Considering starting TRT although levels are not "clinically low" Feedback would be appreciated

[lancelot]

I follow the general principle, but would point out that the short half-life of propionate can lead to excessive variation in serum testosterone. I was measuring around +/-50% variation about the mean with daily use, whereas healthy young men naturally top out at around +/-25%. It's possible to blend propionate with a longer ester to tune the amount of variation.


The prescribing information for Natesto doesn't address whether this product specifically has been shown to help with insulin resistance. But it notes that androgens in general can do this:

Changes in insulin sensitivity or glycemic conrol may occur in patients treated with androgens. In diabetic patients, the metabolic effects of androgens may decrease blood glucose and, therefore, may necessitate a decrease in the dose of anti-diabetic medication.​

I think you'd just need to try it. I don't see much to lose in doing this before going with conventional TRT.

I was looking at some of the products at Empower Pharmacy and noticed they had a compounded nasal testosterone gel. Would you happen to know if it is virtually identical in terms of action to the Natesto brand?
Also, and this may be slightly off topic, I know of someone who has a fairly unusual TRT regime that I am sure would get derided by most. He does daily short ester injections for about 4 to 6 weeks straight..then goes off for two weeks and uses only HCG and clomid. Then resumes the injections. He claims that he experiences more of that elusive "honeymoon reaction" than when he just stayed on all the time and continues to have good libido, sense of well being..etc. Have you ever heard of anything like that? From many of your posts I have read on this and the Peak testosterone forum, you seem to be experimental in differing ways to do your TRT. Curious what you thought of this protocol.

 

[HarryCat2]

Also, and this may be slightly off topic, I know of someone who has a fairly unusual TRT regime that I am sure would get derided by most. He does daily short ester injections for about 4 to 6 weeks straight..then goes off for two weeks and uses only HCG and clomid. Then resumes the injections. He claims that he experiences more of that elusive "honeymoon reaction" than when he just stayed on all the time and continues to have good libido, sense of well being..etc. Have you ever heard of anything like that? From many of your posts I have read on this and the Peak testosterone forum, you seem to be experimental in differing ways to do your TRT. Curious what you thought of this protocol.

Yes, I have heard of guys doing similar protocols and, I'm probably going to be in the minority here, if he feels good doing this and all his blood work looks good, he should stick with it.

 

[Cataceous]

I was looking at some of the products at Empower Pharmacy and noticed they had a compounded nasal testosterone gel. Would you happen to know if it is virtually identical in terms of action to the Natesto brand?
Also, and this may be slightly off topic, I know of someone who has a fairly unusual TRT regime that I am sure would get derided by most. He does daily short ester injections for about 4 to 6 weeks straight..then goes off for two weeks and uses only HCG and clomid. Then resumes the injections. He claims that he experiences more of that elusive "honeymoon reaction" than when he just stayed on all the time and continues to have good libido, sense of well being..etc. Have you ever heard of anything like that? From many of your posts I have read on this and the Peak testosterone forum, you seem to be experimental in differing ways to do your TRT. Curious what you thought of this protocol.

I've been assuming that Empower's nasal gel is similar to Natesto, but I have no direct knowledge.

I'm not convinced that most guys would get good results alternating between propionate and Clomid/hCG in short cycles, but I don't completely dismiss the idea. I suppose the best-case scenario is that the HPTA never goes completely dormant, so you avoid suppression-related side effects. I think more typically the two weeks off of the short ester would lead to quite low T levels because of the restart delay.

 

[lancelot]

After more research and considering the replies on here, I think I will not go on TRT anytime soon. As far as my insulin resistance, I will continue to use Berberine, vandyl sulfate, chromium and maybe small doses of metformin along with cutting carbs to about 50 grams a day. I will also do another bloodwork that covers everything pertinent in a few weeks. It seems the consensus is that unless one has clinically low levels or has severe low T symptoms, it's better to not bother with it.
I thought since I was easily putting on fat, had insulin resistance, was irritable, was not progressing with my workouts or physique..I would benefit at 58 from it. I guess I will do as others and wait until I am extremely low and then treat it instead of putting a halt to the decline now.

