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TRT guidance

MVKid

New member
Newbies
Joined
Mar 3, 2017
Messages
29
Hey guys,

I'm looking for some info if anyone can point me in the right direction on some literature or help answer some questions regarding TRT.

I just had blood work done because of some symptoms I was having throughout my life (trouble losing weight, low libido, minor gyno from puberty, lack of muscle tone despite going to the gym, anxiety, etc...)

I am 31 and finally lost 65lbs this past 15 months and have been going to the gym for one year. Despite all this, I have not put on any noticeable muscle and have a loose fat pouch on my lower abdomen abd love handles that I can't seem to lose. I had some blood work done and my Test level was 320 which the doc said was on the very low end of norm and suggested TRT. He said it shouldn't be that low at my age. I come here for some real straight forward advice from people with the same problem.

I know this is for life but some concerns are after starting TRT for a while, what if I decide to move or my prescribing Doc closes up and a new Doc doesn't want to prescribe me injections, what am I to do?
Do I need to take any anti estrogen while on it?

I am looking forward to learning more about this from people with real world experience.
 
Hey guys,

I'm looking for some info if anyone can point me in the right direction on some literature or help answer some questions regarding TRT.

I just had blood work done because of some symptoms I was having throughout my life (trouble losing weight, low libido, minor gyno from puberty, lack of muscle tone despite going to the gym, anxiety, etc...)

I am 31 and finally lost 65lbs this past 15 months and have been going to the gym for one year. Despite all this, I have not put on any noticeable muscle and have a loose fat pouch on my lower abdomen abd love handles that I can't seem to lose. I had some blood work done and my Test level was 320 which the doc said was on the very low end of norm and suggested TRT. He said it shouldn't be that low at my age. I come here for some real straight forward advice from people with the same problem.

I know this is for life but some concerns are after starting TRT for a while, what if I decide to move or my prescribing Doc closes up and a new Doc doesn't want to prescribe me injections, what am I to do?
Do I need to take any anti estrogen while on it?

I am looking forward to learning more about this from people with real world experience.


I ended up going on because of burning the candle at both ends so to speak most of my life shit my system and I don't regret it in any way ....Sticking a needle in your ass will get old but the benefits far outweigh the inconveniences....As far as loosing a doctor once your on it's easy to get another doc to reperscribe if your goes out of business because the burden of liability to an extent is on the first doc....The next doc is just keeping your current therapy and health up....If the first one you ask don't like it go elsewhere .

If your caring fat you'll probably need anti e depending on how much they put you on but I've found with mine my diet affects sides and amount of anti e I need more than anything else....Get your diet perfect and you'll have alot less trouble.....I'm guilty of letting this slide at times like e everyone and I regret it everytime.....

Good luck and don't expect trt to make you super man over night give it time and it will work it's majic.....
 
I had many similar issues except I was only 130 lbs and couldn't gain weight. My levels tested at 310 at 30 years old. When you test that low at 30, 31, it's likely you'll be on it for the rest of your life. I've been on for about 18 years now. After an injection, levels will fall again and will probably be even lower so a second doc shouldn't have any problem giving TRT to you. As aon1 said, if you're carrying fat, you'll definitely want an anti-e since fat cells are the place the aromatase enzyme carries out the conversion to estrogen. Good luck!
 
thanks for the info guys. I am actually looking forward to it now. how often do you guys inject for trt?

I will post a pic for bf reference. I really don't want anymore gyno. Is it reversible once I start trt without an anti estro? Where does an AI come into play here?

I dont know why the pic is so fucking big...sorry for that
 
Last edited:
thanks for the info guys. I am actually looking forward to it now. how often do you guys inject for trt?



I will post a pic for bf reference. I really don't want anymore gyno. Is it reversible once I start trt without an anti estro? Where does an AI come into play here?



I dont know why the pic is so fucking big...sorry for that



Bro,

Your going to have to do the research on your own. Educate yourself.


Sent from my iPhone using Tapatalk
 
Ideally testosterone injections would be twice a week.

A regular dosage and compound scheme would be

100-125mg/wk test cyp
500-800iu/wk hcg
0.25-0.5mg/wk anastrozole

The ranges are doc specific and what works well with ur body.

