T Nation

Using TRT to Your Advantage?

So your balls or pituitary stopped pumping out enough testosterone or precursor. Now what? Stuck on TRT?

Happened to me… but now I want to start looking at the brighter side of things.

How can those stuck on TRT for life use it to our advantage in helping us lead happier and/or healthier lives than those not “blessed” with hypogonadism?

I’m new to TRT and I’m stuck with the question of whether or not I should stay on TRT exactly as prescribed…? Trial off and see if I bounce back to normal…? Or find a way to use this to my advantage. I’m not talking about taking super-high physiological doses and justifying it because I’m on TRT.

For instance… taking 200mg Test. Cyp. every 2 weeks - which keeps my testosterone values at high-normal range… is there an optimal time for injections… for arimidex… how can I use this regimen to maximize muscle gain and fat loss… or is it of little significance?

Eager to hear your input.

Thanks

Did you try to find the root cause before you began TRT? TRT is not something you just jump on. Have any labs?

Read all the stickies. Specially injection sickie every 2 weeks is horrible. As for muscle I don’t know im in the 200’s TT and have a very hard time gaining and if i do I loose it quick. I would assume , if your nutrition, training, and hormones (TT high normal) are in order you should gain a lot easier than when you were low. Maximize by getting all aspects in order and managing your E2, free t is the biologically active testosterone you want to check most for on TRT.

[quote]Tunapancake wrote:
Did you try to find the root cause before you began TRT? TRT is not something you just jump on. Have any labs?

Read all the stickies. Specially injection sickie every 2 weeks is horrible. As for muscle I don’t know im in the 200’s TT and have a very hard time gaining and if i do I loose it quick. I would assume , if your nutrition, training, and hormones (TT high normal) are in order you should gain a lot easier than when you were low. Maximize by getting all aspects in order and managing your E2, free t is the biologically active testosterone you want to check most for on TRT.[/quote]

No… they’re calling it idiopathic. I was injecting once a week prior, however, it seems I was wasting a lot of it through the syringe. And… I really don’t want to let this run my life. I feel better now and that’s the most important thing. I don’t have time to micromanage this or let it run my life.

Thank you for pointing me to the sticky though… I’ll take a closer look at it and see if I can apply some of the features to my lifestyle after backing it up with some research of course. I’d like to begin an HCG regimin… but spoke to my doc today and said it isn’t covered nor could he give me a prescription. I’d really like to apply this to my TRT though because the boys are not what they used to be. Any help in this department?

By the way… my endo said that Total T was the more reliable marker… although I do understand that free T is the bioavailable component that body is able to use in the form of testosterone.

I’m not a doc, but I’ve heard when your not on TRT or anything FT works more in spikes and TT is the better indicator. When on TRT though they say (bro speak) “cutting edge” docs adjust dose more based on FT. I would say both are obviously important to check, but FT gives a better picture of your hormone level. TT can be high, but bound to E2 and SGBH which means your not getting the same benefits. Older men aromatize more T to E2 and have higher levels of SBGH which is why they need higher doses to get the same benefits as a younger guy.

its good your feeling better, but remember low T can be caused by a lot of things and you don’t want to just cover up a problem.

For example low T can be caused by thyroid issues, prolactinomas, varicocele, E2 disbalance, adrenal issues, and many other things. Its too late to test LH and FSH since they are shut down now, unless you have labs, we don’t know if it was primary, secondary, or mixed hypogonadism. You can call a compounding pharmacy near you and ask for a doc who gives HCG.

[quote]Tunapancake wrote:
I’m not a doc, but I’ve heard when your not on TRT or anything FT works more in spikes and TT is the better indicator. When on TRT though they say (bro speak) “cutting edge” docs adjust dose more based on FT. I would say both are obviously important to check, but FT gives a better picture of your hormone level. TT can be high, but bound to E2 and SGBH which means your not getting the same benefits. Older men aromatize more T to E2 and have higher levels of SBGH which is why they need higher doses to get the same benefits as a younger guy.

its good your feeling better, but remember low T can be caused by a lot of things and you don’t want to just cover up a problem.

For example low T can be caused by thyroid issues, prolactinomas, varicocele, E2 disbalance, adrenal issues, and many other things. Its too late to test LH and FSH since they are shut down now, unless you have labs, we don’t know if it was primary, secondary, or mixed hypogonadism. You can call a compounding pharmacy near you and ask for a doc who gives HCG.[/quote]

Yeah… I had extensive work-ups… the problem was that I had Low TT of 244 with a really low FT - but LH and FSH were normal… so was prolactin and TSH… E2, HgH, IGF, SHBG, even had a semen analysis and of course testicular exam… I had them check everything… except for Thyroid antibodies

The only possible explanation they could find was a non-secreting pituitary microadenoma which they ruled out as being a factor… Idiopathic Secondary Hypogonadism was the final determination.