 

[madman]

After more research and considering the replies on here, I think I will not go on TRT anytime soon. As far as my insulin resistance, I will continue to use Berberine, vandyl sulfate, chromium and maybe small doses of metformin along with cutting carbs to about 50 grams a day. I will also do another bloodwork that covers everything pertinent in a few weeks. It seems the consensus is that unless one has clinically low levels or has severe low T symptoms, it's better to not bother with it.
I thought since I was easily putting on fat, had insulin resistance, was irritable, was not progressing with my workouts or physique..I would benefit at 58 from it. I guess I will do as others and wait until I am extremely low and then treat it instead of putting a halt to the decline now.

Again get a full set of labs using accurate assays to see where your FT level truly sits.

Forget having to be clinically low or experiencing severe low T symptoms.

Many men can have low-normal/sub-par FT levels even with what would be considered a decent TT depending on SHBG.

If your FT levels are truly lowish/sub-par and you are experiencing symptoms then you need to make the decision on what is best for you!

 

[lancelot]

Again get a full set of labs using accurate assays to see where your FT level truly sits.

Forget having to be clinically low or experiencing severe low T symptoms.

Many men can have low-normal/sub-par FT levels even with what would be considered a decent TT depending on SHBG.

If your FT levels are truly lowish/sub-par and you are experiencing symptoms then you need to make the decision on what is best for you!

My testosterone was measured with this:
Testosterone, Free (Dialysis) and Total (MS)...Is the dialysis not the right one for Free? This was the result TESTOSTERONE, FREE 80.0 NORMAL 35.0-155.0 pg/mL

 

[Anonymon]

Have you checked your thyroid levels? In a nutshell - I started TRT a few years ago at 56yrs old due to fatigue and brain fog. After a few months on TRT I still wasn't feeling great and luckily found a doctor that understood the thyroid. All my thyroid lab levels were "within range" but barely. I started supplementing with T3 and within days started to improve. In hindsight if I had started with the thyroid I may not have needed TRT. Although for me the physical benefits of TRT are undeniable, there are some annoying negatives as well that would have been nice to avoid. At this point I feel good, so if it ain't broke I'm not going to fix it - so TRT and thyroid meds for me forever. Good luck to you. This forum will get you up to speed on all aspects of TRT and thyroid support (as well as a bunch of other stuff).

I’ll second the thyroid mention as well. Thyroid and cortisol levels actually have more of an affect on your energy and well being than test. And if you don’t get those right, all the test in the world isn’t going to do much for you and can make things worse.

In general, the people that do best on TRT tend to be guys that are okay in all the other areas, and are generally really healthy and don’t have unknown issues to begin with that aren’t just test. If you have a weak link somewhere else that you don’t know about, like a gut issue or you’re anemic or something like that, TRT and HRT in general will exacerbate that while making other things better, which is probably why a lot of guys, but not most, don’t find what they’re looking for on TRT.

If I get everything else right, I feel great and forever young like you’d expect. If I don’t, I feel the same or worse. Most guys have mostly positive experiences.

 

[CanadaJim]

I was in the same position. At 50 I was feeling sluggish, low energy, low libido. Been a gym rat since my early 20's. Never used anything other than over the counter supps. When I had blood work done, my doc at the time used the words "low normal" with regards to my test levels. This hit home as it seemed to address my physical and mental symptoms. I wasn't in the range for prescribed treatment though. So I took matters in to my own hands. Ordered some test-e online. Researched what a proper cruise trt dose would be as i was not interested in a "blast". I injected and I have to say I felt amazing for a few months (more like 6 weeks) libido up, energy up, clarity. I was injecting every 2 weeks at first. After the third injection I started to feel, for lack of a better word...shitty. No energy, bloat, brain fog, skin rash, no libido etc. I lowered the dose, then tried the twice weekly injection schedule, still no improvement. I eventually just stopped. The cons were outweighing the pro's. I have had blood work done a few times since stopping and things appear to have somewhat returned to homeostasis. I do miss the initial feeling of the test as it did make me feel 20 years younger. But the hormonal imbalance it eventually caused was not worth it to continue. I wish it was possible to "top up" testosterone levels without actually shutting the whole system down.

 

[Cataceous]

... I wish it was possible to "top up" testosterone levels without actually shutting the whole system down.

Along these lines the options are pretty much limited to the nasal gel or enclomiphene. Neither is ideal, but they will work for some.

 

[goolapsh]

Along these lines the options are pretty much limited to the nasal gel or enclomiphene. Neither is ideal, but they will work for some.

