Testosterone replacement therapy (TRT) Experience - my first few months

[Virginian]

TRT Experience - my first few months

My TRT experiences have all been good, but I’ll start at the beginning.

DIAGNOSIS:

I’m 71. I was diagnosed with osteoporosis 2 years ago. My doctor was shocked because I did not fit the risk profile for osteoporosis. I then took Fosamax and calcium and vitamin D supplements for the next 2 years with disappointing results.

This summer my doctor tested for testosterone (among other things) and it came back at 270 ng/dL. I also had a few other symptoms that suggested low test. She asked if I wanted to try TRT. That sounded like a great idea to me.

She prescribed an initial IM injection of 400mg of test cyp. Then 3 more injections of 400mg at 2-week intervals, and then 400mg every 4 weeks afterwards. (Originally, she suggested 300mg injections, but then said let’s not be “wimpy” and changed to 400mg.) (By the way, my doctor’s speciality is cardiovascular health and blood lipid chemistry, not TRT.)

I had my first injection (in my butt) on August 1. It hurt and my butt was sore for a few days afterwards.

STRENGTH:

The day after my first injection I went to the gym to lift weights. My routine for many years was to lift about once a week. I’ve been lifting for years so I was pretty much leveled out and not making any new gains. I was not expecting anything out of the ordinary because thought that testosterone took a long time to build muscle. Instead I was very surprised that I could do several more reps than normal in almost all my exercises. I was also able to do more sets than normal before getting too tired to do more. I wondered, could this be due to the testosterone, or am I just having a good day? I couldn’t believe I would see results after only one day.

Well, now it’s very clear that it was the testosterone. Every time I went to the gym, I made significant progress. My goal is to do 12 reps of each exercise. If I can do 14 reps, I increase the weight slightly at my next workout. I found that every time I went to the gym I moved up on about half of my exercises. The continual increase was so motivating that I am now lifting twice a week. Right now, 3+ months after starting test, I am lifting at least 20% more weight on most of my exercises. For stomach crunches with no weight, I did 100 reps before test. Now I do 350 reps (boring). I also do more sets than I used to because I don’t get exhausted as quickly. And the gains are still coming as fast as ever.

This is enough for one post. I'll continue with my experiences in other posts to follow.

 

[Armed and dangerous]

Great job!!! I'm sure in the beginning it was in your head but after 3 months its definitely working for you now. Show the young bucks in the gym how its done!!! Good luck, have fun getting younger

 

[Megatron28]

I am glad you are beginning to feel better. There are some simple things you could do that would really help you feel even better still.

Injecting once every four weeks puts you on a roller coaster. You start with really high levels and very low at the end of four weeks. At a minumum you want to inject once a week. Many of use inject every 3.5 days. Of course, this is easier when you are self-injecting.

The other problem this helps avoid is Aromatization. When testosterone levels get too high in your body there is an aromatase enzyme that converts it over to estradiol (a form of estrogen). So smaller more frequent injections helps prevent this from occurring. You need some estradiol in your body, but too much is bad.

Some guys have to take drugs known as Aromatase Inhibitors to stop the testosterone from converting. The only way to truly know if you have too much or too little estradiol is to have your doctor check with a blood test. Estradiol should be a standard part of the periodic labs you are running.

Make sure you donate blood every 56 days. Taking exogenous testosterone increase your hematocrit (blood thickness). You can do this at the Red Cross. And obviously, monitor this in your blood work as well.

As a cardiologist, don't assume your doctor already knows this stuff. Cardios are not specifically trained in TRT. You should discuss the management of these side effects of TRT with her.

 

[Armed and dangerous]

That's why megatron makes the big bucks lol I totally missed that good call brother

 

[TatsForTats]

my fathers osteoporosis improved significantly after being on trt for a long period of time! Keep at it and best of luck!!!

 

[Virginian]

Injecting once every four weeks puts you on a roller coaster. You start with really high levels and very low at the end of four weeks. At a minumum you want to inject once a week. Many of use inject every 3.5 days. Of course, this is easier when you are self-injecting.

Thanks Megatron. I did some reading on this forum and I realized that once a month injections are too infrequent and would still require a trip to the doctor's office for each injection. I also learned that many people injected subcutaneously and that it was effective. So after my third IM injection I decided to try sub-q.

