T Nation

New to TRT Therapy, Some Questions

So I had my free T in the 150/160 range doctor said it should be closer to 500 for my age group (35) this was caused by a problem I had with my pitutitary. My other hormones are surprisingly normal. I have been on TRT specifically .25 ml of Cypionate once a week my doctor said he was starting me on a low dose until I could go get a sleep study.

Honestly I am constantly CONSTANTLY exhausted regardless of sleep. Seems like even after I take my shot doesn’t seem to help that much. I had surgery for my pituitary issue a few months ago, ended up gaining quite a bit of weight after due to some issues with blood sugar. But man it is hard to try to get to the gym or doing anything physical because of the lack of energy.

I also suffer from low libido, though it does seem to spike up a bit more now and again. I do have a good amount of hair on my head though my beard is a bit more patchy than I would like it so also hoping that might help.

Does the energy issue get better? I heard it can take a while for you to fully see effects while on TRT is that true? Thanks for the response.

.25 ml. Meaning 50 mg a week. I doubt that’s enough. Some one more experienced will be along shortly. Post full labs for them. I’m on .25 every 3.5 days. On week 5 I think and already feel much better but don’t pull labs for two more weeks

You need to leave this doctor. He has shut your natural T production down and not given you enough T to replace it. The minimum dose is 80-100mg/wk and that is only if your SHGB is mid range or lower. Guys with a high SHGB need a lot more to feel normal.

Yeah, that’s not going to work.

Has thyroid been checked?

“symptoms can continue to improve for sometimes up to a year after starting treatment”
Dr. Saya

So here is what my labs had said for the testosterone.

Testosterone 173L Range (300 - 1080 NG/DL)
Sex Horm bind Globulin - 19.5 Range ( 16.6 - 55.9 NMOL/L)
Calc Free Testosterone 42.8L Range (47.0 - 244.0 PG/ML)

this was taken at like 7:30 / 8 am something like that.

Also yes my thyroid was checked they did all my horomone levels because of the pituitary and the rest are fine / in range

If those numbers are while taking test, you are nowhere near close on the dose. Doubling it might not even put you in the ballpark.

Those numbers are before my treatment yes, also he wannted to start me on a lower dose until I get a sleep study something about how testosterone can effect your lungs. Cuz I had some issues with sleep apnea before, though I think they where mostly resolved since my surgery but who knows.

You are clearing out testosterone quicker than someone with high SHBG, SHBG is low and therefore you need frequent injections, this once per week is not optimal given your SHBG being on the lower end. If your doctor withholds your dosages and you do a sleep study and pass, then increase the dosage, you may actually experience sleep apnea when increasing testosterone.

You need a new doctor immediately, 500 is where healthy 50 years olds are scoring. You doctor shouldn’t be targeting a particular range, he should be interesting in alleviating symptoms and improving your health as higher testosterone is shown time and time again to be healthier than mid normal levels.

The studies show high normal testosterone is more cardioprotective than mid normal levels, so your doctor is harming you be keeping you confined to mid normal levels.

Your energy will not get better on this TRT protocol, multiple smaller injections per week will show excellent results. A 50-60mg twice weekly or 25-30mg EOD protocol would be best using 27-29 gauge insulin syringes in the shoulders and quads.

As long as you get your TRT from a managed healthcare doctor, you will have to figure out your own case to find out what works and what doesn’t because there is no standard of care for TRT so doctors are mostly clueless and direct your TRT protocol without knowing what they are doing.

Yeah, that doesn’t actually make any sense unfortunately. If you are on TRT, they need to be serious and get your level right. Test doesn’t particularly have anything to do with lungs. It is true that sleep apnea can impact your test levels negatively, among 5 million other things, but that really is irrelevant to the dose. It really is kind of all or nothing. Insufficient dosing is way worse than nothing at all, it will shut down natural production and leave you with crap levels that may well be worse than your natural ones.