Advice Please: Struggling over whether to start TRT

[gaffney]

I'm 45, and have been interesting in "age management"/hormone optimization for a while. I've done everything I can from a diet and exercise perspective -- working out regularly, eating well, supplementing with high quality vitamins. I've also tried herbal test booster, maca powder, DAA, etc.

So, I recently went to a doctor to find out what my levels are and whether I should consider testosterone replacement therapy (TRT). My first set of blood work found my total test at 638 and my free test at 136. My doctor told me my numbers were pretty average for a man my age, but not optimal -- she said most men feel better and function better in the 800 - 900 range, with free test above 180. So, to try to boost it up she first tried me on a month of Human Chorionic Gonadotropin (HCG) injections 3 times per week, and then tested again. My levels were basically unchanged. She's now recommending Testosterone Cyp IM injections once a week.

I'm still very interested in hormone optimization. I've noticed that even though I'm very disciplined about my workouts, I'm able to lift less than I was a few years ago. I'm also very active athletically, but I notice that I'm much slower to recover from injuries, and have more nagging injuries that I can't seem to get rid of. So, if boosting my T (and GH) would help with this, I'm interested. But first I have some questions and would like some advice. Here's what I'm wondering about:
• Have I done Human Chorionic Gonadotropin (HCG) for long enough (4 weeks/3 times per week) to know for sure that it's not going to work for me?
• If I begin testosterone replacement therapy (TRT) will I shut down my own ability to produce T (which, at this point, I seem to still be doing quite well, just not quite to optimal levels)?
• If I stop testosterone replacement therapy (TRT) will I be able to go back to producing my own T?
• Should I consider the T cream instead of injections...I've heard that because the cream is used every day, it better mimics our natural T cycles, and also is less likely to shut down the testicles.

And finally, I'm just curious to hear what some knowledgable people feel about doing testosterone replacement therapy (TRT) when one's levels are already in the mid 600s. Most of what I read is about guys who down in the 300s or lower -- and if that were the case, I think it would be a much easier decision for me. I am crazy to even be thinking about this?

Thanks for any reactions. I'm new here, but have done quite a bit of reading and thinking about this for a while.

 

[frank.tb]

Why are you worried about your body's ability to produce natural T? testosterone replacement therapy (TRT) is a "for life" choice...
Unless you are trying to have kids or something at your age I say take the Drs advice...and I wldnt advisethe cream...if it rly worked better everyone wld be using it...and the amount of shut down you see will depend on dosage...

 

[bigdippin]

Your 45 and your T levels are in the 600's? Seems pretty good to me. Maybe you have an underlining problem. Post up your blood work so we can get a better idea.

Trt is for life. Human Chorionic Gonadotropin (HCG) will help keep your boys the normal size. And I would recommend injections over cream.

 

[Megatron28]

I'm 45, and have been interesting in "age management"/hormone optimization for a while. I've done everything I can from a diet and exercise perspective -- working out regularly, eating well, supplementing with high quality vitamins. I've also tried herbal test booster, maca powder, DAA, etc.

So, I recently went to a doctor to find out what my levels are and whether I should consider testosterone replacement therapy (TRT). My first set of blood work found my total test at 638 and my free test at 136. My doctor told me my numbers were pretty average for a man my age, but not optimal -- she said most men feel better and function better in the 800 - 900 range, with free test above 180. So, to try to boost it up she first tried me on a month of Human Chorionic Gonadotropin (HCG) injections 3 times per week, and then tested again. My levels were basically unchanged. She's now recommending Testosterone Cyp IM injections once a week.

I'm still very interested in hormone optimization. I've noticed that even though I'm very disciplined about my workouts, I'm able to lift less than I was a few years ago. I'm also very active athletically, but I notice that I'm much slower to recover from injuries, and have more nagging injuries that I can't seem to get rid of. So, if boosting my T (and GH) would help with this, I'm interested. But first I have some questions and would like some advice. Here's what I'm wondering about:
• Have I done Human Chorionic Gonadotropin (HCG) for long enough (4 weeks/3 times per week) to know for sure that it's not going to work for me?
• If I begin testosterone replacement therapy (TRT) will I shut down my own ability to produce T (which, at this point, I seem to still be doing quite well, just not quite to optimal levels)?
• If I stop testosterone replacement therapy (TRT) will I be able to go back to producing my own T?
• Should I consider the T cream instead of injections...I've heard that because the cream is used every day, it better mimics our natural T cycles, and also is less likely to shut down the testicles.

And finally, I'm just curious to hear what some knowledgable people feel about doing testosterone replacement therapy (TRT) when one's levels are already in the mid 600s. Most of what I read is about guys who down in the 300s or lower -- and if that were the case, I think it would be a much easier decision for me. I am crazy to even be thinking about this?

