Best/Safest Way to Enhance/Supplement my TRT

Hi,

This is my first post, so please be gentle (and if it’s in the wrong place please forgive me and move it to where it’s supposed to be), and please excuse the length of the post, but I want to get as much relevant information in as possible to help with your advice, so I’ve been very thorough and candid with some of my last health issues.

For a bit (actually a lot) of background I’m currently 43, 6"1 and ~103-105kg depending on the day. I used to be a garage (quite literally own a power rack in my garage) powerlifter. Whilst natural my PB (single rep max) for most of the major lifts were 190kg bench press (flat), 130kg seated shoulder press, 260kg back squat and 230kg deadlift. Mind you I would only train 3 days a week and would only do 4 movements per day, primarily compound movements, with some isolated movements when I would plateau (e.g. skull crushers if my bench would stall due to my triceps being the weakest link, etc.). My diet has always been so-so, good food, but I never watched my “macros”, but I’ve always leaned towards savoury, meats/vegetables, and fats over sweet, grains/fruits and carbs, so I’ve never been particularly lean or particularly overweight (although I would never be considered overweight, I’m sorry to say I never really was into measuring body fat percentages, but at a guess maybe 15-18% BF??), and at the time my weight would ordinarily hover around 115kg.

With respect to any previous cycles, I had done only three in my mid-30’s consisting of:

First Cycle:
50mg Test Prop ED
50mg Mast Prop ED
All your usual supplements for liver, cholesterol and blood pressure support. With a PCT comprising two vials of HCG starting the two weeks from the end of the cycle and ending two weeks into the Clomid run (split into roughly equal doses EOD, so roughly 1000iu every 3rd day), which itself comprised 20mg Clomid ED for 4 weeks. The reason for the lower Clomid doses is that at the time all the scientific literature was showing that 12.5mg daily was sufficient to restore testicular function for men with hypogonadism, so I went with the pharms I could grab with the closest dosages and went with that. Well I guessed that either worked, or I was lucky. As before I started the cycle I was ~100kg and finished the cycle (post-PCT) at ~108kg, and lost no strength whatsoever (although my reps on the heavier lifts did drop from like 5-6, to 3-4 depending on the lift) and only 2kg of body weight.

My bloodwork for free testosterone prior to the first cycle was ~1100pmol/L, and post cycle was ~900pmol/L. Although I don’t remember the figures exactly as it’s been a few years now, but I do recall that my total test wasn’t particularly great, but I have unusually low SHBG levels which gave me better than usual free testosterone levels. As far as E2 is concerned, my doctor’s have never tested for E2 (even now even though I have an endocrinologist, I’ll explain why below, must be an Australian thing???), maybe because I don’t hold water and wasn’t complaining about sex drive or erectile issues (which wasn’t a problem), in fact just using a little too high an amount of a DHT based compound is enough for my joints to get creaky, and for my energy levels to crash.

As for my second cycle it was almost exactly as the first, except I added another 50mg Trest Ace ED (all support supplements and PCT were the same). And the third cycle I just swapped out the 50mg Trest Ace ED for 50mg Tren Ace ED. All in all, I had similar bloodwork results throughout (not exactly, but very similar), with my lipids just taking a bit of a hit on the Tren cycle. As for side effects, I can genuinely say that apart from sweating profusely on the last two cycles, and a bit of insomnia and aerobic fitness taking a slight hit on the Tren cycle that it appears that I tolerate some of the hardest AAS’s quite well (like no acne, no hair loss, no explosive tempers, or emotional swings). All in all, I finished the two year run (obviously split up as three seperate cycles) at 115kg and perhaps ~12-15% BF. Needless to say all my lifts improved on average by about 20-40kg depending on the lift.

