TRT for beginners | What I wish I knew before getting on TRT

Diogenes of Sinope

Banned
Banned
Joined
Aug 22, 2018
Messages
10,198
Reaction score
14,068
Ive decided to make this post to answer many of the questions Ive seen on a plethora of outlets regarding TRT. To give background, I have been on TRT since 2018. Why? I compromised my HPTA by taking Anabolics, mainly prohormones and test since age 19. Since then I had been off everything for years at the age of 25 and had gotten multiple panels of bloodwork done over the course of a year with my testosterone and estrogen always being clinically low.

I want to use this test to answer frequently asked questions regarding TRT, as well as give some advice for those who are actually considering starting



1) How do you know you need TRT?

Everyones low T symptoms are different. Some experience loss of libido, loss of energy, depression, anxiety, constant Delayed Onset Muscle soreness, lack of sleep, and the list goes on

for me personally my symptoms were: depression, extreme fatigue and weakness, anxiety in the form of OCD and constant worrying, unable to stay asleep waking multiple times per night, loss of libido.

although these symptoms are generally byproducts of low testosterone, there is only 1 way to know if you are clinically low and that is via bloodwork.



2) What blood tests do I need to get?

I often see people go in to get insufficient bloodwork done, relying on a basic Total testosterone test or serum testosterone level test. This is virtually useless. there are many factors that influence each other in the hormonal system. I will detail the list of recommended BASE bloodwork, Ill also add "nice to have" tests that could be helpful to know as well. Ill then detail why they are important

What blood tests you need:
Total Testosterone
Free Testosterone (Dialysis)
Sensitive or Ultrasensitive Estradiol
Sex Hormone binding Globulin

Nice to Include:
DHEA
Thyroid Panel
IGF-1
CBC and CMP


Now Ill go into why each of these panels are important

Total Testosterone - This is the total amount of testosterone in your system. only a small percentage of this number is actually distributed to your tissue and used. Around 2-3%

Free Testosterone (Dialysis) - This is the 2-3% of testosterone that is used by your body, taken from your total testosterone. It is the more important number, although it cant be the sole indicator of your testosterone levels, and Ill explain why shortly

Sensitive or Ultrasensitive Estradiol - This is the estrogen that is converted from your total testosterone via a process called "aromatization" Ideally whatever your total testosterone is, 5% of that is converted to estradiol. keep this 5% number in mind, regardless of whatever you total test is, your estradiol should scale. it is unhealthy to have high total T numbers while suppressing estrogen, they should rise in unison

Sex Hormone binding Globulin. - these are the transmitters that deliver testosterone from your total reservoir number to the tissues in your body. SHBG is an extremely important number to monitor. If your SHBG is too low, your total testosterone will be crushed into the ground and your free testosterone and estrogen will be artificially increased, yet you will feel awful. why? because you have so much SHBG that it is binding to all of your testosterone and you are secreting it before you can use it.



3) Can I raise my levels naturally?

Most testosterone boosting supplements barely move the marker, and if they do it is only a trivial amount.
There are pharmaceutical methods to raise testosterone, although they are not long term solutions.. Once discontinuing, your testosterone levels will most likely return to baseline.

If your are active and healthy, yet your testosterone is low, there could be an underlying issue. However if you are sedentary, unhealthy, drink often, and dont sleep much. You should correct these issues, then get comparative bloodwork before resorting to TRT (obviously).

If you do decide to attempt to boost your levels using supplements, these are the only ones I reccommend:

Clomiphene (Prescription only and not long term solution), Boron, Ashwaganda, Vitamin D3 with K2, Magnesium, Zinc, 20-Hydroxyecdysone, Turkesterone, Ginger, Tumeric/Curcumin, Mucuna Pruriens, Krill Oil

Regardless I highly doubt these supplements will make anything more than a trivial difference, but everyone is different so it may be worth giving it a shot before resorting to TRT
 
Last edited:
Ive decided to make this post to answer many of the questions Ive seen on a plethora of outlets regarding TRT...

Ah the rare spotting of a sensible sherdog post on the topic of PED's, how refreshing.

I may place a slight bit more value on Total T levels than you do, but that is simply an opinion largely driven by personal circumstance. Other than that I don't see any points of contention, well done, great starting point for newbies and good contribution to the board.
 
Ah the rare spotting of a sensible sherdog post on the topic of PED's, how refreshing.

I may place a slight bit more value on Total T levels than you do, but that is simply an opinion largely driven by personal circumstance. Other than that I don't see any points of contention, well done, great starting point for newbies and good contribution to the board.
Total T definitely has its importance, although I think SHBG is an extremely important factor to consider when looking at both total and free. Once you have an understanding of what your SHBG is, then you can start diving down into what type of protocol is best for you. For example, before TRT I had a relatively high-normal total testosterone, and skyhigh SHBG. I felt awful, since my free test was. In the single digits.

While people with low SHBG have the opposite effect, skyhigh free testosterone and crushed total test.

On second thought, you’re right. All three of them are of equal importance, also including estradiol
 
Last edited:
can you try EPO and do a review for that too !?


whats the difference in day to day activities and then difference when training etc ..