I just can’t afford to take a trial off right now due to school and a new job… I’ll try a trial off period in the future… but I’m still contemplating the pro/cons.

I’ll look for a compounding pharmacy… something tells me that it won’t be quite that easy to have them agree to prescribe it…

Thanks for your input Tuna

Post lab numbers and units in a list!

Where are you located “nor could he give me a prescription”

[quote]KSman wrote:
Post lab numbers and units in a list!

Where are you located “nor could he give me a prescription”[/quote]

I’m located in the Bay Area, CA

Labs Hx:

August 18, 2011 -

Made appointment to come in related to symptoms of painful area under areola bilaterally, fatigue, lack of concentration, low libido. Seen by a resident. Saw nothing wrong with the preceding lab results.

  • Testosterone FREE - 0.65 - 0.95 - 4.30 ng/dL Low
  • Testosterone - 244.4 - 175 - 781 ng/dL
  • HCT - 39.3% - 42 - 52 %
  • HGB - 13.9 - 14 - 18 g/dL
  • PLT - 139 - 140 - 150 K/cmm

December 5, 2011 -

After escalation of symptoms I had requested my medical records and saw the previous labs. Alarmed by the results I contacted resident’s attending physician and insisted to have lab results reviewed and be seen by an endocrinologist. In between this time period the endocrinologist ordered the following labs and placed me on Androderm 4mg patches.

  • Testosterone FREE - 0.85 - 0.95 - 4.30 ng/dL Low
  • Testosterone - 268.8 - 175 - 781 ng/dL
  • Follitropin - 7.3 - 1.3 - 19.3 mIU/ml
  • Lutropin - 3.2 - 1.2 - 8.6 mIU/ml
  • Prolactin - 7.47 - 1.61 - 18.77 ng/mL
  • Estradiol - 35 - >< 57 pg/mL
    Choriogonadotropin.Beta Subunit - <0.5 >< 5.0 mIU/mL

January 11, 2012 -

While on Androderm 4mg patches. Still experiencing symptoms. No FREE Testosterone to gauge bioavailabilty.

  • Testosterone - 459.2 - 175 - 781 ng/dL
  • Cortisol - 13.4 - (no ref range) mcg/dL
  • IGF -I - 212 - 095 - 4.30 ng/dL
  • HCT - 39.8 - 42 - 45 %
  • HGB - 14.3 - 14 - 18 g/dL

February 2, 2012 -

  • Cortisol - 14.0 - mcg/dL
  • Prolactin - 8.53 - 1.61 - 18.77 ng/mL
  • Testosterone - 460.5 - 175 - 781 ng/dL
  • Testosterone FREE - 1.65 - 0.95 - 4.30 ng/dL
  • HCT - 42.5 - 42 - 52 %
  • HGB - 15.3 - 14 - 18 g/dL
  • PLT - 153 - 140 - 150 K/cmm

March 1, 2012 -

Stopped Androderm patches. Taking Clomiphene that I acquired from outside pharmacy. Symptoms persisting without alleviation.

  • Testosterone - 411.2 - 175 - 781 ng/dL
  • Testosterone FREE - 1.63 - 0.95 - 4.30 ng/dL
  • Estradiol - 55 - >< 57 pg/mL

April 6, 2012 -

  • Estradiol - 35 - >< 57 pg/mL
  • Lutropin - 2.7 - 1.2 - 8.6 mIU/ml

May 3, 2012 -

  • Estradiol - 40 - >< 57 pg/mL
  • Follitropin - 7.6 - 1.3 - 19.3 mIU/ml
  • Lutropin - 3.4 - 1.2 - 8.6 mIU/ml

June 8, 2012 -
Results of new regimen as prescribed by Dr. Smith in VASF urology clinic.
- Testosterone Cypionate INJ, 100mg biweekly
- 1mg Anastrozole 1mg q/day
Worsening of symptoms.