In my personal experience I feel like the injections wound up causing more of a hormonal imbalance in me than scrotal cream. (Injections are more potent whereas the cream is in and out). I felt far worse on injections but am glad to be off trt at the moment. Doubt I will go back on until I turn 60.

 

[lancelot]

I was in the same position. At 50 I was feeling sluggish, low energy, low libido. Been a gym rat since my early 20's. Never used anything other than over the counter supps. When I had blood work done, my doc at the time used the words "low normal" with regards to my test levels. This hit home as it seemed to address my physical and mental symptoms. I wasn't in the range for prescribed treatment though. So I took matters in to my own hands. Ordered some test-e online. Researched what a proper cruise trt dose would be as i was not interested in a "blast". I injected and I have to say I felt amazing for a few months (more like 6 weeks) libido up, energy up, clarity. I was injecting every 2 weeks at first. After the third injection I started to feel, for lack of a better word...shitty. No energy, bloat, brain fog, skin rash, no libido etc. I lowered the dose, then tried the twice weekly injection schedule, still no improvement. I eventually just stopped. The cons were outweighing the pro's. I have had blood work done a few times since stopping and things appear to have somewhat returned to homeostasis. I do miss the initial feeling of the test as it did make me feel 20 years younger. But the hormonal imbalance it eventually caused was not worth it to continue. I wish it was possible to "top up" testosterone levels without actually shutting the whole system down.

I hear so many stories of people that had initial great results, but then eventually didn't feel the same benefits and often felt worse. I have some theories on this . Perhaps, like many medications, the body quickly attenuates to the testosterone. Maybe it has to do with various receptors that downgrade combined with the issues from total hpta shutdown. From my experiences in the 80's using fairly mild anabolic compounds, some of the best gains were in the first 6 weeks. After that, I didn't see as much progress and more sides would emerge. Then after a brief layoff, I could resume and notice progress again.
I mentioned in an earlier post of a friend that does daily 12 mg doses of test propionate (actually found out he does that for 5 consecutive days in a row, then on 6 th day a 250 iu hcg shot and takes nothing on day 7.)This is continued for 4 weeks to 6 weeks with a 2 week break from testosterone. On those two weeks, hcg is dosed along with clomid and small amount of aromasin to combat excess hcg produced estradiol. According to him, he seems to continue to feel well, good libido, gym gains and has good labs without hematocrit getting into the abnormal range. Now he might feel a few percent worse during the 2 weeks off but the hcg and clomid prevent too far of a dropoff in test levels. Maybe this protocol gets around some of the receptor downgrade and doesn't totally shut off hpta?

 

[KatyTX]

I'm new to the forum and would like to possibly get some opinions on my situation. I am 58 years old and have considered going on TRT for several years. Between reading lots of information, talking to several highly knowledgeable people and researching this forum for many years, I feel like I am well informed. I have worked out since I was in my early teens (competed in bodybuilding in the 80's but didn't abuse steroids) and have always ate very healthy. Here are some of the reasons I am considering TRT: I have been showing signs of insulin resistance the last 5 or 6 years and my morning blood sugar is averaging between 105-115 even while eating a fairly low carb diet. Many studies show TRT helps with metabolic syndrome. Also new research shows high glucose levels contribute to alzheimer's through the buildup of beta amyloid plaque in the brain. Almost everone on my father's side of the family(including him) has gotten Alzheimers. I take some metformin but it does little at a low dose and I read higher doses lower testosterone..which I don't want.

I am putting on fat easily lately and seeing virtually no results from my training. I also get irritable easily, especially after a hard workout. I've always had a very good physique and I'm not happy with how I'm looking although this isn't a huge factor in my decision. However, I would like to see more results from my diet and training efforts. I am sure I would respond well to TRT for this. In the 80's, I was a super responder to tiny amounts of testosterone and would blow up in a month or so.

My ldl and hdl, due to the glucose issues, have been off for several years. I did do some scans for arterial plaque recently and it didn't show any buildup yet..but that could change. I also think my drive, motivation and focus could be better..even though I get some results from cognitive enhancing nutrients and nootropics. I think testosterone would also be helpful for that. My libido is inconsistent. It's good for a few weeks, then times when it wanes. Not a huge concern since my longtime girlfriend has a very low libido. I get morning wood on some days and then go through periods of none for a few weeks.
I order my own bloodwork a few times a year. I do the comprehensive ones and add in total and free test. My last one in December showed my total to be 476 ng/dl and free 80 pg/ml. My PSA is 1.0 and most all values,except lipids, are in normal range except blood platelets which the last two times are slightly under range.