Fast forward to roughly 5 years later, a week before my 40th birthday I was diagnosed with pericarditis (this was several years after having not used any PED’s whatsoever), which became chronic and finally resulting in surgery where I now have a permanent “window” in my pericardium and pleural sacks (the fluid also spread into my lung sack collapsing both my lungs). However, about a year prior to this I also severely injured my back quite severely (not related to lifting, but a combination of wear-and-tear combined with a hefty compression incident) and I’m now permanently on pain relief medication for the rest of my life (primarily Oxycodone and OTC NSAIDs with flare-ups as I have two ruined discs and with deformed vertebrae which has caused sciatica and severe osteoarthritis in my lower back and neck) as surgery is not considered useful according to two seperate neuro-surgeons. And because of the 5 months of chronic pericarditis and the severe pain it can cause (it is not wholly seperate from the feeling of having a heart attack, except it’s almost constant), I’ve been told that phantom pains are also likely to continue for the rest of my life, so I may genuinely misinterpret a heart attack for my phantom pericarditis pain! Now, if that wasn’t bad enough, I was somehow diagnosed with Type 2 diabetes (never been overweight, never had a sweet tooth, and have no family history) about 2 months after my surgery, followed by being told that my testosterone levels practically no longer exists (cleary an exaggeration, but you get the point), even then, the way the system works here in Aus, I had to have 3 consecutive low results tested every 6 months before I could be approved for TRT (so I had to endure 1.5 years of extremely low testosterone levels before I started receiving my TRT), and let me tell you from someone who always had naturally high test levels, it was my own personal hell. My libido went from being on the higher end for most guys, to non-existent, my motivation cratered to the point where I ended up losing my job where I had built a successful 12 year career at, my house went to shambles (I’m not married so I live alone), and I pretty much stopped leaving my house and I would be considered a pretty outgoing person prior (even more so considering that prior to testosterone issues I was happily opiated most days which usually puts me in a very social mood). And about 9 months later I was hospitalised and put into the ICU after having two consecutive major strokes (which to this day they haven’t given me a cause for, and also initially diagnosed me with epilepsy which was later found to be postural hypotension as I had a string of fainting episodes and they put it down to seizures, and their medication made it worse!) and wasn’t found for several days after my father tried contacting me for a few days straight (when he found me I was apparently conscious, lights were on, but nobody was home kind of conscious, but I don’t recall anything between my last memory of Wednesday afternoon and waking up in the ICU on that Saturday morning). And to top it all off, in the middle of it all I lost my mother to COVID. And all of that within a 3 year period starting a week before my 40th birthday (happy birthday!!).

Ok, all that out of the way, I’m now prescribed 50mg per day of testogel (transdermal testosterone), and although my initial misgivings on the dose, my bloodwork is actually quite good, with my free testosterone sitting somewhere between ~950-1200pmol/L. Again my total testosterone is nothing to write home about, but because of my consistently lower than normal SHBG levels, my free test tends to soar! And free test (usable testosterone) is what it’s all about I guess?? And no, my Endocrinologist still doesn’t test for my E2 (although I insisted on it for my next biannual follow-up). And as I have no issues with needles, my diabetes has been controlled with 12iu (30% instant release and 70% slow release formula) immediately before dinner, and 0.5mg of ozempic.

Now through all that, I did not much lifting (in fact none at all at times) and, as such, my weight dropped back down to 98kg. I started lifting again about 2 months ago and my current strength levels are (I have not tested my single rep max as I’m quite literally 2 months back into lifting) 130kg bench press (flat) for 4 reps, 100kg seated shoulder press for 4 reps, 160kg back squat for 6-8 reps (this is highly dependent on how well my pain meds are working on the particular day of lifting), and 180kg deadlift 4-6 reps (pain status as above). As for my current bodyweight, I’m sitting at about 103-105kg.

Now, I was thinking about doing a blast on my TRT, and I have access to almost all chems of decent quality (including cheque drops for crying out loud), some of which are less dubious than others, but I was thinking considering I’m on 350mg of transdermal testosterone a week (which I think usually gives you about 30% equivalent IM dose due to the method of application), so roughly 100mg of testosterone a week. So for the blast, I would procure some injectable test, boost it up to 200mg/week and add either 200mg/week of primobolan, and 50mg Anavar ED (total of 750mg of AAS per week, which given my past tolerance I think should be fine). Alternatively, I could swap out the primobolan for trestolone also at 200mg/week (as I loved the way I felt on the previous trestolone cycle, I was almost euphoric). I don’t compete in any way, and would just like to increase my strength primarily (size is not a goal of mine, but with the insulin for my diabetes, it’s probably likely, and honestly I wouldn’t shirk from it either), but would also like to shed some BF as well (I’m currently back around 15-18%, and see-saw a bit), but I’m guessing my ozempic should cover that side of things, especially once I start lifting a bit more seriously (the last 2 months have been an easing back in kinda lifting). I’d also be reusing my cycle supplement regime and PCT from previous cycles as it seemed to work perfectly last time.

