TRT

[Yoder]

I started out this February. Total T 262. They prescribed 1mg IM injection of Testosterone Cypoinate once a week. After 3 months I felt zero change. My Total T jumped to 620 but my Estradiol was at the top of normal at 40. They increased my dosage to 1.5mg and added .5 mg of Anastrozole. I thought this was too much change at once. I bumped the T up to 1.2mg and started injecting 2x a week. I was hoping injecting more often might help with the spike in Estradiol. I waited a month and got bloodwork again. Total T 950, E 58. Now I'm having ED symptoms, emotional it was crazy. I added the Anastrozole. I took a half a pill the day of my next injection. Within 6 hrs I felt like a different person. My mood is way better, more energy and motivation. I actually feel like doing things again for the first time in a very long time. If that pill didn't do anything, I was going to quit taking everything.

I guess my point of sharing this is it's not an exact science. You will have to play around with this unless you get lucky and only you can tell how you feel. The doctors really don't care. The other thing is getting blood work often. They only cover it every three months with the plan I'm on. My medical insurance wouldn't cover it since 262 is still "normal". I've paid for three tests myself jut to make sure I'm ok.

 

[bpitcher]

I started out this February. Total T 262. They prescribed 1mg IM injection of Testosterone Cypoinate once a week. After 3 months I felt zero change. My Total T jumped to 620 but my Estradiol was at the top of normal at 40. They increased my dosage to 1.5mg and added .5 mg of Anastrozole. I thought this was too much change at once. I bumped the T up to 1.2mg and started injecting 2x a week. I was hoping injecting more often might help with the spike in Estradiol. I waited a month and got bloodwork again. Total T 950, E 58. Now I'm having ED symptoms, emotional it was crazy. I added the Anastrozole. I took a half a pill the day of my next injection. Within 6 hrs I felt like a different person. My mood is way better, more energy and motivation. I actually feel like doing things again for the first time in a very long time. If that pill didn't do anything, I was going to quit taking everything.

I guess my point of sharing this is it's not an exact science. You will have to play around with this unless you get lucky and only you can tell how you feel. The doctors really don't care. The other thing is getting blood work often. They only cover it every three months with the plan I'm on. My medical insurance wouldn't cover it since 262 is still "normal". I've paid for three tests myself jut to make sure I'm ok.

I had some E issues with larger doses too. Even at 2x a week. With every other day injections I've been able to drop the DIM I was taking completely.

For whatever reason, I only had issues with injections. Never with the pellets.

 

[Marble]

I started out this February. Total T 262. They prescribed 1mg IM injection of Testosterone Cypoinate once a week. After 3 months I felt zero change. My Total T jumped to 620 but my Estradiol was at the top of normal at 40. They increased my dosage to 1.5mg and added .5 mg of Anastrozole. I thought this was too much change at once. I bumped the T up to 1.2mg and started injecting 2x a week. I was hoping injecting more often might help with the spike in Estradiol. I waited a month and got bloodwork again. Total T 950, E 58. Now I'm having ED symptoms, emotional it was crazy. I added the Anastrozole. I took a half a pill the day of my next injection. Within 6 hrs I felt like a different person. My mood is way better, more energy and motivation. I actually feel like doing things again for the first time in a very long time. If that pill didn't do anything, I was going to quit taking everything.

I guess my point of sharing this is it's not an exact science. You will have to play around with this unless you get lucky and only you can tell how you feel. The doctors really don't care. The other thing is getting blood work often. They only cover it every three months with the plan I'm on. My medical insurance wouldn't cover it since 262 is still "normal". I've paid for three tests myself jut to make sure I'm ok.

I'm glad you seem to be on the oath to where you will feel normal. There are ways to get insurance to cover stuff like this, even if it is within normal. I've had to write emails and challenge coverage denials. If you stop injections for 2-3 weeks, your T will drop below normal and your test will show you below the normal. But even within the limits, you can get coverage.

And finding a doctor who cares is tough. I have one that is progressive and will test my blood whenever I shoot them a message, and they will test me for whatever I want. She is a doctor who really cares.

