T Nation

Would TRT Help Me?

Hi, I am wondering if TRT would help me. I have the usual symptoms of low libido, brain fog, general tiredness, bad sleep most of the time, erections not staying hard during intercourse. I am 35 years old.
Would TRT help me? If yes, what dose should I start with?

I went to my GP about a year and a half ago and we tried several things:

  • 250 mg Sustanon every 3 weeks to try and boost my T. In the second week I would feel better, higher sexdrive, better sleep, but the third week I would feel worse.
  • Gels; Androgel in this case. Two pumps applied daily. My energy went through the roof, felt very active and full of mental energy (if this makes sense), however, one big side effect I couldn’t get hard.

Go back on the sustaon, ask for e2w shots, split the shots up into .5 mL ew (e2w is approved as protocol with primoteston, perhaps not sustanon if you’re doc is fickle with outdated guidelines)

This way you’ve got 125mg weekly to play around with

You’re going to get a huge “you’re doctor should be shot blablabla” in response… people tend to be somewhat hysterical about bad protocols… sure, the gel is expensive and doesn’t have the highest rate of patient satisfaction, but it’s simple to apply and hasn’t a high rate of compliance (BUT it does present serious risks regarding cross contamination towards partners and/or kids, and the “don’t exercise for at least X hours of administration… nor can you shower” is irritating)

Truth is however, many go on 250mg e2w and feel fine, many sustain on gels and feel fine (note fine and optimal are two very different facets) but 250mg e2w feels a hell of a lot better than a TT of 7nmol… for most

Yes, the peaks are higher, but you probably won’t develop polycythemia from such a dosage, it’s possible… but I’d garner it’s the minority, not the majority that develops this on said protocol… and medical literature would back me up here

Start with once weekly shots, if that doesn’t work (or TT/FT is still too low… I’d actually say start with 150, but it’s difficult to get decent HRT dosages prescribed nowadays) try 2x weekly (dose split up to .25 ml per shot, sus has test prop in it, pharmacokinetics dramatically differ from other forms of esterified test in the preparation)… primoteston or test cyp is optimal, but sus works too.

How’s you’re lifestyle? Are you overweight/obese or reasonably fit/average

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I am quite fit. I was always skinny/slender growing up. I chase a healthy lifestyle through a diet and every now and then I order out.

I have calculated the FT, it seems that it’s well within range. I am using http://www.issam.ch/freetesto.htm to calculate. Enanthate is also available (underground) so I wouldn’t mind going on that and leave Sustanon out of the picture.

FT isn’t within range, perhaps the percentage of you’re T that is FT is within range, but no… I can guarantee you the concentration of FT you have currently is far removed from normality

UGL TRT is a risk, as is physician provided TRT. I’d suggest educating yourself regarding the risks/rewards associated with AAS/TRT usage. UNMONITERED TRT is the riskiest as potential complications that may or may not develop can impact future health insurance (you get an abcess, have to go to the ER, they ask why… you have to explain you’re pinning black market gear… that’s on you’re record, price of health/life insurance goes WAY up)

However the truth is, in general anabolics when used REASONABLY are generally mild pharmaceuticals (barring perhaps C17AA compounds, trenbolone etc)… testosterone is certainly on the milder side (albeit not for me, I personally find test to be quite harsh comparative to mast/deca) but that’s just me. For replacement purposes, test is king

There is the potential for life threatening complications, however this potential exists for many meds, take SSRI’s for instance, serotonin syndrome is a potentially lethal complication, as hepatocellular carcinoma etc (no, not only c17AA compounds are hepatotoxic)… all AAS are as they do pass through the liver once, however testosterone is considerably more open to hepatic metabolism than synthetic derivatives and the hepatotoxicity induced by most injectable preparations of AAS + test is VERY minimal, however like all sex hormones (including birth control etc), there does appear to be an increased incidence of hepatocellular adenoma/carcinoma within cohorts taking them.

Then there’s the risk of clotting (anyone who tells me testosterone/anabolics in general doesn’t interfere with clotting factors is misinformed), even if the increase in risk is 0.0001% it’s still worthwhile noting…

I’m from The Netherlands, here we don’t have Enanthate available, just Sustanon and some other stuff like Gels, Nebido. I want to try test E for a more stable bloodlevels because as I understand it Sustanon is a blend of esters where bloodlevels can fluctuate more.

Could you explain how FT is out of range? What is a normale range of FT and how does one calculate FT?

Actually, I believe AAS possession/use in the Netherlands is decriminalised and/or legal if I’m not mistaken?

You calculated FT percentage… not concentration

According to here, TT normality is 300-1200ng/dl (optimal would probably be 600-1200)… FT normality is 0.3-1.04nmol… you’re calculated FT is… .194 nmol

https://www.omnicalculator.com/health/free-testosterone

Sus @125mg weekly works as a good starting point if you can get a script for e2w… Even if you dial in you’re protocol, erectile function may or may not improve. Estrogen is pivotal in relation to inducing erectile response due to mediation nitric oxide release/production, neurological homeostasis etc. However ED may be also in part due to neurological dysregulation induced via other parameters

Yes it’s legal possession/use, dealing however is illegal.

So 125 mg weekly. If I were to take Test E instead of Sust should I take the same amount 125 mg divided in 2 injections per week?

Your dosing was too far apart, doc should have increased the injection frequencies (every 2 weeks/every 14 days) and maybe lower the dosage because the pharma company cannot know the optimal injection frequency for everyone because of individual metabolism and excretion of testosterone.

I have high body fat and am sensitive to hormonal fluctuations and must either inject EOD and daily or I just don’t show much benefit on TRT. If you have higher body fat or are sensitive to hormonal fluctuations, injecting weekly may not be the best idea.

Androgel gets a lot of hate from us guys on TRT and with good reason, it ineffective for more than 60% of men do to poor absorption.

These are typical weekly doses, not enough for a every 2 week protocol. Test E or Test C shouldn’t be dosed beyond once weekly because then you’re running into the half-life before the second week begins.