New to TRT. Received first labs. Concerned and need help.

[Phil Goodman]

There's this pervasive myth that 100 mg of testosterone cypionate per week is a low dose. It's not. Top-of-range natural production is equivalent to more like 90 mg TC per week. Typical production in healthy young men is equivalent to 50-70 mg TC per week. Thus you are taking more testosterone than almost any man could make naturally and yet perceive it to be low. There is no evidence that such supraphysiological dosing is better for overall health, and plenty to the contrary.

I agree with a lot of your post, but not sure why you continue to make this specific claim. I’ve provided TONS of evidence that 100-120/week provides a lot more benefits than 50-75/week with very minimal increase in risks(if any increase at all). You’ve provided ZERO evidence that 50-75 mg/week provides comparable benefits, or even that it is particularly safer.


- 100 mg/week is not an absurd starting dose, regardless of how many times you say it is


- if OP ran that protocol for a while and saw no benefits with regard to energy, motivation, or other mental aspects then the two most likely explanations (in order) are that the root cause wasn’t testosterone issues all along, which you alluded to …. Or 2.) he hasn’t given his body enough time to fully adjust, as the full spectrum of benefits can take 6-12 months or even longer to fully emerge. The likelihood that he never saw any benefits on those fronts because his starting dose was too high is low. Sure running excessive doses for extended periods of time can cause issues, but getting a huge bump in dopamine and other things while seeing no benefits on the mental front even during the honeymoon phase doesn’t point to an excessive dose imo. It most likely points to one of the other two things I mentioned earlier, or a combination of various other factors.


The only other thing I disagree with in your post, is that I would say people should be more careful tinkering with various neuromodulators like dopamine. You do a good job of pointing of the complexities when it comes to hormones, but I’d say the neuromodulators can be as tricky or even more so with regard to messing around with them and finding a good protocol.

 

[Willyt]

Symptoms prior to TRT: excessive fatigue, no energy, brain fog, difficulty concentrating, depression, anxiety, low libido, loss of muscle mass, reduced strength.

While there may be other causes, these symptoms are very common for older men (the mid-50 doldrums!). It sucks but its the unfortunate reality of getting older. If you find the solution, let me know.

 

[Phil Goodman]

Thank you for your feedback!

I will look up Will Cole and the tests you mentioned. That is a new area for me but I am willing to try most anything at this point.

I may be over training. I have worked out probably 5-6 days a week (unless I am sick) pretty consistently since I was a teenager. For me, working out gives me energy. Which is part of why it probably became a lifelong habit. Not every day is weight training. I do lots of cardio. More cardio than weights actually. I used to be a runner. Training for races, I often would get sick/worn down after my long runs. I would push myself too far. Probably my personality. I will try to lighten up my workouts and maybe take a day off midweek.

I haven't explored a thyroid correlation because my bloodwork never indicated an issue. Can labs all be within range and the thyroid still be a key piece to chronic fatigue/brain fog/etc? I will research, but if you have any advice on where to start or what meds may be beneficial, please let me know.

Again, thanks for everyone chiming in with their ideas. New ideas at least give me a little hope. After dealing with these symptoms this long, it often feels like I've tried everything.

I worked out 5-6 days/week for years(probably close to 10 years), but honestly now that I work out 3 days per week(push/pull/legs once per week) I have kept all my gains and possible even added a little. Exercise causes inflammation, often in a good manageable way that makes your body stronger… but pushing it too far can lead to excess inflammation and lots of the issues that go along with keeping the body chronically in that state. It could just be that all those years are catching up to you, your body is unable to sustain those levels at this point in your life, or a combination of both of those. As I stated above an easy way to test the impact of that aspect of your life is to take two weeks off from the gym. And as an adamant lifter I fully understand it can be dreadful to think of missing workouts for that long, but at this point in my life I’ve learned that recovery weeks are important… especially if you want to go hard while you are exercising.

