Would I be making a mistake?

[canadianeh]

Posted this to Reddit, and got some interested responses, but wanted to post here as I've been reading here all day.

Over the past 18 months, I’ve been on a journey to naturally increase my testosterone (T) levels. While I’ve tried various methods, including sleep improvement, diet improvement, supplements like tongkat and others, I’ve actually experienced a slight decline in levels with each test.

Background:

• Symptoms: I don’t have many typical low T symptoms. Good / strong libido, regular workouts (heavy lifting compound movement strength workouts with some HIIT twice per week in there 4-5 times a week for the past 7+ years), strong deadlift/squat/bench, full head of hair. Sleep is okay but often disrupted by a bathroom trip. I do have some mental fog and feeling a bit unmotivated.

Dr. Attia says most common symptoms he sees "erectile disfunction, low libido, low mood, difficulty putting on muscle mass, insulin resistance

Over the past 18 months, I’ve been on a journey to naturally increase my testosterone (T) levels. While I’ve tried various methods, including sleep improvement, diet improvement, supplements like tongkat and others, I’ve actually experienced a slight decline in levels with each test.

Background:

• Symptoms: I don’t have many typical low T symptoms. Good / strong libido, regular workouts (heavy lifting compound movement strength workouts with some HIIT twice per week in there 4-5 times a week), strong deadlift/squat/bench, full head of hair. Sleep is okay but often disrupted by bathroom trips.
• Body: Carrying some extra body fat, likely between 18-22% BF.
• Energy: It’s been lower lately. My job isn’t stressful, but I’m feeling a lack of energy and creativity.

Test Results (Over 18 months):

1st Test (6 months)

• Total T: 371 ng/dL
• Free T: 73 pg/mL (7.3 ng/dL)

2nd Test (12 months)

• Total T: 358 ng/dL
• Free T: 75 pg/mL (7.5 ng/dL)

3rd Test (18 months)

• Total T: 351 ng/dL
• Free T: 70.5 pg/mL (7.0 ng/dL)

Despite my efforts, there’s been a slight decline. I did see a drop in estradiol during this time which seems to be a positive. These numbers do suggest 2% of total T is free which is the number Peter Attia suggests.

Concerns and Goals: I’m interested in more energy and zest for life. I’d appreciate leaning out a bit and possibly reducing body fat, dont really want to look way more muscular…..

However, I’m concerned about potential side effects, particularly regarding libido, hair loss, and testicular atrophy.

I haven’t discussed this with my spouse yet.

A Canadian TRT clinic recommended starting with 100mg cypionate split 50mg twice a week. I admit I’m wary about potential side effects.

Question: Given my situation, should I consider starting TRT? Would the benefits outweigh the risks for someone in my situation?e

• Body: Carrying some extra body fat, likely between 18-22% BF.

• Energy: It’s been lower lately. My job isn’t stressful, but I’m feeling a lack of energy and creativity.

Test Results (Over 18 months):

1st Test (6 months)

• Total T: 371 ng/dL
• Free T: 73 pg/mL (7.3 ng/dL)

2nd Test (12 months)

• Total T: 358 ng/dL
• Free T: 75 pg/mL (7.5 ng/dL)

3rd Test (18 months)

• Total T: 351 ng/dL
• Free T: 70.5 pg/mL (7.0 ng/dL)

Despite my efforts, there’s been a slight decline. I did see a drop in estradiol during this time which seems to be a positive. These numbers do suggest 2% of total T is free which is the number Peter Attia suggests.

Concerns and Goals: I’m interested in more energy, feeling more motivated at work, improving sleep, body composition.... I’d appreciate leaning out a bit and possibly reducing body fat, dont really want to look way more muscular…..

However, I’m concerned about potential side effects, particularly regarding libido, hair loss, and testicular atrophy.

I haven’t discussed this with my spouse yet.

A Canadian TRT clinic recommended starting with 100mg cypionate split 50mg twice a week. I admit I’m wary about potential side effects.

