T Nation

Starting TRT with High Body Fat?

Have been prescribed TRT, but currently over 25% body fat @ 6’4” 268lbs…all bloodwork looks great, other than low T (269) low free T (57) and lowish SHBG (21)…glucose was 80, bp 121/71 pulse 54bpm and lipids all good… should I drop some fat first or just start TRT and work to lose it as I go?

There’s valid arguments both ways. I’d give TRT a go now, in a lot of cases it helps with the fat/weight loss side so it’s a double win. Not always. But usually. Especially if you’re having low T symptoms that make it more difficult to lose weight.

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Low energy n feel worn down all the time…get morning wood and no ED, but also a real lack of desire for sex. I’m almost 40 and definitely feel older. I know letting myself get fat n out of shape probably helped lower my T, but now that it’s low, it’s harder for me to make myself do the things needed to raise it or to get back into shape…kind of a vicious cycle

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Yeah I’d go for it then. I think it’ll help with the weight loss which should get the viscous cycle going in the other direction.

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Thanks, man! Am prescribed 100mg weekly to self inject, then reassessment in 8 weeks with new labs…seriously thinking about just starting at 10mg daily subq and going from there…start low and have room to go up if needed…seen lots of guys getting great results from 10-12mg daily n think it would be worth trying…what do you think?

I wouldn’t start at less than 100mg/week. Very few get a lot of benefit below there. Some do, but most need more and it’d suck to be put off on the whole TRT idea because you started too low then went up some and it still wasn’t enough and a little more and that still wasn’t enough and eventually you got frustrated with the whole process before finding out you actually need 150mg a week or something very common/reasonable like that.

Up to you though. Hell I’d start you at 75mg 2x a week if it was up to me to be honest. But I’m not a doctor, not that most of them have a clue what they’re doing when it comes to TRT anyways :sweat_smile:

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I just figured it would be easier to gradually go up if needed, rather than start too high and have to go down.
Having 269 total, now, anything will be an improvement lol

Better dont start sub q you can try that later.
Start 2 or 3 times a week this 100mg weekly and inject it in the deltoid with either 3/4 or 1 inch needle depending your body fat level.

A lot of people here including me had too variable results using sub-q. IM is reliable and predictable.

Also small percentage of people need to inject cypionate daily.

If you use sustanon for example that is another story

TRT with a reasonable diet and exercise regimen will be your best option.

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Just start with 100mg once a week as prescribed. Reassess as prescribed. Perfectly reasonable approach. Save the fancy protocols for “If needed”. And ignore anything Vonko says, or maybe do the opposite.

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I was in the same boat as you, with a higher bodyfat %. I just went for it at 200mg a week and an AI…I think being a big dude, your body will probably handle the test (but I’m no doctor). I inject in my upper quad - no issues for over a year. I only inject once a week. Don’t over think it and give it time to work. Give yourself the best chance to succeed by starting with a good diet, also try to cut back on alcohol, and get sleep.

my doctor actually said i could do any amount/frequency/subq or IM that i like and would stick to, as long as i dont go over the 100mg per week total, until after we get labs back once i’ve had time to stabilize levels

luckily i quit drinking about 10 years ago…and i sleep really well now, that is one thing that i hope TRT doesnt mess up! lol I take some magnesium glycinate about an hour before bed and i sleep until time to get up (sometimes i get up once to use the restroom, if i dont cut my water off soon enough before sleep!)

100mg used to be considered an aggressive starting dose, is now considered a very conservative starting dose. In my opinion, it’s a good place to start. Since you are just starting on the journey, you may not know yet, whether your doctor is a treat by symptom or by numbers kind of guy.
There are some very outspoken forum members that are very anti-AI, but given your higher BF%, there is a good chance that you will aromatize more than average and your E2 will likely climb with your TT. If that’s the case your doc may prescribe an AI. That’s a whole other rabbit hole that you could get lost in for days.
But as for your original question, 100mg is a reasonable starting point. I am novice compared to a lot of guys on here, having only been on TRT for just over a year. But a year ago, I too started at 100mg/wk in one shot. One year later, if I knew then, what I know now I would likely split that 100mg into 33mg IM injections on Monday, Wednesday and Friday.
Is it necessary? No
Is it beneficial? in theory it is; in practice sometimes it is, sometimes it isn’t. But even if it’s not, it won’t be any worse. What i mean is that splitting injections will give you smaller hormonal spikes, so you will have a more consistent level throughout the week. Avoiding the spikes should also in theory limit the amount of aromatization that occurs as well. I find it to be a good compromise. it’s two extra injections a week, but i would rather push .33mL than 1mL at a time.
There are some that preach the benefits of every day (ED) or every other day (EOD) injections, but I would leave those for later in your journey.
Good Luck

TRT made me really warm for the first few months…a fan solved that problem.

Anyways, good luck on your journey. Im pulling for you. It has done wonders for myself with my relationships, career, and overall health.

part of me wanting to do shots every day subq, is to avoid the rise in e2 as much as i can…and keep it in a more normal range for my TT level… also to avoid the spikes that can cause any of the other “side effects”. My girl is type 1 diabetic (caused by pregnancy with our daughter) and she has to take 5 subq shots per day, every day… i figure that making 1 per day part of my regular routine wont hurt me and could possibly make this ride a lot smoother from the get go! Could be wrong, as i’m new to all of this…but that is my hope/goal!

It’s just not necessary to inject that often for most people, in most cases, IMO. But certainly it works fine for a lot of people too so there’s that. I never felt anything on subQ so I switched to shallow IM (still used insulin syringe), did 3x a week instead of 7 to delt and could tell a difference pretty quick. I’m not sure why. You’d think either way it’s getting into your body and should work out to the same amount per day in the end but for some reason some people respond better than others to subQ vs. IM

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ive noticed from reading tons online… guys who start subq tend to have better results with it than guys who start IM and then switch to SubQ… probably due to it’s slower release, guys switching from IM, used to a faster release will “feel” their levels drop until things catch up but often switch back before it has had time to do so?

As well as once per week is not optimal for most people, daily cypionate is not needed for most people as well. 2-3 would be fine

Also the sub q injection will introduce additional variable in comparison to IM. Better just follow the @ncsugrad2002 s advice here and you should be fine

As much as the dose in my opinion most likely low, but better to start low and go up from there

Or the ones starting subQ don’t know any better since they haven’t done IM :wink: so they think they’re better but could be even better. Obviously, not all cases, but I do believe that does happen.

The reality is either can work for most. I think IM is the old tried and true method with the highest chance of working for most people so that’s a good place to start to me.

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