TRT for Endurance Cycling - Advised Based on Symptoms

Pharma / TRT Testosterone Replacement
1

Hello,

I am new, but have been researching this topic for some time. After discussing some of my issues with some friends who is on TRT, they suggested I look into it. However, my concerns are finding a doctor that has a clue since I have only been living in my area for about a year, I don’t live in the same state as my friends, so they can’t recommend a doctor. As one of the articles states on this site, it’s a combination of art and science, and most doctors suck at it.

On the flip side, it would seem there are some very educated individuals in the forum, therefore i’d like to get a few opinions so I have some idea of what I should be looking at to help vet a good doctor.

About Me:
I’m 48, 5’ 11" 165lbs. I played soccer and rode bikes all through my childhood and teenage years. In 1996, I hung up my bike, but continued to stay active and even doing some lifting through 1998 until I was stupid, cocky and squatted too much weight and crushed a disk in my back around L5. It’s crushed in the rear, but OK in the front. My Xray looks like my spine makes a 60 degree angle at L5 region.

Through my 30’s desk jobs and being sedentary had taken a toll. I got up to 190lbs and would tire easily from light/moderate exercise. Approx 3 years ago, I decided to get back on the mountain bike and I have trained regularly, doing 3000+ miles annually. I track my rides on Strava with a heart rate monitor, cadence (RPM) and speed. When at the gym, I use an Expresso HD cycle that also tracks power in watts. Using that machine, I have been able to experiment with RPM to sustained heart rate to power ratios, and have learned how to listen to my body’s feedback and understand what is happening and how to manage my endurance and effort input. During my efforts on either bike, I will average 1:40 to 2:30 time effort, 18 to 30 miles on trails and 1000 to 3000 feet of elevation gain. Average calorie burn is 1200 - 1500, power output varies on courses, but id say sustained is between 200 - 300 watts average. Heart rate is interesting because I can now sustain a 185 average for 2/3 of the session, but my times have dropped (more in this later), I feel like I am working harder than I was a year ago to maintain the same average speeds. Strava app confirms this.

3 months ago I went Ketosis and have stayed in except for a couple of days here and there. Generally my levels are between 2.3 and 3.4 depending on how intense my effort and calorie burns have been. I rarely drop below 1.0 unless I gave in to having a beer or Sushi (at least now I am ordering Sashimi to eliminate the rice). I definitely can feel and see the results of Ketosis, and I plan to stay there.

So here are my issues. First off, the bike training. I initially made huge gains the first year. Lost a bunch of weight. Got down to 158lbs. Still have a little belly fat and love handles, but not much. From second year to now, gained some muscle and before I was in Keto, ramped up to about 167lbs. Started Keto 3 months ago, dropped to 160lbs and then gained a little more muscle and now running about 163lbs. Still a little fat around the naval and love handles, but it thinned out more… I’d say if I had to guess, there is about 5 - 8 lbs I just cant seem to burn off which seems odd since I am eating super clean and constantly in Keto. Also I am adhering to 7 hour window for keto most days. That fat SHOULD be disappearing, but its not.

Sleep - This is kind of a mess. About every 7 to 10 days, I have a bad night of sleep, almost a state of insomnia. Just can’t fall asleep. Takes a couple of days to really recover. So I am qualifying this as a low T symptom.

Mood - I am generally a happy individual, not really depressed. However, I am considerably more short fused with my temper than what I was even a decade ago. I have 2 kids - 9 and 11, and I catch myself giving them the 3rd degree sometimes when it really wasn’t warranted. I feel really bad about this and try to be mindful. To some degree I can control it, but I feel the aggression/anger trigger. Therefore I an considering this also as a symptom.

Sex drive - This is fine. Everything works as expected and I have no complaints, therefore I do NOT qualify this as a symptom

Daily Energy Level - Seems to be some issues here. Maybe because of the sleep issue, I find myself having to literally choose mind over matter to get out of bed. Even when I have a ride planned and I absolutely LOVE to ride my mountain bike, I find myself struggling to muster up the energy to ride. After my rides, sometimes I am stable the rest of the day and feel good, but sometimes tired. This may have a pattern related to sleep, but I haven’t thought about tracking this until just recently, so not enough data to know as of yet. However, I do consider my low energy bouts to be a symptom, and believe me, the struggle is real!

So, 3 different individuals who are on TRT, suggested I look into this based on our discussions of my daily issues and goals. Aside from hopefully correcting the sleep and tired feeling days, my hope is to improve my cycling sessions and goals as follows:

Increase sustained endurance - Middle of last year, I could run an 80% effort for about 1.5 hours before I would bonk or have to reduce to 60% effort in order to recover and complete the session. My 80% was usually a sustained heart rate at about 177bpm. At the time, my legs were not strong enough to push my aerobic effort into max. This year, even though my rides have been more consistent, my 80% effort is pushing low to mid 180s sustained. However my times have dropped and I’m not getting the PRs I was anymore. I fill like my aerobic ability has dropped to some degree. Things seem to have gone backwards a bit. Also, I can barely make an hour at 80% before needing to go into a recovery pace. I would like to start making progress in increased sustain.

