T Nation

Starting TRT Next Week

Hello guys, I decided to start TRT next week as I can’t solve my libido and erection problems for a very long time now.
I will post my diet, supplementation here and what I tried so far and it didnt help. If you have any other suggestion before I pull the trigger next week I’m willing to hear. Pllease excuse my long post!

PDE5 inhibitors couldn’t help, I tried pt 141 (bremelanotide) as well with no effect. I supplement regularly high doses of aswagandha, yohimbine, vitamin D, magnesium oxide, l citruline, vit b complex and vit c, eat a calorie surplus diet with lots of fat (less pufa), don’t smoke/drink and don’t do drugs.
My protein and fat sources are whole eggs, whey protein, beef, chicken fillet, tuna fish, cottage cheese, avocados, whole coconut, olive oil, pumpkin and sesame seeds, peanut butter, my carb sources are fruits in the morning and around the gym (orange, apple, ginger, bananas), I eat a lot of fiber (broccoli, spinach, carrots, cabbage), brown rice, whole grains.

I’m 30y old, natty all my life, I train since my 16’s. 6"2 (190cm) and about 230lb (104kg) atm. I train 6 times weekly and do HIIT cardio (boxing and rope jumping) on my rest days.
I don’t feel any fatigue or lack of motivation, I pack muscle and loose weight easily, literally I have no signs of low T except for libido and poor erections.
This is my form atm, I’m few pounds above my ideal weight but not obese definitely.

This is why I delayed TRT for so long, but it looks impossible for me to fix it naturally.
I think my problems with libido/erections started few years ago when I was on keto diet for far too long - entire summer. I literally didn’t eat any carbs at all, except on cheat meals days, every 10 days.
My form was amazing back then, but I was extremely fatigued, there was no life or joy in me. I was like a skeleton.
Might be wrong, but think it was the time when everything started. Guess I fecked up my hormones big time then forever.

These are my latest results:

Testosterone : 12,70 nmol/L (5.54-25.20)
Free Testosterone: 12.10 pg/mL (7-22.7)
Estradiol : 36.4 pg/ml (0-56)
SHBG : 22 (13-71)
FSH : 5.7 (0.7 - 11)
LH : 2.69 (0.8 - 7.6)
Albumin : 47 (35-50)
Prolactin : 284 (53-360)
T3 total : 1.4 (1.3-2.6)
s-TSH : 3.670 (0.400 - 4000)
T3 total : 1.4

Cholesterol and lipids are in range so I didn’t post them here.
I intend to check DHT as well as I never done it and I read on this very forum DHT can be responsible for weak erections and low libido in general.
My thyroid hormones and prolactin were much lower at one point (TSH close to 1.000) and prolactin around 60 when I was on T4 hormone and bromocriptine, but I didn’t feel any relief with with better ranges so I dropped them (In fact, I felt worse back then).
Of course, I will repeat my blood work before I start TRT.

I already mentioned that I live in one south-eastern shithole country in the Europe - So far I have changed 4 endocrinologists and 3 or 4 urologists and none of them wanted even to discuss my reasons for TRT. They all glance at my results, telling me ‘They are in range or within the range’ and that I’m in fantastic shape and the problem is in my head.
I have also visited cardiologist to check my heart and it is good.
Did my pituitary and thyroid screening 2 or 3 times and they are fine.
My prostate, kidneys and testicle screening showing they are fine as well.
My latest urologist urged me to visit psychiatrist so I went there as well.
He prescribed me SSRI (Wellbutrin) which is not supposed to cause further ED problems, but I don’t feel much better on it after 2 weeks, I feel even more lethargic.
On my own, I took 1/4 of arimidex twice weekly and I think I felt better for a moment - At least my erections were better and my mood improved. After a while I dropped an AI, as it would only worsen my situation long-term.
2 weeks ago, I introduced 12.5mg of clomid EOD and recently I upped a dose to 25mg each day but I don’t feel any difference.