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[Marble]

I just used the 27 g. .5 needle yesterday. It worked great! Right below the hip flexor. Even with drawing and pinning with the same needle, it performed great.

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[Yoder]

I had some E issues with larger doses too. Even at 2x a week. With every other day injections I've been able to drop the DIM I was taking completely.

For whatever reason, I only had issues with injections. Never with the pellets.

IM or sub q injections? I really don't want to take that stuff either. I'm hoping once I drop my BMI it will get a little better. I've dropped about 20lbs since I started, I got 20 to go.

 

[bpitcher]

IM or sub q injections? I really don't want to take that stuff either. I'm hoping once I drop my BMI it will get a little better. I've dropped about 20lbs since I started, I got 20 to go.

I started with sub-q and that seemed to be the worst for me. I was a little heavier at the time (pushing 20ish percent body fat) so I'm sure that didn't help either.

Went to 2x weekly IM after that and saw a pretty decent reduction immediately. 100MG weekly at that time for both the injection types.

My new doc is VERY against AI and will not prescribe them.

 

[Chasing elk]

Three years ago, I finally went and had lab work done. I was so tired, sick, no motivation, couldn't drop weight etc.....I just felt miserable. My primary wouldn't even consider giving me TRT. I ended up going to a men's health clinic.

My test levels were 278 (35 years old at the time) Free test was around 4.

I ended up getting on TRT. I gave myself a shot once a week. 12 months into it I had lost over 30lbs and never felt better. It was life changing. I felt better, slept better, woke up with an umbrella again, could work out again, and had the drive to eat even better. I switched injections into my quads each week. I never injected anywhere else. My insurance covers my TRT. It costs me 25.00 out of pocket from Walgreens for a vial that lasts me 3 months.

My wife and I decided to have kids so I cold turkey came off. I've been off for 25 months this month...I've had lab work done 4 times in the last year (we are going through the IVF process since she can't carry kids)

Every time they draw my blood my test levels are 278-450. free test is always low. I have a few more appointments and our IVF process is DONE! They are freezing my swimmers, and I will be getting back on TRT. I cannot wait...When I get lab work done, I ask for a FULL panel to include free test and a thyroid panel.

I will split my dosage up this time. They claim its better splitting the dose up and inject twice a week. Although I didn't have any issues prior. I just want to try and split the dosage up to see if it works even better.


If anyone else has questions or concerns shoot me a pm...I'll help out as much as I can. Granted I was only on for 12 months I defiantly was a different person while I was on. If you do get on make sure you're willing to commit to it. It'll take at least 6 months to get all your numbers lined out and get you on the right path. And remember you're not treating a NUMBER...you're treating symptoms.

 

[Kdye01]

after many years of bodybuilding and heavy steroid use where my levels were up around 3500 for long periods of time. My body no longer produces T.

I quit bodybuilding and stopped the steroid use. I now take 300mg of test a week. My levels are around 1000, the cutoff is 1200.

I have recently started taking peptides and they have really helped with inflammation, weight management and sleep.

For any man over 35-40, I highly recommend getting levels checked and if they are low, get on TRT.

 

[Yoder]

Be careful with this. My provider told me to increase my dose from 100mg/wk to 150. I only increased it to 120, I thought it seemed like a big jump. At 120 my total T went to 950. If I would have done what the told me too it probably would have been 1200. I felt awesome for a few weeks then it became a problem. I was amped up constantly. Hot, jittery, can't sleep, never get tired. I started hearing my blood pumping in my head when I wasn't working that hard. I checked my BP and it was at 145/90. It's always been normal. I really feel like shit now. I started drinking a ton of water and I even donated blood to try thin my blood and lower my hematocrit. Before the increase hematocrit was 46, 50 is the top of normal. I need to get new blood work. I cut my dose back to a little less than they originally prescribed. I have a Dr appointment on Monday so I'm going to see if I should stop taking it for a while or maybe all together. It's not worth having a stroke. I think my biggest issue was starting trt being fat. You are more prone to complications.