So..although my testosterone numbers aren't real low, and I don't feel overly lethargic or depressed..I feel some of the issues I described would be helped by going on TRT. I know most guys are usually under 300 when they decide to do it with many other classic "low T" symptoms. It seems the idea is to wait until your levels decline to the lowest range and then start. But while those levels are declining..aren't you also physically losing ground? Wouldn't it be better to intervene at the level I'm at ..at 58 years old..instead of waiting till I'm at a 200 test level?
I have some fears, especially when I see all the problems people have on the forums. Should I shut down my hpta while it still has halfway decent function in order to get the benefits I seek? Will I ever be as healthy on a synthetic form of my own hormone as I am now? I know me, and only me,..can make that decision, but I'd love to hear some feedback. I've struggled with this decision for at least 4 years now.
Thanks

Try fasting to bring glucose down. Specifically one meal a day (OMAD). Also, focus on A1C which I view as kind of a 30 day moving average. More reliable than glucose which swings daily.

I went on TRT 3 years ago. Pin every other day. Only take HCG in addition because I didn’t want my balls to shrink

never looked back. Best thing I’ve ever done. No problems. Some might say my E2 is high, but I didn’t care. No Gyno. To me it’s more about how I feel, and not numbers. But having said that I get my blood tested every three months.

I was at 200 when I got on BTW. Life changing!!!

 

[lancelot]

Try fasting to bring glucose down. Specifically one meal a day (OMAD). Also, focus on A1C which I view as kind of a 30 day moving average. More reliable than glucose which swings daily.

I went on TRT 3 years ago. Pin every other day. Only take HCG in addition because I didn’t want my balls to shrink

never looked back. Best thing I’ve ever done. No problems. Some might say my E2 is high, but I didn’t care. No Gyno. To me it’s more about how I feel, and not numbers. But having said that I get my blood tested every three months.

I was at 200 when I got on BTW. Life changing!!!

Thank you. My A1C wasn't too bad. Glad to hear you've had a good experience with your TRT.

 

[John O'Connor]

Have you ever checked your DHEA-S levels? If it's low, you could supplement with Pregnenolone and DHEA supplements to boost it back to normal levels, which would ultimately boost your T levels. Testosterone Pathway: Cholesterol (LDL) - Pregnenolone - DHEA - Testosterone...
Here are a few links that might help.

DHEA-S Test

Discover the benefits of DHEA Sulfate for overall health and well-being. Learn more about this hormone and how to buy your own test on Discounted Labs.

www.discountedlabs.com

DHEA Levels Are Associated With Lower Risk of Type II Diabetes

A recent study published in Diabetologiainvestigated the impact of DHEA, DHEAS, androstenedione, and the ratio of DHEAS to DHEA on type II diabetes. Data from 5,189 men and women were gathered. After adjusting for age, sex, cohort, fasting status, fasting glucose, insulin, and BMI, "both...

www.excelmale.com

The Promise of Pregnenolone

There are various hormones in our bodies, and many of them are made in the adrenal glands. One of them, specifically, is pregnenolone, and it is the one from which all the other adrenal hormones are made - about 150 of them.We've heard of estrogen and testosterone. We've heard of DHEA as the...

www.excelmale.com

Pregnenolone for Men: What You Need to Know

Pregnenolone is an important hormone for men on TRT that may affect mood, sleep quality, anxiety and other mental health factors

www.excelmale.com

Pregnenolone – By Gene Devine

Table of Contents Pregnenolone - Why You Need It Pregnenolone is a hormone that many Doctors and men are not familiar with or understand its role in the CHOL pathways but it’s critically important to our health as it is a "precursor hormone" to all other hormones in our body. Restoring...

www.excelmale.com

 

[madman]

My testosterone was measured with this:
Testosterone, Free (Dialysis) and Total (MS)...Is the dialysis not the right one for Free? This was the result TESTOSTERONE, FREE 80.0 NORMAL 35.0-155.0 pg/mL

Yes as Quest and Labcorp both offer ED and UF.

Would have picked this off if you had posted reference ranges in your first post.

I order my own bloodwork a few times a year. I do the comprehensive ones and add in total and free test. My last one in December showed my total to be 476 ng/dl and free 80 pg/ml.