I also bought proviron as I read it can boost libido and erections significantly but I decided against it as I’m afraid it will supress my hpta even further.

Now, I’m not very familiar with TRT and only recently I started reading about it.
If I decide to go with it, I would really like to maintain my fertility.
I’v been thinking to go with HCG 2x250iu twice weekly.
As for testosterone, I will need to go underground for it as I won’t get it in the pharmacy but source is quite reliable, as it is good friend of mine.
I have a choice of cypionate and enenanthate.
I was thinking to start with lowest dosage of 80-100 mg of testosterone weekly.
Anyway, the biggest doubt I have is the way I want to administer injections -
I would opt for daily subq injections, as I read testosterone is the most stable this way and I would probably need no AI this way?
So, 15mg daily.
The other solution is 40-50mg twice weekly.
What would be your pick for starters?
As I mentioned, I cannot discuss this with any endo as they would think I’m crazy for wanting TRT.

As you may know, most (90%) guys inject once weekly and the dose ranges between 150-200mg. Being “stable” is not an issue for them. However, since you’re leaning towards daily anyway, there is nothing wrong with it. TRT is worth a try and increasing your free test may do it. I’m also wondering if you would do better sexually with increased E2. Some do. Good luck.

By the way, congrats on the diet discipline and training. Sometimes, over training is the issue. Might consider something different for a while? Six times weekly with HIIT/cardio on rest days? If once daily, there is only one rest day. Are you training twice daily on some days?

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It would be great if I could inject once weekly. But I read somewhere (might be wrong) that the more you inject, more stable your testo and e2 are?
I would even start with lower dosage, say 125mg weekly and see where do I go from there?
Yes I’v been thinking about over training but I really doubt. I used to train twice per day last year (fasted cardio in the morning, and gym later in the night) but I dropped it this year.
My workouts are quite vigorous for a natty, I split compound lifts and isolation lifts, train for 2 hrs and hit every muscle twice weekly. I really kill my legs : D
On rest days (every 4th day), I do hiit cardio for 20-25min and I stretch for 30min.
But as I said, I don’t feel any fatigue, in fact I feel very energized and motivated in the gym.
Everything is fine except woody in fact.

“PDE5 inhibitors couldn’t help”?
None of them???

We are similar, same gym story, I’ve been lifting for 20 years, but my case is kinda different:I have many low T symptoms, you only have ED and libido problems. I primarily want my libido back, reversing other symptoms is a plus even though they don’t bother me ‘that’ much, hence decision to start TRT. Cialis takes care of ED, I take 5mg when I have to, it lasts like 4 days, I can go 6 times a day like a 15 year old. But it gives me a headache unles I take it with Ibuprofen, and of course does nothing for my libido, which is 0.

For some time I thought, meh, I am how I am, maybe I will take 5mg cialis every 2 days for ever. Now I know better, starting trt tomorrow. I wanna ‘wanna’ have sex, get wood when I see a hot one, sleep better, be tired seldom, pack even more muscle etc. Starting with a total of 125 mg test e in 2 weekly doses sc.

Tried cialis so far and felt nothing but a face flushing and constipated nose last time with my gf. Later I tried viagra and cialis when masturbating and still nothing. Not sure of the source though, I ordered them online.
But urologist injected penile injection and I only had minor boner. I wasn’t relaxed though and was quite ashamed to achieve full boner.
Last night wanted to check pt 141 and libido and erection improved 7h after injection but it lasted 1 hour.
Trust me mate, I would trade everything I have in check for normal sexual function.

Thyroid looks worse than your T levels from the limited info available. Have you looked there?

It will be interesting to see your results after initiating TRT based off your comment about the AI improving some erection parameters for a short time, because what happened is you were able to free up some extra testosterone (DHT) for use temporarily on the AI.

The elevation in TSH in hinting your thyroid is struggling a little, your thyroid needs a healthy amount of carbs.

