T Nation

What Can I Expect?

I’m 31 years old, used drugs and prohormones heavily in my early 20s. Now I’m starting to feel like things are catching up. After my last ph cycle, it was years before I felt normal.

I am currently about 195 lbs and probably 13-15% bf at 5’11". Not lean but acceptable for most circles.

I found a local clinic that does trt but I’m a bit nervous about making this jump. I do have lower libido and I think it may be becoming a problem and I’d like to continue making progress in the gym.

What can I expect from the clinic style environment over a gp/endo? I have a lot of concerns so I’m just hoping to get pointed in there right directions.

I don’t have any blood work, just symptoms.

Some of these clinics don’t offer much in the way of optimizing protocols and force weekly office visits and can become tiresome going into the clinic 52 times a year.

Do your homework and choose the clinic that best suites your needs, if money isn’t an issue I would prefer being monitored by a doctor in person visits.

A lower libido could be caused by many things, poor sleep being one. I would take the time and post all labs including testosterone and thyroid related labs.

In general, a clinic is going to be a lot more business focused than a GP/endo. At least that’s my experience. My doctor is great, but the whole staff is on the “salesy” side of things.

Best thing you can do for yourself is plenty of research. Here are some common things you should know before going in.

You don’t need HCG when you start TRT.
You don’t need an AI when starting TRT.
Injections are the most effective form of TRT
You should start a protocol with a minimum of 120mg Test-c / week.
You should dose at least once a week, or split the dose up into multiple injections per week.
You should get full bloodwork done (the clinic will do this, but make sure they test at least the following:

CBC
Metabolic panel
LH
FSH
Total T
SHBG
Prolactin
Estradiol (sensitive)
TSH
FT3
FT4

Once you have your blood work. Post it here for further advice.

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Starting to think it may be in my best interest to go to the doc first and get bloodwork done and go from there. I’d like to be on 150-200/wk split up over the week. I just assume a non clinic will be very conservative. I may be wrong.

So you have already convinced yourself you need trt. It’s possible but with that mindset…

Add free t to the list of labs. I also suggest a lipid panel and a1c. And dhea s that can help diagnose adrenal issues.

No way to predict what will be recommended.

These labs would be a good start:

Lipids
CMP
CBC
total testosterone
free testosterone
FSH
LH
prolactin
TSH
free T4
free T3
IGF-1
E2
DHEA-S
SHBG
PSA
VitD

I think this is very good general advice.

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A reasonable assumption. I tried 4 different endocrinologist and 2 GPs and none of them would would prescribe (my pre TRT total T was mid 300s). A lot of docs that do prescribe are in the mindset of prescribing androgel only.

That being said, after getting a script from my clinic I asked my GP if he would take over, he said he wouldn’t have a problem with that, but I didn’t have my labs with me to show him. I have not pursued that yet under fear that he would want to drop my dose. But it would make a lot of sense financially.

I guess my point is, if you’re going to try the GP/Endo route, expect to get turned down if your values are in range.

Also, most if not all clinics will require their own labs, even if you have recent ones from your doc. So plan for that.

You need to locate a knowledge doc that lives and breathes TRT, not some ordinary doc who specializes in other areas of medicine where TRT is the occasional prescription for someone <300 that fits the sick care definition of disease state.

Docs that stick primarily to ranges in not very knowledgeable, a knowledgeable doc knows how to diagnosis based off labs and-> symptoms and knows about normal testosterone.

Most men are told they are normal, this couldn’t be further from the truth.

Not all, I have patients get their own labs all the time, some simply take what we would order and have their GP run it through their insurance. If coming in with initial labs already obtained, we will simply add whatever they did not get and not repeat those ordered from the GP.

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