T Nation

Trying out TRT - Looking for Advice

-age: 44
-height: 5’8"
-waist: 36
-weight: 195
-describe body and facial hair: light/avg body and facial hair
-describe where you carry fat and how changed: belly fat increased over last 5 years (period of stress and having young children)
-health conditions, symptoms [history]: born with one kidney, but have had no issues
-Rx and OTC drugs, any hair loss drugs or prostate drugs ever - flonase for hayfever
-describe diet: relatively healthy/balanced diet, but eat too much. Moderate alcohol.
-describe training: have always jogged moderately, recently started lifting weights and swimming laps
-testes ache, ever, with a fever?: no
-how have morning wood and nocturnal erections changed: dramatic increase after starting TRT

For the past few years I’ve suffered from fatigue, insomnia and too much stress. I previously enjoyed coffee and got a big kick from it, but then got so sensitive to it - where even small amounts of caffeine in the morning affected my sleep that night. In general I felt rundown and…aging rapidly. Sex drive and function decreased. Fitness/exercise decline. Irritable. Had poor sleep also from crying babies/toddlers. My regular doctor gave me ambien.

Then, after seeing testosterone commercials, I stopped into a local TRT clinic. They took my labs which showed my total T at 225 and said I qualified for their treatment. This was 8 weeks ago when I started TRT. I started on 150mg T cyp injections weekly. After 4 weeks my total T had risen to 450, so they increased my weekly dose to 180mg. I also started taking 250iu of HCG twice weekly.

Since being on TRT, I’ve noticed a dramtic increase in sex drive and function and also muscle tone. My fatigue and sleep (my most important issues) have improved only moderately, but have improved. (I’ve been exercising a lot.)

Here’s what I would like input/advice on:

My initial plan for TRT was to try it for a while until my levels are confirmed to be good, see how I feel, then stop treatment to see what that’s like. Then consider if this treatment is something I want to do long term, and if so, start back up again - I guess with the plan that it’s lifelong at that point. I really want to compare being off it and on it to experience the full benefit before deciding to commit.

My biggest reservations about TRT is the lifelong commitment to it, and the shutting down (or reduction) of my own natural T production. Also after reading on forums like this, TRT seems a little bit like a do it yourself chemistry experiment on your endocrine system. The clinic is a little bit shady, not like going to my regular doctor who genuinely cares about my long term health. My biggest reasons for wanting to continue TRT is that I think it makes me feel a bit better (especially sexually) and from what I’ve read, I believe that having normal T levels is healthier overall than having low T levels.

How long (number of weeks) is a good Testosterone ‘test run’? - so that I’m on TRT long enough to feel the full benefit, but not so long that going off is super difficult? Do you have any recommendations for the best protocol for going off TRT? I’ve heard of PCT. I will discuss it more with my clinic, I think they recommend tapering down the T and contining the HCG. What should I expect the transition to be like?

I would really appreciate any advice at all to help me take the right course for me. I would especially appreciate any thoughts from people who have been on T for a long time, what the reality is. I’d like to know the downsides of T treatment, the stuff you wish you knew when you started.

Is it true that doing TRT for a certain amount of time destroys your ability to go off treatment and return to your own natural, low level? Does taking HCG keep your natural production going, or does it merely have a cosmetic affect of keeping your testicles from shriveling up?

(I know I asked a lot of questions here. Any info at all about any of this would be much appreciated.)

OK…just saw something in this post the caught my eye…I too was born with one kidney…and have LOW T…I am at the start of this journey…so I do not “Know” exactly what is causing my Low T…but that made me want to ask the question.

any thing to that?..could that be the cause of our Low T???

Since we were born with one kidney, it’s probably true that we also have only one adrenal gland, although I have never confirmed if I have two or just one. There is a lot of available information/discussion about “adrenal fatigue” which I think can lead to low testosterone. I just bought a book and started reading about it. I think the gist is that your adrenal glands respond to stress (mean boss, screaming children, toothache) by releasing stuff into the bloodstream to help you cope. And if you go through long periods of heavy stress, your adrenal glands get worn out and stop responding as well. This results in you feeling tired, having lower sex drive, etc. I don’t know the relationship between adrenal fatigue and low T, or what the proper treatment should be other than reducing exposure to stress, sleeping longer, and eating more healthy foods. Do testosterone injections help relieve tired adrenal glands? Or does TRT aggrevate adrenal fatigue?

I’ve heard of a possible relationship between high stress and the onset of Low T. Would like to know more.

When one has adrenal fatigue and/or hypothyroidism, there is a lot of dysfunction in the brain and body which makes one less resilient and the body is running in a lowered metabolic state. Adding TRT in these situations can male things worse as the increased metabolic demands of restored T levels exceeds one’s metabolic capacity. In this case, age management docs will be addressing these issues at the same time as adding TRT or delaying TRT. This is covered in the stickies some where.

Interesting point concerning the single adrenal glands.

hCG prevents testicular organ failure and also maintains pregnenolone production in the testes.
Read this: http://en.wikipedia.org/wiki/Steroid_hormone

You need pregnenolone–>progesterone–>cortisol

Get an 8AM cortisol test.

TRT is for life and if you can get it done right, you will not want to stop. We do not have a body of knowledge on short duration TRT. With younger guys, an HPTA is attempt if often done. If you had LH/FSH lab work done before starting TRT, we would know if you have secondary or primary hypogonadism. If primary, you cannot expect to fix anything.

If you have adrenal fatigue, we can expect to see increased rT3 and lowered body temperatures. Review the thyroid and iodine related issues in the advice for new guys sticky.

If you inject once a week and do labs after 7 days, you are catching the low levels and the levels are changing a lot. Read the protocol for injections sticky… do not post in the stickies, come back here.

[quote]KSman wrote:
When one has adrenal fatigue and/or hypothyroidism, there is a lot of dysfunction in the brain and body which makes one less resilient and the body is running in a lowered metabolic state. Adding TRT in these situations can male things worse as the increased metabolic demands of restored T levels exceeds one’s metabolic capacity. In this case, age management docs will be addressing these issues at the same time as adding TRT or delaying TRT. This is covered in the stickies some where.

Interesting point concerning the single adrenal glands.

hCG prevents testicular organ failure and also maintains pregnenolone production in the testes.
Read this: http://en.wikipedia.org/wiki/Steroid_hormone

You need pregnenolone–>progesterone–>cortisol

Get an 8AM cortisol test.

TRT is for life and if you can get it done right, you will not want to stop. We do not have a body of knowledge on short duration TRT. With younger guys, an HPTA is attempt if often done. If you had LH/FSH lab work done before starting TRT, we would know if you have secondary or primary hypogonadism. If primary, you cannot expect to fix anything.

If you have adrenal fatigue, we can expect to see increased rT3 and lowered body temperatures. Review the thyroid and iodine related issues in the advice for new guys sticky.

If you inject once a week and do labs after 7 days, you are catching the low levels and the levels are changing a lot. Read the protocol for injections sticky… do not post in the stickies, come back here.

[/quote]

Very interesting KSMan!..this could be it…I have been trying to figure out why I have LOW T…this might me it…the one Kidney…did not know where your Adrenal gland was…till I looked tonight after this post…also with the body temp…I have ALWAYS has temp lower than 98.6…this makes me happy that I might have found something!!!

you know 1 in 700 are born without a Kidney…it is NOT that uncommon…Lots do not know they one have one kidney…I didn’t know until I was 37 (kidney stone!!!)…others may have be in same boat?

Thanks again for the info!

Athens