Yes. My TSH was above 5500 at one point. I started with t4 medication then and managed to lower it to around 1000 but I didn’t notice any benefits. I dropped T4 then, now I don’t take any medication for thyroid (except aswagandha and eat thyroid friendly foods). Also did thyroid screening and it is ok. I think elevated TSH was due to extreme stress I felt in that period.
In monday I will do another blood tests to check my tsh, free t3 levels (free t3 have always been low).
DHT is the only thing I never checked. I will do it in monday, as well as my thyroid hormones again.
I eat carbs now, I lowered my protein intake and upped carb and fat intake - Fruit in the morning, rice/oats/wheat flour before and after training. I’m on about 300-400carbs daily.

Have you taken roids before? Extremely uncommon to be 230 lbs and have what looks to be only 10-12 % body fat without AAS use. If you are completely natural…hats off to you.

If not…previous drug use may have fucked you up beyond what TRT can fix in my humble opinion.

I have never used steroids but thank you. Just extreme dedication with foods and workouts, I don’t think I have made break longer then 10 days last 15 years.
And I was never satisfied with my looks to be honest.
But in a hindsight, I would trade it all for a working dick, I’m that desperate :slight_smile:

I’m with you…That’s the reason I’m considering TRT as well…I’ve been lifting since I was 15 and am also 6’2" but I’m 242 lbs and probably 20% body fat …I don’t look as good as you for sure…But I am big and strong…

Now you have me wondering if lifelong dedication to heavy weightlifting affects libido/erections.

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@ncsugrad2002 @systemlord
I will have my thyroid results tomorrow. I have one question here - When I used 75mcg of thyroxine for ~ 1.5 month, I managed to lower my TSH to 1500, but FT3 is always at the same range, with or without hormone (1.3/1.4).
Is there any sense in adding (combining) t3 to t4 or higher thyroxin dosage can solve it?

1500 uiu/ml (0.400-4000)
was over 6000 before t4

That isn’t right. The range is 0.400 to 4.500

I have a feeling you’re mixing up commas and periods vs what I am used to and what the ranges mean.

The ranges and results do not go into thousands.

yea sorry, it is 1.5.
and t3 is always 1.3

I think you may have stumbled onto something here. You’re chasing hormones and thyroid when this may be more of a CNS problem combined with a muscle/ligament/mobility/pelvic floor tension issue. This might sound crazy to you but give this a go. Take 10 days off from the gym…in a row. Go for a 45 min walk each day. Look up various exercises/stretches that open your hips and relax your pelvic floor. Its possible to carry enough tension, especially after years of exercise(and perhaps going too heavy, not properly stretching or working through a full range of motion) to inhibit erectile response. The nerves dont function properly and the plumbing literally cant operate at full capacity. Even if you start TRT try this. Given your history, it could be a great help.

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The first time I went to a urologist for ED issues I was around 30 years old…I thought the DOC was crazy because he looked at my legs and told me to stop squatting because it was disturbing something in my ass that was effecting my boners…I completely dismissed him as a nut job…

You just train to much. reduce your Fucking volume man and your test will be back what the fuck did i just Fucking read

im 25 and doing the amount of frequency your doing, intensity and no Fucking day off i won’t be able to fuck Britney spears

Aha moment bro.

@kandeman2 @bigmax
There might be some truth in this, last longer break (7 days) I made was 2 years ago when I went to Greece on vacation, and even then I couldn’t relax, was swimming like a madman and doing cardio in the morning.
Thing is I don’t feel overtrained. I only feel good in the gym, as my life is a wreck at the moment. I have a feeling I could train 2 or 3 times daily, but I know it’s counterproductive. Is it possible to be overtrained if you don’t feel fatigued and demotivated?
Anyway, I will listen to your advice and take a 10d break and will introduce some stretching exercises. I rarely stretch, only after boxing and hiit cardio, but 10 minutes max and rarely I stretch pelvic area.
I’m just afraid I’ll mentally go completely nuts not doing any gym for 10 days.