Let’s talk Testosterone Replacement Therapy (TRT)

[ikeo1]

I'm in early/mid 40s and a hair under 800. Anyone under 400 or even 5 should seriously consider it by doing a lot of their own research. All the "increased risk of heart blah blah blah" is a load of crap for legitimate therapeutic treatments. Just like anything, too much is a bad thing...but you can say the same about drinking water.

800-1000 is what i'd say is typical for enhanced folks 40+. I agree with you ultimately, its like any other medication these days. As long as you do your blood work and stay on top of it. It shouldn't be a big deal. That said, this is kinda new for so many people doing therapeutic doses so it'll be interesting to see how people respond on a larger population. From my understanding, as long as your 140mg or lower, there shouldn't be too many side effects unless you're just not genetically able to handle the extra juice.

 

[H. Bowman]

Most people who parrot the "It's bad for you" line are either ignorant about the facts, or they're mixing up therapeutic use with sport use. Guys who are at 700 and using trt to jump up to 12 or 1500 or whatever...they're the ones who may run into trouble. But they're also likely to be the ones who are most educated about it and who do weekly or bimonthly bloodwork to keep track of and mitigate that risk.

A flat out uneducated ignorant "bad for you you'll be sorry" is about as ridiculous as "30 mag clips" and "You can sneak that plastic glock on an airplane" hysteria. Your lack of knowledge is the problem, not the therapeutic use of legitimate medicine to prolong and increase quality of life.

 

[W.H.O.]

As someone else said; sleep, nutrition & exercise are super important. Nutrition meaning sufficient intake of necessary nutrients, not just calories(carbs, proteins, fats; ie "macros"). You need all of your eaa's(not just some bcaa mix), your essential vitamins & minerals(A, all the Bs, C, D, K(1&2) E, iron, potassium, magnesium, selenium, zinc, copper, calcium...I could go on), EPA, DHA...

Doesn't hurt to toss in some NAC/glycine to help with glutathione levels(keeping that mitochondria functioning well is everything. Look into leydig cell function & oxidative stress...) and also....stress. stress is the MF silent destroyer here. Not just in terms of mental stress, but stress on the body in any form. It's all the same in terms of physiologic processes. It makes the body grow to adapt, but only if the body has the capacity to repair & adapt to it.

On the topic of enhanced...not opposed, but take a hard look at what you're not doing before concluding that it will fix whatever problems you think your low T is causing. While trt can certainly make a huge difference, it's not going to fix your ty habits. It can help you to pull yourself back from the bottom, but it's not going to do it for you.

For the record, I was having orthopedic issues(still recovering) with no real solid cause & spent ~2 yrs stressed out, running around to doctors looking for an answers. Finally said F*** it and bought my own blood panels....lots of them. Came in at 224 total 38 free. SHBG 22, fsh/lh in range...essentially everything else was in range...except cortisol was elevated but not to the degree of something like Cushing's. Being that I was only 33 I didn't want to jump on Test just yet. Opted to try Enclo; 3.125mg EOD(1/4 of the "recommended" daily dose) put me at 677 total 126 free. Still working on getting back to 100%(sarcopenia is a Mother F*****), but I've been on it for just over 6 months, landing at this dose w/labs only a month or two ago. Once I'm back into the swing of things I'll likely run for a bit with exogenous+ (3-4 months) to get back to baseline prior to all the BS, though that's a personal choice I can't recommend anybody just go ahead with. My mother was a bodybuilder during the golden era @ Gold's & World with a lot of the more known people in the bodybuilding community, so naturally I learned A LOT from her reminiscing on her younger years.

 

[revy]

I’m in my mid-late 30s. Noticed my energy levels decreasing horribly over the last couple years. I’ve started to research TRT (Testosterone Replacement Therapy) in hopes to start getting some positive changes. I had my levels checked and I’m at 260. From what I’ve read, optimal is 650+.

I started by going to a local spot, GameDay Men’s Health. Their program starts at ~$225/mo for testosterone injections, averaging $56/week. Then $200/yr for bloodwork. These prices seem pretty high based on my research. I vaguely remember seeing somebody say they’re at about $10/week.

