Should I start TRT? Dr says yes but not sure

[KenAdams]

Just wondering if I could get some real world experience from you guys on testosterone.

43 185lbs 6”4. I lost One testicle to cancer they removed it and then had chemo. So I have one nut.

Reason it got to this is fatigue n lack of concentration and can’t gain any noticeable muscle no matter how often I work out. Seem to keep fat in belly area. Libido isn’t very high either it has dropped over the past year or so. Not that interested which isn’t fun. Concentration could be better.

That being said erections are strong with no issues. Sensitivity is still great too. I can still get through workouts an exercise and do all my yard work etc but no gains really. Happy disposition mostly. Anxiety happens much more often but not depressed etc.

Not on any medications and last testosterone reading was 401 total. I can get more specifics if you need them lab wise but was really hoping we could just discuss overall feeling and is it worth it or is it just a honeymoon phase where you feel good for a brief period of time and then it goes away? Did some of you guys lose penis sensitivity?

Just don’t know if I’m just getting old or if I should start. Dr is ready to start but I’m concerned because I’m not even 45 and what do I do at age 50 or 55. Will TRT still work or will I be in worse shape.
Thank you so much for the help. Would really appreciate honest conversation.

 

[sammmy]

What is your SHBG? If your calculated or measured with dialysis free testosterone is not low, it is unlikely that TRT will lead to any benefit.

You will be better off with a general stimulant like guarana that will make you less fatigued and workout more vigorously.

TRT is not a body building cycle with ultra-high doses of testosterone and anabolic steroids so don't expect a sudden appearance of a 6-pack or swollen muscles. The TRT effects on physique are minor and way overhyped on internet. In people that actually do not have a low free testosterone, no noticeable effect will be observed - you will replace your own free testosterone with an external one and shut down your own production and related systems along the way.

 

[Phil Goodman]

You have a lot of the same symptoms I had when I started except my libido was pretty decent. I also had good total levels but low free t. Decided to start at 39 and am glad I did. Concentration, mental clarity, motivation, assertiveness, muscle gains, and libido are all now as good as ever and f not better(July will be my 2 year anniversary if you’re wondering). I did deal with a little anxiety as I settled into my protocol (only a few rough patches over the course of a few weeks), and after a few months my orgasms decreased in intensity. That was corrected with the addition of HCG to my protocol. It is a big decision though so you’ll have to make it for yourself. Feel free to ask any follow ups you want though.

 

[Systemlord]

I lost One testicle to cancer they removed it and then had chemo.

Not on any medications and last testosterone reading was 401 total.

A bit more context for you, if you score a 401,1-2 days out of the week and the rest of the days Total T is lower, then your average level is lower. One test shouldn’t be the determining factor whether you start treatment.

You’re operating on half the testosterone your body was designed for and one testicle is doing to the work of two.

Symptoms AND labs should be the deciding factor for starting treatment. Symptoms should have more weight though.

If you don’t feel better on TRT, then stop.

 

[Seagal]

Just wondering if I could get some real world experience from you guys on testosterone.

43 185lbs 6”4. I lost One testicle to cancer they removed it and then had chemo. So I have one nut.

Reason it got to this is fatigue n lack of concentration and can’t gain any noticeable muscle no matter how often I work out. Seem to keep fat in belly area. Libido isn’t very high either it has dropped over the past year or so. Not that interested which isn’t fun. Concentration could be better.

That being said erections are strong with no issues. Sensitivity is still great too. I can still get through workouts an exercise and do all my yard work etc but no gains really. Happy disposition mostly. Anxiety happens much more often but not depressed etc.

Not on any medications and last testosterone reading was 401 total. I can get more specifics if you need them lab wise but was really hoping we could just discuss overall feeling and is it worth it or is it just a honeymoon phase where you feel good for a brief period of time and then it goes away? Did some of you guys lose penis sensitivity?

Just don’t know if I’m just getting old or if I should start. Dr is ready to start but I’m concerned because I’m not even 45 and what do I do at age 50 or 55. Will TRT still work or will I be in worse shape.
Thank you so much for the help. Would really appreciate honest conversation.

Could you increase strength from working out?
I assume you considered the side effects of chemo therapy, when was the chemo etc?
Guess you don't have T measured before the procedure.

 

[KenAdams]

Hi thank you all so much for the responses. I really appreciate it and it truly helps me. I will answer any of your questions to the best of my ability. I am so grateful for you all.

I finished BEP Chemo in 2018. I had 3 or 4 rounds over the course of 3 months or so. I won't lie it was rough on me. When I finished I worked very hard to get back to normal or as much as I could.

