T Nation

Problem Losing Weight on TRT

Been having some trouble loosing weight on TRT, (pituitary tumor) made a couple dietary changes over the past few months as well as some dosage changes to help loose weight.

I’m 31, 255 LBS, came down from 275 (this just from lower my t dose). I’m 6"3. Probably more in 25-28% BF range. Goal = 225

Originally started on 250mg 1x a week of Test-C about 4 years ago, currently down to 100mg split into 25mg 4x a week for the past year.

I supplement with
B6, Zinc, Ca D- Glucarate, and 1x a week ADEX.

I’m currently doing an intermittent fasting type eating pattern, I don’t eat past 8pm and don’t start until 12noon.

I do fasted cardio once in the morning and weight lifting 3x a week after 8pm or before last meal of the day. Maintenance calroies are around 3400, but sticking around 2700-2800 per day.

I’ve gone from P/F/C 60/20/20 to 65/25/10 now currently trying 40/40/20.

This has always worked for me in the past, I’m not sure if anyone has ever experienced this before. It seems the more I weight train the more muscle I gain, but dieting isn’t helping lean out, I’ve tried severe calorie deficits with the opposite effect. I was just wondering if anyone out there has any advice, maybe more frequent dosing or maybe lower protien intake, maybe I have to work out harder then I am, (usually lift or run till near puking) but maybe it’s no enough. This could be hormone related I guess.

Can provide lab work if needed, but all numbers are within normal ranges

Lab values 3 months ago
Test - 535
E2 specfic >20
Prolactin 17

A Total T in the absence of Free T and SHBG isn’t very helpful. Your Total T would have me optimal and others far from it, Free T levels are affected by SHBG.

Thyroid hormones are also responsible for fat burning ability, Free T3 speeds up every cell in your body and it needs to be midrange or more likely slightly higher for TRT to show optimal results.

So because numbers are all within the normal ranges you’re perfectly fine? Think again.

SHBG 15
FSH 2.3
T-total was 635 typo

Don’t think I’ve ever had a free test

Obesity is common in men who are low SHBG, so your next step is to check Free T3 and Reverse T3 to see if that may be what’s holding you back.

Actually my thyroid has always been a large concern for me due to the amount of different things I’ve tried that were unsuccessful. I fully understand that my numbers, although within normal parameters, could still cause me issues. When I originally started, I was on clomid, until my GH numbers bottomed out and was switched to Test injections. This made a huge body composition change for me within a very short amount of time. The problem is my GP just believes that as long as my values are within normal ranges, that’s it’s me not doing enough.

Well 300 ng/dL is within the normal ranges, but that doesn’t you won’t have symptoms of low testosterone at this level. The same could be said about having Free T3 at the bottom of the ranges, sure you’re within normal ranges but that doesn’t mean you won’t be symptomatic.

Do not let doctors feed this crap to you, doctors are brainwashed into thinking scoring within normal ranges means you couldn’t possibly be experiences symptoms. This is how managed health care works, it’s quick, painless and doctors get to hurry you out of the office which allows them to see 30 patients in an 8 hour shift.

You go private and all of a sudden doctors are more concerned about your symptoms and are less concerned about the numbers because they understand the numbers don’t alway tell the full story. Medicine used to be about treating the symptoms, then medicare came about and many said it would be the death of medicine, it was and now doctors chase normal ranges and resemble robots instead of critical thinking and reasoning human beings.

Chasing normal ranges allows doctor to do one thing that they couldn’t do without them, see as many patients as possible in a short amount of time, no brain power required.

"You’re within the normal range, “you’re fine”. Then you have the studies below that show the ranges for TSH are wrong.

I have normal free t 4 and TSH numbers, I’m seeing my Endo tomorrow. You thinks it’s worth asking to check my DHT also ?

Endocrinologists the majority of the time are a waste of time for anything not related to thyroid and diabetes, last time I checked they chase normal ranges to determine disease status and those ranges are not valid any longer, yet your doctor is still using those invalid ranges.