Question: Given my situation, should I consider starting TRT? Would the benefits outweigh the risks for someone in my situation? Is this an "inevitable" someday anyways?

 

[Systemlord]

Test Results (Over 18 months):

1st Test (6 months)

• Total T: 371 ng/dL
• Free T: 73 pg/mL (7.3 ng/dL)

2nd Test (12 months)

• Total T: 358 ng/dL
• Free T: 75 pg/mL (7.5 ng/dL)

3rd Test (18 months)

• Total T: 351 ng/dL
• Free T: 70.5 pg/mL (7.0 ng/dL)

Despite my efforts, there’s been a slight decline.

Nope, your testosterone didn’t change at all, it remained relatively the same. This variation can be explained as either a natural daily fluctuation, because biology doesn’t remain in a steady state, where things aren’t constantly changing.

Your testosterone one day is 371, it won’t be tomorrow, even if you are at peak health. You have lab deviation and also your hormones are on a sort of bell curve, like a set of waves and timing is critical! Now you have many different variables to account for.

As far as hormones go, you’re not either deficient or not deficient, on or off, it’s a spectrum, or like a light dimmer switch, raise the switch, the light becomes brighter, the hormones and the effects become more noticeable.

Not everyone with low testosterone will have a low libido or erectile problems. The first symptoms have to start somewhere, and increase in number of symptoms and the severity, as the levels drop further.

You may be on the border of an insufficiency in testosterone and the first set of symptoms are only the beginning.

My job isn’t stressful, but I’m feeling a lack of energy and creativity.

Concerns and Goals: I’m interested in more energy, feeling more motivated at work, improving sleep, body composition.... I’d appreciate leaning out a bit and possibly reducing body fat, dont really want to look way more muscular…..

However, I’m concerned about potential side effects, particularly regarding libido, hair loss, and testicular atrophy.

I haven’t discussed this with my spouse yet.

TRT for me at least, improved my sleep tenfold as well as all other parameters, you’ve listed with the exception of some slight thinning on the back of the head, which pales in comparison to the other benefits.

I have a high self-esteem, I don’t need hair to be attractive to women, or for people to like me, it doesn’t bother me. Testicular atrophy is 25% of what it was when I was natural. As far as other side effects, these usually occur in the first few months as you dial in your protocol.

Given my situation, should I consider starting TRT? Would the benefits outweigh the risks for someone in my situation? Is this an "inevitable" someday anyways?

You already know the answer to this question.

Testosterone replacement therapy is associated with high satisfaction rates: results of a survey study - PubMed

Despite a well-documented increase in both the prevalence of Testosterone Deficiency (TD) and prescription of testosterone replacement therapy (TRT), few studies have investigated the preferences of patients receiving TRT and factors associated with increased treatment satisfaction. To...

pubmed.ncbi.nlm.nih.gov

TRT does not increase cancer risk in men treated for prostate cancer

The prostate is a gland that attracts great attention in men’s health. One of the major issues is related to cancer. Prostate cancer is one of the leading causes of death in men in the United States. As men age, small hidden prostatic lesions become increasingly common. These may or may not...

www.excelmale.com

TRAVERSE: Testosterone and Cardiovascular Safety

https://academic.oup.com/jcem/advance-article-abstract/doi/10.1210/clinem/dgad555/7280102 Over the past decade, concerns about the adverse effects of testosterone have paralleled the escalating rates of testosterone prescriptions (1). The principal safety concerns for testosterone therapy have...

www.excelmale.com

 

[canadianeh]

Nope, your testosterone didn’t change at all, it remained relatively the same. This variation can be explained as either a natural daily fluctuation, because biology doesn’t remain in a steady state, where things aren’t constantly changing.

Your testosterone one day is 371, it won’t be tomorrow, even if you are at peak health. You have lab deviation and also your hormones are on a sort of bell curve, like a set of waves and timing is critical! Now you have many different variables to account for.