Now, I also need to clarify my current health situation at this point. I see a Cardiologist twice a year, as well as an Endocrinologist and a pain specialist also twice a year, not to mention my monthly GP visits for my pain and other medications. And apart from my diabetes (which thankfully was caught early and is under control with no associated heart, kidney, etc. issues) and testosterone (which may be coming back ok as I ran out of my testogel a month early prior to my last visit, and somehow my free testosterone levels were still great when tested after a month of no TRT, make of that what you will??). So all in all I’m back in relatively good health. My heart is fine and in fact having smoked for the best part of 20 years, it’s in far better shape than it should be, as my cardiologist put it, it’s in no worse shape than an ordinary 40 something year old (I no longer smoke), as well as my lungs. My cholesterol is on the higher side, but within normal parameters (it’s controlled simply with diet), one of my liver enzymes is slightly high (can’t remember exactly which one), but my doctors are not concerned and have put it down to my medications, and kidneys have very slight damage (due to me initially being a bit careless with my insulin and going into ketoacidosis a few times, but I check for that too now, not just glucose), but there’s been no change since the first 6 months of my diagnosis. I should also make it clear, that none of my doctor’s believe that my previous AAS use had anything to do with my health issues, as I was honest with all of them all of the time (including discussing using illicit/party drugs all throughout my 20’s, which they also suggested had nothing to do with my strong of health issues) especially when you’re about to have emergency surgery so that I would avoid cardiac arrest due to the severity of my pericarditis!

So, would any of you suggest a different protocol for my blast? Would you prefer primobolan over trestolone (I really like the way trestolone makes me feel, and I think I may as well enjoy the cycle to it’s fullest, and with no bodybuilding goals in mind, I’m leaning towards it)? Would anyone suggest dosage changes? Or changes to my PCT? Or should I just be greatful I’m still alive and leave well enough alone.

Ok

First of all, with your medical history you shouldn’t fucking touch something like trestolone ever again

Everyone is going to tell you to fuck right off with the idea of another blast after two strokes and pericarditis… even though plausibly not related to the gear use life dealt you an unlucky hand and now you can either deal with the cards you’ve been dealt or say “fuck it I don’t care, but this might kill me in five years”

And if it’s the latter trestolone will kill you way sooner than primo would.

Deadlifting 180kg for 6 with two disks that are far beyond gone… what about when you wind up with degenerative disk disease so bad it’s essentially disk on disk/bone on bone?

Anyway, I kind of get it… old habits die hard, I still lift weights when I probably shouldn’t

Are you on Targin or OxyContin? Or just endone? What’s the name of your pain specialist… joking… sort of… I just came off pain medication (also Australian) because I felt I didn’t want to be on it anymore with the way we have cracked down on pain meds it’s just not worth the hassle of seeing my doctor every 2-4 weeks for a new script and still being treated as if I could turn into a junkie at any moment. It might be that I’m young as when you are in your 20s even if you have chronic pain the docs can’t help but think “what does this look like long term? A man in his 20s is prime drug using demographic and probably most likely to get addicted” etc. I wasn’t happy with the way doctors scrutinized me for being on them even though I have a genetic condition that absolutely warrants their use.

But my mother who has cancer was even given shit when she asked for pain meds to treat chemo related pain which is INSANE…

You shouldn’t be taking anything on top of the androgel, but you wouldn’t be the first to take PEDs post heart attack or stroke. Know that you are likely digging yourself a vastly premature grave

If you are ok with that by all means go ahead. AAS alter haematological parameters and clotting factors acutely in manners that are pro thrombotic… more likely to blow a clot…

They also induce cardiac dysautonomia, bind to androgen receptors in cardiac myocytes and signal the heart to grow (disproportionate growth in left ventricle), cause dysfunction of your RAAS, many variables that are risky for someone who has already had two strokes and has had open heart surgery.

If you are well aware of the risks sure… go for it… but don’t be asking for advice online because anyone who tells you “sure, take XYZ” is somewhat complicit regarding your eventual demise here

Btw I personally found tapentadol was better than oxycodone for pain… less sedation/incapacitation. Just food for thought… it’s an opiate but less binding affinity for MU opiate receptor relative to morphine so on paper less addictive but probably not the case but also acts as an SNRI so it’s like tramadol but not dependent on cyp2d6 to metabolize into active metabolite

Great drug. Like tramadol on steroids, there is a ceiling dose but that ceiling dose is equitable to a morphine equivalent dose of literally 180mg/day vs tramadol ceiling of 40mg mme/say and if you are even close to that or even over like 60mg mme/day you probably shouldn’t be powerlifting (anything that aggravates the back)

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Hi Unreal,

Thank you for your candid response and thank you for not holding back.