Thanks for any reactions. I'm new here, but have done quite a bit of reading and thinking about this for a while.

I will be very clear. There is no way in hell I would go on testosterone replacement therapy (TRT) if my natty T was 683. Why put yourself through the inconvenience, cost, and side-effects to get another 100-200 points? No way I can recommend you do that. 683 is a very good natty T number regardless of your age. Run as far away as you can from that Doc for screwing around with your hormones.

Some of your specific questions:

- Human Chorionic Gonadotropin (HCG) is not going to do anything for you. You have healthy natty T. Were you monitoring your estradiol as you took hcg?

- As soon as you introduce exogenous test through injections, creams, gels or some other form your natty T will shut down. Period.

- If you start testosterone replacement therapy (TRT) you MIGHT be able to get your natty T back. The longer you are on testosterone replacement therapy (TRT) the harder it will be though. There are protocols for restarting, but there is no guarantee it works though.

- What you have been told about creams is false. Injections are far superior for many reasons.

- You will find that many of the guys here that started testosterone replacement therapy (TRT) were below 200 before they began. Yes... It was a no brainer to hop on TRT.

I applaud your for asking questions about testosterone replacement therapy (TRT) and questioning your doctor. It clearly is not for you at this time.

Check out other things in your life that can give you similar symptoms. Sleep study, diet, hours of sleep, thyroid panel, vitamin D, vitamin B12, estradiol.

 

[Megatron28]

Sorry -- meant to write 638.

 

[bigdippin]

I would imagine you would need a small dose with injections to get your 600's into the 900's. I started with a T level of 79. My levels are in the mid 400's now but I still got a long way to go until it gets to where I want. I do feel 100% better now though compared to before starting TRT.

 

[Megatron28]

I would imagine you would need a small dose with injections to get your 600's into the 900's. I started with a T level of 79. My levels are in the mid 400's now but I still got a long way to go until it gets to where I want. I do feel 100% better now though compared to before starting TRT.

I doesn't work that way. Taking exogenous testosterone shuts down your natural testosterone production. So your 79 and his 638 go away. You rely entirely on the exogenous testosterone you put in your body.

 

[gaffney]

I will be very clear. There is no way in hell I would go on testosterone replacement therapy (TRT) if my natty T was 683. Why put yourself through the inconvenience, cost, and side-effects to get another 100-200 points? No way I can recommend you do that. 683 is a very good natty T number regardless of your age. Run as far away as you can from that Doc for screwing around with your hormones.

Some of your specific questions:

- Human Chorionic Gonadotropin (HCG) is not going to do anything for you. You have healthy natty T. Were you monitoring your estradiol as you took hcg?

- As soon as you introduce exogenous test through injections, creams, gels or some other form your natty T will shut down. Period.

- If you start testosterone replacement therapy (TRT) you MIGHT be able to get your natty T back. The longer you are on testosterone replacement therapy (TRT) the harder it will be though. There are protocols for restarting, but there is no guarantee it works though.

- What you have been told about creams is false. Injections are far superior for many reasons.

- You will find that many of the guys here that started testosterone replacement therapy (TRT) were below 200 before they began. Yes... It was a no brainer to hop on TRT.

I applaud your for asking questions about testosterone replacement therapy (TRT) and questioning your doctor. It clearly is not for you at this time.

Check out other things in your life that can give you similar symptoms. Sleep study, diet, hours of sleep, thyroid panel, vitamin D, vitamin B12, estradiol.

I really appreciate your response. You seem to understand exactly why I am hesitant to take this step. I think I should probably explore other natural options for the time being.

 

[gaffney]

Oh yeah...she also put me on DHEA and Sermorelin (my IGF-1 levels are 124). Any concerns about either of those (Doc says they're totally safe)? And yes, she's been monitoring my estradiol -- in the first test it was around 26, and on the second (after the Human Chorionic Gonadotropin (HCG) ) it was at 34. Dr. says those levels are fine.

 

[lillywhites]

over 600...i wish, 45...my Total T level was 223. 600 Total T is a good number...if you feel fine, stay there, don't start anything else, it's really a personal choice and not set formula.

 

[halfwit]

The title of your thread must be at least 25 characters long. Please edit the title o

I will be very clear. There is no way in hell I would go on testosterone replacement therapy (TRT) if my natty T was 683. Why put yourself through the inconvenience, cost, and side-effects to get another 100-200 points? No way I can recommend you do that. 683 is a very good natty T number regardless of your age. Run as far away as you can from that Doc for screwing around with your hormones.

Some of your specific questions:

- Human Chorionic Gonadotropin (HCG) is not going to do anything for you. You have healthy natty T. Were you monitoring your estradiol as you took hcg?

- As soon as you introduce exogenous test through injections, creams, gels or some other form your natty T will shut down. Period.