As far as hormones go, you’re not either deficient or not deficient, on or off, it’s a spectrum, or like a light dimmer switch, raise the switch, the light becomes brighter, the hormones and the effects become more noticeable.

Not everyone with low testosterone will have a low libido or erectile problems. The first symptoms have to start somewhere, and increase in number of symptoms and the severity, as the levels drop further.

You may be on the border of an insufficiency in testosterone and the first set of symptoms are only the beginning.


TRT for me at least, improved my sleep tenfold as well as all other parameters, you’ve listed with the exception of some slight thinning on the back of the head, which pales in comparison to the other benefits.

I have a high self-esteem, I don’t need hair to be attractive to women, or for people to like me, it doesn’t bother me. Testicular atrophy is 25% of what it was when I was natural. As far as other side effects, these usually occur in the first few months as you dial in your protocol.


You already know the answer to this question.

Testosterone replacement therapy is associated with high satisfaction rates: results of a survey study - PubMed

Despite a well-documented increase in both the prevalence of Testosterone Deficiency (TD) and prescription of testosterone replacement therapy (TRT), few studies have investigated the preferences of patients receiving TRT and factors associated with increased treatment satisfaction. To...

pubmed.ncbi.nlm.nih.gov

TRT does not increase cancer risk in men treated for prostate cancer

The prostate is a gland that attracts great attention in men’s health. One of the major issues is related to cancer. Prostate cancer is one of the leading causes of death in men in the United States. As men age, small hidden prostatic lesions become increasingly common. These may or may not...

www.excelmale.com

TRAVERSE: Testosterone and Cardiovascular Safety

https://academic.oup.com/jcem/advance-article-abstract/doi/10.1210/clinem/dgad555/7280102 Over the past decade, concerns about the adverse effects of testosterone have paralleled the escalating rates of testosterone prescriptions (1). The principal safety concerns for testosterone therapy have...

www.excelmale.com

The advice I got on Reddit was that my symptoms don’t warrant TRT. And again I’m not really sure, libido is good, Hair is good, energy is a bit low and sleep could be better. I do think I have some insulin resistance.

I am weary of a lifetime of injections, and again I think I’m more Worried about the side effects and the symptoms. For example, there was a good thread here about people who regretted TRT, and I was surprised how many did. Also, my libido is good, erections are strong, sex drive. is good, and I’ve read many people have the complete opposite impact on TRT , losing libido, becoming more stressed, more drained, etc.

I really wish I could try this for three months, without having to do some sort of post cycle therapy process to get back to a baseline, and hope that natural production starts again.

 

[Vince]

If you wish to stay fertile I wouldn't go on TRT. It can't be very difficult for someone to have kids once they start TRT.

A couple of things that may help increase your testosterone. Creatine, working out everyday and also daily orgasm. Either sex or masturbation.

I started TRT at age 60 and I haven't looked back. Personally, I've enjoyed it for over 8 years starting from day one. Others wish they never started.

 

[Systemlord]

The advice I got on Reddit

That’s like saying I went into a Starbucks and a group of people drinking coffee told me that TRT isn’t a good idea, so they must be right.

How is Reddit the authority in male hormones?

I really wish I could try this for three month

It could take that long just to dial in your protocol. You start, your hormone levels are too high, 6 weeks in, you decrease the dosage, 6 weeks later, when your hormone reach a steady state, you’re already 3 months into TRT.

Then at 6 months, you start feeling off on days 5-6, injecting once weekly, so now you need to spilt your doses up twice weekly. Yet another 6 weeks to reach steady states.

It could take 6 months to notice significant improvement. This is just to give you a rough idea of what it may be like for you.

I really wish I could try this for three months, without having to do some sort of post cycle therapy process to get back to a baseline, and hope that natural production starts again.

I was on the first time around for 3 years, stopped without any PCT and restarted my HPTA in 4.5 weeks. That’s with a lot of ongoing health problems.

The majority of men who start and stopped TRT don’t have issues with restarting their HPTA, and those that can’t, you can argue they were already headed in that direction, and the TRT made it happen sooner rather than later.

