TRT is medicine, not something to be used for whatever desired effect.
If you were feeling great, how would you feel even better?
Part of what makes getting dialed in so difficult for some, and also so fascinating, is that how do you ever really know if things could be better or worse, unless you try a different dose?
Iām a high SHBG guy that over the last two or three years has experienced increasing sleep and energy problems, difficulty adding muscle and keeping off fat, and libido/ED issues. Got a lot of blood work done over the last six months and observed normal liver and thyroid function, and fairly normal total testosterone, but high SHBG and free and loosely bound T below range. Started TRT 3.5 weeks ago at 100 per week, once weekly.
Iām going to give it 8 to 12 weeks before I touch anything but have idly wondered if and when I notice some symptom abatement, how sure will I be about how good I feel?
In other words, if I subjectively feel noticeably better than before but perhaps not as good as I could be, what do I do then? If I go from 4.5 to 8 or 8.5 on a 10 scale, do I keep trying to manipulate to push that 8/8.5 up to nine or 9.5 or 10? Or should I just be grateful that Iām feeling a lot better than I was?
Hypothetical still for me but interesting to think about
How do you know what you **might ** be able to feel like? And what kind of feelings are we talking about??
I routinely test at 700 to 900 with 100 mg per week. Iāll be 43 years old in June, have two kids, a job, and a life. So no, I do not feel good all the time or as good as when I was in my teens and 20ās. That has nothing to do with my already normal T values.
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Thatās all I mean. Itās subjective. And itās presumably benchmarked and weighted against ways youāve felt in the past.
Iām 45 with two active kids and a business so in a fairly similar life stage.
āTake how I felt lifting and eating right at 25, deduct a little feel-good for added age, deduct a little for each kid, deduct a little for work and voila thatās where I should be!ā
[chefās kiss]
Itās pretty imprecise and subjective, thatās all Iām saying. I think some combination of realistic expectations given our individual health and life circumstances, with some quantifiable androgen blood work and other health markers mixed in all gets baked into the calculus about whether to adjust your dosage.
Yes, itās subjective.
But I donāt go by that. I do not feel wiped out after exercise, could gain strength and muscle if those were my goals (they arenāt anymore), have morning erections, and donāt have any related morbidities.
Increasing oneās dose for the sake of feeling better isnāt even ethical medical practice and I wonder about some of these docs discussed who do that.
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Are you saying you were asymptomatically low-t?
By āfeeling betterā I donāt mean āimproving general sense of wellnessā I mean āreducing or eliminating sleep, mood, strength, libido, and erection symptomsā presumptively caused or contributed to by low free-t.
If youāre having one or multiple symptoms of low free t, youāre going on TRT to eliminate those symptoms i.e. feel better.
If you eliminate all the symptoms without experiencing sides at your first dosage and frequency, the question/issue of whether to adjust is moot.
I had symptoms of hygonadism in 2001 and have been on TRT since 2002.
Interesting.
How many adjustments to dosage or frequency did you have to get dialed in initially?
Once you got dialed in, have you had to adjust your protocol much over the years?
I never had any adjustments except one. I used ten grams of gel daily when I used Androgel or Testim. Only once I had to go down to 5 grams because my T value went up to 1500 and I didnāt feel good. Eventually we went back to 10 grams.
When I switched to injections in 2013 I was prescribed 100 mg per week and have been on that since.
I think about my numbers and medication and feelings of well being very little. I see my urologist for five to 10 minutes three times a year and go on with life.
T value? You mean his total t at trough? I have no idea. What I do know is that unless his free t is 30, he still has sexual symptoms, like ED. Free T of 30 seems to be his magic number to get ED, which is his last symptom to be alleviated, in check. Itās weird how one guy can get symptom relief with 75mg per week, and it takes 250mg for another guy. Thatās why thereās no exact dosage that fits everyone. Who are we to tell someone that 250mg per week isnāt trt, if it alleviates his low t symptoms.
And why the hell wouldnāt someone want full symptom relief if heās going to be on trt anyway?
Is that trough on once a week?
I donāt even know. I simply get it tested whenever I see my doctor three times per year on any day of the week. I donāt pay much attention to this stuff. I see the doc, a couple of days later see the test results, and move on.
TRT talk with my doc takes a total of 30 minutes per year.
Got you, but at least then are you injecting once or twice a week?
100 mg once per week. I did twice per week a few times and didnāt feel different.
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Is that with low SHBG bud? I want to move to once weekly from dailys (which does nothing) but Iām a 20s SHBG guy and Dr seems to think I need dailys because of thisā¦ even tho ive told him its doing jack
Iām not sure what my SHBG is.
What kind of doctor?
A TRT specialist, private clinic