Trials skills (fine motor skills and balance) - Historically, I was very good at many skill sets on a bike: track stands, stoppies, manuals, wheelies, I even could ride a unicycle. I would think after 3+ years of training endurance as well as regular sessions I should have regained some of those skills. I haven’t. I am hoping this will also improve.

I do not want to bulk up. This is more weight to carry when I ride. I would like to increase my strength and I am aware this will result in added muscle mass, but I’m not interested in vanity muscle, just usable performance muscle.

Quality of Life - I had my kids at an older age. Therefore I am trying to maintain a healthier lifestyle. Also that back injury had me in serious pain which is what scared me into riding my bike and doing something about my health. I didn’t want to be in a wheel chair by my mid 50’s. Because of my injury, I can’t run, but the bike actually loosens my back up and sustained long rides give me great relief since it’s bending my back in the opposite direction that I injured it. Also, after starting Keto, I think some of it has actually repaired as I am not experiencing inflammation pain anymore, just the clicking of the bones knocking together that I used to experience in my early 30’s before an extended sedentary lifestyle. My core has gotten stronger to help manage this injury as well. More improvement with this injury would be awesome!

As said above, I don’t trust doctors. Although I realize I need to find one, I want to be able to monitor as much of my body, system and therapy as possible. I want to be able to ‘compare notes’ and give feedback to a doctor, so aside from lab work which I plan to setup shortly, if there is anything you recommend me testing at home like hemoglobin levels (I’ve seen digital blood test kits for this), please let me know.

Thanks for any advice. Again, I am just now considering taking steps to move forward, but I want to be as educated as possible and know if my goals are realistic.

Thanks!

2

Cyclists use testosterone as a PED. If your testosterone is low, it will help. Any lab work up will include a CBC. Testosterone will typically increase RBCs, hemoglobin and hematocrit, therefore increase endurance.

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One of my best friends is an Ironman and exterra competitor. He is on trt and claims the higher hematocrit/rbc to be very beneficial to his endurance. He is who got me on trt and I couldn’t be happier with the results.

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If his aim was to increase RBC count wouldn’t EPO or something like a low dose of oxymetholone or boldenone be more beneficial than trt. Also if a cyclist uses testosterone as a PED, would they use just a replacement dose? These are serious questions that I’m curious about. I can’t see how trt would help, especially if said cyclist has normal testosterone levels to begin with. My hematocrit is naturally quite high (49-51 percent) even with hypogonadism and trt doesn’t seem to push it up at all, as a matter of fact, nothing seems to effect it much.

Also as to the poster, I’m not sure what’s considered impressive in endurance related stuff but you sound like an absolute beast, props to you for getting back in shape esp with chronic pain, it’s a really hard thing to do.

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Thanks for the compliment unreal24278. 5 years ago I was playing a gig. After the show, I walked half across the stage, stepped funny and the pain from my back was so severe shooting down both my legs, I fell to the ground. I had been dealing with cronic pain for several years, but that incident was a complete eye opener, literally! I started investigating chiropractors in my area at the time. Found a bunch of people who either didn’t know pooh, or how to help, or wanted me to lay out 3K to get stretched in a Vax-D machine over a several week session plan. The only guy who was able to give me any relief was an Asian doctor who was super strong and did adjustments that I could feel immediate relief, studied eastern and western chiropractic therapy as his main focus rather than a 10 week elective like most knuckleheads. He also had extensive studies with acupuncture although never treated me with it. He kept expressing that movement was key to my recovery, I needed to find something low impact that would not aggravate the disc, and if possible stretch it in the opposite direction. Circulation of fluids and movement to prevent spurs and keep mobility were some of his words. He was the only one who could adjust me and I felt better for 12 hours or more. Even as compression set back in, I was getting relief for several days. So I took his advice and started back on the mountain bike.

That fall on stage REALLY scared me. All I could think was that I was gonna be in a wheel chair with chronic pain within a decade if I didn’t do something. My kids were gonna have to push daddy around in a chair before they were old enough to drive… I was EXTREMELY motivated.

The bike worked quite well. Started slow but in the riding position on a hardtail, bumpy trails would loosen me up. I would literally drag myself in pain out of bed, to the closet, get my gear on, walk like a 90 year old man to the garage, get on the bike and take off. Once I hit bumpy trails, it would take 10 to 30 minutes, but eventually my back would pop, I would feel a huge relief and the effects would last sometimes up to 48 hours. As my core got stronger and I started tackling advance terrain which required more body/weight shifting and balance, I started to develop my core and my almost debilitating pain tapered to annoying, then mild, to intermittent. I also found once I hit this stage, inflammation around the area would press on the nerves causing the pain and the spice Turmeric, which is an anti-inflammatory, did wonders for helping with it. I would order India Organic brand from Amazon and dose those every morning. Advil, or any other synthetic OTC pain reliever/anti-inflammatory didn’t compare in results… And good on that, my liver and kidneys didn’t need the extra load since I wasn’t eating Keto and clean at the time.

