T Nation

Started TRT Without Bloods, Facing a Dilemma?

Hi guys!

This is my opening post on this forum, so I will lay out my situation;

Location: UK. Age: 38. Height: 6 foot 5. Waist: 38 inches. Weight: about 117kgs. My muscle tone is improving but generally I am quite flabby all over. I have a big thick beard, but recently my hairline has begun to recede.

For many years (from mid 20s) I have been suffering from the accumulative symptoms of fatigue, low libdo, brain fog and muscle wasting. Added to this I accumulated fat on my belly, my ass and my face until in 2013 I reached 133kg.

I knew there was something not right with my system and to do something so In early 2014 i decided to do something about it. I began training, first cardio; insanity, tabata, and then boxing, but this was in fits and starts throughout the year because I would get fatigued so quickly.

I did some light research on what the causes could be and I identified low-T as a possible cause, so I went to my GP for a check-up. They took my bloods and told me that my Test, Thyroid and liver function were all normal but that I had high cholesterol. I was given no drugs and told to adjust my diet. This was in mid 2013.

At the time I knew very little about what was going on with Doctors and ignorance of hormones. I left the surgery confused, because I was convinced I had low-T.

In early 2015 my friend invited me to join him at the gym. I agreed, and before long I was offered gear. I was initially cautious but because I had continued studying the effects of low-T I was curious. I decided to try it out. For three months, from Feb-May this year, I began taking 2ml Sustanon 250 and 2ml Deca per week.

The effect was almost immediate, after my third shot I felt amazing. The symptoms I had been suffering from for nearly a decade diminished rapidly. It was a great feeling. In addition, I was training three times a week in the gym following the 5x5 Stronglifts routine and began to see rapid gains; my muscle tone was returning and my belly fat was melting away.

However, after the second month, my research into TRT developed and deepened my understanding. I decided to stop taking deca because I knew it had no place in TRT and and upped my dose of Test to 4ml per week, Monday and Friday.

It was around this time, that I found KSmans protocol on injecting, which was a big breakthrough for me and I began to doubt my Test dose and protocol. I decided that I wanted to switch to KSmans protocol and began sourcing Hcg and AI.

I began to realise the importance of blood tests. After my failure with the Doctor I was reluctant to go back there, so began looking for private blood clinics in UK. But the price of the tests put me off.

Then for a reason I still don’t quite understand, I decided to stop taking the Test and came off abruptly. Maybe it was instinctive decision to find out if my new quality of life was just a placebo. Sure enough I crashed hard. My libido simply and completely disappeared along with erections, much more that before I began taking Test. Add to this depression, moods and total apathy … it was a grim two weeks.

I decided to restart the Test but this time I was determined to do it as therapy. I sourced Test Prop, Hcg and AI. About a week about I began KSmans protocol. My QOL has began to improve again, but i’m not quite where I was when I started taking Test in Feb.

I have since read all the stickies and it’s now very obvious to me that I must get bloods done asap. I will try the Doctor first, but if that is unsuccessful I will have to pay for bloods.

So I guess my questions is; would it be best for me to come of TRT and allow my levels to drop then get bloods so that I have a baseline reading or remain on TRT, get bloods done and adjust from there?

I hope this is clear and makes sense.

You should go and get copies of your original lab work. It is important to try to find out why your T levels are low, low-T is the symptom.

You could also have low thyroid function.
Low thyroid function has most of the same symptoms as low T.
Low thyroid function takes away your energy and makes you fat; you might feel cold easily.
Lack of iodine intake can be a cause.
Low thyroid function slows down the mitochondria that burn lipids which can contribute to increases cholesterol.
Many gave low thyroid function and low-T.

The lab ranges for thyroid hormones are quite stupid as are the MD’s.

Check your oral body temperature when you first wake up. 97.7+F is good, 97.3 is a problem. You also need to hit 98.6F/37C in the mid-afternoon. If body temps are low, read the thyroid basics sticky.

Deca is bogus, not a human hormone. Test cyp/eth deliver bio-identical T as the ester groups are stripped off.

When you stop taking TRT and crash, exactly what do you think lab results represent? Lets see your pre-TRT labs and go from there.

pre-TRT labs:
LH/FSH - cannot be done later
vit-D3 [ or simply take 5,000iu vit-D3 per day ]

Hey KSman,

Thanks for getting back to me.

That’s a great idea, ill call the doctor in the morning and request my results. I thought a little deeper on it and I think I went for the test a year ago not 6 months ago. Ill find out for sure tomorrow.

Also, like you said, one has to become an amateur endocrinologist to take responsibility for your own health. So I want to study the information deeper, can you recommend an endo textbook to use for reference?

Thanks again.