You can hold off for now, wait 10-20 years, deal with the lower quality of life, then start experiencing a higher quality of life many years from now, it’s up to you, but TRT is inevitable!

I hope this puts things into perspective for you.

 

[Golfboy307]

Did you mention your age in your post or did I miss it? I think that is a big factor when considering to jump on TRT.

 

[canadianeh]

Did you mention your age in your post or did I miss it? I think that is a big factor when considering to jump on TRT.

43

 

[Systemlord]

I’ve read many people have the complete opposite impact on TRT

This has already been addressed, I linked the higher rates of satisfaction with TRT above. So the majority experience a successful TRT experience, and the minority of men have problems on TRT.

I would argue the majority of the negative experiences on TRT are due to allowing your health to decline to the point where TRT can’t turn things back around, beyond the point of no return.

 

[Golfboy307]

I started at age 48 after wrestling with symptoms for over two years (ED, low libido, terrible moods). But at age 43, the trend lines will not go in the positive direction. You have to decide if want to go on TRT with no apparent symptoms yet. I would wait.

 

[BadassBlues]

You didn't mention your age?

Genetics should be considered before assuming anyone is deficient in testosterone. Some men have lower T levels, but higher genetic and receptor sensitivity. In short, that means they are perfectly functional at a level that is on the low end of the scale.

Once you start chasing numbers, you begin the journey that many have regretted. Symptoms should be your only measurement to consider. You say you're fine, good libido, strong workouts etc... My sincere advice is to stop worrying about your T levels based on a number and enjoy what you have. If at some point you begin to feel the symptoms that could possibly be low testosterone related, then give it a try. I would start with gel however as it is easy to use, short lived, no injections.

TRT is a blessing for those who need it, and a curse for those who don't.

I have been on TRT for over 20 years. If I could go back to my younger self, I would have told him to hold off a bit longer before diving in.

 

[Systemlord]

Genetics should be considered before assuming anyone is deficient in testosterone.

Did you ever consider a testosterone insufficiency? Testosterone deficiency, insufficiency is a spectrum, it’s not all or nothing. My brother started experiencing a testosterone decline, at 62 and his first symptoms was low energy, loss of muscle tone and cognitive deficits.

 

[FunkOdyssey]

Once you start chasing numbers, you begin the journey that many have regretted. Symptoms should be your only measurement to consider. You say you're fine, good libido, strong workouts etc... My sincere advice is to stop worrying about your T levels based on a number and enjoy what you have. If at some point you begin to feel the symptoms that could possibly be low testosterone related, then give it a try.

Strongly agree -- I'm on the side of don't bother with it at this point. You are functioning too well right now and already have most of what people are trying and often failing to achieve with TRT.

I also don't agree with the idea that there's an inevitable age-related decline in T, so you will inevitably need TRT later, so you may as well just start now. It's been shown that a majority of what people think is an age-related decline is just the accumulation of conditions that cause low T, not age itself. If your diet and exercise are in check and you keep yourself metabolically healthy, it is by no means a foregone conclusion that there will ever come an age when you need TRT.

 

[BadassBlues]

Did you ever consider a testosterone insufficiency? Testosterone deficiency, insufficiency is a spectrum, it’s not all or nothing. My brother started experiencing a testosterone decline, at 62 and his first symptoms was low energy, loss of muscle tone and cognitive deficits.

To me, that is just semantics. I firmly believe in, and advocate for HRT in those who need it. Over the years I have seen a pattern of those who chase numbers and have drawn a correlation to overall satisfaction and results. Many of those who have complaints are the ones who are fixated on numbers and constantly adjusting their protocols.

My reasoning to begin HRT back in my 40's was to be proactive. I had no symptoms of low T. I could have waited likely another 10 years before having any symptoms at all as I was in very good physical condition and live a healthy lifestyle.

