Ongoing Discussion with those Experienced with TRT - And my first experience

[Harot]

Clearly this is my first post, so hello. I have just been exposed to the world of TRT, and so far it has been life changing. I simply want to post my story so far with TRT, and see what feedback others may have. Thanks for reading, and sharing any thoughts or feedback you might have.

I currently do not live in the United States, but that is where I am from. I currently live in Central America.

I am started TRT at 35 years old, 185 lbs at 6 ft 2 and likely about 20% BF. I have a wonderful wife and family. When I was younger, I really enjoyed resistance training and was about 225 at about 10% BF at one time. I never tried steroids at the time, but my diet and supplement intake was strict and supportive of my resistance training.

The last few years, the gym never seemed to do much, but make me more tired. My nutritional intake was not perfect, but rather good compared to most. I was tired often...just simply worn out. I began to feel old. It was progressively worse. I blamed it on an international move, owning a global business, and simply having a growing family.

While driving one day, I saw an anti aging clinic. The same company has offices in the States. It got my attention and I checked out their website. After reviewing their material, I decided a blood test would not be a bad idea. I could only learn more I suppose.

It turns out that my total testosterone was in the high 300's. Even though that was in range, it is at the low end, and more consistent with an 80 year old. Since I felt 80 years old, I found this interesting. We did a full work up on labs. My HCG was a little low, but not as bad as my testosterone. My estrogen was ok. Everything else was rather normal, except my DHEA could have been better.

So, I decided to try TRT.

My Dr. placed me on 250 mg of testosterone cypionate weekly. He said that this was likely going to be high. He said that we will remeasure every few weeks to see the results and continuously adjust from there. He is working toward a range of 1200. He listed the possible side effects, of which I already knew...as I had done a lot of research beforehand.

I started taking the following on 10/21 per his recommendation:

1) 250 mb of testosterone cypionate weekly (injectable)
1) a high quality vitamin supplement daily
2) 25 mg of DHEA daily
3) Resveratrol daily

I figured if I was going to have high testosterone for a bit that I would make sure I have a higher protein intake than usual to help me heal better from my workouts.

1) 240-300 grams of whey protein daily
2) Ample high quality minerals for PH balance
3) 5g Creatine and other supplements such as amino acids and taurine

I still did resistance training three times a week, and I just started running in the last week (I hate running, LOL).

RESULTS:

My first week, I felt amazing...it took a couple days to start noticing. But I felt more energy, more "awake" ...happier. I was not as tired in the evenings. It was not like caffeine, but just a sense of "normal" ...I was not achy and worn out all the time. In fact, the gym started to be something to look forward to. I could focus and get work done like never before.

I should have logged my weight. I was watching it. I could tell I was putting on water weight, but that was to be expected.

Certain reoccurring intimate problems with the wife started to go away. This was the real reason I was interested in the TRT, as that began to occur months ago. This was the most rewarding and desired effect of the TRT. It was not fair to my wife for these things to be happening, who is much younger than me, so I am glad the TRT helped with that.

The second week I had to do some traveling to another country. It required a long drive and it was hotter there. I did have some swelling of the feet for a few days. But my Dr. did say that this was possible. So I let him know and we kept an eye on it. It subsided and was no longer an issue.

I started to notice that on day 7 or so, after a shot, that things were not as great as a few days ago. I changed my injections to twice weekly at 125 mg (every 3.5 days). I have not let the Dr. know yet (my wife injects), but I am sure this would be fine.

Things have been more "even" since then. I still have slight swelling of the feet, but barely noticable. I have some acne on my legs and arms, which just appeared in the last week at the beach. That used to occur when I used to work out in my younger days, in just the same way. I ordered some B-5 to hopefully help with that. I just started running too, which could also contribute.

My testosterone results were 2685 at 15 days in. That is quite high. I have another appointment next week. I figure that it will not be as high this time if my natural testosterone is less by now. But since I did not make much to begin with, it is likely still that high.

So, I am expecting to halve my dose...which would be about 60-70mg every 3.5 days. That should lessen the side effects as well.

Couple questions for those who are experienced...

1) Does anyone raise their dosage for a period of a few months to gain higher anabolic effects and then go back down to normal levels? I would assume that is what the hollywood types do, such as Sylvester Stalone...there is no way he could be in that shape with 67 year old testosterone...has anyone done this or do this? I am sure the effects (risks/rewards) would be the same doing a cycle for a few months and then going back to natural testosterone...except I do not have much natural testosterone, so I would go back to my normal therapy dose. This is just a thought...and I am sure some have done this.