The hcg is to keep ur balls working and keep ur sperm count up if u want to have kids in the future. Studies have shown that upwards of 800iu/wk hcg make u have a sperm count equivalent to a male not on hrt.

The ai is to curb estrogen conversion. Too much AI can make u feel like shit. Not enough and ull get estrogen sides so there should be tight control of the ai using blood work and how u feel as guides.

And tbh these are the absolute basics that you should know already after doing a bit of research. Read up a lot more and test out different docs as some are better at treating than others for your overall health.




Sent from my iPhone using Tapatalk
 
Also if ur levels are borderline low some hrt docs do a trial of Clomiphene to see if that will jumpstart ur gonads to produce more testosterone. Temporarily it will but sometimes it can jumpstart em to function properly long term. Not always tho. But worth a shot to mention. And a very fluent doc in hrt will understand the use of that.


Sent from my iPhone using Tapatalk
 
Also if ur levels are borderline low some hrt docs do a trial of Clomiphene to see if that will jumpstart ur gonads to produce more testosterone. Temporarily it will but sometimes it can jumpstart em to function properly long term. Not always tho. But worth a shot to mention. And a very fluent doc in hrt will understand the use of that.


Sent from my iPhone using Tapatalk

Thank you for this. He did mention something about trying clomid on the first visit.
 
For my own patients, if they are young and still want children, we do the clomid trial. I don't mess with HCG for the most part. (I am a urologist)

I went on TRT when I was 34, and have no kids, but wanted/needed it any way and came to terms with possible long term fertility issues.

Once you're already on TRT, changing to a different doc shouldn't be a big deal since you're already on and they should KNOW you are already shut down. If they don't, find a different doc.

If I have guys transfer to me who are already on TRT, I simply refill what they have, check labs in 4-6 weeks, and adjust from there.

Aromatase inhibitor is very individual. Most don't need them at TRT dosages. But find a doc that checks estradiol. It's part of good management.
 
I will also say that I will even treat guys if they're high 300's/very low 400's IF symptomatic and it's especially low for their AGE. I simply tell them insurance prob won't cover so they'll need to pay out of pocket for the testosterone, which isn't actually that expensive for a 10mL vial of cyp.
 
I will also say that I will even treat guys if they're high 300's/very low 400's IF symptomatic and it's especially low for their AGE. I simply tell them insurance prob won't cover so they'll need to pay out of pocket for the testosterone, which isn't actually that expensive for a 10mL vial of cyp.



Heard another doc say test cyp is not a good choice since it's only 60% pure. That enthenate is a better option. Is this something you have heard of ?
 
For my own patients, if they are young and still want children, we do the clomid trial. I don't mess with HCG for the most part. (I am a urologist)



I went on TRT when I was 34, and have no kids, but wanted/needed it any way and came to terms with possible long term fertility issues.



Once you're already on TRT, changing to a different doc shouldn't be a big deal since you're already on and they should KNOW you are already shut down. If they don't, find a different doc.



If I have guys transfer to me who are already on TRT, I simply refill what they have, check labs in 4-6 weeks, and adjust from there.



Aromatase inhibitor is very individual. Most don't need them at TRT dosages. But find a doc that checks estradiol. It's part of good management.



Legitimate question. What is your basis of no hcg if patient is young and would like to have kids at some point?

Wouldn't it make sense to keep your Sertoli cells functioning with hcg and have a decent sperm count than an abismal one? So that it decreases the chances of infertility rather than just coming to terms with it ?


Sent from my iPhone using Tapatalk
 
Heard another doc say test cyp is not a good choice since it's only 60% pure. That enthenate is a better option. Is this something you have heard of ?

I think he is just referring to the fact that the cypionate ester is a bit heavier than the enanthate and because of that it will be a larger proportion of the weight. The difference is pretty small though, and the cyp ester lasts a bit longer. Most use cyp in the US. I think enanthate is more European for some reason. I don't know why that is. Cyp is great.
 
You look fairly lean now and you have accomplished a lot. Once you get your testosterone in a normal range for you age you will be able to more easily fill out your frame. Congrats on loosing the 60 + pounds! Your lower abdomen looks like it just has extra skin right now and hopefully that will tighten up some. I don't see any stretch marks and that is great. You must have fairly strong skin and that's a good thing.

