T Nation

On the Fence about TRT - Advice Needed

Hey everyone! Im really looking for advice as I am torn between taking and not taking TRT. First off, in 45, 6’1 200 lbs. Been involved in sports and working out all my life off and on. The past few years have brought some low T symptoms…more lethargic than normal - although I can still function fine at work and out of work, decreased libido, much weaker and infrequent erections, cant fall back to sleep a lot of times after getting up at night, cannot change my body composition (think skinny fat) even when working out several times a week and eating healthy, very irritable and sometimes short tempered with my family which is affecting my wife and kids. I am speaking to a HRT clinic who recommends TRT. It scares the S%&^ out of me to be on this for the rest of my days, but if it helps I will do anything.

  1. The TRT rep said that I could do a trial w/ cypionate and hcg for 3 months to see if it is for me. Is this a reasonable course of action here? if I see no effects from TRT, then i will be on this stuff for the rest of my life for no reason, and it is expensive and a life altering lifestyle .

  2. Here are some numbers: I am confused because my total is low but free test is OK. ANY advice would be greatly appreciated. Thank you.
    LH 13.7
    DHEA-SULFATE 346.1
    ESTRADIOL 23.1

Not an expert on TRT, but I am currently on TRT at the age of 25.

My levels were around 330 at the age of 22. Started on clomid therapy 50mg daily due to me being secondary. Clomid worked great for over a year, within 2 - 3 weeks of starting my test went from 330 to 1100. Only reason I stopped was because it was effecting my vision, could barely read the E on an eye chart.

I would recommend reading the stickies, really read them and understand them. I would get a second opinion from an actual doctor who has knowledge of mens health. I got an opinion from a clinic and it felt shady, and to be honest they are just money pits.

Also, before anyone asks, post your ranges for the blood work, it will save them time in asking you for them. Honestly the benefits of having healthy T levels far outweigh the experience you are having with low T. Make sure to get dialed in (this is something I am currently having a problem with).

Hope this helped.

You didn’t include the ranges, so this is a guess based on my guess regarding ranges. Your total T is horrible, and your free t is not great. It’s really not that big of a deal. Seriously. You can stop if you don’t like it and all you are out is a little money.

I dont understand why guys are afraid of TRT. When I found out about it i could not get on it quick enough. Like applied gel driving home from the pharmacy. Then switched to injectables. Its slow improvement but I have the energy to workout now and do stuff. Before i would work, fall asleep a few times driving home and then pass out about 10minutes after getting home. I am glad to be able to be on this the rest of my life. Also what is a trial? Are they giving it to you for free? You Will still be shut down from exogenous T. You will see plenty of change in 3 months. Just dont get stuck at a T mill. Make sure you are able to self inject and the Dr. Knows about TRT. Telemedical is great also.

Hi hydro23, thanks for taking the time to comment. Yeah, I guess I dont remember how it felt without these symptoms because it’s been so long, I just remember that I didn’t have them…if that makes sense. I’ve done a bunch of research and cant really find much on why a person’s total can be so low but have free in the normal range, so I’m hesitating on going for it. If my free is ok but total is low, then does the total even matter? Theres so much info out there it’s tough to filter out the garbage. I’m very glad the trt is working for you. I think I may just take the plunge. Life is too short not to try. Thanks for the comments.

Ditto. I was relieved to have found an answer finally. It was a long road to health.

If you have to question it, the. It can’t be that bad can it?

You need a real trt doc to help you.
Someone who has further education. Preferably a worldlinkmedical.com certified doc . Check their database and find a doc who was trained by dr.rouzier and get some real answers.

Keep using these clinics and they don’t care for your health. They just want your money.

How long did it take you to “dial in”? Did you start seeing benefits only after you dialed in?

I have been on trt for like 4.5 months. Switched Drs so im just getting my first labs done this weekend. I have no idea what any of my levels are but i feel good. I’m low shbg 16 pre TRT. I felt good at 50mg e3.5 days when I started then i felt even better at 40mg eod when the new Dr my dose and added hcg. Never took the a.i. and sensitive nipples pretty much went away after a couple months. I got to the gym now. My failing cardiovascular health turned around and I’m good now. Some guys just get crazy with the dialing in stuff.they They are mostly chasing numbers and psychosomatic symptoms.

Thanks man! And excuse my ignorance, but what is e3.5, eod, hcg, and ai? And why would someone want to use them?

Every 3.5 days. Hcg is hcg human chorionic gonadatropin. Pregnant women’s piss extract that you inject lol. Its gets your balls making T and E again and keeps them from atrophy. Some men feel it helps with mood and libido and other hormones. EOD is every other day. Ai is anastrazole. Anti estrogen drugs.

I don’t understand your fear, testosterone cypionate is a bioidentical hormone that the body doesn’t even know the difference. You haven’t mention how often you will inject testosterone and this is important if TRT is going to show benefits.

The first red flag is no SHBG was tested, low SHBG men do much better on multiple smaller injections per week as opposed to 1-2x week for men with SHBG midrange or higher. I say this because your Total T is low and Free T high which could only mean your SGBG is very low.

If SHBG is low, that would mean you don’t bind androgens well, then you would need more frequent smaller injections to keep levels elevated the majority of the time, some men feel small declines in levels and this translates into feeling unwell.

The time span until maximum benefits is achieved on TRT is 12 months, so 3 months is too short a time to notice the full benefits, of course your physical condition if near optimal less time will be needed to see maximum benefits.

