Diagnosed but not yet on TRT, still have questions

[Ice Man Eli]

Hi all,

I'm an otherwise healthy 45 year old male. Here to learn, hoping to find god information. I've been a little put off by some of the ******** TRT forums, and someone suggested this site. After a few years of energy, libido, and issues at the gym, I decided to look into checking my testosterone levels, just to rule it out. Turns out my total T is 229. My PCP gave me a prescription, but I have not yet started TRT. I was prescribed test cyp, 200mg injected once per month. I've been told by several people that on that low a dose I might wind up feeling worse and it isn't a good regimen. I am a bit skeptical of the "low T" clinics that have sprung up everywhere, so I am going to see a urologist for a more complete blood test and consultation in January. I guess it's a bit unusual to get the go ahead from a doctor, but still want a second opinion.

 

[madman]

Hi all,

I'm an otherwise healthy 45 year old male. Here to learn, hoping to find god information. I've been a little put off by some of the ******** TRT forums, and someone suggested this site. After a few years of energy, libido, and issues at the gym, I decided to look into checking my testosterone levels, just to rule it out. Turns out my total T is 229. My PCP gave me a prescription, but I have not yet started TRT. I was prescribed test cyp, 200mg injected once per month. I've been told by several people that on that low a dose I might wind up feeling worse and it isn't a good regimen. I am a bit skeptical of the "low T" clinics that have sprung up everywhere, so I am going to see a urologist for a more complete blood test and consultation in January. I guess it's a bit unusual to get the go ahead from a doctor, but still want a second opinion.

Welcome.

Unreal!

Pointless just like those horribly outdated stone-aged protocols of 200 mg every 2 weeks.

Your T levels will be in the gutter well before the 2-week mark.

Run and do not look back.

Smart move seeking out the uro let alone getting full blood work.

With an absurdly low TT 229 ng/dL your FT would be dismal!

Although TT is important to know FT is what truly matters as it is the active unbound fraction of testosterone responsible for the positive effects.

It would be wise to have your TT, FT, e2, SHBG, DHT, prolactin, LH/FSH, PSA, CBC (which includes hemoglobin/hematocrit), CMP, lipids, full thyroid panel, cortisol (4 point saliva), DHEA, vitamin D tested.

You need to know where your SHBG sits as it will have a big impact on your protocol (dose T/injection frequency) let alone FT levels.

Keep in mind that testing using accurate assays is critical especially when on trt.

The most accurate assays for TT (LC/MS-MS), estradiol (LC/MS-MS), FT (Equilibrium Dialysis or Ultrafiltration).

The panel below includes such!



Use Nelsons discountedlabs.

This panel will cover your bases.

Pre- TRT MALE Hormone / Wellness Panel

Pre- TRT male hormone and wellness panel lab tests performed before men start testosterone replacement therapy

www.discountedlabs.com

Pre-TRT Male Hormone / Wellness Panel

 

[Ice Man Eli]

This is great information, thanks! The uro I'm seeing has experience in TRT, so I will keep this list for reference. My PCP tested total testosterone as a part of my bloodwork with my annual physical exam. TSH, CBC, lipids and CMP were all fine. What concerned me was that he did not test FT, LH, SHBG or anything else on the list above, and I would feel better getting those tested to have a full picture before I start injecting.

 

[madman]

The 12 Year-Old Study That Proves Testosterone Injections Every Two Weeks Fail

We still regularly have members join us who have been prescribed an injection of testosterone, 200mg, every two weeks. New to the TRT game the member, in all good-faith, wonders why he feels even worse than he did prior to the start of hormone therapy. We know that a protocol like this is a...

www.excelmale.com

 

[BJE]

You definitely have low testosterone. However you might want to see if there is an identifiable cause that could perhaps be corrected before starting TRT.

That being said, my suggestion if you do start TRT is to do subcutaneous injections and inject at least once a week if not twice a week. Of course doses very by individual but I would aim for a testosterone trough level at least midrange if not upper range. Don’t settle for a dose that barely gets you into the “normal” range. I would suggest that the dose range to get you there would be something like 100-200mg, (.5ml-1ml) per week.