I asked TJ if he could get me some but he blocked me on social media

<Fedor23>
 
I was speaking to a guy I train with, he reckons once your natural T level is gone, most people around 35-45, run 1ml a week for the rest of your life. He reckons it will give you better health, long term
 
I was speaking to a guy I train with, he reckons once your natural T level is gone, most people around 35-45, run 1ml a week for the rest of your life. He reckons it will give you better health, long term

Sorry but this is another comment of yours today that makes no sense. The OP seemed to be trying to start a thread based on factual and common sense information with the intent of clearing up some confusion and misinformation. If you are unable to run along with that theme than perhaps it's better if you don't post.

"some guy reckons" and "run 1 ml a week" don't add any useful info here. Sayin 1ml is as ambiguous as describing your diet as 14 pieces of food a day.

Posting some questions seems like a better idea, that way someone new won't come here then read and assume the "facts" you are posting to be correct.
 
Sorry but this is another comment of yours today that makes no sense. The OP seemed to be trying to start a thread based on factual and common sense information with the intent of clearing up some confusion and misinformation. If you are unable to run along with that theme than perhaps it's better if you don't post.

"some guy reckons" and "run 1 ml a week" don't add any useful info here. Sayin 1ml is as ambiguous as describing your diet as 14 pieces of food a day.

Posting some questions seems like a better idea, that way someone new won't come here then read and assume the "facts" you are posting to be correct.
I was commenting on what someone said, not stating a fact.

I guess you are having issues down there, sorry bud. Good luck, don't stress too much
 
I was commenting on what someone said, not stating a fact.

I guess you are having issues down there, sorry bud. Good luck, don't stress too much

I put "facts" in quotes bud, that's to indicate how someone may perceive what you wrote not that you stated it was a fact.

I have no issues other than what I've stated here, to be more blunt your posts are not helpful to the intent of the thread and could be harmful to it. Down there? Weird comment

I'm not stressed, maybe you are sensitive?
 
A lot of dudes think they need absolutely tanked testosterone levels to justify being on TRT. What would you guys say would be a good number to consider getting TRT given that you're living a healthy life style prior to. I felt like dogshit when my test was at low 500s.
 
I don't know about actually elevating testosterone,but when I started taking zinc it made me significantly more horny
 
I don't know about actually elevating testosterone,but when I started taking zinc it made me significantly more horny
Taking zinc all the time is a bad idea though. I heard that it will throw off your copper and iron if you supplement it every day for months and months
 
A lot of dudes think they need absolutely tanked testosterone levels to justify being on TRT. What would you guys say would be a good number to consider getting TRT given that you're living a healthy life style prior to. I felt like dogshit when my test was at low 500s.
I've never taken anything and notice a natural ebb and flow to how I feel. I say it all the time, but practicing aip has made such a huge difference in how I feel. I noticed a difference right away in my confidence and ability to attract women once I started the diet.

I'm convinced that most of the food widely available is garbage designed to screw us up.
 
Taking zinc all the time is a bad idea though. I heard that it will throw off your copper and iron if you supplement it every day for months and months
I'm not taking it anymore, I just took it for a little while when I was taking zma supplements. Now I just take magnesium only and eat more foods that are high in zinc
 
A lot of dudes think they need absolutely tanked testosterone levels to justify being on TRT. What would you guys say would be a good number to consider getting TRT given that you're living a healthy life style prior to. I felt like dogshit when my test was at low 500s.

IMO the numbers should not be the deciding factor here, commencing treatment should be based on symptoms, IOW how you feel. Not to disregard the numbers totally however, it's a combination of both.

Feel great? Carry on as you are, who cares about the numbers.
Feel like shit or have indicative symptoms? Investigate fully which would include checking hormones.
Solid numbers but still feel like shit? Need more investigation, problems may be unrelated to hormones. If you are above say 700 and still have issues chances are high that it's not hormone related.

I know guys with very low numbers that could get on TRT if they wished (300 ish) but look and perform at a high level and feel great. No reason to mess with something that working. I'm sure most of us know guys that are juiced out of their minds who look and perform miserably, probably don't feel great either.

It might take you or any individual what we'd consider a very high dose and plasma level (1000?) to just feel normal. All very individual.
 
IMO the numbers should not be the deciding factor here, commencing treatment should be based on symptoms, IOW how you feel. Not to disregard the numbers totally however, it's a combination of both.

Feel great? Carry on as you are, who cares about the numbers.
Feel like shit or have indicative symptoms? Investigate fully which would include checking hormones.
Solid numbers but still feel like shit? Need more investigation, problems may be unrelated to hormones. If you are above say 700 and still have issues chances are high that it's not hormone related.

I know guys with very low numbers that could get on TRT if they wished (300 ish) but look and perform at a high level and feel great. No reason to mess with something that working. I'm sure most of us know guys that are juiced out of their minds who look and perform miserably, probably don't feel great either.

It might take you or any individual what we'd consider a very high dose and plasma level (1000?) to just feel normal. All very individual.
Like ts mentioned, it's not just total t. Shbg is the other big factor.
 