Whether you have lead a healthy life of not or workout, when we men get older, we start falling apart, TRT can delay this process. TRT strengthens bones, muscle (heart) and connective tissue.

Hey everyone. I really appreciate the replies. I am officially over my fears and am ready to go all in. I do have a question that Im sure has been answered already somewhere, so I apologize in advance if it has. But…the clinic I will be going to will be out of pocket, which I can do. I obviously would rather have it covered under insurance and was thinking of going to a urologist. But, I do not want to be wasting time with trying to get my levels up naturally (already tried) and if i get tested again and am barely in the “normal” range then insurance will not cover it anyways. I thought about going to my primary care, but they are pill pushers and I’d end up with a script for Viagra and an antidepressant. I included all my lab results here, Im hoping maybe someone here can take a look and see if they can decipher the numbers (SBH is 23, didnt come out on the image)? To me, it looks like primary hypogonadism based on low total test and elevated LH, but I’m no expert. Again - Im 45, 6’1 200lbs. Also, Im confused on how my free test is OK but total test is in the basement? Thanks in advance guys!!

This is what sick care doctors push on their patients, it’s how the medical system works, you have the pharmaceutical companies manufacturing the drugs and the doctors dispensing it and everyone profits from it.

TRT is low cost, low profit and is not patented so investors go elsewhere, other new prescription drugs are pushed by doctors. The sick care system is geared towards prescription drugs, not low profit hormones.

Guys who hold out and look to sick care doctors for help in managing their TRT are usually the one with unresolved symptoms on TRT. I started TRT with an iron, ferritin and vitamin D deficiency and wasted 2.5 years spinning my wheels.

If I allowed myself to become compromised and sold a piece of my soul to the pharmaceutical companies and was a doctor and you came into my office with ED and low libido do to low testosterone, I would tell you that you are normal and in range and I would prescribe viagra or cialis for the ED and an antidepressant for your depression because I would enjoy a healthy income. TRT doesn’t fit into my life’s financial plan.

I believe 100 years from now we’ll look back and realize how prescription drugs caused more problems than they solve, there are so many side effects, so many unknowns and are unnatural, harmful chemicals not natural to the body.

The pollutants, destruction to our environment and these drugs, chemicals we put in our bodies is killing us slowly. The bioidentical hormones, stem cells and gene editing therapy is the future of medicine.

Do you have any other labs form before? Specifically ones that show Calcium levels, and anything with your vitamin D? And maybe PTH? I seriously doubt anyone had checked your PTH, but I’m curious.

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Hi hardartery. No, these are the only blood test results that I have. So as far as calcium, D and PTH I have no idea. Just what Lab Corp tested. Thanks.

I’m asking because a calcium of 10.1 is actually abnormally high for a 45 year-old man. It can happen occasionally as an aberration that day or something, but it is not normal for anyone in their 40’s. Being pissed off all of the time is a sign of high calcium. Low D and high calcium is an indicator for hyperparathyroidism. Low D will contribute to low T. I know, you’ve never heard ot the 15 syllable disease I just mentioned. It’s rare, most people that have it die from a heart attack or kidney failure as secondary issues and don’t find out that they have it until then. It killed Garry Shandling for example. The best check for it is to get your calcium and PTH (parathyroid hormone) checked AT THE SAME TIME - that part is important. I had it, it’s a real prick of a disease.

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Hi hardartery. Thanks for taking the time to check this out. This forum is great, seems like everyone watches out for each other more than doctors. I looked into the calcium issue and decided to speak to my dr about it. I saw him yesterday and explained that I was concerned about some of the results. He asked where I got it, who ordered it and why, so I explained it was from an HRT clinic and I could see him start to laugh to himself and he sort of dismissed it and used the word “hokey medicine”. He was asking me questions about my symptoms and as he was typing in the computer he said “Ok, so you seem to be suffering from a bit of depression.” I wanted to scream at that point, because it is NOT depression. OK, maybe mild intermittent depression CAUSED by low T. So he finally looked at the results and said OK, we will refer you to an endo and have blood drawn and possible treatment for hypogonadism. I will be hearing back soon with the results. If they say I am in the normal range and don’t want to treat me I will be going to the clinic that I have been speaking with. (results of my clinic ordered lab work I did a few weeks ago is total test is 258 and free 18.5 pg/ml)) However, if the endo says that I need trt, I am thinking of just going though him as it may be covered under insurance and I may get more regular blood checkups than through the clinic. So at this point I’m torn - clinic out of pocket or endo with insurance (most likely some out of pocket). As far as the calcium - he said that since my annual checkup is in 2 months we will check it then and see how it compares to now. If you were in my shoes, would you go with the clinic or the endo? Thanks guys!


op you should check for parathyroid tumor and Anti-TPO, PTH lvls,.
also check your D vitamin lvls.

i just cant believe how incompetent these docs are…

I would see the endo, as insurance is paying. It will get you some more blood work - they always want to run their own stuff. If you bring up hyperparathyroidism, it is harder to get treated than hypogonadism. But an endo will almost always be more than willing to run the PTH test and re-run calcium, the endo will also be way more receptive to TRT than a regular doc. The endo I saw didn’t really think I had hyperparathyroidism, wrote me a script for androgel and Prozac without any hesitation or prompting. Just be careful that you don’t mask one problem by treating another.