T Nation

TRT 4 Weeks/No Effect

Hi I am from India , age 20
Diagnose with low T

Been on trt for 4 weeks , appetite is better but not seen any improvement in my muscle weakness.
My try protocol:
250mg test e every two weeks

Before trt my test level was 88
After four weeks , now my level is 650
My endo don’t agree for per week injection.
What improvement I can expect after 8 weeks

Your outdated protocol is why you are not seeing good results, decades old clinical studies show one injection every 2 weeks fails to show meaningful results, these clinical studies show testosterone dropping below the therapeutic ranges after 6 days of a 200mg injection. Sadly the majority of doctors live in a constant state of ignorance when TRT is concerned.

You are supposed to do labs right before your injection, this is known as your trough or lowest point, doing labs days after or midway between injections fails to show where your testosterone levels are at trough. If your levels are dropping too low on the day right before your next injection or are fluctuating too much, your body may not reach homeostasis and you will not respond well to TRT.

I inject my 18-20mg doses every other day, if I inject less often I don’t respond to TRT. Imagine a world where everyone is biochemically unique. In my experience endo’s are the worst type of doctors for TRT, mainstream is extremely ignorant in hormone therapies. Here in the US going private is where most of the experience doctors can be found.

You are missing a lot of other labs, SHBG, free testosterone and estrogen are all important in determining a proper TRT protocol. Free testosterone is the bioavailable form of testosterone circulating in your blood and is what your body is respond to. Total testosterone is bound to SHBG and therefore not bioavailable, and SHBG test would provide a clue to your free testosterone.

Lower SHBG men can get away with lower total testosterone do to having higher free hormones, if SHBG is higher more total testosterone is needed to equal the same free testosterone as someone with lower SHBG. The majority of men inject twice per week, your SHBG levels can be a factor since testosterone binds to SHBG.

It’s going to take a lot longer than 4 weeks to see changes, it takes 6 weeks for testosterone to stabilize in the blood, for those of us who have been on TRT for a while and change our dose, it will upset this stable testosterone in the blood and you will experience swings until 6 weeks later after testosterone again become stabilized in the blood.

It will take 6-12 months to see major changes when testosterone is injected one or more times per week. We have guys injecting once weekly, twice weekly, M/W/F, EOD and even daily injections, again everyone is different as we are all biochemically unique.

This 2005 study should convince your endo that maybe he doesn’t know everything. Figure 1 graph B shows what happened to the majority of men in this study.

Hormone profiles after intramuscular injection of testosterone enanthate in patients with hypogonadism

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