I have several small doubts...

[Joe56s]

Hi Excelmale friends,

I am on my first week of TRT treatment using a gel everyday. I don't know if this is possible but I have noticed an improvement on this first days of treatment, I am less tired, I feel if I had recovered something of my lost libido, and with a clearer mind. Is that possible or is it only a suggestion in such a short period of time?

I would also like to know if in order to lose weight, have less belly and waist measurement if it is necessary to practice a lot of exercise or lifting weighs. My question is not something of looking better but having a better health as a main reason. if you eat moderately and in a proper way is it possible to reduce weigh with TRT?

A forum member has told me that I don't have to be worried about hematocrit level because at the beginning of the treatment I am only 43 (a low level) and that using gels and in my case it is almost impossible that I reach very high levels of hematocrit. I would also like your opinion about this subject because for me it is important.

I have noticed a low worsening of my high tension. My blood tension was 122/95. Instead of taking half a pill every three days because I have my diastolic tension level (isolated diastolic tension) every four days I am taking half a beta blocker pill every two days. My diastolic level is always a little high. I hope it doesn't get worse.

Best wishes,

Joe

 

[Systemlord]

if you eat moderately and in a proper way is it possible to reduce weigh with TRT?

TRT increases your metabolic rates and metabolism, so yes losing weight can be much easier on TRT provided your levels are high enough. Gels may not get you where you need to be though.

My diastolic level is always a little high.

My diastolic has declined since losing weight and used to be 153/96, this was when hematocrit was 46% and testosterone low.

A forum member has told me that I don't have to be worried about hematocrit level because at the beginning of the treatment I am only 43 (a low level) and that using gels and in my case it is almost impossible that I reach very high levels of hematocrit.

My hematocrit on TRT is anywhere from 51-55% and my blood pressure is 110/66 and bpm 67.

I also take a beta-blocker, half a pill (2.5 mg) daily.

 

[Joe56s]

Thank for your replies very much.

 

[Systemlord]

Newish Study on HCT

Has anyone seen this? It looks like those with higher hct lived longer... https://www.liebertpub.com/doi/10.1089/andro.2021.0019 Testosterone Therapy: Increase in Hematocrit is Associated with Decreased Mortality "Results: HCT increased significantly (median change at final assessment: +5.0%)...

www.excelmale.com

Conclusions: A median HCT increase of 5.0% was associated with TTh, mostly within 48 months of commencing therapy. An increase in HCT (up to 52.0% at final assessment) was independently associated with reduced mortality, indicating current guidelines using a HCT value of 54.0% as a threshold for management change are appropriate until further study."

 

[themud]

I wouldn't worry about HCT or polycythemia. The studies sited are older than moses and coincide with heart attacks and strokes and bph and prostate cancer. All very flawed studies.

Who prostate cancer, younger or older men 45+? Who has lower testosterone levels younger or older men 45+? The whole theory of mtoR and protein synthesis and cancer is flawed.

My HCT is ususaly 50ish and when giving blood the nurse told me only 57ish is borderline high side. I live at 5000 ft., so it's going to be higher here.

My blood pressure was 139/90ish since early 20s while at 5/8 130 doing triathlons and pulse of 45. My blood pressure has come down on trt.

 

[Joe56s]

Thank you the mud for your reply! Your help is also welcome Systemlord.

I don't like needles very much I have to say . When I went to my urologist he offered me the gel as a way to improve my testosterone levels. I had previously looked into the internet web pages and some people who were against TRT commented about strokes, heart attacks, problems in your brain. As a newbie I had several fears. Then I heard about that with the gel there were less side effects and I decided to follow the treatment. I had tried with Alcar and Zinc but I rather felt the same. My symptoms were fatigue, low libido affecting my sexual drive with my wife (she is supporting me though), difficulty to remember things. being depressed, sometimes difficulty to sleep and I was not in very good mood. I thought that I should go to a family physician and he prescribed me a blood test. My total testosterone level was 254. He then told me I should go to an urologist. In my insurance health company the good urologists didn't have an appointment until September so I had to pay for a private doctor. I was not sure what to do but finally I accepted to go on with the treatment prescribed by my urologist. When he recommended to return in three month time for a revision I also thought that there was some risk involved. The curious thing is that he told me that with this treatment there were nearly no side effects. My hematocrit level as I told Systemlord is only 43. I deem I am a bit hypochondriac...I am sorry!!!

 

[Systemlord]

I had previously looked into the internet web pages and some people who were against TRT commented about strokes, heart attacks, problems in your brain.

This isn't the case as far as the credible studies go. A junk study that came out in 2013 that got a lot of attention in the media was debunked by Dr. Morgentaler (top doctor in the field of testosterone and prostate cancer) and was a seriously flawed study.

This same doctor was able to show no correlation between high testosterone, TRT and prostate cancer.

Testosterone Controversies in Men's Health: Lecture by Dr. Khera​

 

[Fortunate]

Welcome to the forum @Joe56s. My advice is spend some time poking around here and read up. There are lots of really smart dudes willing to give advice. There is also a lot of anecdotal information which can be helpful.