Free T3 is the only active thyroid hormone, T4 is converted to Free T4, then Free T3 is the final result and is the hormone that soaks into every cell in your body and your endo doesn’t bother testing it.

You need a competent doctor, under insurance they will be hard to come by.

In my area, a competent doctor is hard to come by. As a matter of fact his only suggestion to controlling my E2 was lowering my T dose. E2 has always been an issue for me, eating heavy carbs and alcohol are thing I can no longer consume. So initially my hormones we’re like a roller coaster. Until I learned what adex was and how to use it.

I will see of I can have my labs redrawn tomorrow, but I will ask to have a full thyroid panel done including T3 / FT3. Thanks for the advice!

Have you given any thought to Keto? Worked wonders for me.

If you are gaining muscle then you are definitely not in a caloric deficit. Are you calculating your needs based on current weight, or lean body mass?

I’m pretty sure the calculations have been a total weight not lean mass.

I’ve tried keto and it worked for me, my only concern is the amount of fats long term, the best I’ve looked actually was doing a modified keto, it was more of 45/45/10 kinda of deal. Kept carbs under 50 grams daily spread throughout the 8 hours I generally eat.

I’ve seen people successfully calculate it both ways (meaning they got numbers that worked out for them), but the more excess fat you have, the more you typically want to tilt your calcs toward the lean mass side. Another method which I’ve had good success with personally is to base RMR on the total target weight. Then base the protein intake on LBM. Whatever way works for you is the correct way, but I’m offering this to you because you implied that what you’re doing now isn’t working that well.

Consuming fats long term is not a concern IF you are consuming mostly healthy fats. Omega 3 and 6, MCT Oil, etc. Don’t want to make your total daily fat intake beef, pork lard, and butter lol. Some of that’s ok but make sure that the majority is coming from nuts, MCT oils, and omegas.

Also, concerning the carbs, try to hold off on them throughout the day and hit your body with about half of them 30-45 minutes pre workout, and the other half after your workout (if your carb intake is at keto levels). I would do this when my levels were at 50g per day and it made a difference. Now that I am at a 20g allowance, that’s harder to do because normal high fat / moderate protein meals are going to add up to at least 10-20g of carbs throughout the day.

I don’t generally use ratios, but my F/P/C usually winds up being around the 70-75/20/5 mark.

I use the following formula for cutting.

Total cals are Total weight RMR - 15-20%

.8g protein per lb LBM
20g carbs
Whatever is left in Fats.

If I adjust up or down I do it modifying only fat intake.

I also keep track of ketones using a meter at least 2 times a week. I shoot to keep my levels at around .8 - 1.5

Not saying that this is your magic ticket, but it has worked very well for me.

I lost a fair amount of fat going low carb, but recently I added in sugar free oatmeal and a lot of fruit (basically balancing the diet) and saw big changes on the scale and in the mirror. Seems like my body likes the extra carbs. Not sure if this might be a carb cycling like effect, but it’s made a difference.

I wanted to just post an update to this before and I guess ask so random questions along with it.

So I have changed my dose of T to 50mg every 3 days.

I tried the keto diet for 4 weeks at 1800 calories. It was sort of successful, but I’m guessing most of the number loss was from calorie drop and uping the T. I went from 260 - 248lbs.

The past week I have switched to high protien, under 50g of carbs and lower fats. Which has helped me strength wise in the gym, and I can def see positive changes, but the past 4 weeks I have remained at 249. So I believe I’m in that weird area where fat is coming off as slow as muscle is being added.

I do have one question about Adex though, it seems like I’m very sensitive to prolactin producing exercises, like post orgasim, heavy carbs meals, alcohol, and stimulants. I have been using the Adex .25 once a week to combat the esotrgen, but I feel like I should be taking more? I’m concerned about the frequent use of it and can’t really judge if I’ve taken to much or not enough.

I have a bought of Gyno in my right nipple that I have been using as a guide to how high my estrogen is, because after any of the exercises above, with an hour it begins to throb and become painful? Do you think I should up the Adex? Would it help with fat loss ?