Once you begin HRT, things change. Adding exogenous substances into your body brings about changes in chemistry. For some, including myself, it was very easy. I dialed in a protocol that works and have not since changed it. For others, it has proven to be more difficult. Libido is the main complaint you hear about. That delicate balance of hormones and neurotransmitters gets out of sync with some and is difficult to realign.

I just feel that if it aint broke, don't fix it. But that is just my opinion.

 

[canadianeh]

That’s like saying I went into a Starbucks and a group of people drinking coffee told me that TRT isn’t a good idea, so they must be right.

How is Reddit the authority in male hormones?

Not saying they're right, but they're opinions and discussion points from folks just like I'm getting here, which is really all we can ask for.

 

[canadianeh]

Strongly agree -- I'm on the side of don't bother with it at this point. You are functioning too well right now and already have most of what people are trying and often failing to achieve with TRT.

I also don't agree with the idea that there's an inevitable age-related decline in T, so you will inevitably need TRT later, so you may as well just start now. It's been shown that a majority of what people think is an age-related decline is just the accumulation of conditions that cause low T, not age itself. If your diet and exercise are in check and you keep yourself metabolically healthy, it is by no means a foregone conclusion that there will ever come an age when you need TRT.

Thank you for your thoughts. Appreciate it.

 

[canadianeh]

You didn't mention your age?

Genetics should be considered before assuming anyone is deficient in testosterone. Some men have lower T levels, but higher genetic and receptor sensitivity. In short, that means they are perfectly functional at a level that is on the low end of the scale.

Once you start chasing numbers, you begin the journey that many have regretted. Symptoms should be your only measurement to consider. You say you're fine, good libido, strong workouts etc... My sincere advice is to stop worrying about your T levels based on a number and enjoy what you have. If at some point you begin to feel the symptoms that could possibly be low testosterone related, then give it a try. I would start with gel however as it is easy to use, short lived, no injections.

TRT is a blessing for those who need it, and a curse for those who don't.

I have been on TRT for over 20 years. If I could go back to my younger self, I would have told him to hold off a bit longer before diving in.

Thank you as well. I'm not really chasing the numbers but they're certainly a sign.,..

I mean, I feel good, and I understand aging/tiredness/busy lifestyle etc...

The doctor who I had my consult with said something like.,,, "maybe you've always been low and deficient and just learned to cope/live and so thats your normal"

And that really got me thinking about the what ifs..

 

[BadassBlues]

Thank you as well. I'm not really chasing the numbers but they're certainly a sign.,..

I mean, I feel good, and I understand aging/tiredness/busy lifestyle etc...

The doctor who I had my consult with said something like.,,, "maybe you've always been low and deficient and just learned to cope/live and so thats your normal"

And that really got me thinking about the what ifs..

It’s a decision we have all made. At least you are giving it some intelligent thought. Take everything you have researched and weigh the pros and cons.

 

[FunkOdyssey]

The three month trial you were talking about doing is a low risk proposition. We can't put accurate numbers on this but based on what I've seen, I would guess your chances of suffering any permanent loss of HPTA function after 3 months of TRT are less than 0.1% (less than 1 in 1000 men would have that outcome).

The reason I am not in favor is that it is also a low reward proposition, given your baseline which is already enviable.

 

[madman]

Posted this to Reddit, and got some interested responses, but wanted to post here as I've been reading here all day.

Over the past 18 months, I’ve been on a journey to naturally increase my testosterone (T) levels. While I’ve tried various methods, including sleep improvement, diet improvement, supplements like tongkat and others, I’ve actually experienced a slight decline in levels with each test.

Background:

• Symptoms: I don’t have many typical low T symptoms. Good / strong libido, regular workouts (heavy lifting compound movement strength workouts with some HIIT twice per week in there 4-5 times a week for the past 7+ years), strong deadlift/squat/bench, full head of hair. Sleep is okay but often disrupted by a bathroom trip. I do have some mental fog and feeling a bit unmotivated.

