T Nation

Start TRT or Not?


I am 29 years old, 6’1, 220lb, about 18% bf, I’ve had a visit to a TRT clinic due to some symptoms that i have been dealing with over years, after giving blood work my test level turned to be 213 only
LH 3.3 mIU/mL 2.8-6.8
FSH 1.8 mIU/mL 1.3-11.8

The clinic suggested that it is way too low and i should start a TRT, 200mg test, twice a week, and also HCG weekly. along with estrogen blocker pill, i think one per week.

I am a little bit concern whether i should start TRT or not, mostly because of risk of infertility in future.

The symptoms that i am having is mostly lack of energy, inability to build muscle mass even that i worked out for the past 4 years, and also weight gain issues and the round edges appearance (sucks), whenever i lose weight i end up recovering everything rapidly after the diet. the main concern here is my appearance. i don’t care a lot about the rest.

As for libido it is pretty high at all time, but some ED issues now and then, Viag usually solves it.

Thought about using TRT as a cycle for 6 months to change the body appearance but a lot are saying it is not going to work that way.

Would appreciate any advice on what to do at this point and whether its worth it and if infertility is really something that needs to be concerned. any advice is appreciated.



Your labs are inadequate, you simply need more labs. A low functioning thyroid can cause fat gain as well as low T, many who come here have hypothyroidism and low testosterone. Do you consume iodized salt? Thyroid requires iodine to function properly and can become diseased without it. Check oral body temps per thyroid sticky.

If this is all the labs this clinic ordered it is setting you up for failure, these T mills keep the real hormone specialists busy from screwing guys like you up. The dosages this clinic is suggesting is for someone with very high SHBG and I’m betting you don’t know your SHBG level.

These T mills like to over prescribe and go aggressive on protocols for everyone because of profit from selling drugs, you require individualized care and a protocol needs to be tailored extensive labs looking at all your biomarkers.

Most elderly healthy men have higher hormone levels than you do. If missing any of the labs below, you are about to descend into hormonal hell. You don’t take an estrogen blocker one weekly, this would result in varying estrogen levels during the week and would never reach a stable level. This T clinic screams inexperience.

It is very likely you won’t need Viagra anymore one you spend a couple months with your hormone levels in the 600-800 ranges. At your levels it’s amazing you have erections at all. Targeting an E2 levels of 22-30 pg/mL will be critical for erection quality using the E2 sensitive LC/MS/MS labs. Most clinics use the wrong E2 labs designed for females.

Total Testosterone
Free Testosterone
Estradiol (E2)
LH-Luteneizing Hormone
FSH-Folicle stimulating hormone
Thyroid Panel
CBC-complete blood count
Comprehensive Metabolic Panel
Lipid profile/panel


I agree that some of TRT clinics are trying to make business. I’ve had two full blood work test, one was in a foreign country and the other was at the TRT clinic that i mentioned, both were full tests, not just Testosterone.

The one i had outside of US was with a primary doctor, it did included full thyroid test, and i was indeed concern about that too. the doc said “everything is normal” the Testosterone showed 340 there. I am sharing all details below.

The one i had in US at the TRT clinic was 3 months after (i dont have it handy right now), it also showed normal thyroid values, however i remember the cholesterol was high. and the clinic doc highlighted it. but didn’t commented much on it. maybe because i had breakfast before the blood work. not sure. I did research at time and found many articles advising that taking Niacin would balance the cholesterol level, i started taking them on daily bases for 2 months, still gained weight. no much difference. i also take multi vitamins every day. nothing seems helping and i look like chit.


You’re still missing the most important test of all, SHBG regulates and activates testosterone at receptor sites. You’re also missing estrogen labs. You don’t have it so it will be difficult to even to tell how your body holds onto testosterone, it dictates dosage and injection frequency. This one test would have allowed us to determine if the dosage is right for you and how many injections per week you will require.

None of these doctors understands male hormones if they are missing the most important test, it would like a mechanic not knowing what a ratchet is used for. You can’t start TRT blindfolded. You don’t even know where E2 levels are prior to starting TRT, you can’t determine AI dosing without this test.

It seems like the clinic is starting you out on a cookie cutter protocol designed for everyone. If everyone was a clone of the same person, this practice might not be so bad. No one injects HCG once weekly or takes an AI once a week, those that do find their way here wondering why they feel so terrible.