The Road to Optimization

Optimal is obviously a relative term. I’ve been lurking on the nation for about two months now, and just want to share my experience thus far and get some outside perspective.

I’ve been taking meds now for PTSD and depression, but even after modifying doses and even combining multiple meds I still felt bad. Exercise has always been my outlet, and not being able to drag myself out of the chair to work out was making matters worse. That’s when I decided to get my T checked.

The VA tested me first, and I fell within "acceptable guidelines at just over 300 ng/dl. Anyone who knows the VA knows its difficult to accomplish anything, and by this point I was determined that my T levels were the root cause of these issues. I found a civilian clinic online, and had my first panel done.

The panel revealed my total T was 224ng/dl, free T @ 5.1, and my estrogen was too low to register (<5.0)…so I started my first protocol in May:

Test C - 200mg / 0.5ml IM twice a week (Mon, Thurs)
HCG - 0.25ml SubQ twice a week

Along with the Sertraline/Bupropion, I’ve also been taking Cialis (6mg) daily to combat the ED the other meds are notorious for causing. I also have Viagra through the VA, but its limited and timing/half life are always a factor, so I decided to try the daily Cialis.

The first couple weeks things were great. I had my energy back, I was lifting 4-5x a week and even lost a little bit of weight. However, around week 3-4 I noticed my right ankle was swollen. I fish often, and figured it was just hot and I had been standing on the boat all day. I continued to watch it, but it gradually just got worse. Now both of my feet/ankles pretty much stay swollen, based on the amount of time I’m on my feet. I’ve also noticed my face is bloated, and overall I just look bigger. My diet the first month was pretty good, but then I got covid and started having the ankle issues and now it feels like that progress is gone. I know water retention on TRT is a thing and my water intake could always be better too, but I’ve always struggled with it.

I decided to get a second panel done this week, and I’m still waiting on those results to be reviewed. I understand everyone is different, and I know these things take time…but staying motivated and mentally healthy is very important too, and these issues are gonna bug me until I can draw some sort of conclusion.

Apologies for the long winded post, but any comments, criticism or words of encouragement would be appreciated. TIA


What was your SHBG?
How much do you weigh (or estimated BF%)?
Have you started working out again? Have you gotten back on your diet?

Particularly with TRT. You did well by seeking another clinic.

I’ve never had SHBG tested, which is annoying…I’m a novice in this space, so I’m learning something new everyday.

Body fat has always been an issue for me. I was always “tape tested” in the military, and since getting out in 2010 I’ve fluctuated anywhere from 215 to my heaviest at nearly 280. I was about 260 when I started TRT, so I definitely know I have weight to lose…

Diet is still fluctuating, and I haven’t worked out for about two weeks. In the past I have always focused on cardio/HIIT, but with the TRT I was hoping to gain some more muscle and just get leaner over time. I have focused more on hitting my daily protein and fat macros, and trying to maintain a slight calorie deficit. I’m pretty familiar with the diet side of things, its just the combination of lack of motivation and building frustration what is currently holding me up…

You also have a 30% greater risk of suffering a major cardiovascular event and premature death from any cause at levels below 550 ng/dL.

It seems like this is acceptable to providers nationwide.

Defining “Healthy” Testosterone

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Results from second panel:

Total T: 1124
Free T: 29.9
E: 78.9

I’m thinking I need to make some adjustments. Thoughts?

Was blood drawn at your trough, yes?

Your response is fairly typical for someone on 200mg/wk, perhaps a bit lower than average, but nothing to be concerned about. How are you feeling? Any high E sides?

FYI on dose response:

Don’t play the numbers game, if all other biomarkers are healthy, and you feel fine, don’t do anything.


Units and ranges?

I clearly missed that post. In light of reading the post, it would be prudent, if you haven’t done so already, to check your thyroid and at the very least lower your Test dosage.

A lot of guys start to reach homeostasis at the 2 month mark regardless of the T ester or half-life.

T levels at this point may be higher or lower. I have seen on three separate ocasions, my labs showing a consistent decrease after 2 months compared to testing after 1 week (Jatenzo = steady state @ 7 days) on three different dosages.

I have seen the same thing on injections.