T Nation

Starting TRT, Need Your Opinion




  • 27 years old
  • 1m82 cm or 5.97 feet
  • waist unknown. (I am thin and my abs are visible but my waist is not straight and looks more like a hourglass figure.)
  • I almost have no hair on cheeks. I have a sparse light colored beard. Most of my hair is under the chin, jawline and around the mouth. I have some hair on my chest. Most of my hair is on the legs.
  • Weight unknown. I have not changed really since my last checkup. My weight was around 79 kg (174,165 lbs) a month ago.
  • I have a multiple familial lipomatosis since 2013. I also broke my arm in 2012. I believe that my immune system is getting weaker. I started having the flue and then two weeks later shingles on my back and torso between October and November 2017. I am also under a lot of stress. I have always been stressed out my entire life. My fingernails are purple or blue, I do not have any lunula but on my thumbs.


  • All of them.
  • Depression
  • Suicidal thoughts
  • Strong mood swings
  • Rare morning woods
  • Fatigue
  • Social anxiety
  • No self confidence
  • No libido
  • Very tired looking face
  • Very easy to obtain fat
  • Very easy to lose muscle
  • Very hard to obtain muscle ( Same physique since I started back in 2014, despite everything I could do )
  • Hard to focus
  • Lethargy
  • Wrinkles despite age and healthy lifestyle.

Thyroid Info: None. I still have to learn about it.

First Lab Test (I am giving you what I have):

  • Sex Binding Panel:
  • Testosterone - Testosterone (F). 11.00 nmol/L (317.002 ng/dL)
  • Sex Binding Globulin - Sex Binding Globulin (F). 34 nmol/L. (979.827 ng/dL)
  • Free Androgen Index - Androgen Free Index (F). 32,4. if it is in nmol/L then it means 922,190 ng/dL.

DHEAS. 8,5 umol/L.

Liver Panel:

Bilirubin - Total - Bilirubin Total (F). 14 U/L.
ALP - Alkaline Phosphatase (ALP) (F). 82 U/L.
ALT Alanine - Aminotransferase (ALT) (F). 48 U/L.

The rest of the lab test is about Urinalysis Microscopic Panel and Glucose Fasting.

This is what I received when I asked for a testosterone blood test to my doctor back in june 2017.

Diet: Almost everything is organic.

During Workout: 10g of BCAA.

  • Morning: Oatmeal 100g with 30g of whey protein. 1 orange (sometimes kiwi or blueberries), 1 lemon, 10-12g of ginger. 15g of almonds. 3g of creatine. Fish oils, magnesium, zinc, tribulus, and more for testosterone.

  • 10 AM: 30g of whey protein. one fruit.

  • Lunch: 130g of rice or pasta. (whole grain). 150g of fish, or white chicken, or 4 eggs. 150g at least of green vegetables.

  • 5 PM: 180g of bread (whole grain) or 120g of oatmeal. with 3 eggs or 30g of whey protein. 15g of almonds. 1 fruit. 1 piece of chocolate.

  • 8PM: 30g of carbs. 200g of green vegetables or carrots. 150g of meat, fish, or 4 eggs. 1 piece of chocolate.

I try to drink at least 2 L of water everyday.
I do not drink alcohol and I do not smoke.


  • 5 times a week.

  • Wake up at 6 AM or 5:45 and fight against myself to go to the gym in the morning before going to work at 9 AM.

  • If too tired, I go after work.

  • It is always hard to go to the gym.

  • It is always hard to workout.

  • My body does not change.

In order to lose my hour glass figure and destroy the fat, I stopped drinking and eating anything that could be bad for my health.

This has been a terrible fight and I finally learned about TRT and Low T years after my first day of training.


  1. Despite starting a TRT next week, I had to tell my doctor that I also wanted some HcG and AI in order to avoid any risk. I know some people don’t even use HcG or any Aromatase Inhibitor but I thought it was the best option.

  2. I am in my late 20s, I don’t smoke, I don’t drink, I drink plenty of water and my diet is healthy. However I never sleep well, my bones are thin and I have wrinkles on my face like a late 30 years old man. I am thinking about adding some Ibutamoren once I will get used to my TRT.

Is using Ibutamoren a good idea if you were lacking HGH during your teenage years?

Thank you

My Protocol for TRT. What Do You Think?

Would like to give some advice but please read the stickies so all of the information needed is there.

For your second point Ibutamoren has nothing to do with HCG. HCG is a luteninizing hormone analogue, Ibutamoren has some rumor to increase plasma IGF-1 and GH. Do not have the time at the moment to look for peer reviewed published studies to verify that fact.


I’m not on HCG or an AI and am making great gains in every respect, especially since start injection EOD, this move has made a huge difference. Only been doing it a month and already my muscles and veins are popping, I feel full of energy. I’ve never had high E2 symptoms in the almost eight months on TRT. If you share your labs we might be able to assist you in choosing a protocol better suited for you as most endo get it wrong. It doesn’t matter how smart they are, if they simply don’t know that makes them uninformed.


Sorry but I think that my message was not clear enough. I know it has nothing to do with HcG. I just wanted to know if adding a bit of Ibutamoren with my TRT would be good for my skin and my natural lack of HGH.

Thank you anyway for your answer.


This is just great if you do not need an aromatase inhibitor. Personally, I think I will use HcG because I want to keep my natural testosterone but I am not so sure about using an AI. I am thinking about starting my TRT with an AI so I would not have to worry about my estrogen levels.

But something tells me it is not that simple.

