T Nation

Patience with TRT

Hello everyone,

If any of you guys have followed my thread since I started TRT, you would know that I’m one of the many guys guilty of being impatient with TRT. I’ve since learned that you need to be patient and stick with a protocol for awhile to experience benefits. TRT is not a magic pill.

Anyway, I’m creating this thread for a few reasons. I want to know why ^that^ is a thing. I’ve read “you need to allow your body to repair itself” tons of times, but what does that mean? Why don’t people feel better Day 1 of TRT? Also, I want to hear other people’s experiences just being impatient vs. sticking it out and seeing benefits.

Part of the reason I’m curious about this is because I recently dropped AI dosage significantly. I actually dropped it completely, but then symptoms arose immediately so I reintroduced it at a lower dose. Anyway, I’m going to stick with this protocol for a long ass time, unless any major symptoms show up, regardless of if I see benefits or not. My plan is to get bloodwork around week 6, and so long as FT and E2 look good, I’m gonna stick with the dosage for a long ass time, regardless if I’m seeing benefits or not. I believe that, if FT and E2 look healthy and other labs don’t show any red flags, I should just sit back and be patient and let my body repair itself.

I made it through my first 9 weeks of TRT this past Saturday. My main side effects were sleep loss in the first couple of weeks, and then minor acne from weeks 4-7. Now - acne is gone, sleeping like a baby, improving muscle growth, having great work outs, and a more stable mood.

I started with the AI and HCG right from the get go and have no issues with them. I know the prevailing thought in this forum is to avoid AIs at all costs, but considering I’ve done well on my TRT regimen, it doesn’t make sense for me to eliminate it. I do realize I am still new to TRT and things might change and as such, I will adjust accordingly.

BTW my TRT dose is 200mg per week IM.

Things have gone so well with my first nine weeks that it’s very difficult to fight the urge to try more test from external sources. But common sense prevails as my health isn’t worth the risk from taking more T. I got on TRT to get better, not to get better and then get worse.

Like you said, TRT isn’t a magic pill. I am a firm believer that once you start dosing T, you need to give it a place to be used in your body. I think lifting heavy weights has helped me reap the benefits of TRT quickly, although that’s truly subjective and I realize it. I also cut out almost all alcohol, and that was hard to do, but well worth the benefits. I get my first bloods done, since starting TRT nine weeks ago, at the middle of August.

Be patient - your body will respond. Good luck with your health too.

I could not understand what exactly is your protocol?

Why people do not feel better on TRT since day 1 - well you cannot fix your blood levels with one injection :smiley:

I feel like there is something very specific that you are referencing, but being vague for the purpose of the thread…

What is it that you are expecting that hasn’t happened?

How long have you been on TRT?

It sounds like you’re dealing with estrogen excess and are playing around with AI’s inducing a E2 rollercoaster, in this case it sounds like you protocol isn’t working out for you. If you want to control estrogen without inducing an E2 rollercoaster, then you might do better on more frequent smaller dosing.

When you make significant moves expect significant consequences.

Hormones interact with and repair tissue, this takes time to repair tissue and howe long this takes depends on androgen receptor sensitivity. If you don’t address your high TSH and deal with your thyroid problem, TRT will never show good results.

Note AI’s can degrade the benefits of TRT.

If you don’t address your high TSH and deal with your thyroid problem, TRT will never show good results. You should have seen TRT benefits by now. I notice significant benefits only 3 weeks into TRT.

You don’t start to feel bad immediately either. It takes a while to build up stable levels (your body likes stability), it also takes a little time to adjust. Your body is used to low levels, it’s not used to that rush of test. It also is synthetic, so that can play into the adjustment as well.

That’s interesting that you bring up my thyroid labs. I noticed complete symptom relief when I began iodine replenishment, but the benefits went away with time, even though I never changed my iodine dose. I followed the IR protocol from my doctor and had stopped the iodine completely after a few months. I started it back up again a while ago to see how it’d go and there was definitely symptom relief, but i think it went away again. Is there another way to get those numbers looking healthier? TSH is high but everything else looks mid range? I know this forum promotes TSH ~1, not sure where it wants T4/T3.

Also, this thread was more so just for my own knowledge. I’ve been keeping a consistent protocol and it really helps me to feel better week by week, even after a few months. Just wanted to learn why that is.

It’s not this forum the suggests TSH closer to 1.0 is optimal, 95% of the population has a TSH <1.5, the start of hypothyroidism will see normal thyroid hormones and high TSH. If you haven’t noticed any benefit on TRT by now, you most certainly have a thyroid problem as indicated by TSH.