Dr. Attia says most common symptoms he sees "erectile disfunction, low libido, low mood, difficulty putting on muscle mass, insulin resistance

Over the past 18 months, I’ve been on a journey to naturally increase my testosterone (T) levels. While I’ve tried various methods, including sleep improvement, diet improvement, supplements like tongkat and others, I’ve actually experienced a slight decline in levels with each test.

Background:

• Symptoms: I don’t have many typical low T symptoms. Good / strong libido, regular workouts (heavy lifting compound movement strength workouts with some HIIT twice per week in there 4-5 times a week), strong deadlift/squat/bench, full head of hair. Sleep is okay but often disrupted by bathroom trips.
• Body: Carrying some extra body fat, likely between 18-22% BF.
• Energy: It’s been lower lately. My job isn’t stressful, but I’m feeling a lack of energy and creativity.

Test Results (Over 18 months):

1st Test (6 months)

• Total T: 371 ng/dL
• Free T: 73 pg/mL (7.3 ng/dL)

2nd Test (12 months)

• Total T: 358 ng/dL
• Free T: 75 pg/mL (7.5 ng/dL)

3rd Test (18 months)

• Total T: 351 ng/dL
• Free T: 70.5 pg/mL (7.0 ng/dL)

Despite my efforts, there’s been a slight decline. I did see a drop in estradiol during this time which seems to be a positive. These numbers do suggest 2% of total T is free which is the number Peter Attia suggests.

Concerns and Goals: I’m interested in more energy and zest for life. I’d appreciate leaning out a bit and possibly reducing body fat, dont really want to look way more muscular…..

However, I’m concerned about potential side effects, particularly regarding libido, hair loss, and testicular atrophy.

I haven’t discussed this with my spouse yet.

A Canadian TRT clinic recommended starting with 100mg cypionate split 50mg twice a week. I admit I’m wary about potential side effects.

Question: Given my situation, should I consider starting TRT? Would the benefits outweigh the risks for someone in my situation?e

• Body: Carrying some extra body fat, likely between 18-22% BF.

• Energy: It’s been lower lately. My job isn’t stressful, but I’m feeling a lack of energy and creativity.

Test Results (Over 18 months):

1st Test (6 months)

• Total T: 371 ng/dL
• Free T: 73 pg/mL (7.3 ng/dL)

2nd Test (12 months)

• Total T: 358 ng/dL
• Free T: 75 pg/mL (7.5 ng/dL)

3rd Test (18 months)

• Total T: 351 ng/dL
• Free T: 70.5 pg/mL (7.0 ng/dL)

Despite my efforts, there’s been a slight decline. I did see a drop in estradiol during this time which seems to be a positive. These numbers do suggest 2% of total T is free which is the number Peter Attia suggests.

Concerns and Goals: I’m interested in more energy, feeling more motivated at work, improving sleep, body composition.... I’d appreciate leaning out a bit and possibly reducing body fat, dont really want to look way more muscular…..

However, I’m concerned about potential side effects, particularly regarding libido, hair loss, and testicular atrophy.

I haven’t discussed this with my spouse yet.

A Canadian TRT clinic recommended starting with 100mg cypionate split 50mg twice a week. I admit I’m wary about potential side effects.

Question: Given my situation, should I consider starting TRT? Would the benefits outweigh the risks for someone in my situation? Is this an "inevitable" someday anyways?

You have been a member of the forum since Dec.2022.

A fair amount of knowledge kicking around on the forum.

You are missing many other blood markers which should be looked at because having healthy testosterone (TT, FT, and BAT) levels is only one piece of the puzzle.

Dysfunction thyroid/adrenals can easily mimic low T symptoms let alone even if one had healthy T levels dysfunction thyroid/adrenals can wreak havoc on the overall effectiveness of TRT.

Looking over the results for the labs you posted (TT/FT) your TT 350-375 ng/dL is not so stellar and more importantly your FT level is on the lower end which is well below where a healthy young male would sit.

In Canada, FT is calculated using the cFTV.

With the FT level you posted then you would have normal SHBG not high or low.