 

[Riplip]

I’ve been listening to Dr. Peter Attia recently. He has some really good, detailed discussions on health and longevity issues.

This recent podcast covers quite a bit about hormone therapy (and fertility).

Most of the hormone discussion starts around the 1 hour mark.

They also discuss my question about blood clot risk and TRT. Apparently, the old doses of 200 mg every 2 weeks caused polycythemia (high RBC counts) which can predispose you to clots.

Male fertility: optimizing reproductive health, diagnosing and treating infertility, and navigating testosterone replacement therapy | Paul Turek, M.D.

Podcast Episode · The Peter Attia Drive · 06/02/2025 · 2h 19m

podcasts.apple.com

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Very important to regularly check and monitor your Hematocrit levels. I was on TRT for several years and started to see a steady increase in levels, even after regular therapeutic phlebotomy therapy. Ultimately I had to cycle off as the clotting and elevated stroke risk was too concerning.

 

[Marble]

Be careful with this. My provider told me to increase my dose from 100mg/wk to 150. I only increased it to 120, I thought it seemed like a big jump. At 120 my total T went to 950. If I would have done what the told me too it probably would have been 1200. I felt awesome for a few weeks then it became a problem. I was amped up constantly. Hot, jittery, can't sleep, never get tired. I started hearing my blood pumping in my head when I wasn't working that hard. I checked my BP and it was at 145/90. It's always been normal. I really feel like shit now. I started drinking a ton of water and I even donated blood to try thin my blood and lower my hematocrit. Before the increase hematocrit was 46, 50 is the top of normal. I need to get new blood work. I cut my dose back to a little less than they originally prescribed. I have a Dr appointment on Monday so I'm going to see if I should stop taking it for a while or maybe all together. It's not worth having a stroke. I think my biggest issue was starting trt being fat. You are more prone to complications.

Do you recall what day of your injection cycle you were getting your blood test?

 

[Yoder]

I was injecting 2x a week. It was three days after my injection from what I remember.

 

[Kdye01]

Be careful with this. My provider told me to increase my dose from 100mg/wk to 150. I only increased it to 120, I thought it seemed like a big jump. At 120 my total T went to 950. If I would have done what the told me too it probably would have been 1200. I felt awesome for a few weeks then it became a problem. I was amped up constantly. Hot, jittery, can't sleep, never get tired. I started hearing my blood pumping in my head when I wasn't working that hard. I checked my BP and it was at 145/90. It's always been normal. I really feel like shit now. I started drinking a ton of water and I even donated blood to try thin my blood and lower my hematocrit. Before the increase hematocrit was 46, 50 is the top of normal. I need to get new blood work. I cut my dose back to a little less than they originally prescribed. I have a Dr appointment on Monday so I'm going to see if I should stop taking it for a while or maybe all together. It's not worth having a stroke. I think my biggest issue was starting trt being fat. You are more prone to complications.

The other thing you need to make sure of is that you are taking an estrogen blocker. When your estrogen gets too high that will thicken the blood faster and it will cause insomnia. Elevated testosterone levels typically to not cause insomnia and a jittery feeling. Clen can cause that but it sounds like you are not taking that.

1200 is at the top of the range that a Dr wants you to be at but everyone is different. Make sure you are going to a Dr that specializes in wellness as most Dr do not fully understand the chemical side of HRT.


But yes, dump blood every 8 weeks. And get your weight down. We only have one life.

 

[Yoder]

The other thing you need to make sure of is that you are taking an estrogen blocker. When your estrogen gets too high that will thicken the blood faster and it will cause insomnia. Elevated testosterone levels typically to not cause insomnia and a jittery feeling. Clen can cause that but it sounds like you are not taking that.

1200 is at the top of the range that a Dr wants you to be at but everyone is different. Make sure you are going to a Dr that specializes in wellness as most Dr do not fully understand the chemical side of HRT.


But yes, dump blood every 8 weeks. And get your weight down. We only have one life.