Which leads me to this discussion/question. Is anybody here on TRT? What are the advantages you have noticed? Costs associated? Do you have a Dr. you would recommend? (I am located in Riverside County FWIW)

i went there too lol. i had lower test . got my results and bounced

 

[H. Bowman]

Yep, general health via nutrition sleep and exercise is suuuppeeerrrr important.

 

[GenghisDong]

Depending on your age and body composition, there’s two ways. Natural and Enhanced.

Personally I prefer natural but enhanced is reasonable depending on your age, lifestyle, and tolerance. Natural is the more difficult way to go since you need to adjust your life and requires discipline. 8 hours sleep, clean diet, lift heavy and regularly. Then monitoring your T levels to see if what you’re doing is working. If it doesn’t doing low dose T via non primary Dr. can be the next step. Main thing is to keep an eye on your bloodwork to see if you're a good candidate.

Natural way takes a really long time too in comparison and requires a lot of patience. I've had a similar issue after surgery, but at 315 your not too far off from being ok. Lifestyle changes can bring you back to ~500

I'm far from a slob, I eat good and healthy. My work and home are physical I just can't get that extra boost to do an actual work out. Doesn't help I have a 3 year old I have to change after

 

[RustVendor]

Ive been on trt for 5 years, I'm mid 40s. I was in the 100s so I get it for like 5 dollars a month with insurance. Before I began I expected a panacea. The reality is that yes, I feel better but it's just not what people think it is. The common idea is that more is better, but its not. The higher you go the higher your side effects. So to the question of is it bad for you? Not if you stay within therapeutic doses. I feel best on 100mg a week which puts me at ~550-600. I always read people trying to "optimize"by going up to 900. The thing is the number is arbitrary because everyone is going to respond differently. If I go higher than 100mg a week I get high blood pressure and my hematocrit goes to like 60 which does indeed increase blood clots and stroke risk. I also get more tired and don't feel good at all. Someone else can take 200mg per week and be at 900 and not have side effects. That said I think a lot of people just ignore the side effects because they want to be jacked.

The thing is, I never had an issue even in the 100s with building muscle, I was doing 500lb deadlifts the year before I went on TRT. That obviously goes against everything that people tell you online which is that you are weak because you don't have enough T or whatever. The point I am getting at is that if you are 3-400 but you don't have symtoms of actual hypogonadism don't go on it. there's a big difference between no T and enough T, and not a big difference between mid range high range. If you are overweight, don't go on it because your T is likely only low because you are overweight. When you are overweight the T converts to E and you will get bloated, fatter and literally grow . If your in "normal" levels which I would characterize as the levels that are below the level of unecessary side effects but high enough to treat hypgonadism you can get body recomposition though.

Anyway the point is that unless you have an actual deficiency it's not going to change your life and can even have dangerous and unwanted side effects if you go to a clinic and they prescribe you 200mg a week without titrating up to see what you actually need. A lot of people would actually be better served with GLP 1 meds as reducing adipose tissue with give you a lot more upside and will even increase your T which is what you wanted in the first place. If you are going to do it, do it right and start low and get bloodwork a few months in to see what your hemaocrit/cholesterol/BP are at because it can F- all that up.

 

[Crucifier41]

Urologist here.

Labs and injections are covered by your insurance as long as you really have hypogonadism (Testosterone usually sub 250 base on lab assay).

Pellets are usually extra 600-800 additional as most insurance don't cover.

As a younger man just be cautious. Although if indicated testosterone has many benefits, it can cause infertility if you are planning on having children and can cause polycythemia (elevated red blood cells), liver issues, BPH (enlarged prostate), and a rise in your PSA among other elements.

Talk to your doctor before proceeding....

 

[Josh3239]

I've been on TRT for a few years. For me the worst was being unmotivated, depressed, putting on fat, and losing muscle. Basically all the usual symptoms less the erectile dysfunction. Sometime in my early 30s did two blood tests and my T was low, like below my 70 years old Dad low, and of course insurance told me it wasn't crushed into the ground low enough. Went to a men's clinic and paying out of pocket since. Not nearly as depressed, keeping active, and I finally have shoulders and a chest. Unfortunately I do have really bad sleep hygiene, sleep does not come easy to me at all and that is about the only thing TRT didn't help me with. I do get elevated HCT and RBC, and was instructed to donate to the Red Cross though I honestly don't do that as much as I should. My blood pressure is kind of high, but it is impossible to tell if this is related to the TRT/elevated HCT and RBC, of course it likely is, but also my insomnia likely messes that up too, but I have no baseline.