 

[madman]

You definitely have low testosterone. However you might want to see if there is an identifiable cause that could perhaps be corrected before starting TRT.

That being said, my suggestion if you do start TRT is to do subcutaneous injections and inject at least once a week if not twice a week. Of course doses very by individual but I would aim for a testosterone trough level at least midrange if not upper range. Don’t settle for a dose that barely gets you into the “normal” range. I would suggest that the dose range to get you there would be something like 100-200mg, (.5ml-1ml) per week.

subcutaneous injections and inject at least once a week if not twice a week. Of course doses very by individual but I would aim for a testosterone trough level at least midrange if not upper range.

I would suggest that the dose range to get you there would be something like 100-200mg


Although TT is important to know FT is what truly matters as it is the active unbound fraction of testosterone responsible for the positive effects.

One should be more concerned with where their FT level truly sits on such protocol (dose T/injection frequency).

In order for such, they would need to have it tested using the most accurate assays such as the gold standard Equilibrium Dialysis or Ultrafiltration.

A FT 16-31 would be considered healthy.

Most men will do well with FT in the 20-30 ng/dl range and many tend to aim for the higher end.

Comes down to the individual as some may run slightly higher levels whereas others may do better running lower levels.

Most men on trt are injecting anywhere from 100-200 mg/week and even then many would never need the higher end dosed (200 mg/week) to achieve a healthy FT level.

Too many are over medicated and running much higher levels than they think/need due use of relying on inaccurate testing methods/assays.

Also need to keep in mind that trying to hit an upper range true trough on once-weekly injections would be misleading/overkill as peak levels (8-12 hrs) post-injection let alone during the first few days would be through the roof.

Even on the twice-weekly protocol running a true trough on the higher end would have peak levels much higher.

When it comes to peak/trough levels injection frequency needs to be kept in mind!

The most sensible piece of advice would be to start low (100 mg/week) and go slow.

 

[gerardo]

Hi all,

I'm an otherwise healthy 45 year old male. Here to learn, hoping to find god information. I've been a little put off by some of the ******** TRT forums, and someone suggested this site. After a few years of energy, libido, and issues at the gym, I decided to look into checking my testosterone levels, just to rule it out. Turns out my total T is 229. My PCP gave me a prescription, but I have not yet started TRT. I was prescribed test cyp, 200mg injected once per month. I've been told by several people that on that low a dose I might wind up feeling worse and it isn't a good regimen. I am a bit skeptical of the "low T" clinics that have sprung up everywhere, so I am going to see a urologist for a more complete blood test and consultation in January. I guess it's a bit unusual to get the go ahead from a doctor, but still want a second opinion.

Thanks for your topic. I am also trying to adjust my TRT. I am 51 years old, 12 months ago I started TRT with fog. 1 injection + 1 with 45 days + 1 with 120 days + 1 every 3 months. My initial TT was 320. FT 14. E2 16. Side effects: the hematocrit increased from 47 to 53 and I had fluid retention. I realized that when urinating the jet was not as strong and the sensation that there was still urine in the bladder. At the end of the 3 months my libido decreased. I talked to the endocrinologist, but it didn't help much. I had to make a blood donation and I'm looking forward to starting a new protocol. Current tests: TT 650 FT 35 Estradiol 55 DHT 185 Hematocrit 47. My testicles decreased and so did my sperm. I will have to start a new TRT and I believe that here in this forum I will be more successful than walking with so many doctors. I thought about starting with Testosterone Gel 20 mg a day + 250 IU HCG twice a week. Or 50 mg of Testo Cyp per week. Thank you all.

 

[Ice Man Eli]

You definitely have low testosterone. However you might want to see if there is an identifiable cause that could perhaps be corrected before starting TRT.

It's possible, which is why I am seeking out a urologist for a more comprehensive blood test.

 

[gerardo]

subcutaneous injections and inject at least once a week if not twice a week. Of course doses very by individual but I would aim for a testosterone trough level at least midrange if not upper range.

I would suggest that the dose range to get you there would be something like 100-200mg


Although TT is important to know FT is what truly matters as it is the active unbound fraction of testosterone responsible for the positive effects.