I called at the Doctors and requested my results from 2014. Here they are;

HbA1c level - IFCC standardised - (LBO) - No action 36 IFCCmmol/mol <41.00IFCCmmol/mol

Urea and electrolytes - (LBO) No normal action required
Serum sodium 138 mmol/L 133.00-146.00mmol/L
Serum potassium 4.9 mmol/L 3.50 - 5.30mmol/L
Serum chloride 101 mmol/L 95.00 - 108.00mmol/L
Serum bicarbonate 27 mmol/L 22.00 - 29.00mmol/L
Serum urea level 3.3 mmol/L 2.50 - 7.80mmol/L
Serum creatinine 81 umol/L 50.00 - 130.00umol/L
GFR calculated abbreviated MDRD >90ml/min/1.73m^2 >60.00ml/min/1.73m^2
Serum anion gap 15 mmol/L 10.00 - 20.00mmol/L

Thyroid function test - (LBO) - Normal no action required
Serum TSH level 3.0 mu/L 0.30 - 6.00mu/L
Serum free T4 level 15.4 pmol/L 10.00 - 22.00pmol/L

Plasma Testosterone level - (LBO) - 15.5 pmol/L 10.00 - 22.00pmol/L
Normal no action required

!Serum lipids - (LBO) - Abnormal - routine appointment see GP
!Serum total cholesterol level 6.0mmol/L <5.00mmol/L
!Serum triglycerides 2.8 mmol/L <2.30mmol/L
Serum HDL cholesterol 1.1 mmol/L >1.00mmol/L
!Serum LDL cholesterol level 3.6 (calculated) <3.00(Calculated)
!Total cholesterol:HDL ratio 5.5 ratio <3.50ratio

!Liver function test - (LBO) - No Action
Serum albumin 45 g/L 35.00 - 50.00g/L
Serum total protein 70 g/L 60.00 - 80.00g/L
Serum globulin 25 g/L 19.00 - 35.00g/L
Serum alkaline phosphatase 73 u/L 30.00 - 130.00u/L
Serum total bilirubin level 10 umol/L <21.00umol/L
!Serum ALT level 37 u/L <35.00u/L
Plasma gamma GT level 26 u/L <50.00u/L

Plasma glucose level - (LBO) - No Action 5.7 mmol/L 3.50 - 6.00mmol/L
Serum ferritin - (LBO) - No Action 63 ug/L 30.00 - 400.00ug/L
Plasma C reactive protein - (LBO) - No Action <5 mg/L <5.00mg/L
Erythrocyte sedimentation rate - (LBO) - No Action 6 mm/h 0.00 - 10.00mm/h

Full blood count - FBC - (LBO) - No Action
Haemoglobin 153 g/L 130.00 - 160.00g/L
Red blood cell (RBC) count 4.95 1012/L 4.32 - 5.661012/L
Haematocrit 0.445 L/L 0.39 - 0.50L/L
Mean corpuscular volume (MCV) 89.9 fL 80.00 - 100.00fL
Mean corpusc haemoglobin (MCH) 30.8 pg 28.00 - 33.00pg
Platelet count 244 109/L 150.00 - 400.00109/L
Total white cell count 5.5 109/L 3.50 - 11.00109/L
Neutrophil count 2.3 109/L 2.00 - 7.50109/L
Lymphocyte 2.5 109/L 1.00 - 3.50109/L
Monocyte count 0.6 109/L 0.20 - 0.80109/L
Eosinophil 0.1 109/L 0.00 - 0.50109/L
Basophil count 0.0 109/L 0.00 - 0.20109/L


I took my oral temperature this morning, I am surprised by the results.

9AM: 96.08F
12PM: 96.26F

I wasnt expecting that, so I guess I have thyroid issues. I will take the readings again a few more times this week to check for consistency.

What are your thoughts moving forward?

I have just taken another reading, 13:44PM: 96.16F

Body temps do not surprise me. You can get someone else to use the thermometer to see that it will get to 98.6. But if your thyroid problem is from an iodine deficiency, others in same house can have the same issues.

For many years (from mid 20s) I have been suffering from the accumulative symptoms of fatigue, low libdo, brain fog and muscle wasting. Added to this I accumulated fat on my belly, my ass and my face until in 2013 I reached 133kg.

Thyroid function test - (LBO) - Normal no action required
Serum TSH level 3.0 mu/L 0.30 - 6.00mu/L
Serum free T4 level 15.4 pmol/L 10.00 - 22.00pmol/L

TSH should be nearer to 1.0; ranges are stupid and docs don’t know any better.
fT4 and fT3 should be near mid-range. fT4=15.4 looks very good.
So fT3 is low or perhaps rT3 is blocking fT3

If you have had a lot of stress or illnesses, acute or cronic, or accidents, you can get adrenal fatigue and elevated rT3.

Please read the thyroid basics sticky.

If you are increasing your iodine intake, you need a multi-vit that contains iodine AND selenium.

You can also have thyroid anti-bodies checked if you have been using iodized salt.

Hypothyroidism can also lower T levels in some cases.

Labs say that you are normal and your doc will not understand what you are concerned with and may not want to do more labs.

Endocrinology: Read the links to Wikipedia in the ‘advice for new guys’ sticky. You do not want a text book.