1 year in on TRT

[Bobrebooted]

Well, it's been a full year since I started on TRT. For anyone new to this, I can tell you it is a process, at least for me it's been. No set and forget for this guy. So much has changed and I am definitely a completely different person than I was at this time last year. I sleep better and my snoring is almost gone. I wake up feeling better rested and knowing I can get through the day without feeling like I died. In fact a year ago I had to set a 30min alarm at work and sleep during my lunch! I've lost 40lbs and the simplest physical tasks aren't wiping me out. I work out on a regular basis, and I'm no longer feeling like I'm just going through the motions.
However, as I keep mentioning it is a work in progress, I'm guessing if you truly give a shit about the results, it always will be to some degree. Luckily I seem to have found a doc who's willing to listen and give decent recommendations. If you go with Onmen (online TRT clinic here in Canada), you can end up seeing a different doctor every visit, and I'm not a fan of that. They told me there is no problem asking for the same doctor for each visit and that's what I do now.
For those in the know, this is where I hope you'll chime in. I now have my appointment coming up and although I have filled you all in in other posts, I'll give an update here too. I'll only put up notable results, but if there is other things you want to know just ask.

Also, I'm in Canada. So for those of you who think my numbers are wonky, we do everything metric up here. I've made the stuff out of range BOLD.

Baseline Oct 2021
A1C - 6.2 (prediabetic),
Hemoglobin 150,
Hematocrit 0.448,
Testosterone 9.1 nmol/L,
Free Test - 227 pmol/L,
prolactin LO - 3.9,
Estradiol 75 pmol/L
Put on TRT with daily cream

First 3 months cream (Jan 2022) - cream appears to have not done much.
A1C - 6.0,
Hemoglobin 159
Hematocrit 0.458
Testosterone 11.8
Free test 313
prolactin 7.3
Estradiol 157
felt little to no improvement. Put on test cypionate 80mg split into 2 shots a week.

April 2022
A1C - 6.0
Hemoglobin 170
Hematocrit 0.490
Testosterone 24.9
Free test (HI) 704
prolactin 8.3
estradiol (HI) 244.
starting to finally see positive changes. Mood and activity level are going up. Libido isn't much better but erection quality has improved. Not so tired. Decide to start being more active and overhauled my eating habits to hopefully help with A1C. Dr. prescribes Anastrozole to lower Estrogen levels. Keeps test at 80mg split twice a week.

July 2022
A1C - 5.7 (at risk instead of prediabetic)
Hemoglobin 167
Hematocrit 0.492
Testosterone 25.9
Free test (HI) 771
prolactin 5.9
Estradiol 43.
pretty much the same as last time, maybe slightly worse. Libido seems to have gone down again. Erection quality has decreased a bit as well. No more morning wood. I asked to go off the Anastrozole as many people told me to get off it ASAP, some going so far as to call it poison. Freaked me out. Doc agreed, but asked that I try 20mg test every other day to help keep levels steady and Estradiol down. I also asked to get put on HCG to help with Libido and erection etc, although maintaining fertility is not an issue and I'm having no problems with my testicle size. Put on 50 units twice weekly. Lost 30lbs in 4 months.

Sept 2022 (today)
A1C - 5.3 (Normal!)
Hemoglobin 165
Hematocrit 0.475,
Testosterone 19.4
Free Test 487
prolactin 6.5
Estradiol (HI) 174
First, down a total of 40lbs. 40 more to go. A1C back to normal which is awesome. However, I knew that something had to have changed, I could actually feel that I was starting to go backwards. Moody at times and feeling lazier than I have in a bit despite being a lot more active at the gym. Not "Lazy" per say, but just that "no mojo" kind of feeling. Libido seems to have improved a bit, but erection quality sucks to say the least. I can get it done, but it's a ton of work and I better keep my concentration. I know I'm almost at 50, but I feel I should be progressing faster in the gym. Making gains, but not what I'd like to be.

