Started TRT Last Friday

I got my first injection last Friday. A 250mg injection. I have a few questions/issues. The biggest issue/concern is that my T level came back @ <10 - virtually undetectable. I have been having symptoms of Low T for years, but being stupid I didn’t want to talk about it. Now, I have no choice. And I am glad I got the blood work done so I can correct this problem and potentially save my marriage.

  1. My doc wants me to go to her office for injections every 2 weeks. From what I have read, this is not the ideal route to take. Am I correct in this? She absolutely refuses to write a script for home injection. I have contacted my Urologist that performed my vasectomy a couple months ago and they have already said they will write the script.

  2. I was in a motorcycle accident in '03. Could this be the cause of my test being so low? I don’t recall having any issues with the testicles back then, but then again I was knocked out and had a pretty good concussion. I was off work for 12 weeks.

  3. I printed off the TRT Injection Protocol that KSman wrote up (thanks for that by the way). Should I take this to my Urologist and see what he says?

  4. I have still having “performance” issues. Is this normal to still be having these issues after the first injection? I am under the impression that this takes a few injections to get things moving in the right direction.

Sorry for the newb questions, but I am just at the start of learning about this. I am trying to get as much info and education as possible to approach this problem.

It will take upto a few months of TRT to get system acclimated to the T - you should plan on addressing the Estrogen conversion issue now also . Good luck on your journey - there will be ups and downs but Trt is entertaining and fascinating .

Thanks, I will make sure to get the Estrogen under control. I printed out the injection protocol from KSman and plan on taking it to the Urologist on Oct 3.

Your brain will have physical changes and evolving patterns of activity and thought. This takes time.

Sounds like you are on the right path.

A MRI will probably show damage to your pituitary. And that has implications for all of your pituitary mediated hormones. So act accordingly. Do not have T tunnel vision, there may be several other problems and low T is only one symptom. You need broad lab work. You will need to work on that and doc’s will not initiate.

Was someone else liable for the accident?

Read the advice for new guys sticky, post your labs and other info about you.

KSman - Thanks for the reply. I have a copy of my blood work from May. I will post that up later this evening after the gym.

I don’t have T tunnel vision, per say. I just want to feel like I should. If that means T injections, so be it. If there is another route, I will try anything at this point. I will say that after being on T for a little over 2 weeks, I definitely feel a difference. I notice that I am not such a grumpy prick like I was. I can be honest and say that I felt like shit and acted like it. I just didn’t know why.

As for the accident, yes, the driver of the car was cited and at fault. That was back in 2003. We have long ago settled that lawsuit. Long story on that for another day.

I have read the new guys sticky and have printed out quite a lot of information. I want to be as well versed as I can be when I go to the Urologist this Thursday. I am wanting to see what his protocol is before interjecting my own thoughts and theories on it. I am hoping that he knows what he is doing, but I don’t hold any real hope. I will go in armed with the info from the sticky’s in the hopes he will se that I am not just there for some T but to get my levels where they should be.

Again, I will post up my lab results later this evening.

Lab results from May 6, 2013. Blood draw at 2:46 PM. Received in lab at 4:00 PM.

Sodium: 141mmol/L Range: 135-145
Potassium: 4.1mmol/L Range: 3.5-5.0
Chloride: 102 mmol/L Range: 95-107
CO2: 26 mEq/L Range: 19-33
Glucose: 99 mg/dL Range: 65-115
Bun: 17 mg/dL Range: 5-27
Creatine: 1.4 mg/dL Range: 0.7-1.5
Bun/Creat Ratio: 12 mg/dL Range:10-20
Calcium: 9.8 mg/dL Range: 8.5-10.3
Total Protein: 7.0 g/dL Range: 6.0-8.3
Albumin: 4.5 g/dL Range: 3.5-5.3
Alk Phos: 75 U/L Range: 31-115
ALT: 41 U/L Range: 10-60
AST: 14 U/L Range: 9-48
Total Bili: .8 mg/dL Range: 0.3-1.0
Globulin: 2.5 g/dL Range: 2.2-4.2
A/G Ratio: 1.8 g/dL Range: 0.8-2.0

Lipid Panel

Cholesterol: 208 mg/dL Range: 140-200 (high)
Triglycerides: 216 mg/dL Range: 35-150 (high)
Direct HDL: 58 mg/dL Range: 40-95
"<40 elevated risk factor for CHD > or =60 Negative risk factor for CHD
Calc LDL: 107 mg/dL Range: 0-130
Optimal = <100mg/dL Near Optimal = 100-129 mg/dL Borderline high = 130-159 mg/dL High = 160-189 mg/dL Very High = >190 mg/dL
LDL/HDL Ratio : 1.84 Range: 2.0-4.0 (low)
Chol/HDL Ratio: 3.6 Range: 0.0-4.0
Coronary Risk: 0.28 Range: 0.00-4.00