They prescribed Anastrozole. 5mg. My last Estradiol reading was 58 before I took it. I know those drugs are really bad for you so I take them sparingly. That is probably the issue. The first time I had high E symptoms it was way different. I was just really emotional and tender nipples and ED. When that never came back, I thought I was ok without the Anastrozole. I didn't take it after my previous injection, but even before that I was wired all the time. I lost a bunch of weight so I thought my E might have dropped a little. I did finally take it Monday and the hot flashes and jitters went away. My BP is still elevated. Hopefully that goes back to normal in a few weeks. What I think is the root of the problem is the dose was too high and I had way too much body fat. I don't want to take an Estrogen blocker for an extended period of time.

 

[Marble]

I was injecting 2x a week. It was three days after my injection from what I remember.

IME that would bump the numbers up a bit. Actually rather significantly. I've always done my blood work on day 7, the day I normally inject, and it seems to be a little more accurate. On the week I get my blood test, instead of twice weekly injections, I'll do a one injection and then on day 7 get my test. The jump you had seemed rather drastic; that's why I asked.

Everyone is different though, so listen to what your body is saying and adjust accordingly.

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[Marble]

They prescribed Anastrozole. 5mg. My last Estradiol reading was 58 before I took it. I know those drugs are really bad for you so I take them sparingly. That is probably the issue. The first time I had high E symptoms it was way different. I was just really emotional and tender nipples and ED. When that never came back, I thought I was ok without the Anastrozole. I didn't take it after my previous injection, but even before that I was wired all the time. I lost a bunch of weight so I thought my E might have dropped a little. I did finally take it Monday and the hot flashes and jitters went away. My BP is still elevated. Hopefully that goes back to normal in a few weeks. What I think is the root of the problem is the dose was too high and I had way too much body fat. I don't want to take an Estrogen blocker for an extended period of time.

There are other options besides what you were taking. I've used DIM therapy, and it dropped my estrogen levels. It's more of a natural solution and didn't have side effects.

My doctor is in that "wellness" category and treats the entire body, understanding how one thing affects others. Even on blood tests, some come back abnormal, but that is because I have an unusual amount of muscle mass, eat a lot of protein, and have a very rigorous workout schedule. The combination of those will make some blood test results be "off" on paper, but when other factors are taken into account, the results are normal.

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[aMurderOfCrows]

I’ve been low T for at least 10 years and I’m 54 now. I can not get any Doctor to lift a finger get to help me. They will NOT prescribe anything.

 

[_S_R_]

I’ve been low T for at least 10 years and I’m 54 now. I can not get any Doctor to lift a finger get to help me. They will NOT prescribe anything.

Any men’s health clinics in your area would help you. Buddy of mine using online clinic, other one his chiropractors

 

[Kdye01]

They prescribed Anastrozole. 5mg. My last Estradiol reading was 58 before I took it. I know those drugs are really bad for you so I take them sparingly. That is probably the issue. The first time I had high E symptoms it was way different. I was just really emotional and tender nipples and ED. When that never came back, I thought I was ok without the Anastrozole. I didn't take it after my previous injection, but even before that I was wired all the time. I lost a bunch of weight so I thought my E might have dropped a little. I did finally take it Monday and the hot flashes and jitters went away. My BP is still elevated. Hopefully that goes back to normal in a few weeks. What I think is the root of the problem is the dose was too high and I had way too much body fat. I don't want to take an Estrogen blocker for an extended period of time.

Estrogen blockers are ok to take for a long period of time. Did your Dr tell you to take .5 a week or .5 on shot days? Also are you breaking your shots up to twice a week? Due to the half life of test, it is best to break it up into 2 shots a week. And you should take your estrogen blocker on those days. Personally I would take .5 both days.

When I was bodybuilding I was taking around 1200mg of test a week along with a couple other compounds. I would take 1mg of estrogen blocker on shot days, every other day.

Have you considered taking peptides? Reta is a phenomenal peptide for weight loss. Cjc/IP is amazing for natural GH release, which will help you sleep.

If your Dr doesn’t know this stuff, I would definitely find a wellness Dr that can help you. There are great ones that do telehealth out of Florida. As men, we want to live great and live as long as possible.