One should be more concerned with where their FT level truly sits on such protocol (dose T/injection frequency).

In order for such, they would need to have it tested using the most accurate assays such as the gold standard Equilibrium Dialysis or Ultrafiltration.

A FT 16-31 would be considered healthy.

Most men will do well with FT in the 20-30 ng/dl range and many tend to aim for the higher end.

Comes down to the individual as some may run slightly higher levels whereas others may do better running lower levels.

Most men on trt are injecting anywhere from 100-200 mg/week and even then many would never need the higher end dosed (200 mg/week) to achieve a healthy FT level.

Too many are over medicated and running much higher levels than they think/need due use of relying on inaccurate testing methods/assays.

Also need to keep in mind that trying to hit an upper range true trough on once-weekly injections would be misleading/overkill as peak levels (8-12 hrs) post-injection let alone during the first few days would be through the roof.

Even on the twice-weekly protocol running a true trough on the higher end would have peak levels much higher.

When it comes to peak/trough levels injection frequency needs to be kept in mind!

The most sensible piece of advice would be to start low (100 mg/week) and go slow.

Hello Madman. Can you who already have a good experience answer some questions?

I am 51 years old, 12 months ago I started TRT with fog. 1 injection + 1 with 45 days + 1 with 120 days + 1 every 3 months. My initial TT was 320. FT 14. E2 16. Side effects: the hematocrit increased from 47 to 53 and I had fluid retention. I realized that when urinating the jet was not as strong and the sensation that there was still urine in the bladder. At the end of the 3 months my libido decreased. I talked to the endocrinologist, but it didn't help much. I had to make a blood donation and I'm looking forward to starting a new protocol. Current tests: TT 650 FT 35 Estradiol 55 DHT 185 Hematocrit 47. My testicles decreased and so did my sperm. I will have to start a new TRT and I believe that here in this forum I will be more successful than walking with so many doctors. I thought about starting with Testosterone Gel 20 mg a day + 250 IU HCG twice a week. Or 50 mg of Testo Cyp per week. My Shbg is at 11.6 nmol / L. 0.07 LH and 0.18 mIU / ml FSH Progesterone <0.10 ng / ml. Everything low. Today is exactly 73 days since Nebido's last injection. Thank.

 

[madman]

Hello Madman. Can you who already have a good experience answer some questions?

I am 51 years old, 12 months ago I started TRT with fog. 1 injection + 1 with 45 days + 1 with 120 days + 1 every 3 months. My initial TT was 320. FT 14. E2 16. Side effects: the hematocrit increased from 47 to 53 and I had fluid retention. I realized that when urinating the jet was not as strong and the sensation that there was still urine in the bladder. At the end of the 3 months my libido decreased. I talked to the endocrinologist, but it didn't help much. I had to make a blood donation and I'm looking forward to starting a new protocol. Current tests: TT 650 FT 35 Estradiol 55 DHT 185 Hematocrit 47. My testicles decreased and so did my sperm. I will have to start a new TRT and I believe that here in this forum I will be more successful than walking with so many doctors. I thought about starting with Testosterone Gel 20 mg a day + 250 IU HCG twice a week. Or 50 mg of Testo Cyp per week. My Shbg is at 11.6 nmol / L. 0.07 LH and 0.18 mIU / ml FSH Progesterone <0.10 ng / ml. Everything low. Today is exactly 73 days since Nebido's last injection. Thank.

PM me!

 

[gerardo]

PM me!

Thanks for the explanations. They will be very useful for Trt and care for prostatic hyperplasia, low SHBG. Thanks.

 

[Ice Man Eli]

As an update to this - I saw a different doctor who prescribed 80mg 2x per week, with blood testing in 6 weeks to see where my levels are. I was surprised that he did not want to test Free T or SHBG before starting. He seemed to be confident that with a total T level of 229 my free T would be pretty bad. (I provided my most recent bloodwork from my PCP which included several other tests - CBC, TSH, cholesterol etc)

Anyway, I'm a week and a half in, and waiting to see what happens. Have already noticed some "morning wood", that hasn't happened in years. I've never injected prior to this, and it wasn't nearly as bad as I thought it would be.