- If you start testosterone replacement therapy (TRT) you MIGHT be able to get your natty T back. The longer you are on testosterone replacement therapy (TRT) the harder it will be though. There are protocols for restarting, but there is no guarantee it works though.

- What you have been told about creams is false. Injections are far superior for many reasons.

- You will find that many of the guys here that started testosterone replacement therapy (TRT) were below 200 before they began. Yes... It was a no brainer to hop on TRT.

I applaud your for asking questions about testosterone replacement therapy (TRT) and questioning your doctor. It clearly is not for you at this time.

Check out other things in your life that can give you similar symptoms. Sleep study, diet, hours of sleep, thyroid panel, vitamin D, vitamin B12, estradiol.

Well said man. So much for the theory that we try to get others on testosterone replacement therapy (TRT) that don't need it.

Oh yeah...she also put me on DHEA and Sermorelin (my IGF-1 levels are 124). Any concerns about either of those (Doc says they're totally safe)? And yes, she's been monitoring my estradiol -- in the first test it was around 26, and on the second (after the Human Chorionic Gonadotropin (HCG) ) it was at 34. Dr. says those levels are fine.

What was your DHEA-S blood panel before she put you on this? Honestly it sounds like someone is trying to make a buck or two off you. Sure you're under the upper 2% of males, but is the cost to benefit ratio really worth it at this point? I'd look into some of the things Megatron suggested like B-12/vitamin D/et cetera.
Here's a chart showing the natural ranges of IGF-1 for those curious:
View attachment 552505

Edit: If you haven't already, I'd also look into a sleep study. Even mild sleep apnea can mess with cortisol levels, making you feel less than optimal.

My .02c

 

[gaffney]

over 600...i wish, 45...my Total T level was 223. 600 Total T is a good number...if you feel fine, stay there, don't start anything else, it's really a personal choice and not set formula.

I feel pretty decent most of the time. But, as I mentioned, I feel like I've been losing ground in the gym, and I feel like I take a lot longer to heal from sports injuries. I also don't have quite the same umph I once did in the bedroom...I mean, I'm not talking about ED, but just not as strong as I once was. So...while I know I can't stave off the effects of age forever, I've been hearing more and more about hormone "optimization" as a way of "managing" the aging process, and have become increasingly interested over the past few years. That's why I went to get the panels a few months ago, and that's what I told my doc. Sure, I feel pretty good -- but I was interested in feeling great, if that involved a low-risk, high-reward treatment regime. I'm not really worried about the cost, btw -- while of course I don't want to waste money, I've got the disposable income to invest in anything that would benefit my health and well-being significantly, even if it's pricey.

So, that's my story. I've really appreciated the responses so far. You guys have helped me come to the conclusion that, at least for now, I should hold off on the TRT. Maybe if I drop down to the 500s or 400s I'll reconsider at that time -- but I don't think it makes sense to mess with my system while I still seem to be producing my T pretty adequately. I kind of think GH may be another story though. It seems that my levels there (as indicated by IGF-1) ARE on the very low end of the "normal" spectrum, so I'm more interested in taking steps to boost GH.

Anyway, thanks again for the responses. You guys have a lot of knowledge and are a great resource. If anyone has experience with or thoughts about GH, sermorelin, etc...or anything else I've said here...please chime in.

 

[gaffney]

over 600...i wish, 45...my Total T level was 223. 600 Total T is a good number...if you feel fine, stay there, don't start anything else, it's really a personal choice and not set formula.

I feel pretty decent most of the time. But, as I mentioned, I feel like I've been losing ground in the gym, and I feel like I take a lot longer to heal from sports injuries. I also don't have quite the same umph I once did in the bedroom...I mean, I'm not talking about ED, but just not as strong as I once was. So...while I know I can't stave off the effects of age forever, I've been hearing more and more about hormone "optimization" as a way of "managing" the aging process, and have become increasingly interested over the past few years. That's why I went to get the panels a few months ago, and that's what I told my doc. Sure, I feel pretty good -- but I was interested in feeling great, if that involved a low-risk, high-reward treatment regime. I'm not really worried about the cost, btw -- while of course I don't want to waste money, I've got the disposable income to invest in anything that would benefit my health and well-being significantly, even if it's pricey.

So, that's my story. I've really appreciated the responses so far. You guys have helped me come to the conclusion that, at least for now, I should hold off on the TRT. Maybe if I drop down to the 500s or 400s I'll reconsider at that time -- but I don't think it makes sense to mess with my system while I still seem to be producing my T pretty adequately. I kind of think GH may be another story though. It seems that my levels there (as indicated by IGF-1) ARE on the very low end of the "normal" spectrum, so I'm more interested in taking steps to boost GH.

Anyway, thanks again for the responses. You guys have a lot of knowledge and are a great resource. If anyone has experience with or thoughts about GH, sermorelin, etc...or anything else I've said here...please chime in.