Regarding my back, I had been complaining for almost 20 years about my back pain starting in my early 20’s, and every doctor in would speak to kept telling me I was too young to have back problems, fast forward to 39yo and a GP finally gave me a referral to get an MRI showing damage to my C6-C7 disc, and L2-L3 (these vertebrae have been mashed together so badly, no disc can be seen on the MRI and the vertebrae are mushroomed from being so badly compressed). I also have various degrees of damage and dessication to the discs above and below both areas and was diagnosed with degenerative disc disease. This was then followed up by a nuclear bone scan which showed severe osteoarthritis in my lumber spine and moderate to severe osteoarthritis in my cervical spine. And if that wasn’t bad enough, and to rub salt in to the wound, I was told that had someone taken my complaints about my back more seriously much earlier, I could’ve mitigated the damage. But that said, my back feels much better when lifting, then when not. I’ve had the conversation with my neuro-surgeon, and although they never (and would never) endorsed further heavy lifting (although they did endorse light lifting as strong supportive muscles around the spine can elevate the pain), they did indicate that provided I perform the lifting with correct form and avoid any movements that cause direct pain, that it should be ok (and I’ve taken this advice seriously and if any pain is felt during a lift, I’ll either abort the lift immediately and lighten the load, or in some cases I’ve had to drop entire movements from my lifting program). As for the pain meds, I’m on OxyContin and endones for breakthrough pain, and you are absolutely right about being treated like a junky, even at +40 years of age, and I certainly don’t present as one either (I actually have a professional career and have almost always been gainfully employed, so I’m not emaciated, dirty, I have good personal hygiene, etc.). But because surgery is not considered feasible in my case, my pain specialist is adamant that I will have to be on my pain meds likely for the rest of my life (although they take it down to a point where you still feel the pain, but it’s tolerable, no pain in their books means your dose is too high! I’m not sure what the logic behind that thinking comes from, but it almost certainly comes from someone who doesn’t suffer from chronic). And some doctors are absolutely callous with respect to the way they treat chronic pain patinets, as they almost always believe you’re exaggerating the amount of pain you’re in (unless they can clearly see it on a scan of some kind, even though they fully admit that people can experience severe pain without presenting with anything that can be seen on a scan), or they’re always quick to point out how there are so many people in worse pain than you, as if that somehow diminishes the amount of pain I’m in. Or as in my case, I was told that I just need to learn to live with the pain by one specialist, only to be told a few minutes later the horrific statistic regarding chronic pain patients and suicide rates, so apparently I should just deal with it, until I no longer can and then just off myself??? And as I’ve been in chronic pain for roughly 20 years now (with only being “treated” for the last 3 years, if being told there’s nothing to be done, here’s some pills and see you after your yearly MRI to check the progression of the degeneration is being treated), it just simply wears you down. My dose has also been heavily reduced from my initial dosages, but when an Australian doctor of any kind tells you that you will require any type of opioid medication long-term, than you can be certain that it is a total understatement (here in Aus unless you have cancer, or post-op, you will almost certainly get nothing stronger than codeine, or tramadol), which is also why I have to get government approval every six months, which requires me to see the pain specialist at least twice a year, and as you stated is a total hassle having to see your GP every 2 week in my case, to get your fortnightly scripts (and don’t get me started on every pain specialists favourite drug to push, Lyrica, not only is infinitesimally more dangerous to detox from, it does nothing for the pain and makes you a walking zombie). And if for whatever reason you need to go to another pharmacy to get your medication (e.g. on holidays), get ready for the lectures and why you should be searching for alternatives (as if that never crossed my, or my doctor’s minds). That is also considered a no-no here too, opioids when prescribed regularly should be sourced from the same pharmacy each time, with it only being looked past if only done occasionally. As for the tapendatol, I have tried it, but the OxyContin works best for me, the tapendatol gives me brain fog (no where near the amount Lyrica does), and that’s something I can’t have when doing my job. I find that Oxycodone not only doesn’t sedate me at all, but has a slight stimulant effect on me (don’t ask me why, as I don’t know and the doctors can’t explain it either), and both my GP and pain specialist are happy with that approach. Sorry that was a bit off topic, but chronic pain has been a dark cloud over my life for more than half of it now, and it’s something that doctors are extremely reticent to treat or take seriously (acute pain is very different), so I can get a bit worked up about it.