2) How long have some of you been on TRT? This is clearly going to be a lifelong thing, eventually causing me to be in a perpetual and permanent hypogoadism state which what natural testosterone I did have shuts down entirely. This of course would further require TRT therapy for life. Any long term studies out there? How well do those who have hypogonadism fair in doing this for decades? Any long term effects. This question assumes keeping levels within range...below 1200.

I have a decision to make here. It would be so hard to going back to how I used to feel, and some of the issues I was having. If this could be long term without any sides, I believe I could accept the fact that I would have to be on treatment for life. I would have to have a good reason to not want to be given the results so far.

3) If I visit the States, can I bring my treatment from my Dr. with me? I assume not since it is a schedule III drug. I could get the pellets. That being said, who had done that and what were the results. I checked this forum, and it seems most discuss the injectables. However, if anyone has some quick comments on that therapy based on experience, that would be helpful for trip planning.

CURRENTLY:

215 lbs...maybe 15% BF

Life is great now...it is nice to spend good time with the kids...have no intimate issues with the wife...love going to the gym...and feel good all day long...

In short, unless this is going to kill me in the next 30 or so years...this is one of the better decisions I have ever made.

 

[Harot]

Also, next week I want to talk to my Dr. about an aromatase inhibitor...I will likely take some home...but I want to get my estrogen checked...having had swollen ankles and acne makes me nervous that I may have converted a lot of that T to estrogen.

 

[Spunkey71]

Welcome! It is great to hear that you are feeling so much better, once you are dialed in you will truly be glad you made this decision!

I am not an expert but I would think that 250 a week is on the high for a starting dose, and it makes sense why you are experiencing sweeling in the feet. That is from a spike in your E2 so a AI should be introduced to help with the sides, however a lower dose injected twice a week will result in lesss estrogen conversion which will help keep your E2 lower.


Best of luck and have you spoken to your doctor about HCG?

 

[Megatron28]

Welcome!

Sounds like you need to manage your Estradiol (E2) as Spunkey pointed out. At your Test dose you are pretty much guaranteed to get a spike in E2. Arimidex and Aromasin are good Aromatase Inhibitors. Most guys start at .25mg every 3.5 days and increase the dose if blood work indicates E2 is still high. Generally, guys seem to feel good when their E2 is between 20-40. But everyone is different of course.

As for your questions:

1) Does anyone raise their dosage for a period of a few months to gain higher anabolic effects and then go back down to normal levels? I would assume that is what the hollywood types do, such as Sylvester Stalone...there is no way he could be in that shape with 67 year old testosterone...has anyone done this or do this? I am sure the effects (risks/rewards) would be the same doing a cycle for a few months and then going back to natural testosterone...except I do not have much natural testosterone, so I would go back to my normal therapy dose. This is just a thought...and I am sure some have done this.

Yes, some guys do this. It is called Blast and Cruise. You would want to ask about this is the AAS section of this website. Not in the TRT forum.

2) How long have some of you been on TRT? This is clearly going to be a lifelong thing, eventually causing me to be in a perpetual and permanent hypogoadism state which what natural testosterone I did have shuts down entirely. This of course would further require TRT therapy for life. Any long term studies out there? How well do those who have hypogonadism fair in doing this for decades? Any long term effects. This question assumes keeping levels within range...below 1200.

Some guys here have been on TRT for 10-20 years. Most studies out there are on the long-term benefits of hypogonadism. That is linked to things like early death, heart disease, etc. TRT will shut down your natural testosterone production in probably a few weeks. It happens pretty quickly. There are ways to "restart" it, but the longer you take exogenous testosterone, generally the harder that is. But if you are already hypogonadal, why would you want to return to that?

I have a decision to make here. It would be so hard to going back to how I used to feel, and some of the issues I was having. If this could be long term without any sides, I believe I could accept the fact that I would have to be on treatment for life. I would have to have a good reason to not want to be given the results so far.

There are generally two negative side effects that you need to manage on TRT. Estradiol and Hematocrit. Estradiol is managed by lowering your testosterone dosage or using an Aromatase Inhibitor. Hematocrit (blood thickness) is managed by donating blood (e.g. Red Cross) on a regular basis. In the US they let you donate blood every 56 days.

3) If I visit the States, can I bring my treatment from my Dr. with me? I assume not since it is a schedule III drug. I could get the pellets. That being said, who had done that and what were the results. I checked this forum, and it seems most discuss the injectables. However, if anyone has some quick comments on that therapy based on experience, that would be helpful for trip planning.

If you have a prescription you can travel with your medications. You will want to bring proof of your medication with you. Don't get pellets. There are horror stories around those. Watch YouTube to see what the procedure is like.

