TRT expectations

I’m new here on the forum and posted a hello in the intro. Hello again. My question to all with experience is what are rational expectations to have regarding TRT. I’m 45 and my quest began 8 months ago with a visit to the urologist after seeing my pcm. I was complaining of fatigue, weight gain, no libido, and ED. I had very minimal testing with a low free-T manifested. No shbg, dhea, or other real specific labs drawn. The urologist prescribed TRT without blinking an eye. He put me on 300mg IM q2wks. All symptoms were relieved almost immediately. However, the honeymoon only lasted a couple of months.

I began to have shortness of breath and red face daily. My totalT was >1500 and my free T was 48 up from 4.2. My hct was 48 so I started to give blood every Unfortunately, my urologist was out on medical leave and has since retired. I began reading anything I could find and found you. I’m relatively well versed in all things medical, but have a limited endocrine knowledge. I chose to begin dosing 75mg subs q4d and it has relieved the redness and flushing, but I’ve had some weight gain and a lot of fatigue. I lift weights 3 days a week and have a decent physique, but I’m heavier than I’ve ever been. I’m 6’3” and now weigh 240. Is it unrealistic to expect to lose weight, have decent energy that maintains throughout the day, and keep my libido where it is?

I did find another doc and she was appalled that I was left to flounder after starting TRT. She’s ordered a panel of labs that I’ll have done later this week.
 
I would also get a complete thyroid, at least once. TSH, free T4, free T3, reverse T3 and both antibodies. It will be interesting to see your labs. Hopefully this doctor is better then your last one.
 

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TRT Hormone Predictor Widget

TRT Hormone Predictor

Predict estradiol, DHT, and free testosterone levels based on total testosterone

⚠️ Medical Disclaimer

This tool provides predictions based on statistical models and should NOT replace professional medical advice. Always consult with your healthcare provider before making any changes to your TRT protocol.

ℹ️ Input Parameters

Normal range: 300-1000 ng/dL

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Understanding Your Hormones

Estradiol (E2)

A form of estrogen produced from testosterone. Important for bone health, mood, and libido. Too high can cause side effects; too low can affect well-being.

DHT

Dihydrotestosterone is a potent androgen derived from testosterone. Affects hair growth, prostate health, and masculinization effects.

Free Testosterone

The biologically active form of testosterone not bound to proteins. Directly available for cellular uptake and biological effects.

Scientific Reference

Lakshman KM, Kaplan B, Travison TG, Basaria S, Knapp PE, Singh AB, LaValley MP, Mazer NA, Bhasin S. The effects of injected testosterone dose and age on the conversion of testosterone to estradiol and dihydrotestosterone in young and older men. J Clin Endocrinol Metab. 2010 Aug;95(8):3955-64.

DOI: 10.1210/jc.2010-0102 | PMID: 20534765 | PMCID: PMC2913038

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