Oh, you are lean enough. I don't think youll need any antiestrogen if you use a true TRT dose administered by a doctor. Ive been on TRT now for about 8 years and haven't used any. I don't have any issues with estrogen.
 
Last edited:
Hey guys,


I know this is for life but some concerns are after starting TRT for a while, what if I decide to move or my prescribing Doc closes up and a new Doc doesn't want to prescribe me injections, what am I to do?
Do I need to take any anti estrogen while on it?

Once you have a prescription, it should not be difficult to find a doctor who is willing to continue your TRT if you move. You may need to visit more than one doctor before you find one you're happy with, but this is true for everyone, not just people on TRT.

No one can tell you whether or not you'll need an anti-estrogen with 100% certainty. The only way to know for sure is to get bloodwork and see where your estradiol is at a given dose of testosterone. Ideally you want to find the "sweet spot" for your testosterone dose where you get the benefits of treatment but don't need an AI. This sweet spot differs from person to person, and can even change over time. For example, I had more estrogen related issues when I was at a higher bodyfat percentage. Since dropping bf, I can tolerate more testosterone without an AI.
 
Legitimate question. What is your basis of no hcg if patient is young and would like to have kids at some point?

Wouldn't it make sense to keep your Sertoli cells functioning with hcg and have a decent sperm count than an abismal one? So that it decreases the chances of infertility rather than just coming to terms with it ?


Sent from my iPhone using Tapatalk

Clomid will do a great job at getting both LH and FSH going in MOST cases. HCG is 3 injections per week and many don't wanna mess with that. I also think there is probably a bit of a roller coaster effect hormonally with spiking HCG 3 times per week, but that's anecdotal on my part I admit.

If it's a FERTILITY thing, then they will see the urologist who is specialized in male infertility.

If it's for TRT and they just wanna feel better, but try and prevent shutdown, then I'll do clomid.

Something of note, guys on the clomid don't tend to FEEL as well as guys on testo, even when their levels are high normal. I counsel them on this as well.
 
Heard another doc say test cyp is not a good choice since it's only 60% pure. That enthenate is a better option. Is this something you have heard of ?

I haven't. And the ester weight of both is fairly similar I believe. So I don't see the benefit of doing one over the other, aside from convenience/availability in a region.

Enanthate isn't a popular Rx given here.

Also, test IS test, regardless of what people say. Get the levels where you need them, the estradiol where it needs to be, and go from there.
 
For my own patients, if they are young and still want children, we do the clomid trial. I don't mess with HCG for the most part. (I am a urologist)

I went on TRT when I was 34, and have no kids, but wanted/needed it any way and came to terms with possible long term fertility issues.

Once you're already on TRT, changing to a different doc shouldn't be a big deal since you're already on and they should KNOW you are already shut down. If they don't, find a different doc.

If I have guys transfer to me who are already on TRT, I simply refill what they have, check labs in 4-6 weeks, and adjust from there.

Aromatase inhibitor is very individual. Most don't need them at TRT dosages. But find a doc that checks estradiol. It's part of good management.

Outstanding response, thank you you for this Doc.

You look fairly lean now and you have accomplished a lot. Once you get your testosterone in a normal range for you age you will be able to more easily fill out your frame. Congrats on loosing the 60 + pounds! Your lower abdomen looks like it just has extra skin right now and hopefully that will tighten up some. I don't see any stretch marks and that is great. You must have fairly strong skin and that's a good thing.

Oh, you are lean enough. I don't think youll need any antiestrogen if you use a true TRT dose administered by a doctor. Ive been on TRT now for about 8 years and haven't used any. I don't have any issues with estrogen.

This was one of the main reasons which triggered me to get tested. In a previous thread, I was looking at going on AAS because I was fed up not being able to put on muscle and lose the last bit of fat. I kept reading about getting my levels tested first and glad I did now.

I am not sure how much of it is loose skin. I can still pinch a fairly thick amount which I believe is fat. However, when I sit or lean forward, it does hang significantly. I always thought loose skin was an issue for people who lost 100+ lbs. I was losing a steady 2-2.5lbs in the beginning to prevent the skin. How long should it take to tighten up before having to correct it with surgery?


Thanks to everyone else for their input.
 

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