As far as elimination diets, the AIP (automimmune protocol or anti inflammatory protocol) diet has been the best diet I’ve ever found. It’s very restrictive for the first month, but when I stuck to it strictly it was probably the most positive impact a diet has ever had on me. Mental clarity and energy levels were through the roof. If you plan to do it though, I hope you like sweet potatoes because you’re about to eat a shit ton of them lol. And you’re supposed to slowly re-introduce foods so you can clearly identify any that cause issues for you, which I didn’t follow those phases all that good and ended up drifting back towards less healthy diets… though I’d say my diet overall is better than the vast majority of the population. And I do think people can benefit from it even if they just do it for a month at a time then go back, just because of how much inflammation and stress it removes from the body during that time. So yeah, if you think you can stick to it for a month then definitely go with that one.

 

[Cataceous]

I agree with a lot of your post, but not sure why you continue to make this specific claim. I’ve provided TONS of evidence that 100-120/week provides a lot more benefits than 50-75/week with very minimal increase in risks(if any increase at all). You’ve provided ZERO evidence that 50-75 mg/week provides comparable benefits, or even that it is particularly safer.

If you recall, I dismantled every one of your purported references. Not one refuted my claims. You basically relied on one study in which no subjects experienced physiological levels of testosterone throughout each injection cycle.

Meanwhile, you continue to defend the indefensible: that a starting dose for replacement of a hormone should be well over what most men would make naturally. Of course this is absurd. And all the while the parade of posters suffering from this stupidity somehow escapes your notice.

 

[Guided_by_Voices]

Thank you for your feedback!

I will look up Will Cole and the tests you mentioned. That is a new area for me but I am willing to try most anything at this point.

I may be over training. I have worked out probably 5-6 days a week (unless I am sick) pretty consistently since I was a teenager. For me, working out gives me energy. Which is part of why it probably became a lifelong habit. Not every day is weight training. I do lots of cardio. More cardio than weights actually. I used to be a runner. Training for races, I often would get sick/worn down after my long runs. I would push myself too far. Probably my personality. I will try to lighten up my workouts and maybe take a day off midweek.

I haven't explored a thyroid correlation because my bloodwork never indicated an issue. Can labs all be within range and the thyroid still be a key piece to chronic fatigue/brain fog/etc? I will research, but if you have any advice on where to start or what meds may be beneficial, please let me know.

Again, thanks for everyone chiming in with their ideas. New ideas at least give me a little hope. After dealing with these symptoms this long, it often feels like I've tried everything.

Some comments in no particular order.

- Your Vitamin D reminds me that there are apparently some infections that use the Vitamin D receptor as an entryway into cells, and for those infections Vitamin D can make actually make things worse. Dr. Michael Ruscio (who you should also look into) did a whole podcast on that years ago. I'm a big beleiver in Vitamin D levels above 50, but you might stops the supps for a couple of weeks and see if you notice anything better. That would be a clue that you have a related infection although that is by no means definitive.
- It is well-known that endurance exercise that goes beyond an hour or so IIRC weakens the Innate immune system for a few days. I think one of the main researchers on that topic is from NC State.
- While I am not an endurance athlete, I follow some people who are and many of them stress that most people tend to train at too high of a level. The Maffetone Method is focused on that topic, or as Mark Sisson says, make your short hard workouts shorter and harder, and your long easy workout longer and easier. I think Brad Kearns wrote a book about his issues going into the runner's version of overtraining which somewhat overlap with your issues.
- The types of Doc's I mentioned should be very familiar with thyroid issues, but it is another topic with a lot of nuance and unreliable testing that doesn't correlate with symptoms. I've forgotten what the "right " thyroid tests are, but it's not TSH, and at some point experimentation may be in order if nothing else has worked.
- Testosterone is kind of a "sledgehammer" brute-force treatment which is often appropriate, but there are a lot of other issues that can require a lot more digging.
- As Chris Masterjohn has pointed out, there are enough conditions that are considered "rare" that having a rare condition is actually not all that rare.