What Are Things Someone Should Know Before Starting TRT?

Nelson Vergel

Founder, ExcelMale.com
There are several things that your doctor may fail to tell you when you start testosterone replacement therapy (TRT):

1- TRT decreases your sperm count.

2- TRT may increase your blood viscosity (hematocrit). Some doctors want to stop your TRT when this happens, but this side effect can be managed easily with blood donations.

3- TRT shuts down your own testosterone production. It may recover after a few weeks and up to 6 months after you stop.

4- TRT works to improve your sex drive, muscle mass, and burn fat. But it does not work for everyone and dose/frequency are important along with other factors like side effect management. It is not a magic bullet.

5- Testosterone can be injected under the skin (Most doctors think you should inject deeply into muscle)

6- Testosterone gels and creams are effective but most doctors do not use the right dose or do not adjust dose based on your blood level.

7- Many doctors still prescribe testosterone injections at 200 mg every two weeks. Many are moving towards 100 mg/week or 50 m twice per week with insulin syringe.

8- TRT can worsen sleep apnea

9- TRT only improves erectile function in younger men. It improves libido in most men regardless of age, though.

10- You can monitor your own blood tests via companies that sell discounted labs without a doctor visit.

11- You can access a testosterone doctor via telemedicine if you don’t have one close by.

12- TRT does not cause prostate cancer or heart attacks (cardiovascular outcomes depend on proper monitoring of hematocrit, HDL, and blood pressure, though)

I can go on, but these are probably some of the most frequently ignored facts.

Nelson

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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

Predicted Hormone Levels

Enter your total testosterone value to see predictions

Results will appear here after calculation

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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