Keep in mind in order to know where your TT/FT level truly sits your blood work needs to be done in the early AM in a fasted state as we want to test at peak when T levels are highest due to the natural endogenous 24 hr circadian rhythm of a healthy young male.

Top it off the most accurate assays for TT/estradiol/DHT (LC/MS-MS) and FT (Equilibrium Dialysis or Ultrafiltration) should be used.

If you do not have access to such then you will need to use/rely upon TT/estradiol (standard immunoassay) and FT (cFTV).

If you train with weights it would be wise to take a week off as overtraining can drive down natty T levels.

You stated that you have been lifting very heavy.

How is your recovery?

Do you periodize your training program?

Also need to understand that your FT was calculated using the linear law-of-mass action cFTV which as of now tends to overestimate when compared against what is considered the most accurate assays for testing free testosterone the gold standard Equilibrium Dialysis.

Your FT level may very well be somewhat lower.

Now for the tricky part which is symptoms.

Although low libido and lack of spontaneous/nocturnal erections are common symptoms for some this will not happen until FT levels are absurdly low.

One can still have a decent libido/erectile function with lower-end/subpar FT levels but still experience other symptoms related to low-T.

Again testosterone is only one piece of the puzzle as dysfunctional thyroid/adrenals can cause numerous issues when it comes to energy, mood, libido/erections, recovery, and so on.

Always best to have a more thorough set of labs before jumping on TRT.

Blood work should be done for TT, FT, estradiol, SHBG, DHT, prolactin, Vit D DHEA-S, LH/FSH, PSA, full thyroid panel (TSH, Free T3, Free T4, Reverse T3, antibodies), salivary cortisol (Four Specimens), lipids, CMP, CBC, and CRP.

Now for the tricky part which is that you stated you lack many of the low T symptoms.

More importantly, you have a strong libido and hopefully erectile function.

Hard to say how you would fair on TRT as it is not so cut and dry.

For some men it can do wonders as in life-changing in many ways, for others they will be better off than before but have nothing to brag about, many may end up struggling with ups/downs for years to come and some will be far worse off.

No point in getting caught up on this as you need to decide what is best for you.

The best piece of advice to increasing your chance of reaping the benefits of TRT is to always start low and go slow.

T only protocol, no AI (aromatase inhibitor) or hCG.

You can always add in hCG eventually if need be, increase your dose, or tinker with an AI (would try to avoid such).

Patience is key.

Do not get caught up in that more T is better mentality.

Do not go in with unrealistic expectations.

I understand you are on the fence here when it comes to libido let alone testicular atrophy.

Again no one can say where your libido will end up on TRT as it could stay the same, be better or lousy, and worst-case scenario non-existent.

Too many factors are involved especially when it comes to libido/erectile function as they are multi-factorial.

As for testicular shrinkage, this can easily be prevented/minimized with the use of hCG.

To be honest in your situation if you want to kill 2 birds with one stone while at the same time getting a taste of having higher T levels then your best would be trialing the nasal T gel (Natesto) which many of the endos/uros in Canada love to prescribe due to it being the least suppressive when it comes to the hpta let alone would allow one to maintain fertility, prevent/minimize testicular shrinkage and top it off will have the least impact on experiencing side-effects especially when it comes to elevated hematocrit.

Another option would be clomid/enclomiphene which some may fair well on although eventually many end up jumping on TRT.

Again take in as much as you can from everyone and decide what is best for you!

 

[BadassBlues]

You have been a member of the forum since Dec.2022.

A fair amount of knowledge kicking around on the forum.

You are missing many other blood markers which should be looked at because having healthy testosterone (TT, FT, and BAT) levels is only one piece of the puzzle.

Dysfunction thyroid/adrenals can easily mimic low T symptoms let alone even if one had healthy T levels dysfunction thyroid/adrenals can wreak havoc on the overall effectiveness of TRT.

Looking over the results for the labs you posted (TT/FT) your TT 350-375 ng/dL is not so stellar and more importantly your FT level is on the lower end which is well below where a healthy young male would sit.