One of the best decisions ever for me, right up there with Lasik. My biggest piece of advice to anyone is 1) atleast once a year get a complete blood test (cbc) and check your blood pressure. Even if you don't want/need any drugs, get a baseline. I really wish I had tracked all of this before jumping on. 2) Doctors follow a dogma that is very rigid and narrow. This is triple in TRT. No one is coming to help you, study it yourself - the internet literally has all the information in the world on it including what doctors are taught and more importantly what they aren't taught. Educate yourself.

 

[H. Bowman]

So many people think trt is only for muscle building or sexual function/drive. There's so many other factors that it can improve one's life, from brain fog and concentration, weight loss, cardiovascular, memory and focus, energy, joints and muscle recovery... It aint just about big muscles and a hard . Long term health is important and a lack of testosterone is detrimental to long term health.

 

[RustVendor]

I've been on TRT for a few years. For me the worst was being unmotivated, depressed, putting on fat, and losing muscle. Basically all the usual symptoms less the erectile dysfunction. Sometime in my early 30s did two blood tests and my T was low, like below my 70 years old Dad low, and of course insurance told me it wasn't crushed into the ground low enough. Went to a men's clinic and paying out of pocket since. Not nearly as depressed, keeping active, and I finally have shoulders and a chest. Unfortunately I do have really bad sleep hygiene, sleep does not come easy to me at all and that is about the only thing TRT didn't help me with. I do get elevated HCT and RBC, and was instructed to donate to the Red Cross though I honestly don't do that as much as I should. My blood pressure is kind of high, but it is impossible to tell if this is related to the TRT/elevated HCT and RBC, of course it likely is, but also my insomnia likely messes that up too, but I have no baseline.

One of the best decisions ever for me, right up there with Lasik. My biggest piece of advice to anyone is 1) atleast once a year get a complete blood test (cbc) and check your blood pressure. Even if you don't want/need any drugs, get a baseline. I really wish I had tracked all of this before jumping on. 2) Doctors follow a dogma that is very rigid and narrow. This is triple in TRT. No one is coming to help you, study it yourself - the internet literally has all the information in the world on it including what doctors are taught and more importantly what they aren't taught. Educate yourself.

The problem is that most info online is bad info. No legitimate doctor will prescribe you enough TRT to raise your hematocrit and BP to unsafe levels for instance. The clinics are scams in the same vein as the medical marijuana cards. I believe in freedom and assessing your own risk tolerance but you honestly are exhibiting symptoms of overdosing TRT and that includes the sleep issues. T increases sleep apnea and insomnia if you are overdoing it. Obviously do what you want but I would try a lower dose for a while you may find you actually feel better.

 

[DIYPSCM]

Kind of a funny story...

Age 67 I've been on T therapy for years. Not for gains, just to be normal... I was 150 or so. Started with gel, didn't work for me.... my body doesn't seem to be able to absorb it. Switched to doc visits every 2 weeks, worked for me but inconvenient. I asked if i could just do it myself... it's not rocket science. Quick demo, short video to watch & I was my own clinic. Sweet.

One of the things taught in the video was to insert, draw back the plunger slightly & look for blood.... this would mean you hit a major vein, bad thing. After literally hundreds of injections & never seeing blood I figured it was just BS & stopped doing it. Until that day.

I always figured those scenes on TV where the junkie gets a fix & within seconds melts under the effects were BS. Did my normal injection, within seconds I was coughing uncontrollably & gasping for air. I literally could not breath, got dizzy. I had just coated my lungs with what amounts to mineral oil. I hit the vein.

Thought went through my mind... "this is how they will find me... on the floor, fetal position, pants around my ankles, syringe by my side, another OD".

Seems like it lasted for an hour, probably more like 10 minutes. I look for the blood now.

 

[Nowhereman89]

I'm 35 and started on it at 25. I did it myself for the first five years or so but went legit about 5 years ago. The place I go to in Woodland Hills also charges 200/month, plus extra for HCG if you want that. Would love a cheaper option. I did cut the dose down and pumped HCG and HMG to get my wife pregnant (twins woohoo!). It wasn't the end of the world but you do notice little emotional things get worse without it.

