I'm currently in the process of getting on TRT, I'm living in Austria and just started a protocol and would sincerely appreciate your feedback - thank you!
-height: 180cm (5'11)
-waist: 80cm (I wear waist 31 jeans)
-weight: 77kg (170lbs)
-body and facial hair: slightly below average
-describe where you carry fat and how changed: belly, glutes
-health conditions, symptoms [history]: no health conditions, symptoms see below
-Rx and OTC drugs, any hair loss drugs or prostate drugs ever: no drugs (neither medical nor recreational), no alcohol/tobacco, weed occasionally
-diet: CBL oriented (no/very little junk food, enough fat and I'd say very healthy)
-training: 4 times a week about 1 hour heavy lifting, rep ranges 5-12
-testes ache, ever, with a fever?: Nope
-how have morning wood and nocturnal erections changed: never had/have morning wood
lab results: I've had 3 tests done within the last month
1. 4 weeks ago (at 6PM); 2. 2 weeks ago (at 8AM immediatly upon wakening); 3. 2 days ago (1PM)
Total Testosterone: range: 2.49-8.36 ng/ml: 1. result 0.578; 2. result 4.7; 3. result 2.47
E2: 27.1-52.2 pg/ml: 1. 16.6; 2. 10.9; 3. 14.2
SHBG: 16.00-60.00 nmol/l: 1. 56.86; 2. N/A 3. 56.60
Free Testosterone: range: 1.26-4.11 ng/ml: 1. 0.172; 2. N/A; 3. 0.78
LH: 1.7-8.6 mU/ml: 1. 1.7; 2. 3.3; 3. N/A
FSH: 1.5-12.4 mU/ml: 1. 8.11; 2. 8.62 3. N/A
Prolactin: 4.6-21.4 ng/ml: 1. 6.59 2. 6.72 3. N/A
TSH: 0.3-4.0 mU/ml: 1. 1.47 2. N/A 3. N/A
Vitamin D: 30-70 ng/mol: 1. 52 2.N/A 3. N/A
The first blood work was horrible (in terms of total test), I can't explain the result (it was taken in the evening but still), the second was okay and the third still slightly below reference. SHBG is pretty high as well.
Symptoms - why did I get my hormons checked in the first place?
1. Poor sleep quality, concentration issues in work - can't stay focused in meetings and have problems processing complex issues (was always my strong suit), less "drive"
2. Sports/gym: muscle&strength loss while adding fat (weight unchanged, waist significantly bigger and abs almost disappeared - I've been relatively lean (<12%BF) and now can't get back to my old stats (I've dropped a few pounds in a short cut but almost all muscle loss so stopped), although my nutrition&training is as disciplined as ever
3. Libido: Just a slight difference luckily, I've noticed I'm less horny but erections are still hard and 98% no problems, about 2-3 times sex/week (long-term relationship), a few years ago i wanted more than that, now it doesn't bother me anymore, so yes, slight decline
The first two points really bother me, the libido thing is actually no problem since it is now in perfect sinc with my girlfriend.
I'd say I live a healthy lifestyle, stress is minimal, I'm happy with work&relationsship, I supplement zinc and Vit D (levels are ok, see above).
Anyway I consulted with my doc yesterday, he agreed that my lab work makes me a candidate for TRT. In Austria it's a very delicate subject, unfortunately we are not as progressive in this field as you guys in the states. The standard treatment is testosterone undecanoate 1000mg/4ml every 12 weeks.
Testosterone enanthat is not standard and only available (250mg e14d, I know same of his patients administer 250mg e10d) if you pay for it yourself and find a progressive doctor (which I did, but he might still only administer it himself, which would mean I'd have to come in every 2 weeks - I live 2 hours away so not really an option - but there is a slim chance I could convince him to give me a prescription, than I'd probably do 125mg e7d myself).
I've read the stickies here, so I know that an AI and HCG is recommended as well, but not an option here, no way to get a prescription and I'd rather not go the illegal route. I want kids in the future, so this might be an issue (options would be doing HCG maybe once or twice a year for a few weeks/freezing my boys). AI I think the doc would prescribe if E2 would be a problem, which shouldn't necessarily be the case considering the low dose, my current natural E2 level and absence of HCG.
I'll see him again in 6 weeks to make a decision on that. For now he gave me a tube of andractim (androstanolone - DHT) to try if my symptoms even get better with exogenous testosterone and get my feet wet. His argument for it was, that this DHT gel will not shut down my endogenous production, so no harm done (in terms of fertility) if I'm not satisfied in the following 6 weeks.
I've applied the gel yesterday for the first time on my scrotum and will continue to do so for the next 6 weeks. I guess I'll have to expect androgenous side effects from the gel (possible hair loss and oily skin) and an improved libido, but on the other hand I guess it won't help me with body composition since it is not anabolic and doesn't increase testosterone directly, as far as I understood.
What do you think about the strategy/DHT? What would you recommend to do?