Well, sub-Q worked well for me. I use a 29 gauge 1/2 inch insulin needle injected into my inner thigh. I am injecting about twice a week. My exact schedule and doses vary. I am sort of self-medicating to find out what feels best. The shortest time between injections was 2 days and the longest was 7 days. Largest dose was 90mg and the smallest was 40mg. The doses during about a week probably ranged from 100mg to 180mg. Fortunately, it always feels great no matter the size of frequency of the dose. I have never felt a 'low."

I had my first blood test after 6 weeks of sub-q self injections:

Total testosterone: 1244 ng/dL (range 250-1100)
Free testosterone: 331 pg/mL (range 30-135)

My doctor didn't mind the Total Test number, but thought the Free Test was too far out of range and suggested that I lower the dose. I told her I thought I was injecting about 180mg/week. She suggested that I lower it to 120mg/week. When I returned home and looked to see how much I was really injecting I found that in the 3 weeks before the blood test I injected a total of 360mg (average of 120mg/week). Not sure what to do now. I love the dose that I am on. Not sure that I want to lower it.

 

[Sedg1]

My doctor didn't mind the Total Test number, but thought the Free Test was too far out of range and suggested that I lower the dose. I told her I thought I was injecting about 180mg/week. She suggested that I lower it to 120mg/week. When I returned home and looked to see how much I was really injecting I found that in the 3 weeks before the blood test I injected a total of 360mg (average of 120mg/week). Not sure what to do now. I love the dose that I am on. Not sure that I want to lower it.

Congrats on your success. Because I had to use the "bad" steroid (Prednisone) in the past which put me in the osteopenia range, my doc willingly supported TRT as well.
I have been doing 150mg per week and it has been going well for me, without the need for any estrogen-leveling medications (ie: AI).
If your doc says that you should limit your dosing to 120mg, and that is what you are doing with good results, then you are where you should be. As others have suggested above, keep an eye out for increased estrogen levels that can result from excessive exogenous testosterone. An E2 test can quantify this. Google gynocomastia/testosterone for one of the more undesirable sequella of too much of a good thing.
Best of luck in your efforts to take charge of your health and for finding a doc that seems very progressive in her treatment approach.

 

[Megatron28]

I would stay at your 120mg per week then as it seems to be working well. Just try to find a way to inject on a more regular frequency.

And definitely get your estradiol and hematocrit checked.

 

[Virginian]

Congrats on your success. Because I had to use the "bad" steroid (Prednisone) in the past which put me in the osteopenia range, my doc willingly supported TRT as well.

keep an eye out for increased estrogen levels that can result from excessive exogenous testosterone. An E2 test can quantify this. Google gynocomastia/testosterone for one of the more undesirable sequella of too much of a good thing.

In my case the osteoporosis was discovered due to a baseline bone density test BEFORE starting a course of prednisone. Fortunately, my condition improved quickly so I took prednisone for a very short time.

I am concerned about gynocomastia. I started getting "old man's tits" 35 years ago, and I would like my tits to shrink or at least not get any bigger. I have not had an E2 test yet. I'll request it next time I see my doctor.

 

[Virginian]

I would stay at your 120mg per week then as it seems to be working well. Just try to find a way to inject on a more regular frequency.

And definitely get your estradiol and hematocrit checked.

How important is the regular frequency? My injection intervals and doses have been fairly variable so far because I am kind of experimenting. Regardless of that I always seem to feel good. I have not noticed any "down" feelings.

I will ask for an estradiol check the next time I see my doctor.

I have regular blood tests 3 to 4 times/year due to some cholesterol issues that I have, and hemocrit is always checked. In the last test before starting TRT, hemocrit was 44.8 (range 38.5 - 50.0%). After 3 months of TRT it was slightly higher at 46.3, but still within range. My doctor had no concern about that. Do you think it is a problem?

 

[Megatron28]

How important is the regular frequency? My injection intervals and doses have been fairly variable so far because I am kind of experimenting. Regardless of that I always seem to feel good. I have not noticed any "down" feelings.

I will ask for an estradiol check the next time I see my doctor.

I have regular blood tests 3 to 4 times/year due to some cholesterol issues that I have, and hemocrit is always checked. In the last test before starting TRT, hemocrit was 44.8 (range 38.5 - 50.0%). After 3 months of TRT it was slightly higher at 46.3, but still within range. My doctor had no concern about that. Do you think it is a problem?