As others have said the mental benefits are great. I noticed I'd have a hard time meeting people's eyes and just feel weird without it now. My bloodwork is always top notch. It helps motivate you to workout regularly etc. I'd love to not have to rely on it in a SHTF scenario but the quality of life improvement is just huge.

 

[couragewolf]

Most people who parrot the "It's bad for you" line are either ignorant about the facts, or they're mixing up therapeutic use with sport use. Guys who are at 700 and using trt to jump up to 12 or 1500 or whatever...they're the ones who may run into trouble. But they're also likely to be the ones who are most educated about it and who do weekly or bimonthly bloodwork to keep track of and mitigate that risk.

A flat out uneducated ignorant "bad for you you'll be sorry" is about as ridiculous as "30 mag clips" and "You can sneak that plastic glock on an airplane" hysteria. Your lack of knowledge is the problem, not the therapeutic use of legitimate medicine to prolong and increase quality of life.

I'm not a doctor but I pretty much have the same undergrad education level in biology and tbh I think there's plenty of reason to suspect that tRt as a persistent therapy can probably have all kinds of negative outcomes.

There's really not a lot of long term studies to rely on here so how we measure that against the long term outcomes of healthy people who don't supplement test is really hard to say. Could be like Ozempic in some sense could cause more harm than good. To confidently say one way or the other that this is the case seems really short sighted to me though.

I'm in my 40s and I'd love to have the same Test level I had in my 20s but I don't trust the endocrine disruption of supplementation of T that could occur under the circumstances that your supply potentially gets cut off, or you end up having some kind of heart issue and need to back off it etc.

My suspicion is that long term supplementation probably shortens your life span to some degree but probably improves most outcomes due to increased muscle mass into older age. How can we really know though most humans in history have not lived as long as we now routinely do.

 

[Calibreeze]

Been on TRT for about 6 weeks now and I am 46. Levels were about 200, currently paying out of pocket as we are trying to get insurance to cover, I am at 35 bucks a week for 100mg injectable. Definitely had some gains and libido shot up. First Pic was from mid June before Injections, 2nd Pic is from this last Monday. I would recommend my urologist but he is up in the San Jose area.

I don't see a difference in the pictures you posted. Not trying to bash you. Just my observation for what it's worth.

 

[Nowhereman89]

I'm not a doctor but I pretty much have the same undergrad education level in biology and tbh I think there's plenty of reason to suspect that tRt as a persistent therapy can probably have all kinds of negative outcomes.

There's really not a lot of long term studies to rely on here so how we measure that against the long term outcomes of healthy people who don't supplement test is really hard to say. Could be like Ozempic in some sense could cause more harm than good. To confidently say one way or the other that this is the case seems really short sighted to me though.

I'm in my 40s and I'd love to have the same Test level I had in my 20s but I don't trust the endocrine disruption of supplementation of T that could occur under the circumstances that your supply potentially gets cut off, or you end up having some kind of heart issue and need to back off it etc.

My suspicion is that long term supplementation probably shortens your life span to some degree but probably improves most outcomes due to increased muscle mass into older age. How can we really know though most humans in history have not lived as long as we now routinely do.

I definitely respect your opinion, and recognize that it's definitely possible that I am in fact doing more harm than good. But just to play devil's advocate, here's how my own logic has gone:
-Been on TRT since 25-35, other than coming off/lowering dose a bit to impregnate my wife easier.
-Before T was a skinny fat with low motivation, consistently underperforming in pretty much every area of life. Yes was drinking a lot and partying. And in law school which I didn't enjoy but was also a poor student. Kind of depressed too.
-After T I've been much more motivated, consistently workout, according to my "smart scale" which is probably not that accurate my health metrics are consistently good with 11-12% bodyfat, bull estimated "metabolic age" is 26 when I'm 35.
-Bloodwork is always fantastic
-Motivated to make a career change after law school, work hard, make a family have kids etc. making a lot of money

Basically for me - all the improvements I've gotten, I'm willing to take the risk.
On top of that:
-Our food is not as nutrient dense as it used to be
-GMO everything
-5G and EMF everywhere (all the bees dying)
-Birth rates and natural T levels declining anyway
-Pretty much seems like part of the global elite depopulation plan is doing everything to F with our hormones. They know 9/10 will just live feeling like .
-Most people are on pharma drugs to make up for the lack of good nutrition, GMO, etc.
-Most people are fat and have poor bloodwork, and fell like garbage

Can't point the finger directly at any of the above but as a whole I think you get the idea.

