Just Registered - First Time TRT

MRJR3 · Aug 31, 2017

Hello! I found this site while researching what to expect after starting TRT. I am 36 and my labs came back very low, especially when compared to my age demographic range. My doctor, who is a very cool practitioner, said I had the testosterone of a healthy 90 year old! Thanks....

I'm currently on 200mg injections every two weeks, which seems to be the default for most prescriptions. My plan is to self inject, but my doc wanted me to come in for the first one to ensure I knew what I was doing. Honestly, I hadn't really thought about the procedure, which made for a few amusing moments with the nurse...but that's another story.

All in all, the injection went well and I'm curious what to expect, how to keep getting healthier, and what to watch out for. I'd be more than happy to hear from this community!

codus2112 · Aug 31, 2017

Welcome! So many good guys here. This forum is an amazing wealth of info.

If you have pre-trt labs feel free to post them, it gives those who know the most alot more to work with. The only thing i will say is that T Cyp has roughly an 8 day half life, so i think that by the time you are due for your next injection you are not going to feel as good as you could on weekly (at a minumum) injections. Most here pin 2-3 times a week. Also, were you prescribed hcg or an AI?

Gene Devine · Aug 31, 2017

Welcome MRJR3!

I would encourage to read everything on this site as you can and learn, learn and learn...it's your health.

Sounds like you got a good Doc but every two week injections are all wrong. Testosterone Cyp has about a 6 to 7 day half life which means by the end of week two your serum levels are going to be very low again before your next injection which will peak again at about 72 hours from injection and from there decline yet again till your next injection.

At the very least you need to be on weekly injections. Most of us here inject ourselves and actually do two smaller injections per week.

Talk to your Doctor about your injection protocol and go weekly.

Also, learn about why you need HCG when on a TRT protocol...it's all here.

Also, learn what labs you need to test when on TRT as there some that are very critical to your health like estrogen, hematocrit, SHBG among others...

MRJR3 · Sep 19, 2017

Hello! Sorry for the delayed response. My initial injection went well and whether it was placebo effect or the actual Test boost, I felt a lot of good things in all areas of health for the first 7-10 days, as you mentioned. Instead of switching up to weekly injections, I waited the full two weeks and did the second 1mL injection and will be speaking with my doctor.

He did not prescribe HCG or an AI, when I asked he understood the questioning and reasoning, but seemed a bit apprehensive that it was necessary. How do I convince him? Here are my lab results pr-TRT.

Hematocrit - 42.7
Total T - 336.2
Free T - 63.8
DHEA-S - 225.2
Estradiol - 28.9
SHBG - 31.3
FSH - 4.7
LH - 6.5

I've got a ton more...not sure what else is needed. I have hypothyroidism and my TSH is 5.17 at the time of labs. I'm on 150micrograms Synthroid. Vitamin B12 is low, D is low, Homocysteine is low. Saturated Fatty Acids are high, cholesterol is a bit high overall, but good cholesterol is great. Campesterol is high.

I'm not sure it is all related, but I've had some ED issues the past year, which seem to be blood flow and maybe testosterone related. Anyway, let me know if you need more info! Thanks!

CoastWatcher · Sep 19, 2017

MRJR3 said:
Hello! Sorry for the delayed response. My initial injection went well and whether it was placebo effect or the actual Test boost, I felt a lot of good things in all areas of health for the first 7-10 days, as you mentioned. Instead of switching up to weekly injections, I waited the full two weeks and did the second 1mL injection and will be speaking with my doctor.

He did not prescribe HCG or an AI, when I asked he understood the questioning and reasoning, but seemed a bit apprehensive that it was necessary. How do I convince him? Here are my lab results pr-TRT.

Hematocrit - 42.7
Total T - 336.2
Free T - 63.8
DHEA-S - 225.2
Estradiol - 28.9
SHBG - 31.3
FSH - 4.7
LH - 6.5

I've got a ton more...not sure what else is needed. I have hypothyroidism and my TSH is 5.17 at the time of labs. I'm on 150micrograms Synthroid. Vitamin B12 is low, D is low, Homocysteine is low. Saturated Fatty Acids are high, cholesterol is a bit high overall, but good cholesterol is great. Campesterol is high.

I'm not sure it is all related, but I've had some ED issues the past year, which seem to be blood flow and maybe testosterone related. Anyway, let me know if you need more info! Thanks!

Tests without the associated ranges mean...very little. Each lab has their own, established references. As for your protocol, while I wish you all the best, the half-life of testosterone is such that it's next to impossible for an injection every two weeks to bring a patient success. There's a wealth of documented information that indicates smaller, more frequent injections of testosterone lead to success. As for an AI, why do you want one now? Have you documented high estradiol, on the sensitive, LC, MS/MS, lab test? Absent symptoms and elevated e2 values, an AI is a foolish thing to do. There is no misery like the misery associated with crashing your estradiol.

MRJR3 · Sep 19, 2017

I'll post up the ranges from the lab, wasn't sure what previous posters were suggesting. As far as AI, I had read here and heard from other posters that it was common in conjunction with TRT, but I don't want it if it isn't necessary.

CoastWatcher · Sep 19, 2017

MRJR3 said:
I'll post up the ranges from the lab, wasn't sure what previous posters were suggesting. As far as AI, I had read here and heard from other posters that it was common in conjunction with TRT, but I don't want it if it isn't necessary.

Anastrozole, the typical AI prescribed, is a good drug, but it is frequently overprescribed for men on testosterone replacement. Estradiol is NOT a waste product, to be flushed from the body. It's a necessary hormone that men need in order to function sexually, maintain cognitive performance, and bone stability.

MRJR3 · Sep 28, 2017

Thanks for your patience. I am supposed to take my third 1ml injection today and was hoping the doctor would ask me to do labs prior, but he didn't. Before my next injection, I plan on doing labs. However, here were my initial results with ranges:

Total T: 336.2 (249.0-836.0ng/dL)
Free T: 63.8 (50.0-210.0pg/mL)
DHEA-S: 225.2 (88.9-427.0ug/dL)
Estradiol: 28.9 (11.3-43.2pg/mL)
LH: 6.5 (1.7-8.6mlU/mL)
FSH: 4.7 (1.5-12.4mlU/mL)
SHBG: 31.3 (16.555.9nmol/L)
Hematocrit: 42.7 (39.0-50.0)

I appreciate any feedback. Thanks!

CoastWatcher · Sep 28, 2017

MRJR3 said:
Thanks for your patience. I am supposed to take my third 1ml injection today and was hoping the doctor would ask me to do labs prior, but he didn't. Before my next injection, I plan on doing labs. However, here were my initial results with ranges:

Total T: 336.2 (249.0-836.0ng/dL)
Free T: 63.8 (50.0-210.0pg/mL)
DHEA-S: 225.2 (88.9-427.0ug/dL)
Estradiol: 28.9 (11.3-43.2pg/mL)
LH: 6.5 (1.7-8.6mlU/mL)
FSH: 4.7 (1.5-12.4mlU/mL)
SHBG: 31.3 (16.555.9nmol/L)
Hematocrit: 42.7 (39.0-50.0)

I appreciate any feedback. Thanks!

Your doctor ordered the wrong estradiol test (the reference range is a dead giveaway). You were tested with the assay for use in women. All men need to test with the sensitive/ultrasensitive test (either term can be found depending on the lab) that utilizes LC, MS/MS technology. Yet another red flag with your doctor...