Injecting on a regular basis and the same dose -- say 60mg every 3.5 days -- will help keep your testosterone and estradiol levels more stable. That's a good thing.

Your hematocrit will likely keep increasing since you are taking exogenous testosterone. 46.3 is fine, but what will it go up to in another 3 months? It is better to donate blood before it becomes a problem. Besides, you are helping someone who needs blood. It is a win-win. You can meet pretty girls down at Red Cross to and chat then up over a cookie.

 

[TatsForTats]

I believe the Half Life for test cyp is only 7-8 days and that's one of the reasons I'm getting a new trt dr.

 

[willnorthwest]

I agree that giving blood can help with hematocrit and rbc's, I would just say to be weary of donating too often. When you give blood you are also depleting your bodies' iron stores. My ferritin levels tested low after I gave blood twice in a 4 month period. Doc had to put me on daily iron tabs to get it back up

 

[Virginian]

So to continue my story, I'll tell you about changes in my physique.

Weight gain: I weighed 147 pounds before I started. Now, after almost 4 months of TRT, I weigh 153/154. a gain of about 6 or 7 pounds.

Waist and abdomin: I lost about an inch off my waist. I just bought a new pair of levis with a waist 1 inch smaller than I always used to use (31 vs 32). My old levis were getting a little loose. The new ones are still a little loose. I never had the pot belly so common among men my age (71), but my belly stuck out a little more than my belt. Now when I wear a tight shirt my stomach looks just totally flat. Small love handles have almost totally vanished. I can't see ab muscles (yet), but there is definitely some definition that I didn't have before.

Arms: Upper arms are visibly larger. Biceps and delts are visibly more prominent and defined.

Legs: I do a lot of biking so my legs were always muscular. Now they are visibly larger and better defined. Climbing hills on the bike is much easier.

Compliments: Friends are remarking that I am looking really good.

 

[Virginian]

Update - One year on TRT

I just finished my first year on TRT and I am still loving it. Age 71, weight 147.

My current doctor-approved dose is 0.22 ml every 4 days. That is equivalent to 77 mg/week. Sometimes I use a little more - 100 mg/week - to get a little more effect. I can't say I really notice a difference. I experience no highs or lows during the 4 day cycle. I always feel the same. During my first few months, I took about twice that dose.

Based on blood results I estimate that my total testosterone levels troth to peak range between 800 to 950 ng/dL. Hemocrit is OK. I donate blood every few months. PSA is higher (about 4), which concerns my doctor.

I inject in the thigh using a 29 gauge 1/2 inch needle. It goes into the muscle, but not by much. It is probably not quite IM and not quite sub-Q. You might call it a hybrid.

I have tried arimidex several times to see if I could detect any effect. I noticed nothing. Two blood tests suggest that E2 is at acceptable levels.

Here are the changes:

Weight: I started at 147 lbs, gained 6-7 lbs early on, now back to 147 lbs. I suspect the early weight gain was water bloat from higher doses, but who knows?

Strength: I gained 25 to 30% increases in the weight lifted for most exercises within the first few months. Also added endurance. Then I stabilized and have made only small gains since, but no back-sliding. In biking, I made tremendous gains in hill climbing and endurance the first few months, but no additional gains since then.

Sex: I continue to be fairly active (considering age) - about twice/week. On TRT orgasms are much more intense and satisfying. Erections did not improve, which I find disappointing.

Appearance: Muscles visibly larger and more pronounced, less fat, about an inch off waist. All in all, a leaner more athletic appearance.

Overall: Very happy with the results. No adverse effects.

 

[Alpin]

No its not in your head. That stuff when given IM starts to ever so slightly begin to do its thing day after shot.
I could feel a difference when getting on TRT with IM shots by next day.
You dont have to be on it for several months to feel the "effect". If you are hypo the Stuff will noticeably begin to work within the first month if done IM.

 

[Alpin]

I agree that giving blood can help with hematocrit and rbc's, I would just say to be weary of donating too often. When you give blood you are also depleting your bodies' iron stores. My ferritin levels tested low after I gave blood twice in a 4 month period. Doc had to put me on daily iron tabs to get it back up

Same here