T Nation

New to TRT and Need Help on Dosage


#1

Hi everyone, as the title suggests, I’m new to TRT and I’m looking for some help. I’m 30 and after having symptoms of hypogonadism such as fatigue, difficulty concentrating, low motivation, low libido, weak erections, difficulty keeping muscle etc. Anyway after many months convincing my GP it wasn’t psychological I was sent to an endo and my total testosterone came out at 12 nmol/l (346 ng/dl) - this was the only result I was told after asking for it - I was also tested for thyroid, iron, diabetes and a few others which all came back fine. I was originally prescribed a testosterone gel to increase my levels but it gave me a bit of a rash and lots of itching so I insisted I be switched to an injectable form of trt. I am now on 150 mg of test E per week. I’m slightly worried as I think this is quite a high dose for my test levels as I’ve seen many with total T in the range of 200 ng/dl skyrocket to over 1000 ng/dl with this dose plus no AI was prescribed so I’m worried about high E2 levels too.

I am considering only doing 80-90 mg per week and splitting this and injecting twice a week. I have read many stories of how too much test can cause a whole host of problems. Do you guys think this would be a better dose?

Also I’m due to have another round of blood tests at week 6 - I’ll ask for a full hormonal blood work and an actual copy of the results.


#2

Please post labs with ranges. If doctors saying things were fine was good enough, we would not need this forum.

pre-TRT
TT
FT
E2
LH/FSH - cannot be done after TRT
prolactin
RBC
HTC - hematocrit
hemoglobin
TSH
fT3
AM cortisol - at 8AM or 1 hour after waking up
fasting cholesterol, glucose
A1C
AST/ALT
fT4 [these are better than T3, T4]

You are at risk of infertility with TRT not using hCG.


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.


#3

Try injecting T twice a week then always do labs halfway between injections, avoiding lab changes driven by changed timing. You very likely still need anastrozole and should inject hCG 250iu subq EOD. You will need to fight for proper protocol and that may require a different doctor. The biggest problem is the doctors who are not trained in these things. They are of a one disease one medication mindset.


#4

I think when I was told I had low T, I assumed that the doc would know what’s what so I didn’t really think to get a breakdown on all my blood results.

I’ve heard that there isn’t much need for an AI with younger guys on TRT at doses around 100mg of test but I suppose everyone’s different… I’m gonna wait until my blood test next month to see what my e2 result is before starting an AI.

Good point about HCG - the doc never mentioned it… I’ll bring it up at our next appointment.

What about me considering lower my doses? I feel that 150mg a week is too much. My gut is telling me to lower the dose to 90mg a week split into 2 injections throuh the week and see what comes up in my blood test results. Does anyone think I’ll notice much of an improvement by lowering it to 90mg per week?

Thanks


#5

Already gave my best advice.

We do not typically see guys that are your age not needing anastrozole to get optimal E2 levels. From the viewpoint of many brain dead doctors, most do not need anastrozole to be in-range. But high normal E2 can be a very poor quality of life. Most doctors are clueless about optimal levels and quality of life issues. Read the stickies and understand what you need to fight for.


#6

Gotcha cheers, I’ll wait until my blood tests, see where my e2 level is then decide from there.