You didn’t even test Reverse T3 which can block free T3 and you would see TSH elevate. If you started iodine and you felt good for a little while and then you didn’t, that tells me your thyroid is your weak link.

Something is not right here, thyroid can’t be alright if TSH is high. T4 is the total thyroid hormone being produced by the thyroid. Your T4 should be midrange, its below midrange and this tells me your thyroid is not a star performer.


At what point does TSH start to become a concern? Mine was 2.4 before starting TRT. I’ve considered getting thyroid stuff tested again. I never had reverse t3 checked.

Sometimes TSH and thyroid hormones can appear normal and still thyroid problems are present, lab testing is not always providing the best possible diagnosis tool.

We do not have testing for receptor sensitivity, if receptors were resistant, that person will need more Free T3 than the next person. There is medical literature which shows people with normal thyroid labs with hypothyroid symptoms which thyroid medicines cure.

Usually when TSH exceeds 2.5 problems are in the making, the severity differs from person to person, but optimal status is not possible with TSH 2.5>, not when the general population is <1.5.

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My TSH runs 2.0 - 2.5, It doubled when I went on TRT, and then went back down to my normal number after a month or two.

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My TSH went from .6–>1.01 after starting TRT, never see it higher.

It sounds like your thyroid was able to cope with the demands of TRT. I wouldn’t be at all surprised to see the OP TSH even higher on TRT, we know demand is higher on TRT and T4 was already on the lower end.

Still I did not understand did the author inject 200mg once per week?

Those thyroid labs were a few months to TRT, so I’d imagine they would’ve normalized by then, indicating that my TSH is normally that high. That was a few months ago, shoUld I test again for TSH, T4, T3, ft3, and rT3? I could start taking body temps as well?

I’ve been on a 250mg weekly split up ED, w .5mg ai e3d protocol, 240iu HCG eod.

Ok, I understand

Body temps are irrelevant. That is a thing put forward by a Dr. Wilson, who is trying to peddle treatments for “Wilson’s Syndrome”, which is a course of T4 and T3 for anybody who shows up at his clinic. Nonsense.

35mg daily is insane, 20mg would get most men in the supraphysiological ranges.

What dosage do you recommend I try? I’ve tried as low as 140mg weekly and as high as 300mg (all split daily) and i’ve found that I’ve felt best around 200-250. I don’t have any issues with blood pressure, and I don’t feel any symptoms of high/low estrogen. The symptoms that persist are some brain fog (noticeable poor memory and some absentmindedness is the best way i could describe it) and low libido. Ironic that I can’t remember if my brain fog lifted with the Iodine, but everytime I start up the high dose Iodoral, something like 50mg a day, I notice an increase in libido and noticeable fuller testicles… Unless you think it would be beneficial to solving my thyroid issues, I’d rather not have to dial in E2 and T again by slicing my dose way lower. I agree that the dose sounds high, and it does sound wise to test TT, FT, E2, lipids and maybe DHT with the thyroid labs I plan on getting, just to make sure everything looks healthy, but so far if theres one thing I’ve learned, its to take it one step at a time and I’d rather not slice my T dose in half and start dicking around with thyroid stuff on top of that.

I want to add, what are your thoughts on rT3. Do you think its a potential contender for the source of my wacky TSH number?

I’ve looked up some things that might elevate it, and I do think it could be an issue. According to some websites that I’ve seen, I may have elevated rT3 and blocked my T3 from receptors by:

  • dieting (went a few months, started at 300 and climbed to an 800 calorie deficit while adding cardio with every workout)
  • too much working out (I used to train 7 days a week. I’ve since eased up to 6, and sometimes only 5. Sort of off-topic but I’ve learned that you aren’t training hard enough if you are physically capable of training everyday)
  • caffeine use, does this elevate cortisol? I take 400mg caffeine with every workout, no other stimulants but a decent assortment of vascodilators. I’ve taken ashwagandha in the past, can’t remember if I was taking it when I had a good libido on TRT or not.
  • Dipping tobacco, though this has never influenced my libido or anything in the past
  • Any of my daily supps (Boron, ZMA, Mens MV)

I want to add, in case anyone has experience with the same issue. As of right now, my symptoms are purely libido… I get spontaneous, strong erections throughout the day, usually have morning wood too. But the desire for sex isn’t there anymore. I used to be able to just look at a girl and get aroused. Now, its like a struggle to get an erection. Takes constant physical stimulation, and if theres even one moment where action pauses, it’s gone. Lol sucks