Just Started TRT: What to Expect?

Pharma TRT
1

OK, guys. Just started TRT today after about 6 years of slowly gaining weight (fat), watching my sex drive steadily decrease, and generally feeling sluggish and lethargic all the time. I had pretty much given up weight training as nothing seemed to work like whan I was younger. I would train hard, eat well, and get a reasonable amount of sleep…all for nothing. My cardiovascular workouts would yield “some” results with weight loss (or at least allowing me to maintain the status quo), but weight training did nothing. Nada. Zilch. With a testosterone level 0f 213, what would I expect?

Anyway, now that I’m started, what should I expect? How long until I start to feel more energetic and a stronger sex drive? A week? A month? 3 months?

2

First time topical: response took like 4 days…

First injection (400) took more then a week, then barely felt it… 2 weeks after first got another 400 and felt great in like 3 days and felt great for 2 weeks.

3

uhmmm… yeah… I am sorry Null, but Tantal, please just ignore what Null said.

ok now then… welcome on board -

1st - please read through the stickies to get the basics
2nd - read the advice for new guys sticky - and post some additional details here per that thread so that we can help you
3rd - check out some of the other threads here to see how conversations go in general and to get some good advice
4th - engage in the conversation

good luck

4

Sorry, should’ve been more specific. I got the first injection today, which, if memory serves, was .75 ml. I have to go back every 10 days for the next month to get my levels checked to ensure that the dosage is correct. After that, they’ll send home pre-filled syringes and I’ll get the wife to stick me (she’s an RN and could probably do a better job than I could). Strangely enough, I already “feel” better, but I’m well aware that this is simply due to the placebo effect. I guess it’s just that the anticipation of getting back to “normal” has me all giddy. Now, I’ve just got to peel my ass off of the sofa and get back to the gym.

It’ll be nice to finally see SOME results. Not looking to powerlift, bodybuild, or do any sport-specific training. I just want to get back to my “fighting weight” of 185 lbs. (I’m @ 220 now). I’m looking for a good combination of strength, endurance, flexibility, agility, and good overall health. I’m married with 3 kids, so I’ve got nobody to impress by throwing 400 lbs. around at the gym.

So, the answer to the injection question is 2-3 weeks?

5

tantal - unfortunately it is A LOT more complex then that. you will go through a great transition phase, but then unless you are prepared you will start suffering side effects from high estrogen, hormone swings due to the long wait between shots, etc, etc, etc,

PLEASE for your own sake (truly) please read the stickies and come back and give us some more info.

.75ml is not a dosage. mg is a dosage. how many mg per ml? any why use prepared syringes? oh wait, that is so the doc can charge you x3, x4 what you can get from any pharmacy (without insurance).

6

PureChance…I read through the stickies, and am quite confused. There’s quite alot of information there and I got lost in all of the abbreviations. Sorry. It’s quite a bit of medical information to try to absorb at one time. Having never used steroids, I’ve never had to study this before.

Anyway, I was given 140 mg of testosterone cypionate yesterday and have scheduled 3 more visits in 10 day intervals. Doc says that after that, I can just take it home and come back in for the checkups (and labs) to make sure everything is running smoothly.

7

yep. it sure is a lot of info (and this is the simple stuff - it can and does get more complicated). I’ve been slowly learning over the past four years to get to the stage I am at.

140mg T-Cyp weekly is crazy.

Can you discuss with your doc and suggest self injections of 50mg E3D to avoid the hormone swings? plus get him to write a prescription for a bottle of T-Cyp 200mg/ml 10ml bottle.

8

How is the 140mg crazy? Too much? Not enough? Too long between injections? Also, it’s every 10 days, not every 7.

I’ll try. Doc seems like a nice dude so I hope he’s not one of those “this asshole is spending too much time on the internet and second guessing me”-types. I’ll see if he’ll write the script for the bottle, but I doubt that he will. I’m at the LowT Center in Southlake and coming in for shots is probably how they make their money. Fortunately, I have excellent insurance, but I still don’t want to drive all the way over there when I could just have my wife stick me.

9

How often are they going to inject you? You say every 10 days for bloodwork, but is that for injections too? If so, you are going to have bigger problems than just wasting gas money to drive out there…

Read the stickeys and ask specific questions…you say you dont understand them, but what do you not understand? We don’t spoon feed but we will answer your questions the best way we know how…you have to put in some legwork on your own…

10

140mg every 10 days is not that crazy, except for the every 10 days part.

50mg E3D is pretty much best practice with tweaks depending on your personal genetics.

Southlake, Tx (DFW area)? if so, I have the names of two possible doctors if your’s doesn’t work out.

11

[quote]PureChance wrote:
uhmmm… yeah… I am sorry Null, but Tantal, please just ignore what Null said.

ok now then… welcome on board -

1st - please read through the stickies to get the basics
2nd - read the advice for new guys sticky - and post some additional details here per that thread so that we can help you
3rd - check out some of the other threads here to see how conversations go in general and to get some good advice
4th - engage in the conversation

good luck[/quote]

He asked how fast people felt results. When I started I asked the same question, and got no answer… I posted my experience for what that’s worth.

I’ve read the stickies, but haven’t found a doctor both willing to prescribe injections and follow a fact based (or study based) treatment protocol. I’m in Raleigh, NC and am willing to drive. IF ANYONE OUT THERE HAS A GOOD DR. EXPERIENCE. Please send the Dr.'s name.

Dr. wants infrequent injections of large doses…
I wish it were different. I wish I was on a higher frequency protocol. It is better then no protocol, and it is better then my experience with topical.