So, once again, this is where I want everyone to chime in. I am definitely going to ask for an increase in my test. I've never gone up from initial dose of 80mg/week and never saw improvements above what I'd call moderate. Question is, how high do I ask to bump it? It will be six months before my next appointment, and although I can probably request more, I don't much feel like another $200 per appointment.
I'm also thinking of asking to go back to twice a week. every other day doesn't seem to have helped my estrogen so I'd like to cut back on the pinning.
So what's everyone scoop on Anastrozole? It definitely helped, but then I was scared off by the internet, and now I'm reading it's not so bad as I thought.
continue on HCG? Doesn't help noticeably, but doesn't seem to do any bad either.
Oh, and ACNE. HELP! I have been on Doxycycline for too long, and it isn't helping anymore. My back is moderate, and my chest is what I'd call bad. I've always been prone to acne even as an adult but now it's enough to be self conscious about. And these pimples are nasty, stay forever and cause scarring.
Any other suggestions? My big wish list at this point is better libido and erections, and better energy levels particularly at the gym. I'd love to be able to continue on the trend with my weight loss and body composition.
I always appreciate all the comments and advise here, thanks guys. Reddit just leaves me feeling like an idiot, always being talked down to for not being an instant expert on this subject.

 

[Systemlord]

Put on 50 units twice weekly.

Moody at times and feeling lazier than I have in a bit despite being a lot more active at the gym. Not "Lazy" per say, but just that "no mojo" kind of feeling. Libido seems to have improved a bit, but erection quality sucks to say the least.

HCG can negatively affect your libido, erectile quality and energy levels.

Oh, and ACNE. HELP!

HCG can cause ache even more than TRT alone.

I would drop the HCG and get a slight increase in Test and stay on the every other day protocol. I also believe your body responds better to more frequent injections if your A1C has anything to say about it.

 

[Bobrebooted]

HCG can negatively affect your libido, erectile quality and energy levels.


HCG can cause ache even more than TRT alone.

I would drop the HCG and get a slight increase in Test and stay on the every other day protocol. I also believe your body responds better to more frequent injections if your A1C has anything to say about it.

Seeing the A1C like that was nice! I didn't know injection frequency could help with that. Losing 40lbs sure did too. I will definitely talk more about the HCG

 

[Systemlord]

Seeing the A1C like that was nice! I didn't know injection frequency could help with that.

The one thing I've notice over the years is men with metabolic syndrome, or prone to diabetes, is they get better results on very frequent dosing. My theory is keeping the hormone levels flat allows one to overcome the metabolic abnormalities associated with metabolic syndrome.

If one has metabolic syndrome, declining testosterone can only lesson the positive effects it has on the body.

I'm no exception.

 

[Bobrebooted]

So I had my dr appointment last night, this is what she wants me to do.....

Increase test to 110mg weekly. Why 110 vs 125 I don't know, but it's an increase so I'm happy to start there.
Drop the HCG, but she said not to just stop, cut it in half this week, then half that next then none.
Put me on Aromasin, she prefers it over the Arimidex. Can't remember the dose but I'll get the prescription today.

 

[Belekas]

Still I believe too many variables in play FWIW. I'd go just with testosterone, give it time and go from there. Too many variables will make it next to impossible to figure it out. Been there done that. Less is more. I know it's hard as we always want to "improve" something along the way by adding this or that which gets us a mixed bag of results plus feeling like shit and additional stress as well. I'm not a Doc though but learned this the hard way over the years I've been involved in bodybuilding, TRT, longevity and overall health.

Interested how your journey moves from here. Following.

Best of luck,
Bel

 

[Bobrebooted]

Still I believe too many variables in play FWIW. I'd go just with testosterone, give it time and go from there. Too many variables will make it next to impossible to figure it out. Been there done that. Less is more. I know it's hard as we always want to "improve" something along the way by adding this or that which gets us a mixed bag of results plus feeling like shit and additional stress as well. I'm not a Doc though but learned this the hard way over the years I've been involved in bodybuilding, TRT, longevity and overall health.

Interested how your journey moves from here. Following.