Just curious... what country are you in?

 

[Harot]

Thank you all, you have been most helpful.

If you are willing and able (no rush) I have a few more questions, because I could clearly benefit from some education.

1) Is there is a trusted and well tested "TRT" intro document somewhere that covers the basics of TRT protocol and FAQ's?

2) I skipped my 3.5 day dose yesterday, intentionally, to begin to drop my T. My next dose on Sat I plan to only inject about 60mg of testosterone cypionate instead of 125. Going forward I expect this dosage to be closer to "ideal" for long term TRT. If my total T was about 2400 at 250mg (125 x 2) per week, then perhaps 125mg +/-(60mg x2) may place me around 1200. Is that a valid methodology and assumption?

3) My Dr. said 1200 total T is what he is shooting for (he is keeping an eye on other metrics in the lab work as well). Is 1200 really an average ideal? (I realize every case study can be different)

4) When I finally figure out my ideal dosage to place me at my ideal T levels (expecting 1200), will I always need an AI for the long term? Do I only need an AI if I see sides (swelling/acne)? My biggest fear is gyno. What is the average risk of gyno (again, I realize case studies differ) long term at a maintenance of T levels at 1200? Are there side effects from AI's? (I generally do not like taking drugs if I do not have to, which sounds odd since I am now opting to go on TRT for life) Are there any "Here is what you need to know/do articles" you can share to educate me on AI's and HCG?

5) What about long term injecting? Are there consequences to injecting twice a week long term? Scar tissue? Anything to consider here?

6) Is there anything else I should consider or educate myself on?

7) I plan on doing labs every 3 months. What should be the "always measure" components of my labs? 1) Total T? 2) Red Blood Cell count? 3) E2? 4) Cholesterol? Anything else? ...to make sure all is going well?

My next Dr. appointment is next Wednesday. I will be discussing all of these things with my Dr. as well, but it is good to have multiple opinions. We will also be doing labs.

I apologize. That was more questions than I anticipated. I really appreciate your time and feedback.

Megatron...Costa Rica.

 

[Spunkey71]

3) My Dr. said 1200 total T is what he is shooting for (he is keeping an eye on other metrics in the lab work as well). Is 1200 really an average ideal? (I realize every case study can be different)
That is on the high side of normal on most scales that I have seen, I personaly would go more by how you feel instead of a specific number.

4) When I finally figure out my ideal dosage to place me at my ideal T levels (expecting 1200), will I always need an AI for the long term? Do I only need an AI if I see sides (swelling/acne)? My biggest fear is gyno. What is the average risk of gyno (again, I realize case studies differ) long term at a maintenance of T levels at 1200? Are there side effects from AI's? (I generally do not like taking drugs if I do not have to, which sounds odd since I am now opting to go on TRT for life) Are there any "Here is what you need to know/do articles" you can share to educate me on AI's and HCG?
Every person is different, there are many factors that effect how much test your body converts to estrogen. The best way to monitor this is by watching your E2, if your E2 is elevated then you are more subseptable to estrogen sides than if your E2 is lower. There are proactive measures you can take that will lessen the degree at which your body converts the Test to estrogen such as diet, keeping your body fat low and the frequency of injections.

6) Is there anything else I should consider or educate myself on?
Stay active on this site and read, I can not even begin to tell you how much I have learned in my short time on this site. Look to other members for information like Megatron, Halfwit and Austinite, they are very knowledegable on TRT.


Hope this helps!

 

[Harot]

Thanks Spunkey...all made sense

 

[Megatron28]

Thank you all, you have been most helpful.

If you are willing and able (no rush) I have a few more questions, because I could clearly benefit from some education.

1) Is there is a trusted and well tested "TRT" intro document somewhere that covers the basics of TRT protocol and FAQ's?

2) I skipped my 3.5 day dose yesterday, intentionally, to begin to drop my T. My next dose on Sat I plan to only inject about 60mg of testosterone cypionate instead of 125. Going forward I expect this dosage to be closer to "ideal" for long term TRT. If my total T was about 2400 at 250mg (125 x 2) per week, then perhaps 125mg +/-(60mg x2) may place me around 1200. Is that a valid methodology and assumption?

3) My Dr. said 1200 total T is what he is shooting for (he is keeping an eye on other metrics in the lab work as well). Is 1200 really an average ideal? (I realize every case study can be different)

4) When I finally figure out my ideal dosage to place me at my ideal T levels (expecting 1200), will I always need an AI for the long term? Do I only need an AI if I see sides (swelling/acne)? My biggest fear is gyno. What is the average risk of gyno (again, I realize case studies differ) long term at a maintenance of T levels at 1200? Are there side effects from AI's? (I generally do not like taking drugs if I do not have to, which sounds odd since I am now opting to go on TRT for life) Are there any "Here is what you need to know/do articles" you can share to educate me on AI's and HCG?