I may get a little stronger but I don't feel a big difference even when I do heavy weights etc. I actually do have numbers from various years. I will post them below. Ill start with most recent. I have a variety so I will just post in hopes that I cover what you need. If I am missing something let me know and I will look for it. My goal is to improve the way I feel etc. I don't want to get too hung up on numbers but I am just scared to start something and make things worse. I just don't want to do the wrong. I have worked so hard to come back this far from what happened to me. So I apologize for asking so many questions.


June 2023 Total Test 401
TSH 2.21
Cholesterol 152, Trig, 58, HDL 52, LDL 88
Vitamin D 25-OH = 47.13

Feb 2023 Total Test 340
Free 5.5

Jan 2023 Total 449
Free 15.6
Estradiol 11
PSA .53

Dec 2021 Total 416
Free 13.4
Estradiol 23
FSH 6.4
LH 3.6
Prolactin 5
PSA .42

Dec. 2018 Total 427

June 2011 Total 529 (felt good and normal back then) Way before Chemo etc.
Free 9.2

Just for background I don't drink alcohol I don't smoke, no drugs. I don't drink coffee or sodas. No caffeine. I make my own meals to handle portion control etc. I sleep well. I am not on any Rxs either. Just a multi vitamin each day.

Hope this will help some. Thank you so much.

 

[Guided_by_Voices]

My two cents...I am a big supporter of TRT but only in the right context. I would explore other avenues first. You appear to have signs of high cortisol (mid-section fat) so getting a work-up from a good holistic Dr seems like a logical step. Checking on thyroid would be good too, as well as for any chronic infections. Without knowing your lifting and eating protocol it's also hard to say, but under-eating and over-training (too much intensity) could also explain your symptoms. Having seen countless case studies over the years, the biggest risk in TRT, it appears to me, is that some people lose erectile function and find it hard to get it back, so since you have that, I would be very hesitant to risk it until you have taken a more holistic view. While T is important, so are lots of other things that make sense to investigate first. I have recommended the protocol in the book The perfect Health Diet many times here and I think it is a very comprehensive low-risk home base for diet and supplementation.

 

[Seagal]

Hi thank you all so much for the responses. I really appreciate it and it truly helps me. I will answer any of your questions to the best of my ability. I am so grateful for you all.

I finished BEP Chemo in 2018. I had 3 or 4 rounds over the course of 3 months or so. I won't lie it was rough on me. When I finished I worked very hard to get back to normal or as much as I could.

I may get a little stronger but I don't feel a big difference even when I do heavy weights etc. I actually do have numbers from various years. I will post them below. Ill start with most recent. I have a variety so I will just post in hopes that I cover what you need. If I am missing something let me know and I will look for it. My goal is to improve the way I feel etc. I don't want to get too hung up on numbers but I am just scared to start something and make things worse. I just don't want to do the wrong. I have worked so hard to come back this far from what happened to me. So I apologize for asking so many questions.


June 2023 Total Test 401
TSH 2.21
Cholesterol 152, Trig, 58, HDL 52, LDL 88
Vitamin D 25-OH = 47.13

Feb 2023 Total Test 340
Free 5.5

Jan 2023 Total 449
Free 15.6
Estradiol 11
PSA .53

Dec 2021 Total 416
Free 13.4
Estradiol 23
FSH 6.4
LH 3.6
Prolactin 5
PSA .42

Dec. 2018 Total 427

June 2011 Total 529 (felt good and normal back then) Way before Chemo etc.
Free 9.2

Just for background I don't drink alcohol I don't smoke, no drugs. I don't drink coffee or sodas. No caffeine. I make my own meals to handle portion control etc. I sleep well. I am not on any Rxs either. Just a multi vitamin each day.

Hope this will help some. Thank you so much.

Here is my opinion: I think in your case one could try supplementing with a small dosage of testosterone. Let's assume your brain (LH,FSH) is 'aiming' for 500 T but you might be only able to produce 400 T. If you supplement with an equivalent of 100 T, e.g. testogel, then you should be able to evaluate by blood test if your total T increases to around 500 T AND you won't 'shut down' your own production.

I'm aware that many here might say that it is nonsense what I'm suggesting.

And what guided_by_voices mentioned: overtraining/excessive stress is a good point to rule out before 'experimenting' with hormones.

About gaining muscles, getting stronger, in my experience most men approach their natural strength muscle mass rather quickly (within ~3yrs). That doesn't mean that they are T deficient.

