Just Started TRT

Pharma TRT
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Hey guys, so a little background. 29 year old lifter here. Started noticing sex drive drop for the past few years and it got really low. Just got my first T shot last Friday.

Labs-

LFP
AST-24
ALT-24

CBC
H/H- 14.8/42.3
WBC-5.2
Plt- 232

LH 3.0
FSH 4.7

Prolactin 13.5
Estradiol 24.1
Progesterone 0.1

HDL 46
LDL 107
VLDL 13
Ratio 2.3

TSH 1.920
T4 7.1
T3 uptake 28%
Free thyroxine 2.0
PSA 1.1

IGF1 215
Serum Test 332

Any insight anyone can give me? Mostly I just feel tired a lot, gotten where I gradually could do less and less in the gym, thought I was over training

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What is protocol, how much test and how often? It sounds like you’re going through exactly what I felt early on, feeling tired is very common when first starting TRT. I wouldn’t be surprised if it took you months to start feeling better, I’m in my tenth week and everything is happening slowly, so slow that I wondered if the feel good was all in my head. There might be times when you feel great and times you don’t, hang in there because sometime it takes MONTHS to start feeling good. I alway feel really tired before I start feeling good again. Initially I was on 200mg every 3 weeks which was a waste of time, was put on 75mg weekly before I started feel consistently better, still long way to go though.

Hang in there, patience is key.

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Please edit your post above, look for pencil icon, and add lab ranges.

CBC: please post RBC, hemoglobin, hematocrit [HTC], ferritin -not commonly tested

Over training is relative to your metabolic situation and with low T and thyroid issues, training can stress the adrenals, maybe increasing rT3 that blocks some of the active T3 hormone.

TSH is way too high, should be closer to 1.0
T3, T4, fT3, fT4 need to be close to mid-range or a bit higher.
Thyroid lab ranges are stupid, ‘normal’ captures many problems.
You may be iodine deficient from not using iodized salt.
Please evaluate your overall thyroid function via last paragraph in this post.

fT3 is the active hormone and should be tested.

Thyroid is very important and guys with low thyroid function can feel quite crappy even with high-normal or better TT, FT and optimal E2. Please so not overlook this.

At your age, fertility may be a driving concern and simply injecting T can make testes shrink and scrotum pull up which can effect sexual self-image as well as how one is regarded by women.

Your testes and fertility are best protected by injecting 250iu hCG subq EOD.

E2 [estradiol] was not tested and is extremely important. Most will need anastrozole [oral] to keep near E2=22pg/ml which seems optimal for almost all men with regards to mood, energy, libido, sexual performance, fat gain/loss and fat patterns. E2 in upper 30’s can spoil everything and initial gains slip away.

Future labs:

  • do not test LH/FSH again, they -->zero
    TT
    FT
    E2
    CBC
    hematocrit - needs to be tracked, TRT can make high for some guys
    AST/ALT - take a break, muscles need to be fully recovered and not sore
    TSH
    fT3
    fT4

Please read the stickies found here: About the T Replacement Category - #2 by KSman

  • advice for new guys - need more info about you
  • things that damage your hormones
  • protocol for injections
  • finding a TRT doc

Evaluate your overall thyroid function by checking oral body temperatures as per the thyroid basics sticky. Thyroid hormone fT3 is what gets the job done and it regulates mitochondrial activity, the source of ATP which is the universal currency of cellular energy. This is part of the body’s temperature control loop. This can get messed up if you are iodine deficient. In many countries, you need to be using iodized salt. Other countries add iodine to dairy or bread.

KSman is simply a regular member on this site. Nothing more other than highly active.

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Labs updated

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1 mL of 200 per week, once a week, then recheck labs in 8 weeks, then recheck every 6 months

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Oral temp 98.1

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E2=24pg/ml is near the on-TRT target of 22pg/ml and assuming that was pre-TRT, it can only go up. 200mg T per week can drive a lot of T–>E2.

Oral temps 98.1 - what time of day?

Try harder, you are missing points in my post.

  • I asked about your use of iodized salt.
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I eat iodized salt heavily. I am Louisianan and we are are heavy handed with the salt, and it’s summer so I’m eating tons of crawfish.

Also my sodium and chloride are near the upper limits at 144 and 103 respectively

Temp was at around midnight.

And yes those were pre labs. I’ve only had one dose of T so far.

I’ve gained a lot of strength in two years. For the last year and a half until a couple months ago I mostly worked in the 3-5 rep range doing heavy compound lifts. I’ve put on a lot of muscle, but I’ve also lost a ton of fat in my extremities and off of my back, and gained a lot of fat in my core, around my butt, thighs, belly, and chest area. I have a lot of body hair and my facial and head hair grows very fast

Retook oral temp at 1921 today. 98.1 again.

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We need oral body temperatures when you wake up AND mid-afternoon. You did not read.

Some get dehydrated for fasting labs, drink some water.

Not all salt is iodized and packages can be very similar.

What questions after reading those stickies?

Your TRT involves going to doctor once a week and injecting 200mg T cypionate? You need to self-inject T twice a week and will need anastrozole dosed at time of injections to avoid toxic levels of E2.

A tried to get you involved with a conversation about avoiding infertility and small testes.

You are not sufficiently engaged. Passive will not work and later your thread will be out of site as I deal with new comers.

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Okay bro. I work nights. So 7 pm is soon after I wake up, 7 pm is my 9 am so so, and midnight is my 2 pm. And I’ve been working the past 5- 14s in a row so forgive me.

I eat iodized salt. I know all about iodine and it’s importance. When you mentioned that, I mentally thought it over and said no I’m good on that. I thought you were just giving me points to consider.

I’ve also read your posts on the complimentary therapies suggested.

The main questions i have now is how likely is my condition caused by overtraining? i want to avoid taking anything if it’s possible I just need to rest.

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Something else I’ve thought of. I hardly ever see daylight except for about 10 minutes when I’m getting off work, so my vitamin d level was 10. I drink a lot of milk so I thought I was getting plenty so clearly I was wrong.

Doc also put me on a vitamin d supplement, any chance this could be my problem?

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You should be taking at least 5000iu Vit-D3 per day. That gets converted to Vit-D25 an active steroid hormone that is critical for proper gene expression.

We have seen many cases of over-training here. Have you read all of the things that damage your hormones sticky?

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Okay I’ve been taking the 10,000 a day the doctor put me on. Let me see if I can find that sticky

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That amount of Vit-D3 is more than enough. Next Vit-D25 lab results will be informative.

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It’s two weeks in and I notice that my sex drive is about half of what it was at its best, vs almost nothing. Also I don’t have to take a 30 minute nap on my lunch break to get me through work and I feel like my brain is working much better.

Possibility I won’t end up needing to stay on T?