Best of luck,
Bel

I hear ya, but at the same time everything was actually done one thing at a time. Started with test cream only for 3 months. Numbers were worse and felt like shit. Switched to Test cyp 80 mg for three months. Numbers improved, but only felt slightly better and estrogen went through the roof. Kept at 80mg and added anastrozole for high estrogen. waited three months. Estrogen back to normal but still not feeling better. Asked to go off Anastrazole. This was the first point in which we made more than one change, and it was at my request. Went off anaztrazole and was asked to change to every other day injections to help with that. I also asked to try HCG at that time. Still stayed at 80mg. Finally at the 1 year point last night, decided to go back to what worked and got off what didn't AI did get my estrogen down last time and that was the point I actually felt best. So basically we went back to that and increase test for the first time. In hindsight, we probably should have went with an increase right off the bat and nothing else. I understand the take your time approach, but a year in and not really feeling all that awesome takes its toll. At this point, I'm down to two things, test and aromasin.
I wonder if things would have gone smoother if we were doing labs every 6 weeks instead of 12. But in the end I feel like we're pointed in the right direction

 

[Charliebizz]

The one thing I've notice over the years is men with metabolic syndrome, or prone to diabetes, is they get better results on very frequent dosing. My theory is keeping the hormone levels flat allows one to overcome the metabolic abnormalities associated with metabolic syndrome.

If one has metabolic syndrome, declining testosterone can only lesson the positive effects it has on the body.

I'm no exception.

I’m not sure that is always the case. Low shbg guy. That struggles with trt. Currently trying once a week injections. Feel fine so far. But we will see.

all The drs on the forums and groups that have “normal” practices and aren’t trt clinics seem to have almost all patients doing well on 1x and at most 2x a week. And I’m sure tons of them have metabolic issues.

 

[andrewBwinter]

I'm going a different way with this thread:
Woohoo!!! 40 lbs. and still going!!!

I looked at OnMen (Ontario here) but have a local specialist in the GTA who after a year and seeing you are stable, will release you back to your primary GP). This is great because I have an excellent relationship with my GP and I look forward to working with him on this. He has a few patients who came back from the same specialist I am currently with.

Congrats on one year!

 

[Willyt]

Great detailed post. You made a lot of progress.

The best practice around here is to include the ranges on your tests though. Also make sure to tell people when you tested (e.g., day of injection, day before injection etc.)

I'm in agreement with @Systemlord, eliminate the HCG and see how you feel. Many do not tolerate it well when it drives up E2.

Also, there are some guys who seem to benefit from less frequency for whatever reason. I am not one of them, but check this thread out if you haven't already.

For those who are struggling on TRT

As many of you know, I have struggled over the years ever feeling well on TRT. I’ve had doses all the way from 200 mg per week down to 60 mg per week. I have now been on TRT 13 years and can honestly say I’ve pretty much tried it all. I have contemplated, and even attempted quitting a few times...

www.excelmale.com

 

[Bobrebooted]

I'm going a different way with this thread:
Woohoo!!! 40 lbs. and still going!!!

I looked at OnMen (Ontario here) but have a local specialist in the GTA who after a year and seeing you are stable, will release you back to your primary GP). This is great because I have an excellent relationship with my GP and I look forward to working with him on this. He has a few patients who came back from the same specialist I am currently with.

Congrats on one year!

Yeah, I could see that for sure. Up north we don't have a lot of good resources like that, everything takes longer than it should. In my case, it took a few bumps along the road, but I'm very happy with my experience with Onmen. Once I got a practitioner I liked, I simply said I didn't want to deal with anyone else.

 

[Bobrebooted]

Great detailed post. You made a lot of progress.

The best practice around here is to include the ranges on your tests though. Also make sure to tell people when you tested (e.g., day of injection, day before injection etc.)

I'm in agreement with @Systemlord, eliminate the HCG and see how you feel. Many do not tolerate it well when it drives up E2.

Also, there are some guys who seem to benefit from less frequency for whatever reason. I am not one of them, but check this thread out if you haven't already.

For those who are struggling on TRT

As many of you know, I have struggled over the years ever feeling well on TRT. I’ve had doses all the way from 200 mg per week down to 60 mg per week. I have now been on TRT 13 years and can honestly say I’ve pretty much tried it all. I have contemplated, and even attempted quitting a few times...

www.excelmale.com

Thank you so much, I'll check it for sure