5) What about long term injecting? Are there consequences to injecting twice a week long term? Scar tissue? Anything to consider here?

6) Is there anything else I should consider or educate myself on?

7) I plan on doing labs every 3 months. What should be the "always measure" components of my labs? 1) Total T? 2) Red Blood Cell count? 3) E2? 4) Cholesterol? Anything else? ...to make sure all is going well?

My next Dr. appointment is next Wednesday. I will be discussing all of these things with my Dr. as well, but it is good to have multiple opinions. We will also be doing labs.

I apologize. That was more questions than I anticipated. I really appreciate your time and feedback.

Megatron...Costa Rica.

1. It is quite that easy. We can't spoon feed it to you. Here is some reading you can do.

Read the third one from the bottom about hypogonadism:
https://www.aace.com/publications/guidelines

Here is more reading:
Chapter 253 ? THE TESTIS AND MALE SEXUAL FUNCTION

2. It isn't a linear equation, but what you are proposing is a decent starting point.

3. The typical normal range is about 348-1197. So he is trying to put you at the top of the average range. For comparison, the average 30 year old probably has TT is the 600 range.

4. There are two general approaches to TRT. One is to take the most Test you can tolerate WITHOUT needing an aromatase inhibitor (AI). For many guys though, they are not happy at that TT level. So the option is to aim for the peak of the normal range and use an AI. Both are perfectly good approaches. Depends if you want to take more or less medication. It sounds like you would prefer the former approach over the latter.

If you choose to aim for the higher TT, it is likely that you will need an AI. Typically then, you would always need that AI unless something changes (I.e. body fat).

Some people are more gyno prone than others. No way to know how you respond. Low and high estradiol have other complications though. It isn't just gyno that you have to worry about.

5. Scar tissue is the biggest concern. Rotate spots. You said you wife injects you so that makes it easier. I would rotate you quads, glutes and delts. That should keep you going for quite some time. Another risk is infection or abscess if you have poor injection technique.

6. Read everything you can on this TRT forum. Go through old posts. It has all been asked before. Read until you can read anymore.

7. CBC, Metabolic Panel, TT, E2. I would look at PSA, Prolactin, and cholesterol profile also occasionally but not every time.

8. Donate blood every 56 days. This lowers hematocrit.

Finalmente, es bueno conocer un "medio" Tico. Bien venidos a 'Ology.

 

[Harot]

1. It is quite that easy. We can't spoon feed it to you. Here is some reading you can do.

Read the third one from the bottom about hypogonadism:
https://aace.com/publications/guidelines

Here is more reading:
Chapter 253 ? THE TESTIS AND MALE SEXUAL FUNCTION

2. It isn't a linear equation, but what you are proposing is a decent starting point.

3. The typical normal range is about 348-1197. So he is trying to put you at the top of the average range. For comparison, the average 30 year old probably has TT is the 600 range.

4. There are two general approaches to TRT. One is to take the most Test you can tolerate WITHOUT needing an aromatase inhibitor (AI). For many guys though, they are not happy at that TT level. So the option is to aim for the peak of the normal range and use an AI. Both are perfectly good approaches. Depends if you want to take more or less medication. It sounds like you would prefer the former approach over the latter.

If you choose to aim for the higher TT, it is likely that you will need an AI. Typically then, you would always need that AI unless something changes (I.e. body fat).

Some people are more gyno prone than others. No way to know how you respond. Low and high estradiol have other complications though. It isn't just gyno that you have to worry about.

5. Scar tissue is the biggest concern. Rotate spots. You said you wife injects you so that makes it easier. I would rotate you quads, glutes and delts. That should keep you going for quite some time. Another risk is infection or abscess if you have poor injection technique.

6. Read everything you can on this TRT forum. Go through old posts. It has all been asked before. Read until you can read anymore.

7. CBC, Metabolic Panel, TT, E2. I would look at PSA, Prolactin, and cholesterol profile also occasionally but not every time.

8. Donate blood every 56 days. This lowers hematocrit.

Finalmente, es bueno conocer un "medio" Tico. Bien venidos a 'Ology.

Thank you Megatron, for the white papers! There was some good information contained in them. I will certainly be continuing my learning, and I imagine this website will be highly conducive to that.

Not officially a Tico yet, but in 7 years we hope to apply for citizenship. If you ever need any info related to CR, we would be glad to help!