 

[ikeo1]

I definitely respect your opinion, and recognize that it's definitely possible that I am in fact doing more harm than good. But just to play devil's advocate, here's how my own logic has gone:

I agree with both your opinions. It's one of those things, he's right because we don't have long term studies. You're right because its a quality of life improvement based on environmental factors that changed over the years.

I supplement my diet with food I grow in the garden and have a vermiculture farm where I recycle a lot of the organic food I eat and then end up with worm castings to fertilize my other fruit trees and veggies. The flavor, color, taste, is very different from home grown vs store bought.

I was considering T for awhile but decided to do it naturally because I'm already on the bigger side for my height. Ultimately, we don't know long term effects, but if it improves your quality of life in your 30's-40's is it ok if you're taking from your 80's-90's? Its a different story if its your 60's, but seeing OG body builders like Dorian Yates, jay cutler, tom platz, mike ohearn, robby robinson, marius pudgzianoski it shows you can still have longevity if you do it right and have good genetics. Been following these guys for decades now. A lot of people who, I think, overuse are the ones that end up with bad outcomes. Ultimately, that's going to be the case with anything.

As long as you do what you need to responsibility wise with your bloodwork, not juicing too hard like the young kids these days, you should be ok. The thing is the old school guys would cycle. These days, its year round for the young cats, so I'm curious to see how this all turns out. A lot of youngins, have body dysmorphia because of social media. A normal body is no longer normal. Everyone expects to be jacked and you have another segment who's body positivity. Super polar opposites these days in everything.

 

[Drivedabizness]

I am now 63 - was in my early 50's when I finally got tested. I think my initial level was like 155 - my GP put me on injectable. Pretty soon I had blood in my spunk and I was mad all the time - she tested me and I was like 1200. She cut my dose in half (and made my urologist do all the prescriptions from then on). Last summer fall, my old urologist was transiitoning to retirement and my new guy failed to do the medical necessity paperwork for the authorization so, my insurance refused to approve the presciption. Long story short, I had been out of work since february and was already carrying Cobra and I ended up being off T for about 2 months. I got tested again - came in at 75. I felt TERRBLE - could barely walk around the house. I FINALLY got back onto a prescription. I'm doing better - I walk a MINIMUM of 3 and closer to 4+ miles every day and do my best to eat clean. Do need to cut back on alcohol - hard for me to do when I'm totally stressed.

 

[couragewolf]

I am now 63 - was in my early 50's when I finally got tested. I think my initial level was like 155 - my GP put me on injectable. Pretty soon I had blood in my spunk and I was mad all the time - she tested me and I was like 1200. She cut my dose in half (and made my urologist do all the prescriptions from then on). Last summer fall, my old urologist was transiitoning to retirement and my new guy failed to do the medical necessity paperwork for the authorization so, my insurance refused to approve the presciption. Long story short, I had been out of work since february and was already carrying Cobra and I ended up being off T for about 2 months. I got tested again - came in at 75. I felt TERRBLE - could barely walk around the house. I FINALLY got back onto a prescription. I'm doing better - I walk a MINIMUM of 3 and closer to 4+ miles every day and do my best to eat clean. Do need to cut back on alcohol - hard for me to do when I'm totally stressed.

Man, so sorry to hear this what a nightmare.

This is sort of exactly what I was attempting to point out. Your body with insulin and and test and cortisol is constantly playing a hypercomplex cell local balancing act with all of these molecules. Additionally, your endocrine system will permanently change it's behavior based on proteins your cells produce when they recognize certain quantities of any of the above and then they turn their generation processes down.

So you may very well have low test, but by artificially increasing your test you introduce a new dependency and your body can adjust to that dependency quickly, and semi permanently in a way that can be disastrous.

Again, very sorry you experienced this. Scary stuff.

 

[couragewolf]

Another factor that should be considered here is muscle density is one of the most clear correlations to quality of life in old age, so that's a tradeoff that also has to be considered obviously if you supplement for test you'll hang onto your mass longer.