33 year old male here, for the last 4 years I have tested my testosterone and it always comes back in the lower range (oscillating between 200s and 300s). At the end of last year, it tested even I the low 200s.
Should have a more thorough set of labs done before jumping on TTh.
Blood work should be done for TT, FT, estradiol, SHBG, DHT, prolactin, Vit D, DHEA-S, LH/FSH, PSA, full thyroid panel (TSH, Free T3, Free T4, Reverse T3, antibodies), salivary cortisol (Four Specimens), lipids, CMP, CBC, and CRP.
At the very least you should have tested TT, FT, estradiol, SHBG, prolactin, LH/FSH, full thyroid panel, and cortisol.
When testing testosterone (TT, FT and BAT) blood work needs to be done in the early AM in a fasted state as we want to test at the peak.
If you are into training with weights it would be wise to take a week off and make sure that you are well rested before getting blood work done.
Keep in mind that although TT is important to know FT is what truly matters as it is the active fraction of testosterone responsible for the positive effects.
If your previous tests have your TT 200-300 ng/dL range which is low then your FT is going to be dismal!
This needs to be addressed if you are concerned with improving your quality of life let alone improving your overall health!
As Cataceous stated if you are concerned with maintaining fertility/avoiding shutdown of the hpta then the Nasal T-gel (Natesto) or clomiphene/
enclomiphene would be your best bet.
Another option for maintaining fertility would be hCG monotherapy but it will still result in shutdown of the hpta.
Keep in mind that although some may do well using clomiphene/
enclomiphene or hCG monotherapy many tend to end up on TTh sooner or later.
These are your options before jumping into full blown TTh using other forms of exogenous T.
You have numerous options as there are different formulations such as pellets, transdermal T gels/creams (big pharma/compounded), oral, nasal and injections.
All of the formulations have advantages/disadvantages.
Transdermal let alone injections are the most common modalities used.
The majority of men are using injectable esterified T.
Most cost effective option let alone one can easily drive up testosterone levels very high!
I have depression and anxiety since a young age and a few years ago my sudden interest to a healthy lifestyle helped manage that depression. Started going to the gym and started eating healthy as this gave me hope for the future. I don`t smoke and I don`t drink alcohol so that didn`t change for me.
This is a big red flag here!
Have you been diagnosed with clinical depression?
My reply from a previous thread may give you some insight when it comes to using/relying on testosterone to treat depression/anxiety.
Need to tread lightly on this one especially if you have been diagnosed with clinical depression.
*Although TRT can improve mild depression, anxiety, and overall well-being it is highly doubtful that it will have a big impact on treating MDD.
*Keep in mind that even men with healthy testosterone levels can still suffer from mild, moderate, or severe depression.
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I have been reading about TRT for a few years now and I finally decided to make the jump this month because I just figured it was my last resort. I researched the topic A LOT in these past few years and I decided that if I would start this would be my protocol:
- 90 mg divided in two or three shots per week.
- 500 iu HCG divided in two or three shots per week because I want to maintain fertility since I am married and we want kids in the near future.
Now I came up with this protocol knowing that there is no sure thing with TRT, but this should make things easier to be dialed in.
Most men on TTh are injecting 100-200 mg T/week.
The majority of men can easily hit a healthy let alone high trough FT level injecting 100-150 mg T/week especially when split into more frequent injections.
Yes some men may need the higher-end dose 200 mg T/week but this is far from common as in RARE!
Keep in mind running too high a trough FT level can be just as bad in many ways as having too low a trough FT level especially when it comes to libido, erectile function and mood.
Best piece of advice is to start low and go slow on a T only protocol as we want to see how your body reacts to testosterone and where said protocol (dose of T/injection frequency) will have your trough TT, FT and estradiol let alone other critical blood markers such as RBCs, hemoglobin and hematocrit.
Much easier going up then coming down!
Common starting dose is 100 mg T/week or better yet 100 mg T split twice-weekly (50mg T every 3.5 days)
There will always be time to increase your dose if need be or add in hCG if your are concerned with maintaining fertility and minimizing/preventing testicular atrophy.
The issue is, by researching the topic a lot, I came across so many negative accounts on how TRT made things worse, how it is difficult to be dialed in, how it ruined things for people, how the effects would be awesome at the beginning and then VANISH suddenly (another fear of mine is that is working and then suddenly bringing back to this current state where now, I have to continue to inject myself for life otherwise I would crash and feel worse, etc etc etc)
Valid concerns but keep in mind that forums only represent a small slice of the TTH pie.
Unfortunately many still lack the understanding of how exogenous T works.
Hate to be the bearer of bad news but I would not set your expectations too high.
Many are aiming for something that will never be there!
Forget trying to mimic/chase that honeymoon period which gets many hooked when first starting let alone when tweaking a TTh protocol (increasing dose T) or you will end up being sorely disappointed in the long run!
The majority should notice improvements in mood, energy, libido/erectile function, body composition, recovery, and overall well-being once healthy FT levels are achieved but it is far from a given, and to what degree depends on many other factors.
No amount of testosterone is going to overcome a lack of quality sleep, poor diet, excessive stress (mental/physical), and lack of exercise.
Top it off dysfunction thyroid/adrenals can easily hamper the overall effectiveness of a TRT protocol.
Having healthy testosterone levels is only one piece of the puzzle.
Too many are caught up in that more T is better mentality which can easily have one in for a bumpy ride struggling with sides till the cows come home.
Running too high a trough FT level can be just as bad as having too low a FT level in many ways especially when it comes to libido/erectile function let alone mood.
Too many factors are involved especially when it comes to libido/erectile function as they are multifactorial.
Hard to say how one would fare on TTh as it is not so cut and dry.
For some men it can do wonders as in life-changing in many ways, for others they will be better off than before but have nothing to brag about, many may end up struggling with ups/downs for years to come and some will be far worse off.
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