Newbie here. 50yrs old and just prescribed TRT

[Jaycat]

Hello all.

Great forum! I have been doing a ton of reading on here lately. I'm an active 50 year old and I'm in decent shape.

I have had Low T symptoms for a few years, but my numbers always showed on the low side but just inside the normal. My last doc strictly just looked at my numbers and not my symptoms. Healthier diet, dropping a few pounds etc, never helped my numbers or symptoms.
My normal doc retired last year and I decided I really needed to get serious about trying to fix my Low T issues with my new doc. Luckily, my new doc is a lot more open minded about ways to make me feel better. Here are my current lab results:

Total Testosterone: 381 (250-1100) (highest its been in years)
Free Testosterone: 32.2 (35-155)
SHBG: 43 (16.5-55.9)
LH: 5.8 (1.7-8.6)
Estradoil Sens 29.2 (8-35)
TSH 2.900 (.450-4.500)

The good news: My new doctor is prescribing Test and is sure that my insurance will cover it. After the initial injection in his office, he is also fine with me injecting on my own. He thinks I'm a good candidate for TRT.

The not so good: He doesn't seem like the most educated on TRT. He first suggested that I start with one 300mg injection every three weeks. After some discussion I was able to talk him into 100mg every week. He also isn't familiar with HGC or anything if estrogen goes up. But I think he is open to suggestions.

I am sure that I will have a lot of questions along the way. I am a sponge and ready to soak up as much knowledge as I can from this forum. Thanks!

 

[Systemlord]

Your estrogen sensitive is already towards the higher end and once you increase testosterone into the high normal ranges, I fully expect the situation to worsen. You want healthy testosterone levels and estrogen not in excess, you need to inject smaller doses more frequently.

I inject 20mg every 2 days for that purpose or else estrogen is close to the 100 mark.

TSH >2.5 is indicators your pituitary gland isn't happy with the amount of thyroid hormones in the body, further investigation is needed. TSH isn't a thyroid hormone, Free T3 is the most potent thyroid hormone, checking Free T4, Free T3, Reverse T3 and antibodies is recommended. Doctors who take insurance are restricted from from treating us men unless our levels are ridiculously low all so insurance can save of healthcare costs.

A lot of us men have gone private where doctors treat the symptoms and aren't overfocused on labs numbers which never tell the entire story. You can expect more knowledgeable doctors going privately versus going to a sick care doctor.

 

[Gman86]

I second getting your thyroid checked out further. That level of TSH pretty much guarantees you have a low functioning thyroid. Without an optimized thyroid, it’s going to be extremely difficult to have any success with TRT. Low thyroid symptoms mimic low testosterone symptoms almost identically.

You absolutely have low testosterone though. So getting that optimized is vital as well. Hopefully your doctor is willing to continue working with you on your dose frequency, with HCG possibly, and controlling E2 if needed.

 

[Jaycat]

Thanks for the replies guys.

Quick update. I called doctor's office today and spoke with nurse practitioner who put in a lab request for full thyroid panel. I will hit the lab tomorrow morning and results should be ready by my next doc visit. Next visit will be so that the nurse practitioner can teach me how to self inject at home. She seemed interested to discuss the thyroid results then also.

Insurance approved the test prescription and it's waiting for me at Walgreens for just a $10 copay. Will pickup after work.

Thanks again for the advice on my thyroid.

 

[CoastWatcher]

Congratulations. You're becoming your own health advocate; we've all had to do that.

Spend more time here reading what you can on thyroid values and what the indicate/suggest. Don't be at all surprised if, once again, you have engage in educating your medical team. A result that's "in- range" is all too often mistaken for normal...as you discovered.

 

[Gman86]

Thanks for the replies guys.

Quick update. I called doctor's office today and spoke with nurse practitioner who put in a lab request for full thyroid panel. I will hit the lab tomorrow morning and results should be ready by my next doc visit. Next visit will be so that the nurse practitioner can teach me how to self inject at home. She seemed interested to discuss the thyroid results then also.

Insurance approved the test prescription and it's waiting for me at Walgreens for just a $10 copay. Will pickup after work.

Thanks again for the advice on my thyroid.

$10 for a bottle of test, can’t beat that!

 

[Tremonti22]

Your estrogen sensitive is already towards the higher end and once you increase testosterone into the high normal ranges, I fully expect the situation to worsen. You want healthy testosterone levels and estrogen not in excess, you need to inject smaller doses more frequently.

I inject 20mg every 2 days for that purpose or else estrogen is close to the 100 mark.

TSH >2.5 is indicators your pituitary gland isn't happy with the amount of thyroid hormones in the body, further investigation is needed. TSH isn't a thyroid hormone, Free T3 is the most potent thyroid hormone, checking Free T4, Free T3, Reverse T3 and antibodies is recommended. Doctors who take insurance are restricted from from treating us men unless our levels are ridiculously low all so insurance can save of healthcare costs.

A lot of us men have gone private where doctors treat the symptoms and aren't overfocused on labs numbers which never tell the entire story. You can expect more knowledgeable doctors going privately versus going to a sick care doctor.

