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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
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
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