In Canada, FT is calculated using the cFTV.

With the FT level you posted then you would have normal SHBG not high or low.

Keep in mind in order to know where your TT/FT level truly sits your blood work needs to be done in the early AM in a fasted state as we want to test at peak when T levels are highest due to the natural endogenous 24 hr circadian rhythm of a healthy young male.

Top it off the most accurate assays for TT/estradiol/DHT (LC/MS-MS) and FT (Equilibrium Dialysis or Ultrafiltration) should be used.

If you do not have access to such then you will need to use/rely upon TT/estradiol (standard immunoassay) and FT (cFTV).

If you train with weights it would be wise to take a week off as overtraining can drive down natty T levels.

You stated that you have been lifting very heavy.

How is your recovery?

Do you periodize your training program?

Also need to understand that your FT was calculated using the linear law-of-mass action cFTV which as of now tends to overestimate when compared against what is considered the most accurate assays for testing free testosterone the gold standard Equilibrium Dialysis.

Your FT level may very well be somewhat lower.

Now for the tricky part which is symptoms.

Although low libido and lack of spontaneous/nocturnal erections are common symptoms for some this will not happen until FT levels are absurdly low.

One can still have a decent libido/erectile function with lower-end/subpar FT levels but still experience other symptoms related to low-T.

Again testosterone is only one piece of the puzzle as dysfunctional thyroid/adrenals can cause numerous issues when it comes to energy, mood, libido/erections, recovery, and so on.

Always best to have a more thorough set of labs before jumping on TRT.

Blood work should be done for TT, FT, estradiol, SHBG, DHT, prolactin, Vit D DHEA-S, LH/FSH, PSA, full thyroid panel (TSH, Free T3, Free T4, Reverse T3, antibodies), salivary cortisol (Four Specimens), lipids, CMP, CBC, and CRP.

Now for the tricky part which is that you stated you lack many of the low T symptoms.

More importantly, you have a strong libido and hopefully erectile function.

Hard to say how you would fair on TRT as it is not so cut and dry.

For some men it can do wonders as in life-changing in many ways, for others they will be better off than before but have nothing to brag about, many may end up struggling with ups/downs for years to come and some will be far worse off.

No point in getting caught up on this as you need to decide what is best for you.

The best piece of advice to increasing your chance of reaping the benefits of TRT is to always start low and go slow.

T only protocol, no AI (aromatase inhibitor) or hCG.

You can always add in hCG eventually if need be, increase your dose, or tinker with an AI (would try to avoid such).

Patience is key.

Do not get caught up in that more T is better mentality.

Do not go in with unrealistic expectations.

I understand you are on the fence here when it comes to libido let alone testicular atrophy.

Again no one can say where your libido will end up on TRT as it could stay the same, be better or lousy, and worst-case scenario non-existent.

Too many factors are involved especially when it comes to libido/erectile function as they are multi-factorial.

As for testicular shrinkage, this can easily be prevented/minimized with the use of hCG.

To be honest in your situation if you want to kill 2 birds with one stone while at the same time getting a taste of having higher T levels then your best would be trialing the nasal T gel (Natesto) which many of the endos/uros in Canada love to prescribe due to it being the least suppressive when it comes to the hpta let alone would allow one to maintain fertility, prevent/minimize testicular shrinkage and top it off will have the least impact on experiencing side-effects especially when it comes to elevated hematocrit.

Another option would be clomid/enclomiphene which some may fair well on although eventually many end up jumping on TRT.

Again take in as much as you can from everyone and decide what is best for you!

Very well thought out and detailed reply. Pretty much gives all relevant material to determine how to move forward.

As to the Reddit equation, things are a bit different here. I suppose you could equate this venue as a community of like minded individuals searching for the truth as opposed to a group of people just looking to post their opinions. There is a difference, but both have intrinsic value to the end user. This is a community, Reddit is a social media platform. We keep each other in check here, posting BS will result in an Immediate challenge to the credibility of the content. That keeps everyone honest.