I would like to know the difference between using an AI or not with my TRT.

I am seeing my doctor next tuesday, I will ask him about that.
I will also send you my blood test on this thread then.


Is there a reason you want to use an AI before you’ve determined if you need it? The best case scenario is that you don’t need to use an AI, right?

Anastrozole is a chemical that has side effects, whereas testosterone is a bioidentical hormone your body is built to process.

Presumably you’ll have your e2 checked after a month or so of test, and at that point you can determine if you need an AI based on actual data.


Thanks a lot, it’does better to live without it.
However my doctor wants me to do my lab test every 3 months…


I’m no expert but one thing I do know is that if you’re taking the TRT route, you should keep in mind that you are the person in charge of your health. Doctors are people who provide a service to clients, and they typically have an extremely limited amount of time/attention to devote to your particular case.

Maybe every 3 months is fine once you’ve normalized your protocol, but if it were me, I would figure out a way to get labs done a month after starting.


This is so true, my endo had me come in for a blood test 4 weeks after starting TRT to see where my levels were including SHBG, then when SHBG came in low she mentioned nothing about it at all. I went 17 weeks injecting 75 mg weekly which is wrong for someone with low SHBG, it wasn’t until I took an interest in my protocol where I started requesting more frequent injections which my endo was glad provide. At the same time I was surprised that by the time I heard back my phone made a noise and found a prescription had already been filled, I couldn’t help wonder why my endo dropped the ball like this.

They simply aren’t given the necessary time required to dial someone in, 8 months later she never once asked how I was feeling, she only looked at my labs and assumed I must have been doing well by looking at my numbers. If I hadn’t taken charge of my protocol I’d still be reading about everyone else rave about how TRT quickly transformed their life and wondering why it was taking me so long the feel the benefits. My first post I was making a point that just because other people require the use of an AI, when one doesn’t require one can put you in a low E2 hell for more than a month.


Three months is not miserable. Depending on what your protocol is you may not need an AI. If you think something is wrong after a month spend the few bucks and buy the script for the labs on online and go to your local labcorp. As mentioned doctors do not have a lot of time. My doctor still prescribes 1ml of 200mg once per week with no AI or HCG. I have desrire to ever have more kids so no HCG is fine for me. My SHBG crashed and my E2 was high from the protocol by my endo. This was found out because I paid for the labs myself to check as I did not want to wait six months and ask for tests that was not on his preprinted form. So I switched to .5ml of 200mg weekly and I started to feel better in about two weeks. Plan to have labs redone soon see what the levels are. Point is, your doctor is to advise you on your health. Insurance is a for profit middleman connecting patients with providers with onerous requirements on both parties.


Hello everyone, I updated my introduction so you could have a better view of my case and body type.

I should start my TRT tomorrow and I am a bit scared. My doctor just said yes for a TRT when he learned about my symptoms.

The problem is:

  1. He never told me if I had Primary Hypogonadism or Secondary Hypothyroidism.

  2. He told me to do a blood test 3 months after the first day or TRT. (After some advice given above, I will do it myself in a month).

  3. I do not know if he has all the necessary numbers and information coming from my blood test. (From june 2017). The one I gave you in my introduction.

  4. I do not know if I need an AI. It is recommended by KSman though.

I really want to be cured, but I don’t know if I can trust him. Should I ask for another lab test. If yes, how can I get the right results? It seems that the labs here just give you what they want, not what you need.

I live in SK, Canada.

Thank you.


I don’t think you realise how lucky you are to get TRT especially in Canada, primary or secondary the treatment is the same. What protocol has your doctor suggested? If he has you one injection beyond once a week that is troubling, if this ends up being the case ask for two injections per week.


what is the protocol the doctor has you on?


I will know more tomorrow but he said that I will have about 100mg/mL of Testosterone a week that I can divide by two and some hCG.
I don’t know anything else.
I asked for an AI as suggested on this website by KSman.


I will know more tomorrow but for now I know that I will get 100mg/mL of T per week that I can divide by two. I also know that I will get some hCG. I asked for an AI as well as suggested on this website by KSman.


This is where know if you are primary or secondary is important. If you are primary HCG will provide little to no benefit as what is an LH analogue if the testis do not respond? If you are secondary, 250IU of HCG every 3 days will closely mimic natural average LH values in a healthy male. 1ml of 100mg is a great place to start, if you find SHBG crashes and or E2 elevates to high you can always switch to more frequent doses and even subq injections.


I thought the treatment was the same either I had hypo 1 or hypo 2.
I will split the T dose but an AI should also be able to avoid any high level of E2.
I suppose then that I can start my TRT tomorrow.


I’m assuming you’re secondary, otherwise why would your doctor give you HCG?


Well, I don’t know.
I think he just said yes to hCG because I’d like to have children someday.


My doctor is not here today. He just keep rescheduling our appointments. I am going to the pharmacy anyway in order to pick up my prescription. I don’t know though if the syringes are given with the hCG and Testosterone. I am hesitating if I should wait for him for my first injection. I have already been waiting for months and it seems pretty easy to do.

From what I have seen, I should inject 50mg SC of T near my belly button with a 25 or 26 gauge needle.

I should then inject 250 IU of hCG and take a small piece of arimidex. 1.0mg per week divided and taken EOD. Some people take 1/4 and others 1/8. I think I will divide 1.0 mg of Arimidex by four.

I still have to check online how 250 IU looks like. I still have to see what kind of syringes I will get as well.

What I don’t know is if I have primary or secondary hypogonadism.