WBC: 6.7 10^3/uL Range: 4.0-10.9
Lymph: 2.0 10^3/uL Range: 0.6-4.1
Lymph %: 29.7% Range: 10.0-58.5
Gran: 3.7 10^3/uL Range: 2.0-7.8
Gran%: 55.3% Range: 37.0-92.0
MO: 0.42 10^3/uL Range: 0.20-0.80
MO%: 6.3% Range: 5.7-10.3
EO: 0.54 10^3/uL Range: 0.04-0.40 (high)
EO%: 8.0% Range: 0.0-5.5 (high)
BA: 0.05 10^3/uL Range: 0.02-.10
BA%: 0.7% Range: 0.0-2.2
RBC: 5.08 10^6/uL Range: 4.20-6.30
HGB: 15.9 g/dL Range: 12.0-17.0
HCT: 46.4% Range: 36.0-51.0
MCV: 91 fL Range: 80-97
MCH: 31.3 pg Range: 26.0-32.0
MCHC: 34.3 g/dL Range: 31.0-36.0
PLT: 296 10^3/uL Range: 140-400
RDW: 11.9% Range: 11.0-16.0

TSH: 1.34 ulu/mL Range: 0.35-5.50


Test, free
Test, total: <10 ng/dL Range: >18 yrs old 241-827

Sex Horm Bind Glob: L5 nmol/L Range: 11-80



PSA: .67 ng/mL Range: 0.02-4.00

TSH: 0.43 ulU/mL Range: 0.49-4.67 (low)
LH: 2.5mIU/mL Range: 1.2-8.6
fT3: 2.50 pg/mL Range: 2.50-3.90
fT4: 0.61 No units of measure or range provided

This is all the blood work data I have. I know some of the blood work is a few months old. Steps were taken to reduce Cholesterol and Triglycerides. Unfortunately they have not been check since this blood work was performed in May.

I expect that your cholesterol will improve with TRT and meds will not be needed for that.

Your LH is low but should still drive some T. Your really low T then suggests primary hypogonadism. From a technical point of view I would have wanted a re-test.

fT3 would be best here mid range: 3.2

Low TSH and low thyroid are an odd combination. Does not look like iodine deficiency. Have you read the thyroid basics sticky and checked your body temperatures?

KSman, I have not checked body temps to date.

I went to the Urologist yesterday. He seemed a lot more knowledgeable than my PCP. He ordered new blood work which was done yesterday afternoon after my appointment. I should have the results within the next couple days. He hit on primary or secondary as being the cause right away. My PCP never checked Estrogen levels so that was also put in the order. He is going to call me with the results when they come in. I will also have him send me a copy of the results so I can post them here once again. He questions the results of the test level as it was SO low.

I will get a thermometer and start checking my temps. I will check the thyroid sticky to find the protocol for that.

Thanks for your help.

I will have more blood work to log in the next day or two. I talked to the Urologist’s nurse and all I could get from her was:

Pituitary hormone was non existant
Test level was 413
Estogen was 133

The Urologist is not worried about any of these things and wanted to wait another 3 months.

We told him that we are not waiting and I needed to talk to him. Once I get test results, I will post them up once again.

This is turning into a huge PITA.

You cannot have zero LH/FSH and have TT=413.

133 or 13.3? E2: What lab range and units? If E2 is high, we need to look at liver ALT/AST to see if that is why you cannot clear E2.

Urologist is the problem. He was trained to remove prostates not finesse hormones.

What has been your long term source of iodine? Need body temperatures. Are you exposed to bromine?

KSman - I was hesitant to post those numbers without the lab results on hand to know the ranges and units of measure.

Iodine comes from salt that my wife uses in cooking. Almost everything we eat is home made. We buy our proteins from a local butcher and it is all grass fed. I am not exposed to bromine that I know of, but I will look into that.

I do need to get on with getting my body temps. I will check tonight to see what we have in the way of a thermometer.

The only range I can remember off hand that I was given was for Estrogen. The range the nurse told me was 40-115. Again, without the lab results, it seems meaningless to me other than it is way too high. But she said the Urologist wasn’t worried about it right now. Which I don’t understand. More info to come as I get it.

KS - In the blood work sticky you say that testing LH/FSH after starting TRT is stupid. Could this be the reason why my levels tested non existent? Could it be that the exogenous test is killing these numbers? At the time of the blood work, I had already had 2 injections. 1 @ 250mg and 1 @ 200mg. The 200mg injection was 6 days prior to this blood work. I am just trying to understand this better.

[quote]machinemanrjb wrote:
KS - In the blood work sticky you say that testing LH/FSH after starting TRT is stupid. Could this be the reason why my levels tested non existent? [/quote]

Yes, that’s the reason. TRT shuts down LH and FSH quickly. It is expected and normal. So it’s really not useful to check them after starting TRT.

Something may have been learned if you had them checked before TRT, but at this point it is too late, unless you go off TRT for a few months and retest them, whcih I doubt you would really want to do.

9-18-2013 (date that I received the test results - date of test unknown but at the latest May - before TRT started)

TSH: 0.43 ulU/mL Range: 0.49-4.67 (low)
LH: 2.5mIU/mL Range: 1.2-8.6
fT3: 2.50 pg/mL Range: 2.50-3.90
fT4: 0.61 No units of measure or range provided

Seekonk - this is from my previous post with the lab results. It shows LH at low normal. Unfortunately I do not have anything showing FSH.

What catches my attention now (since I have learned a little more) it that in May TSH = 1.34 but then in September TSH = .43. What could cause this level to go down? I was not on anything (AAS or DS or any other supps).