I've never taken anything and notice a natural ebb and flow to how I feel. I say it all the time, but practicing aip has made such a huge difference in how I feel. I noticed a difference right away in my confidence and ability to attract women once I started the diet.

I'm convinced that most of the food widely available is garbage designed to screw us up.
Shit ton of food we purchase here in the U.S doesn't even qualify to be sold for human consumption in the EU.
 
Like ts mentioned, it's not just total t. Shbg is the other big factor.
Of course that is true but it does not change anything I said, the overall point being to treat symptoms rather than blindly chase numbers (of any of the hormones).
Manipulating SHBG and free T is often tough to do and measure depending on what practitioners and labs you have access to. Total T is always king the others we discuss in this realm will follow.

Edit - Keeping with the spirit of the OP of informing those new to the subject matter let's remember that the thread was started as a sort of FAQ. With that in mind I'm sure he would agree that this info is actually very basic, their are at least another half dozen hormones to consider and multiple other factors as well in a comprehensive program.
 
Last edited:
A lot of dudes think they need absolutely tanked testosterone levels to justify being on TRT. What would you guys say would be a good number to consider getting TRT given that you're living a healthy life style prior to. I felt like dogshit when my test was at low 500s.
Like I said, total testosterone levels arent the only indicator. You need to look at the free testosterone reading, total testosterone reading, SHBG and estradiol. If your total and free testosterone or slightly above the middle of the range, and your estradiol is 5% of your total then I would say Youre in an ideal scenario. If it’s slightly lower then I still wouldn’t worry; you could potentially get it up naturally. Your total testosterone was 500 ng/dL, but what was your free testosterone ? What was your estradiol? And your shbg; which is the factor that dictates the ratio between all of these things.

You can have a high total testosterone, but if your SHBG is driving down your free testosterone and estradiol, then that means absolutely nothing and you will feel awful much like myself before I got on TRT
 
Last edited:
Like ts mentioned, it's not just total t. Shbg is the other big factor.
IMO the numbers should not be the deciding factor here, commencing treatment should be based on symptoms, IOW how you feel. Not to disregard the numbers totally however, it's a combination of both.

Feel great? Carry on as you are, who cares about the numbers.
Feel like shit or have indicative symptoms? Investigate fully which would include checking hormones.
Solid numbers but still feel like shit? Need more investigation, problems may be unrelated to hormones. If you are above say 700 and still have issues chances are high that it's not hormone related.

I know guys with very low numbers that could get on TRT if they wished (300 ish) but look and perform at a high level and feel great. No reason to mess with something that working. I'm sure most of us know guys that are juiced out of their minds who look and perform miserably, probably don't feel great either.

It might take you or any individual what we'd consider a very high dose and plasma level (1000?) to just feel normal. All very individual.


I do agree that chasing symptoms rather than numbers is a better idea, as everyone’s different and will feel better with different levels. But I think it’s ideal to sort of use this as a reference point. Some people feel better with higher estradiol and others feel better with lower but since we have no way of finding out what bloodwork best fits our symptom resolve, I feel it’s best to attempt to achieve the formula I laid out in the OP then adjust from there If symptoms havent improved.

Finally I want to add that hCG does more harm than good when it comes to symptom relief in my experience. It makes estradiol nearly impossible to control. Although it will keep your balls somewhat working. And some say that it enhances their libido. I’m not saying that it’s a bad idea to take, but in my experience many people who get off TRT have a difficult time finding symptom resolution due to HCG making it difficult for them to get “dialed in”
 
Last edited:
Some people feel better with higher estradiol and others feel better with lower but since we have no way of finding out what bloodwork best fits our symptom resolve, I feel it’s best to attempt to achieve the formula I laid out in the OP then adjust from there If symptoms havent improved.

I appreciate you wanting to show facts. The confirmation bias here is that you had your eyes on TRT from the beginning as a solution to your symptoms as do most patients who end up like that. Your comment about estradiol puts that perfectly into context. There are no certain levels or numbers in scientific research right now that would recommend synthetic testosterone intake . Its a fad in the US. There is a reason why we have next to no TRT recommendation in my country as it is seriously lacking of research and full of people just wanting a shortcut and in the US scetchy doctors wanting to make a buck.

The possible side effects are also not well researched but from what we know there can be very severe consequences. Your symptoms f.e. can lead to a number of other solutions / diagnostics / treatments without abusing synthetic testosterone and I would guess at a quite deeper level of understanding the origin of your problems then just "low testosterone". A dlinical depression f.e. will near always lead to a loss in libido but you dont cure that with testosterone. Thats like having an injured organ and only taking heavy opioids. You feel great but it doesnt cure anything and is long term harmful.

In general I do hope that people reading this thread stay very sceptical of TRT because if you are on long enough there is no going back and if you then develop an illness that makes TRT impossible to continue or the side effects get to be a problem your body will go into a downfall I guarantee you no one wants to experience. Not even mentioning you might mistreat yourself entirely and ignore annother illness. Its at first a money making machine and and an easy way out of symptoms that might otherwise take a much more serious look to uncover, understand and treat.
 
Back
Top