So fast-foward to the past year and my discussions with a close friend about TRT began. He is 35 and a thyroid cancer survivor which almost killed him at age 16. He is on TRT. His dad is a doctor and also on TRT. I think he does about 1CC a week since he is in his 70’s, but he has access to labs and self monitors being a doctor. This was my first introduction to the subject of TRT and got me thinking.

I started thinking more serious about it after my shift to a Keto diet had time to do it’s thing. I don’t think I’m gonna be able to lose all the remaining fat, but I have benefited from it, I do feel better and my sleep, irritability, and tiredness symptoms did improve somewhat.

As for EPO, I don’t know a whole lot about it, but from what I have read, it’s a bit more risky, so I didn’t really want to consider it. Also, it may help my endurance performance, but that doesn’t solve the other symptoms. I was hoping feeling good and the ability to keep fit and strength gain in my core would continue to help manage my back injury. The endurance benefits are something I just recently started thinking about since I have plateaued in my performance, and even regressed a little, but I think some of this might be because of heat and humidity displacing oxygen concentration. I had a little bit of a regression last summer in the heat, but this year seems more intense.

Off topic regarding EPO, I did see the LiveStrong documentary on Lance’s EPO use (It’s quite interesting). Definitely seems to be a science with that stuff. For what it’s worth, Pro cycling on the world tour level should not be regulated for performance enhancement… Because everyone is freaking doing it! They just aren’t getting caught. With the money and sponsors behind the Tour, they can afford the best doctors and research, and since they are willing to take the risks anyway, that data could be extremely useful to a myriad of human physiology studies. Humans are not NASCARS. You can’t bolt on a restriction manifold and limit tolerances to equalize the field. Instead they should just list their protocols. Everyone is different, and their protocols would be interesting to compare. Just sayin’…

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I’d be very interest to know more about your friend’s experience with TRT and exterra performance. Is he just dosing TRT or stacking with anything? What’s his diet like? How he felt before therapy as compared to now? Did he have any low T symptoms beforehand similar to mine?

It seems so few endurance focused people have posted on the subject with first hand experience. I’ve combed through a dozen forums, even googling. Not a whole lot, mostly just questions not a lot of answers or experiences.

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He also uses EQ. 200mgs of both each week. Im not sure of his diet other than he eats clean most of the time. I can ask him for more detail

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Those would be effective, but I think it is more about beating the drug test. WADA has improved EPO detection over the past decade or two and anabolics can be detected at extremely small levels. I understand that TRT does not push hct with some guys, but some get into the high 50s. For them, a non supraphysiologic dose of test will benefit and fly under the drug test radar. Tour de France cyclists have been reported to take their hct into the high 60s, but they’re not using test alone.

I know a couple of local cyclists that race casually, i.e. they are not professionals or anything, that are on TRT. However, they are on it more for the TRT benefits and the endurance boost they get is just icing on the cake.

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All guys on TRT with fail the blood test. Your FSH and LH will basicly be 0 and that is a dead give away your natural T has shutdown and you are not natty.

xm_Mtn_Biker you really need a comprehensive male hormone blood test. That is only way to tell if you have T issues. Even if you get your T maxed you will never be 20 again. TRT doesn’t work that way. Google male hormone blood testing and you should find places that will give you blood test from a rep site like LabCorp. Best of luck to you. I also Mtn bike and have been on TRT for tha last two years.

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Firstly, they typically only test testosterone to epitestosterone ratio, one can easily use trt or even supraphysiologic doses of testosterone suspension/no ester without getting caught if it only the testosterone to epitestosterone test.

Secondly if OP has primary hypogonadism his LH and FSH won’t be 0, although it’s unlikely it’s possible. If I competed in a tested sport and they tested my LH and FSH it’s still mid-upper range despite me being on TRT for… I believe it’s nearly a year now

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I personally know guys who have used testosterone and passed drug tests.

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All I am saying is its a simple test if they really want to know.

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Sorry that is not possible. If you are on enough T to be mid range for your age you have to be shut down. How about showing us a pict of your latest blood test. Here’s mine I have been on TRT for the last two years.

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yea I’ll send you a picture of my bloods tomorrow if I can find them. My LH and FSH were mid-upper range when my test levels were like I want to say 550ng/dl (had been on TRT for like six months at the time). With primary hypogonadism sometimes gonadotropin levels aren’t fully suppressed on TRT. This doesn’t really mean anything though as the elevated LH and FSH doesn’t do jack shit as my testis, whether on or off testosterone, don’t secrete adequate amounts of testosterone. Here’s a study showing LH and FSH aren’t fully suppressed in patients with primary hypogonadism
https://onlinelibrary.wiley.com/doi/pdf/10.2164/jandrol.05140. My LH and FSH wasn’t even low when my test was 250ng/dl, the only time I ever had a lowish LH and FSH was before TRT when I was like 15 (before my testosterone levels went extreeeeemmeely low, they were 1000+ng/dl when I was 13 and 14, 430ng/dl at 15 and 250ng/dl at 16)

I believe my case to be a combination or primary and secondary… or primary, never been sure and I don’t want to get a testicular biopsy to find out, as I was offered it and it sounds like a painful hassle. Currently testosterone is higher as I find I feel much better in the upper ranges. I wonder what my LH and FSH currently are