 

[Systemlord]

Here is my opinion: I think in your case one could try supplementing with a small dosage of testosterone. Let's assume your brain (LH,FSH) is 'aiming' for 500 T but you might be only able to produce 400 T. If you supplement with an equivalent of 100 T, e.g. testogel, then you should be able to evaluate by blood test if your total T increases to around 500 T AND you won't 'shut down' your own production.

I'm aware that many here might say that it is nonsense what I'm suggesting.

Not that it might sound like nonsense, it is nonsense. By the time your levels reach steady states and you’re ready to draw labs, you’re mostly shutdown already.

He will bounce back much faster than someone on TRT for 10+ years though.

 

[Seagal]

Not that it might sound like nonsense, it is nonsense. By the time your levels reach steady states and you’re ready to draw labs, you’re mostly shutdown already.

He will bounce back much faster than someone on TRT for 10+ years though.

Also why does someone have to be deficient in testosterone to start TRT? Let’s say someone with low normal levels (350-400) has erections 50% of what they used to be and has noticeably lower energy.

This person shouldn’t consider TRT because he’s not deficient. How do we defined deficiency when there’s no agreed-upon cut off?

Here’s a thought, you don’t have to be deficient to have symptoms.

Hey Systemlord, I read many of your posts and found them helpful. Thank you for commenting on my post. Just for clarification what I meant: using a topical like testogel or cream which sort of resembles the diurnal T level variations.

You are right about my use of the term deficient, it's not clear. Your example ED is a good one. In my case I had all the symptoms of low/deficient T but ED. I guess everyone here is a bit biased by his own experience, thus it is so valuable that many contribute to this forum. By that I do not intend to mean that my suggesting is not nonsense, glad you commented quickly and reasoned why it is nonsense.

 

[Willyt]

Hey Systemlord, I read many of your posts and found them helpful. Thank you for commenting on my post. Just for clarification what I meant: using a topical like testogel or cream which sort of resembles the diurnal T level variations.

You are right about my use of the term deficient, it's not clear. Your example ED is a good one. In my case I had all the symptoms of low/deficient T but ED. I guess everyone here is a bit biased by his own experience, thus it is so valuable that many contribute to this forum. By that I do not intend to mean that my suggesting is not nonsense, glad you commented quickly and reasoned why it is nonsense.

Just to clarify, the only forms of fast acting T that do not shut down internal production are nasal gel/cream (Natesto or Empower) and troches (which @readalot has commented on before). Unfortunately Testogel and other transdermal creams linger too much in your system and therefore shutdown HPTA

 

[Guided_by_Voices]

Here is my opinion: I think in your case one could try supplementing with a small dosage of testosterone. Let's assume your brain (LH,FSH) is 'aiming' for 500 T but you might be only able to produce 400 T. If you supplement with an equivalent of 100 T, e.g. testogel, then you should be able to evaluate by blood test if your total T increases to around 500 T AND you won't 'shut down' your own production.

I'm aware that many here might say that it is nonsense what I'm suggesting.

And what guided_by_voices mentioned: overtraining/excessive stress is a good point to rule out before 'experimenting' with hormones.

About gaining muscles, getting stronger, in my experience most men approach their natural strength muscle mass rather quickly (within ~3yrs). That doesn't mean that they are T deficient.

I think there is some merit to the concept of using a brief pulse of short-acting T as an experiment to try to determine if that is one of your (OP's) issues. A low dose of clomid might also be a low-risk experiment, although it could confound the results. While you likely could not get to steady state blood levels, it might give you good information about whether that is your issues since some people experience immediate improvement.

It is important to distinguish between "suppression" and "shutdown". As others have posted in the threads about T-suspension, a single dose of short-acting T is not going to shut you down. On a related note, I also heard an interview recently that suggests another company (Quicksilver Scientific of liposomal fame) is working on a very short-acting T-pulse type of delivery based on exactly this premise.

 

[tareload]

. As others have posted in the threads about T-suspension, a single dose of short-acting T

PK profile almost identical to Test Prop FYI to reader.

 

[Seagal]

Large Testosterone Blood Level Variations Found with the Use of Androgel

Serum Testosterone (T) Level Variability in T Gel- Treated Older Hypogonadal Men: Treatment Monitoring Implications Ronald S. Swerdloff et al doi: 10.1210/JC.2015-1542 J Clin Endocrinol Metab Context: The optimal frequency for on-treatment serum testosterone (T) measurement used...

www.excelmale.com

declined with increasing time from dose application (44% at 2 hours, 38% at 4 hours, 22% at 8 hours, 3% at 16 hours).

Has anybody more information about testogel T variations throughout a day?