T Nation

TRT - What Would You Do If You Were Me?

Hey guys, I’m pretty close to hopping on TRT but thought I’d also get some opinions from the guys on here.

35 yrs old - barely drink, good diet and about 13% body fat + physically active and sleep 8 hrs a night. Blood tests over the past 5 or 6 years have come back at TT being around 450 (264-900) and free T anywhere from 8 - 13 (8-26 range). ( Vitamin D is 35).

I know these aren’t terrible numbers but I’ve accepted that they certainly aren’t getting any higher naturally given that my lifestyle is on point. Overall I am semi- symptomatic. Descent libido but not amazing, slight brain fog + reluctantcy to make decisions, slightly lethargic especially at night etc. I did run a bunch of testosterone cycles back in my early 20’s as well so in some ways I’m pleasantly surprised to still be hovering in the 400’s to be honest.

Since I feel like I’m in that gray area of not feeling terrible but also not feeling optimal I’d love some opinions on whether or not you’d make the leap if you were me? Before this gets asked I do most likely want kids some day but not in there near future. Curious what you’d do in my shoes. Thanks!

A little off topic but since you brought it up, do you really want to be 60 years old with a teenager? Children are a lot of work and well worth it but they wear you out. If you wait five more years that’s what you’re looking at.

Anyway, TRT is awesome for me. It wasn’t initially (in my 40s) due to shitty doctors but I’m 55 now and feel great and carrying more muscle than I ever did. Libido is on point, erection quality is great.

Appreciate the response and glad to know TRT was a big benefit for you! It’s a fair point on the kid thing but at this point there are career factors that are just simply more important to me at the moment. A lot can change in a few years though so we’ll see.

Very difficult to say, but so many guys feel so much better after starting TRT and say they wish they would have done it sooner. I would include myself there. I wouldn’t have a problem with trying it and going from there.

@highpull thanks for sharing your experience!

I started with pretty much the same numbers as you and same age. The biggest benefit has been libido. I thought I had a decent libido before TRT, like you. But now I feel like a teenager again. I forgot how that felt. It’s pretty awesome.

If you don’t feel like 60 years old, then it’s not a big deal. Good thing he’s choosing TRT. Anyway, if that worried just freeze sperm pre-TRT.

TRT - Would You Do If You Were Me?

As for running TRT, I personally would do it if I were you. Just make sure you can afford it ($150-$500 a month, more money in the beginning) and are willing to dedicate some months to a year to dialing in.

@marcus007 @galgenstrick Appreciate all the input guys. I’ve decided I’m going to hop on and that it’s worth a shot to see if quality of life improves. Thanks!

It happens to a lot of us! There are positives too. Like being more mature and able to handle the kids both mentally and financially. :smile:

I found that that was about the time I started developing T issues, but I had no idea it was hormone related. The first symptom was intermittent ED problems. Second symptom was difficulty in holding on to muscle and losing fat. Third symptom was major ED and fat gain. Finally, cognitive issues set in around age 50 and got progressively worse until I started TRT at age 55 (hence the ‘55’ in my screen name, which is when I began to educate myself in multiple forums like this.

Your numbers are not very good and probably going to get worse with time. I am particularly concerned about the Free T level. I began to develop the cognitive issues around that level and was highly dysfunctional when it dropped to 7 pg/mL (when I started TRT). I would add in SHBG in your next set of labs. You are slightly less than mid-range for Total T but near the bottom of the range for Free T. I suspect your SHBG may be on the high side of normal.

Your D3 levels are also on the low side of current recommendations. Low D3 is correlated with high SHBG and low Free T. Whether or not you start TRT, I’d consider increasing that immediately. I find that about 8,000 IU per day keeps me in the upper 75th percentile of the ‘normal’ range. That may help to lower SHBG and free up some T.

Regarding my recommendation for TRT, I wish I had considered it at your age instead of waiting another 20 years, but then again I was still in the baby business back then. If you do go down this path, I’d make sure you find a doctor that is willing to also prescribe HCG to keep your testicles functional.

I agree with the maturity level. Hell, I was still drinking pretty heavily when I had my daughter. But now, I’m 55 and my kid is 31. We were young when we raised her, and she spent the first 7 years of her life in living on campus in married student housing watching me go to school and seeing how important education is.

@youthful55guy Appreciate you sharing your story! That actually helps put me at ease a bit. And since you mentioned it, the main symptom I’m looking to resolve is cognitive ability along with energy. There’s a lack of focus and mental sharpness that just seems to be there despite having all controllable factors on point (sleep, diet, etc). Sex drive isn’t too bad which I’m assuming is why a descent amount of guys go on.

Also to your fertility point: My doctor is only prescribing 250 iu’s of HCG per week. I was expecting to take about 3 times that amount. Does any on here actually take that low of an amount or am I right in thinking that’s basically useless?

That is a very low amount and I’m not sure it will do much good.See the graph below. It’s data I pulled from two publications that did dose-response studies on the use of HCG in normal subjects to overcome the negative feedback of a rather high (200mg/week) dose of T-eth. They used Intratesticular Testosterone (ITT) as a measure of testicular function. No, don’t ask how they measured it! It’s as painful as it sounds. ITT is known for being a surrogate measure of male fertility because sperm cells require a high local concentration of T for final maturation.

In these studies, they gave subjects 200mg of T per week to suppress normal ITT levels and then added in HCG in various doses and compared ITT to the basline (suppressed) values and calculated % suppression. As you can see, the lines from the two studies cross the 0% suppression level (i.e., ITT back to normal pre-suppression levels) at roughly 1000 IU per week. They used divided doses and if I remember correctly, it was E2D but I’d need to review the studies again to be sure. Regardless, if this data is predictive of your situation, at 250 IU, your ITT will only be up to about the -60% suppression level.

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I wish they had done some additional amounts on the low end to see what like 200 IU’s would look like. It might not be linear from 400 to 0

Also, another data point around 1200 would be nice to see. That’s a big jump from 800 to 1700 IU’s (roughly)

I’m assuming the points with dots are actual results and everything in between is just interpolated linearly

@youthful55guy Great info thanks! They just told me I could purchase an additional 250 iu’s per week. Looking at $85 for a 5000 iu bottle. I was debating if I should even start hcg right away because I wanted to get a good baseline of what the Test alone was doing in my body and how I felt especially since last time I was on hcg i felt like crap.

I usually recommend dialing in the T dose first and then layering in HCG.

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