiety problem, then I’m all in.

Thank you again for your help,


Who knows what “benzo” is?
benzodiazepine should never be long term.

Your T is converting to E2 as normal, but E2 probably getting too high. That would need to be managed by an Aromatase Inhibitor which is mostly an anastrozole. See if you can get 0.5mg twice a week prescribed. You need to have E2 lab levels checked. The objective is optimal, near 22pg/ml. If your doctor’s objectives are to only deal with this if not “normal”, you are screwed.
You also need a conversation about injected hCG to preserve your testes.

Given your medical history, you could have adrenal fatigue that then reduces thyroid function with elevated rT3 that interferes with the active thyroid hormone fT3 [free T3]. Start by getting your oral body temperatures as per the last paragraph in this post. If low, read all of the thyroid basics sticky noting references to iodized salt, stress factors, adrenal fatigue, Wilson’s Book.

Post all lab work with ranges. The world is a lot bigger than TT.

Always try to get labs done halfway between injections. Time of doctors office visit can be wrong. And wrong time of day too.

do not test LH/FSH while on TRT
Fasting cholesterol
Fasting glucose
AST/ALT, please do not have sore muscle from the gym, get recovered
AM cortisol - at 8AM please
If body temps are low:

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.


Thank you KSMAN

Yes I now know Benzo’s shouldn’t be used long term. I had 2 doctors prescribe me for 1.5 years before I found that out. Now I’m paying the ultimate price for not doing my own research.

As far as blood work goes, all I have right now is what’s below. These were all done before I started TRT. I live in Canada so I am unable to order my own. I can work with my GP (I won’t be able to see an Endo for probably 6 weeks - it takes a really long time in Canada to see specialists).

TT 6.7 NMOL / L
FT 86 PMOL / L
E2 114 PMOL / L
hematocrit 0.47 L/L
Fasting cholesterol 3.9 MMOL / L
Fasting glucose 4.9 MMOL / L
AST 28 U/L
ALT 30 U/L
DHEA-S - not DHEA I don’t have this for blood work.
AM cortisol - at 8AM I don’t have this for blood work. But, I had a Saliva test done in Jan 2016 and it was 1.61NG/ML (9am). Probably still the same or worse.

If body temps are low:
TSH 1.07 MIU/L
fT3 4.5 PMOL / L
fT4 14 PMOL / L
Thyroglobulin Antibody 11 KIU / L
WBC 4.9 x E9/L
RBC 5.07 x E12/L
Hemoglobin 161 g/L
Hematocrit 0.47 L/L
MCV 93 fL
MCH 31.8 pg
MCHC 343 g/L
Platelets 282 x E9/L
RDW 13 %
Neutrophils 3.2 x E9/L
Lymphocytes 1.1 x E9/L
Monocytes 0.5 x E9/L
Eosinophils 0.1 x E9/L
Basophils 0 x E9/L
Biochemical Investigation of Anemias
Vitamin B12 516 pmol/L
Hematocrit 0.47 L/L
Folate 1770 nmol/L

Thank you for your help and guidance. Let me know what I should do from here. For now I’m taking 50mg Cyp injections every 3 days.

best regards,


Sorry, people do not memorize lab ranges and for different units. And different labs have different ranges too. Use the pencil icon above to edit your post and add the ranges please.

Please get oral body temperatures as requested in last paragraph of my post above to eval overall thyroid function.

In your climate, most will be Vit-D3 deficient. Try to find 5,000iu Vit-D3 capules, hopefully tiny oil based gel caps. Take with a low fiber meal, preferably with some fats/oils. High fiber will reduce absorption. Take 25,000iu for first 5 days.

To get feeling great, multiple hormone systems need to be firing on all cylinders.

All common table salt in Canada must be iodized. But sea salt and other specialty salts do not contain iodine. I suspect that you are using iodized salt based on TSH.

E2=80 pmol/L is optimal and you were above that with very low T. So I expect that E2 will be a problem for you. See my notes on that above.



Added the ranges. I’ll update body temps; morning, noon, night after I do some temp readings tomorrow. I’m assuming I can use a standard thermometer. Is there a way to lower E2 naturally for the time being? I’m not seeing an Endo until May / June. I might be able to get my GP to prescribe something but not sure.

thank you,

TT 6.7 NMOL / L 8.40 - 28.8
FT 86 PMOL / L 196 - 636
E2 114 PMOL / L <162
hematocrit 0.47 L/L 0.40 - 0.5
Fasting cholesterol 3.9 MMOL / L NO RANGE
Fasting glucose 4.9 MMOL / L 3.60 - 7.7
AST 28 U/L <35
ALT 30 U/L <50
DHEA-S - not DHEA I don’t have this for blood work.
AM cortisol - at 8AM I don’t have this for blood work. But, I had a Saliva test done in Jan 2016 and it was 1.61NG/ML (9am). Probably still the same or worse.

If body temps are low:
TSH 1.07 MIU/L 0.32 - 4
fT3 4.5 PMOL / L 3.10 - 6.2
fT4 14 PMOL / L 9.00 - 19.00
Thyroglobulin Antibody 11 KIU / L <40
WBC 4.9 x E9/L 4.00 - 11
RBC 5.07 x E12/L 4.50 - 6
Hemoglobin 161 g/L 135.0 - 175
Hematocrit 0.47 L/L 0.40 - 0.5
MCV 93 fL 80.00 - 100
MCH 31.8 pg 27.5 - 33
MCHC 343 g/L 305.0 - 360
Platelets 282 x E9/L 150.00 - 400
RDW 13 % 11.5 - 14.5
Neutrophils 3.2 x E9/L 2.00 - 7.5
Lymphocytes 1.1 x E9/L 1.00 - 3.5
Monocytes 0.5 x E9/L 0.20 - 1
Eosinophils 0.1 x E9/L 0.00 - 0.5
Basophils 0 x E9/L 0.00 - 0.2
Biochemical Investigation of Anemias
Vitamin B12 516 pmol/L 138.00 - 652
Hematocrit 0.47 L/L 0.40 - 0.5
Folate 1770 nmol/L >1186


This must be pre-TRT:
TT 6.7 NMOL / L 8.40 - 28.8

Please use edit [pencil icon] and correct directly in your post above.


Yes. 1 Week before I started TRT. I’ve been on TRT for 2 weeks now. I will correct this.

thank you for your help


I’ve only been on TRT for three or four weeks, on 250 mg per fortnight.

I found my mood to be good for about a week after the first shot, and ten days (so far) after the second. I’d probably equate it to having a reasonably effective low dose SSRI.

However, it could be a placebo effect, and I’ve just started dating a girl, so I’m in a reasonably happy place at the moment.

It’s not a cure for depression by any stretch. I know of one guy who’s been on TRT for about a year, and he still has very bad spells, similarly Bignoknow’s YouTube channel shows him having problems despite treatment.

There’s often a view on boards like this that fixing any real (or imagined) hormonal problems will solve all your health problems. I think that’s overly simplistic. However, there is a strong correlation between low free testosterone and depression, so TRT should help you.