Disagree
There is no “sweet spot” across the board for all men. No AI should ever be used unless symptoms of high E2 show themselves (pain in the nipple areas). Nipple sensitivity is absolutely normal when running testosterone. There are many videos and information on this forum evaluating and educating on estrogen. 100 mg of testosterone per week will not require an AI and less it’s an extreme circumstance

 

[Jaycat]

$10 for a bottle of test, can’t beat that!

Well I went to the pharmacy last night to pick up my test, and what I got was 2 x 1mL vials. Not sure why I didn't get one bigger vial. I'll talk to my doc about it this week. Not sure if it's an insurance thing or that's what he prefers. I prefer not having to go to the pharmacy every other week.

 

[Gman86]

Well I went to the pharmacy last night to pick up my test, and what I got was 2 x 1mL vials. Not sure why I didn't get one bigger vial. I'll talk to my doc about it this week. Not sure if it's an insurance thing or that's what he prefers. I prefer not having to go to the pharmacy every other week.
View attachment 6929

Huh, ya have no idea why you didn’t get a 10ml vial. You’re in America?

 

[Jaycat]

Huh, ya have no idea why you didn’t get a 10ml vial. You’re in America?

And proud of it!

So I'm confused on the dosage. Doc told me 100mg a week. So is that going to be the full mL vial or just half of it? The 200mg / mL is confusing me. Guess I will find out on Thursday for my first injection at the Doc's office.
Thanks for the help!

 

[madman]

And proud of it!

So I'm confused on the dosage. Doc told me 100mg a week. So is that going to be the full mL vial or just half of it? The 200mg / mL is confusing me. Guess I will find out on Thursday for my first injection at the Doc's office.
Thanks for the help!

You will be injecting .5 ml (100mg) weekly.

You are using a 1 ml vial and the strength of testosterone is 200 mg/ml.....you are going to be using half.

 

[Tremonti22]

Well I went to the pharmacy last night to pick up my test, and what I got was 2 x 1mL vials. Not sure why I didn't get one bigger vial. I'll talk to my doc about it this week. Not sure if it's an insurance thing or that's what he prefers. I prefer not having to go to the pharmacy every other week.
View attachment 6929

It may be Walgreens. I had the same issue with them. They did not want to distribute the 10ml vial. CVS on the other hand will. Have them switch you to CVs

 

[Ronnny]

Well I went to the pharmacy last night to pick up my test, and what I got was 2 x 1mL vials. Not sure why I didn't get one bigger vial. I'll talk to my doc about it this week. Not sure if it's an insurance thing or that's what he prefers. I prefer not having to go to the pharmacy every other week.
View attachment 6929

Its one month supply. You could have got 6 bottles for 3 months supply from walgreens.My prescription was written for 10ml but because of insurance , they had to do this way.Cypionate is good for 28 days once you open the bottle. so 10ml will be wasted , insurance wont cover it.

 

[Tremonti22]

Its one month supply. You could have got 6 bottles for 3 months supply from walgreens.My prescription was written for 10ml but because of insurance , they had to do this way.Cypionate is good for 28 days once you open the bottle. so 10ml will be wasted , insurance wont cover it.

Test does not go bad for like over a year.
Not sure where you heard it went bad in 28 days. If that was the case the 10ml vial would be no good because it lasts 3 months.

 

[Tremonti22]

Test does not go bad for like over a year.
Not sure where you heard it went bad in 28 days. If that was the case the 10ml vial would be no good because it lasts 3 months.

What I’m saying is Walgreens won’t give the 10ml vials but CVS will, and that’s what you want

 

[Ronnny]

Test does not go bad for like over a year.
Not sure where you heard it went bad in 28 days. If that was the case the 10ml vial would be no good because it lasts 3 months.

If you don't know about the shelf life of Cypionate ask your pharmacist or search google. My pharmacist clearly told me.Expire 28 days after you open it.That is why I told you no pharmacy/insurance will give you 10ml for one month supply.

I think you are confusing yourself with the expiration date written on the bottle.

 

[Systemlord]

Nonsense, back when we were on 200mg every two weeks a vial of T-Cyp lasted us for months, we wouldn't be able to fill our scripts again for months. It takes me 12 weeks to use up a single vial.

We've heard pharmacists say some pretty incredible nonsense, like injecting using insulin syringes will shred the testosterone molecules.

 

[Ronnny]

But I don't know why the pharmacist told me only 28 days once open.
she was even ready to give me 10ml vial for $100 cash every month but she said its useless after 28 days.My prescription was written for 10ml vial but 400mg/month.
So the pharmacist just gave me 1ml bottle to match the dosing.

 

[Systemlord]

But I don't know why the pharmacist told me only 28 days once open.

It's no different than an overprotective parent, they believe after 28 days the risk of infections is not acceptable, but in practice it's less of a concern.

 

[Tremonti22]

Testosterone can be good for up to 2 years amigo. You’re just wrong on this no offense. I’ve been on for years and always have a 10ml vial that lasts me 3 months. Blood work regularly confirms. Pharmacists are idiots. I asked a pharmacist the other day what’s the difference between the extra strength breath right strips were and she said “it’s a higher dosage” - it’s a nose strip. Don’t listen to your pharmacist. Test will be good for up to 2 years.