For what it's worth, some are on cream long term and do really well. Others do well for a period of time, after which the experience worsens. Do a little digging on this forum and you will see what I mean.

It sounds like you most likely need to be on TRT based on symptoms described and the fact that many of them have already improved. That said, my advice is to take a close look at lifestyle to see if there are any modifiable variables that could have led to low T in the first place and address them:

• sleep quality
• stress levels
• sensible diet
• regular exercise
• medications
  • some are known to lower testosterone levels, like opioids, certain anti-depressants to name a few

Also, the time of day you measure your testosterone and the type of the actual lab test matters and can influence your readings. Maybe post more labs in more detail, which may be helpful giving you feedback.

Try to also identify other possible reasons you were in bad shape prior to TRT: is your thyroid OK? Do you need to address unresolved depression/anxiety? If you know you need TRT, I recommend keeping it simple. Try to resist the temptation to make multiple changes at once (guilty as charged here), such as adding DHEA or other supplements while you are sorting things out. Also, the mantra "Go low and slow" is an excellent rule of thumb with TRT.

Final thought: if cream does not work out, I would consider Natesto. It has a good chance of reducing symptoms without shutting down whatever endogenous capacity you have and without raising your HCT. Lots of information on it around here.

Best of luck.

 

[Michael D]

The immediate improvement you've noticed is not your imagination, it's real. TRT very quickly makes you feel better. In fact, I felt like superman during the first few weeks, particularly with my mood and energy, but unfortunately that did not last. But the improvements in libido and ED were lasting, and I slowly converted fat to muscle (I'm not a bodybuilder, TRT for me is strictly to address a real deficiency and I do not maintain T levels above "normal).

High hematocrit has been a real problem for me. I switched from injections to gel/cream to try to better control my hematocrit, but it didn't work. So after a year or so of cream use I've gone back to injections. Yes, there is a lot of debate as to whether hit hematocrit is really a problem with regard to heart disease, but regardless of that debate I get headaches and ringing in my ears...so I have had to get phlebotomies. I also have high BP and high hematocrit does not help that issue.

 

[Joe56s]

Dear Excelmale friends,

First of all I would like to tell Systemlord that I am sorry because I didn’t explain myself well. The risks of strokes I commented were in reference to the high hematocrit problem caused indirectly in some cases by TRT and if it was not well controlled.

I am happy to have read your post, Fortunate. Apparently there are people who can absorb or synthesize the TRT gel in a good way, and others can’t do it very well. Has this something to do with the stronger layers of skin protection or thinner ones in different people? For example, someone with a stronger protection would have a less capacity of absorption.

Yes, Fortunate. I have some small problems due to stress. At the age of 18 my father who was a USA citizen told me that I travelled from Spain where we were living to the States. In the United States there are more chances to find jobs than where I live. After many, many years of living in Spain (At the end I would have had to go alone without family) of living in this country I find that I haven’t had a lot of opportunities to take off even though I have a school teacher degree. Now, I depend only on my father’s inheritance which it is not much but enough to cover several years. This makes me sometimes feel stress.

And finally I would like to tell Michael D. that these are the doubts many people have. On one hand if you use injections they can make you have the hematocrit level up, and on the other hand if you use the gel perhaps the absorption level can’t be successful. Fortunate has commented something I think of a nasal TRT that doesn’t increase Hematocrit.

The doctor told me to return in three months time. Should I have a blood test earlier to know in advance that the gel is working? (I ask all of you)

Best wishes,

Joe

 

[Systemlord]

The doctor told me to return in three months time. Should I have a blood test earlier to know in advance that the gel is working

On Jatenzo I reach steady states in 7 days due to the very short half-life, gels are very similar, so provided you're absorbing through the skin well, you should reach therapeutic levels within a couple of weeks.

If your levels are high enough, you'll know it.

If you doctor refuses testing, you can always go to Discount Labs and order your own testing.

You normally tested 2-4 hours after applying the gel.

 

[Joe56s]

Dear Systemlord and other members,

I would like to know if there is an study or an analysis of what is the level of successful activity with TRT gels? For instance, only half of the people with this treatment are successful or only a third. Can the TRT gels be useful for sometime and after some months be pointless or futile? Do these gels depend on the absorption capacity of the skin or do they also depend in a certain way of the human flesh involved?

I am grateful for your last reply, Systemlord.

Best wishes,

Joe

 

[Fortunate]

Dear Systemlord and other members,

I would like to know if there is an study or an analysis of what is the level of successful activity with TRT gels? For instance, only half of the people with this treatment are successful or only a third. Can the TRT gels be useful for sometime and after some months be pointless or futile? Do these gels depend on the absorption capacity of the skin or do they also depend in a certain way of the human flesh involved?

I am grateful for your last reply, Systemlord.

Best wishes,

Joe

It’s hard to anticipate how things will go and you won’t know until you try it. If things are going well, I would stick with it and watch how things evolve.

As a matter of good practice, you should get follow up labs six weeks at the earliest after starting a new protocol. Good rule of thumb is to monitor how you feel rather than basing treatment solely on lab values. On the other hand, there are certainly things that you should strive to keep in normal range, such as a healthy hematocrit, which it sounds like you are doing.