Your FT is under the mean.

What is your SHBG?

 

[lancelot]

Have you ever checked your DHEA-S levels? If it's low, you could supplement with Pregnenolone and DHEA supplements to boost it back to normal levels, which would ultimately boost your T levels. Testosterone Pathway: Cholesterol (LDS) - Pregnenolone - DHEA - Testosterone...
Here are a few links that might help.

DHEA-S Test

Discover the benefits of DHEA Sulfate for overall health and well-being. Learn more about this hormone and how to buy your own test on Discounted Labs.

www.discountedlabs.com

DHEA Levels Are Associated With Lower Risk of Type II Diabetes

A recent study published in Diabetologiainvestigated the impact of DHEA, DHEAS, androstenedione, and the ratio of DHEAS to DHEA on type II diabetes. Data from 5,189 men and women were gathered. After adjusting for age, sex, cohort, fasting status, fasting glucose, insulin, and BMI, "both...

www.excelmale.com

The Promise of Pregnenolone

There are various hormones in our bodies, and many of them are made in the adrenal glands. One of them, specifically, is pregnenolone, and it is the one from which all the other adrenal hormones are made - about 150 of them.We've heard of estrogen and testosterone. We've heard of DHEA as the...

www.excelmale.com

Pregnenolone for Men: What You Need to Know

Pregnenolone is an important hormone for men on TRT that may affect mood, sleep quality, anxiety and other mental health factors

www.excelmale.com

Pregnenolone – By Gene Devine

Table of Contents Pregnenolone - Why You Need It Pregnenolone is a hormone that many Doctors and men are not familiar with or understand its role in the CHOL pathways but it’s critically important to our health as it is a "precursor hormone" to all other hormones in our body. Restoring...

www.excelmale.com

Thank you. I'll look into that. I've used DHEA and Pregnenolone but not consistently over years.

 

[lancelot]

Yes as Quest and Labcorp both offer ED and UF.

Would have picked this off if you had posted reference ranges in your first post.

I order my own bloodwork a few times a year. I do the comprehensive ones and add in total and free test. My last one in December showed my total to be 476 ng/dl and free 80 pg/ml.


Your FT is under the mean.

What is your SHBG?

I haven't measured SHBG yet. 80 free test is low, when the range is 35-155 pg/ml?

 

[opus11]

After more research and considering the replies on here, I think I will not go on TRT anytime soon. As far as my insulin resistance, I will continue to use Berberine, vandyl sulfate, chromium and maybe small doses of metformin along with cutting carbs to about 50 grams a day. I will also do another bloodwork that covers everything pertinent in a few weeks. It seems the consensus is that unless one has clinically low levels or has severe low T symptoms, it's better to not bother with it.
I thought since I was easily putting on fat, had insulin resistance, was irritable, was not progressing with my workouts or physique..I would benefit at 58 from it. I guess I will do as others and wait until I am extremely low and then treat it instead of putting a halt to the decline now.

I am 66 and have very similar TT & FT values as yours, and I am hesitate of starting TRT because do not want to disrupt my own hormones production.

However, I am using resveratrol to control blood sugar, and it works for me, my blood work on March showed both glucose and hba1c are in good shape.

 

[lancelot]

I am 66 and have very similar TT & FT values as yours, and I am hesitate of starting TRT because do not want to disrupt my own hormones production.

However, I am using resveratrol to control blood sugar, and it works for me, my blood work on March showed both glucose and hba1c are in good shape.

I hear you. Perhaps in the not too distant future, a healthy method of boosting hormones up into optimal levels without shutting down the body's own production will be discovered. Or...maybe that method already exists , but hasn't been thought of. I will look into resveratrol again..I took it several years ago.

 

[Cataceous]

... I will look into resveratrol again..I took it several years ago.

Something interesting about resveratrol is that it has some aromatase-inhibiting activity. This means that in theory it could somewhat boost testosterone in men not on TRT. I haven't seen any real-world reports of this, but maybe people haven't been looking for it or the typical doses are insufficient to produce the effect.

In the T47D-BAF co-culture, a melatonin concentration of 20 nM and resveratrol concentration of 20 μM have an aromatase inhibitory effect as potent as 20 nM letrozole, which is a clinically used anti-aromatase drug in breast cancer treatment.[R]​