1mg Anastrozole 1mg q/day

  • Testosterone - 386.3 - 175 - 781 ng/dL
  • Testosterone FREE - 1.47 - 0.95 - 4.30 ng/dL
  • Estradiol - < 20 - >< 57 pg/mL
  • Follitropin - 8.9 - 1.3 - 19.3 mIU/ml
  • Lutropin - 6.4 - 1.2 - 8.6 mIU/ml

August 3, 2012 -
Results of new regimen after visiting urology with complaints of worsening symptoms and results of previous labs.
- Testosterone Cypionate INJ 400 mg biweekly
- Anastrozole 1 mg q/day

  • Testosterone - 816.1 - 175 - 781 ng/dL
  • Testosterone FREE - 3.14 - 0.95 - 4.30 ng/dL (High - SEE UPDATED REFERENCE RANGE)
  • Estradiol - < 20 - >< 57 pg/mL
  • Follitropin - 0.4 - 1.3 - 19.3 mIU/ml
  • Lutropin - 0.2 - 1.2 - 8.6 mIU/ml

deleted estrogen comment

THYROXINE.FREE 10.9 pmol/L 7.5-21.0

This should be mid range! Post waking and mid afternoon body temperatures.

[quote]KSman wrote:
You have an estrogen problems.

Try 0.5 mg anastrozole per week in EOD divided doses. If Y increases as a result, then you will increase anastrozole.

THYROXINE.FREE 10.9 pmol/L 7.5-21.0

This should be mid range! Post waking and mid afternoon body temperatures.
[/quote]

Which date range are you referring to as the period with estrogen problems?

During a period I was taking clomid - which increases estradiol lab values d/t a mechanism that I cannot recall right now.

I was taking arimidex at 0.5 mg for the last week - but just switched to tamoxifen 20mg/ ed until gynecomastia resolves a bit… then I will continue Arimidex at the dosing that you suggest. What is “Y”?

I’ll have to buy a thermometer and get the temps to you within the next week. Thank you for that suggestion.

One thing I’m curious of is if diet and rest are as big of factors as they were when without an exogenous source of testosterone?

For instance… can I afford to reduce caloric intake and maintain muscle mass more efficiently if my testosterone values remane in the high-normal range? This could manifest as a more positive muscle : fat composition when dieting… right?

And rest… both in between workouts and hours of sleep per day? Any significance here?

My typo, Y should be T -testosterone. Will fix

TRT increases metabolism, restores to a youthful level, you may loose fat, gain muscle and have a greater hunger.

Why stop stop AI to take SERM! Use both. SERMs typically increase E2!

E2: May have been confused. "- 1mg Anastrozole 1mg q/day " is very wrong and will make a TRT guy feel horrible. We recommend 1mg/week.

You are injecting 800mg T per week? 4 ml?

Stop testing LH/FSH, you are now shutdown.

Edit typo: 100 mg / week = 400 mg / month --> taken 200 mg bi-weekly

Incorrect: (I’m taking 400 mg / week)

Yeah… I’m gonna go for 0.25 mg / eod, but I’ll keep the option open to bump it to 0.5 mg/eod if symptoms arise.

The conjunctive use of anastrozole and tamoxifen has been linked to decreased efficacy… I’ll look into that a bit more though.

You are at 400 mg/week and are talking about using “TRT” to your advantage? I hate to break it to you buddy, but you are not REPLACING your Testosterone, you are SUPPLEMENTING it (and shutting your natural production down in the process).

You are not on TRT, you are on a long-term standard steroid cycle. Of course you can use that to your advantage. If you aren’t gaining on supra-physiological doses of testosterone, then you are doing something entirely wrong.

[quote]VTBalla34 wrote:
You are at 400 mg/week and are talking about using “TRT” to your advantage? I hate to break it to you buddy, but you are not REPLACING your Testosterone, you are SUPPLEMENTING it (and shutting your natural production down in the process).

You are not on TRT, you are on a long-term standard steroid cycle. Of course you can use that to your advantage. If you aren’t gaining on supra-physiological doses of testosterone, then you are doing something entirely wrong.[/quote]

Yeah… that was a typo my brotha… meant 400 mg / month… 100 mg / week

By the way… I’m going with 200 mg / every other week. I know that some will not agree with this frequency, however I haven’t noticed much of a difference over more frequent dosing, plus I was wasting significant amounts of the prescription in the process.

If every two weeks feels the same, then you were not doing things right in the first place. E2 problems can be part of that. You need to be more trusting about what we recommend. You came here for information and seem unable or unwilling to do things right.

Wasted T in syringes. There are two solutions.

  • leave a bubble of air in the syringe, that will push out the T in the dead space.
  • use insulin syringes as per ‘protocol for injections sticky’