He tried 400 every 2 weeks at first when levels maxed the test (Free 1600, which he said was max the test would report). Had me skip a month, then 300, every month (after 2 weeks felt like crap)…

Now he has me on 300 every 3rd week. After 2 - 2 1/2 weeks I start getting the subjective symptoms of low T. It seems to take 3-4 days to feel the injection even at the 3 week interval.

to the point:
I’m getting too much practice identifying how long it takes before I feel an effect. This protocol feels like peak, downhill, then fall off cliff… It still takes me a couple days to identify when the symptoms return and are not just normal life variations.

I’m sure your (and his) mileage will vary… I reported my experience on first dosages of both topical and injections…

I’m glad he feels better sooner.

I hope you and others post their how long it takes for them to feel a response (both initial and ongoing).

12

Null - I should have been more specific. The dosage and schedule your doctor is using is crazy. The body is not meant to go from 1600+ down to 200 or lower over three weeks.

PLEASE call around to local compounding pharmacies and find a new doctor.

injecting 50mg E3D allows most to keep themselves very steady in to 600-900 range - which then allows you to balance your estradiol control if needed, and mitigates possible cortisol/thyroid strain.

btw, null - have you ever tested your TSH levels, ferritin, cortisol, etc.? There seems to a correlation between hypothyroidism and the inability to absorb transdermal medications and I am wondering if that was the case for you as well. If you weren’t back then, you probably are now with the strain those overdoses of T followed by period of no T.

13

I know the protocol is crazy. He doesn’t even test E2.

Subjectively a given level feels worse on the way down then on the way up. I would presume this is due to increased Estrogen. Interestingly, I usually have high ratio for Total T to Free.

I’m on a little Synthroid. Cortisol is 1/3 the low normal range. I haven’t seen any good research on low cortisol implications for people with my life history.

Topical works for a few months, then doesn’t, then double the dose, then doesn’t. I am now resensitized to topical after being mostly off it since January.

Also Doctor asked me if I was feeling aggressive when I was >1600. Funny, I felt fine, great even. It is when my levels are low that I have to watch my temper…

14

OMG - run from this doctor. run far far away.
‘Testosterone causes aggression.’ <sigh - shaking head> can you get any more old school?

I was the exact same way with topical. months of doing great, followed by months of wait… what’s happening?

have you ever read stopthethyroidmadness.com about T4 only meds. Also your 8am cortisol level needs to be at 15-20. without sufficient cortisol your body will send what it considers excess T to aromatase to E2. and your T4 meds will start converting to Reverse T3 blocking what free T3 you have from working.

it’s all connected, interwoven, and freaking complicated especially when you have a doc who may be doing more harm then good.

have you called around to any local compounding pharmacies and asked for a referral to docs who are know to prescribe compounded Thyroid and/or Testosterone medications?

15

I’ve tried the calling/showing up at compounding pharmacies and asking… It got me a great GP, but that’s it. I’m almost ready to cold call Doctor’s asking their protocols for TRT…

To complicate it even more. People with my personal history have really low cortisol as matter of course. They’re just starting research in this area. It is not known if this population can be treated like people outside the population.

The cortisol thing really explains things about me: stress, excitement and caffeine junkie, cortisol for Poison Ivy was just heaven. Lifting, particularly heavy for reps on things like squats and deads. They give me a feeling of being alive.

I will read the link you sent. Thanks…

About running from the doctor, we talked about self injection, then I could just do the math myself and subdivide the prescription. However, levels have been all over the map… ~340, >1600, ~200, don’t know last test result… If it were me, I’d pick the 1600…

16

me personally, I am just trying to get back to my personal genetic optimal level (which I am guessing is somewhere between 600 and 900). Once you push your T above your personal genetic optimal level (which is different for each one of us), then you start stressing your system and putting too much demand on cortisol, you have to start on AIs to control your aromatase of T to E2 as your body takes evasive action to get ride of what it considers too high levels, you have to watch out for interactions with DHT, stress to the liver, the impact to your thyroid, complications with high iron levels/blood thickness, etc. etc. etc.

it is hard enough to feel good and get everything balanced without having to deal with all of the potential issues that come from 1600+ levels of Total Testosterone. I associate 1600+ levels with people who are doing cycles and not with people just in it for true Hormone Replacement Therapy, but that’s just me.

17

Null, if you had read the advice for new guys sticky, you would not be hijacking this thread. This forum is not a chat room, open a thread for your case and keep your case there.

18

Hey, PureChance. Send me the names of those other doctors in the DFW area. Spoke to mine today about some areas of concern, but don’t feel that they were answered to my satisfaction.

#1. Asked about the potential for high E2 levels and whether I would need an AI. He said that they would check my levels after my 4th treatment and that if an AI was needed, it would be prescribed. I’m comfortable with that answer.

#2. Asked about using a smaller dose every 3 days instead if my current 140 mg (it could go up depending on my bloodwork in 20 days) every 10 days. He gave me one of those answers that wasn’t really an answer and basically said that there was no difference.

#3. When asked if I could get a prescription for the TestCyp (after we had my dosage worked out) and inject myself @ home, he balked. Gave me a line about potential for abuse and how it had to be tightly controlled. I countered with the argument that 1. my labs would give me away. and 2. if I went through a 4-month supply in 6 weeks, that would give me away also. If I really wanted it to blow up, I’d just get some illegal stuff and call it good. He finally admitted that coming in to the office for the shot was how they made their money.

If you know of some good docs around here (preferably the Mid-Cities area) that are more concerned with patient care than chiseling money out of my insurance company, let me know.