Also, sorry I should’ve been clearer about my ICU visit regarding the strokes as I did write it (actually quite emphatically for some reason, it was late I guess and my brain wasn’t working at full speed) in a way that indicated that I was hospitalised due to the strokes.(I think I may have even said that for some reason??), and that wasn’t the case. I was actually hospitalised for severe hypoglycemia (as in dipping in and out of consciousness and not knowing my own name when conscious, not that I remembered any of it) and the strokes were found during the visit after a brain MRI was undertaken by the neurology department after they suspected I had epilepsy (a very wrong diagnosis that lead to me losing my last job as that just stack another CNS depressant on top of the Oxycodone, pregabalin, baclofen and occasional valium for my chronic insomnia), the only things the doctors could tell me with any real certainty was that they were old (they clearly couldn’t tell me when they occured exactly, and that they were likely caused by hemorrhaging of aneurysms, as my mother had the same thing happen and it can be hereditary, but I have since been cleared of any further aneurysms). I know that doesn’t change the fact that I still had two major strokes at some point in my life without ever having symptoms of, or any obvious mental or physical deficits, which is why we couldn’t pinpoint when they may have occurred (I even asked friends and family if there were any times that I had shown signs of having had a stroke, and no one could point to a time in my life when they could point to and say there was something clearly wrong with me, which would then suggest to me that I had them when I was very young, perhaps as an infant or toddler).

That said, I’m not going into this (perhaps not at all after giving your post some genuine consideration) without looking at every angle I can from my end, my heart is not enlarged (I’ve had about 10 echo’s, and two cardiac MRIs, countless ECGs and CT scans), I’ve had about 6 brain MRIs to make sure that the hemorrhaging isn’t still active, and to confirm the diagnosis of them being quite old. I also regularly check for cholesterol and hematocrit (as well as glucose and for ketoacidosis) which can be done with the one expensive blood glucose meter that I purchased. I also take blood pressure readings everyday and it’s always very good (usually 105 -120 over 65 - 85, even when on previous.cycles my BP never exceeded 140 over 90 and even that would immediately drop down within several minutes of resting before retaking the measurement), But I take your point, I am at a higher risk of having another stroke by virtue of already having had two.

I am totally aware of the risks, and I understand why people would be reticent to provide advice which they perceive may lead to me having another stroke. And given that my free testosterone levels are consistently high simply using the transdermal testosterone (I initially thought about simply adding 25-50mg ED of proviron, but having naturally lower levels of SHBG, and this being provirons primary mode of action (binding to SHBG to free up testosterone), perhaps I should leave well enough alone, or at worst adding a low dose of Anavar (say 25mg ED). But after reading your post, I’m leaning towards not going ahead with anything except my TRT. With the levels of free testosterone I currently have, and having previously lifted what I had, with some patience, and not pushing too hard too quickly, I should be able to reach my modest goals (I’m certainly going to stick to no more than 200kg for the squats and deadlifts to not put further undue pressure on my back), sticking with my current TRT dose and my 12iu of insulin (again this is a 30% instant release and 70% slow release formula) in the evening before dinner as instructed by my Endocrinologist.

Thanks for the advice and for not pulling any punches (without being rude about it). It’s what I needed to hear. Now I need to decide whether I keep up as is and simply be patient as my free testosterone levels alone should be enough to achieve my goals, or run the risk and supplement with a small amount of one the safer steroids I can use (and honestly I’m leaning towards not supplementing at all, especially if I’m going to use such a small dose anyway, and although I’m sure it will make some difference, is that difference worth the risk to my health? Almost definitely not).

Thanks Unreal for the talking to I needed. If I do proceed with the Anavar (which at this point is unlikely), I will discuss this with my Endocrinologist, Cardiologist and Neurologist first. I have always been honest with my doctor’s, and I don’t want to change that now considering the risk I would be taking.

Cheers brother.

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Tldr.

best way to enhance ? add tren 150mg of course :joy: NOT THE SAFEST THOUGH LMAOOO. I been on like a 150mg for over 2 years though alongside 150mg eq, bloods good.

edit: I should add I was on a gram of tren E for over 6 months and around 500mg for over a year. bloods good! will post them if anyone wants.

I’d rather see photos of the physique after all that time on tren than bloods.

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Nothing special honestly (not a bodybuilder just a gym rat/roid junkie), I sit at around 220 lean at 6’. (the above photos are all from cruising at 150/150 tren/eq, back when I was on a gram I was 240ish, not sustainable though for me.)

I keep tren mostly for the mental boost, nothing replaces insulin in terms of sheer mass IMO.

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