AI’s shouldn’t be used for weight loss, big no no. AI’s will strip you of bone and joint lubrication and inflame joints.

That’s my big concern, but I’m also wondering if under dosing is keeping my E2 to high and that’s preventing fat loss ? I didn’t mean to use it for fat as much as I ment it as keep it balanced allwoing for fat loss

weightgainer you do know you can buy just an E2 blood test on line from Quest or LabCorp. There are many discount blood test site on the internet. No Doc required. Guessing about the stuff is really dumb.
If you really want to kick your weight loss in gear look into the sarms CARDARINE its a liquid you squirt in your mouth do 20mg a hour before going to gym and be amazed.

My MD, is off, he let’s me run wild with T doses, but refuses to help me out with off label meds such as Adex. I voiced my concern with him multiple times about how sensitive I am to E2 and Prolactin spikes, but his answer to that is “avoid the triggers” (which I do most of the time) and “lower your T dose to control E2”.

Im using research Adex so potency maybe be an issue.
He has also brought up a medication bromocriptine which I’ve read about, but not sure that’ll help control my prolactin spikes.

So far being on trt, it has not been a favorable experience. I will look in to the quest diagnostics E2 is there something specific I need to be looking for ?

I’m having trouble with the math here. Your last post where we were talking about diet options was about 4 weeks ago. You said you went on keto for 4 weeks and dropped to 248, but you’ve been at 249 for 4 weeks now…that’s 8 weeks. Am I missing something or are you referring to when you did keto way before?

It’s VERY typical to see intial results from ANY major change in diet or exercise for 4 weeks and then taper off. That’s what they call the stall effect and it usually starts moving again after a week or two of that. With diet it’s just the opposite of TRT. With TRT, we WANT to reach hemostasis. With diet, at least if it’s for the purposes of fat loss, requires constantly trying to throw your body OUT of stabilized state to keep your metabolism guessing as to whether to store or let go. If you tried keto for 4 weeks, then your first week to two weeks was adaption and you only spent two weeks at best seeing any real results from it. That’s assuming you didn’t allow a “cheat day” to make you have to start the adaption process all over.

You also have only been doing the 50mg E3D protocol for about 5 weeks (that math thing again😜). That whole 6-week marker is a very good general rule, but we ALL know that nothing about TRT comes in a one size fits all box. It may take some guys two months to actually stabilize, and some may reach hemeostasis in 3 weeks. What’s the reason for the AI? Are you going by feel on your E2 or are you verifying this with blood work? I wouldn’t think you would need an AI at all at your dosage (assuming you aren’t fudging the number a bit here and there to try to get a little “extra” boost). I would think that you would level off just fine if you would do test only and give the E2 a couple of months to stabilize in your system? That’s just my opinion.

Sorry should have clarified that better. The first week of Keto + increased T, I dropped from 260 - 248. So it’s been about 5 weeks of 50 mg e3d, AI .25mg wk. At the 4 week mark of the keto diet, I was still only consuming 1800 calories a day, and weight was 248-250.

So for about a week and some change, I traded over to the higher protien, below 50 carb diet which def works better diet wise for me. I can see that I’m loosing fat and putting on muscle.

I’ve been using the AI every week at .25 mg but have noticed that with increased T, my E spikes from prolactin based triggers has recently increased as well. Believe me I would love to not use AIs period, but for me anything that triggers an increase in Estrogen gives me all the bad sides (decreased libido and weakened erection, puffy nipples, water weight, emotional highs and lows). I also have gyno in my right nipple, when my E2 gets high, so does the swelling and pain in my nipple.

I’ve been using the AI throughout my stent on TRT, and have always come up with numbers like 38-44, I tried lowering my T dose to 25mg e3d as recommended by the MD to lower the estrogen and didn’t use AI, and came up with an E2 of 68. I’ve been keeping a record of when I take everything to try and fine tune the numbers, but I try and keep everything very stable and consistent.