50 years old - questions on TRT

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    50 years old - questions on TRT


    total test: 480
    free test: 80.5
    my dr. did not want to take my estrogen levels.

    i'm 50 years old. have a 5 month old son. i'm always exhausted by the time i get home after work and not sure if it's purely stress. i don't recall being this tired after work before my gf got pregnant so maybe it's just being a daddy that is wearing me down. i absolutely love my son but i always worry about finances and time management. mood is not bad overall though. libido is way down. workout at the gym 5 days/week. decided to get my levels checked because a 45 year old friend of mine started on TRT and he said he feels amazing and has way more energy than before and his libido is through the roof (so he says).

    1) are my levels that bad?
    2) should i try something else to raise libido or energy levels?
    3) or should i just go and see the dr. my friend is seeing (who is an anti-aging specialist)?
    4) any other advice?

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    Your results are hard to interpret without at least Estrogen, Estradiol, SHBG, Thyroid panel, (I like D-3), and a CBC panel. Labs on Test without E & E2 tell me your doc may not fully understand this area of health which is not uncommon.

    BTW, use search as there is literally world class info in this exact topic.

    You need to get the additional lab-work done before you proceed.
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    thanks. after reading through some of the life extension therapy sticky, i realize that i need more testing done. unfortunately, my dr. is stingy with ordering in-depth testing. i will seek out someone who can get me tested and better help diagnose my problems.

    i did get my CBC done. is there any specific reading i should look for in that section? they all seem to be within range. no thyroid panel was done.
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    480 at 50 is more than twice what mine was when I started trt 18 months ago, so yeah it's not that bad. It would be at approx the lower third of most labs ranges.

    Trt would be a tough sell to a doc with levels where they are. You might however find one that would prescribe based on symptoms.

    Have you thoroughly examined your sleep, diet, stress levels etc..? These areas always contribute to the symptoms you're describing.

    Then again, there's always the anti aging clinics who will treat anyone who has the cash.

    Good luck...
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    I believe mine was around 260-270.
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    Quote Originally Posted by goobypls View Post
    thanks. after reading through some of the life extension therapy sticky, i realize that i need more testing done. unfortunately, my dr. is stingy with ordering in-depth testing. i will seek out someone who can get me tested and better help diagnose my problems.

    i did get my CBC done. is there any specific reading i should look for in that section? they all seem to be within range. no thyroid panel was done.
    The big think I watch for is RBC which can be a problem for some on TRT. For someone considering TRT with your symptoms, slight anemia can be a cause. Thyroid function can also be a major contributor to energy levels. Also, this will be a great baseline when you start TRT.

    Vitamin D-3 is pretty basic and I can almost guarantee you are deficient. I take 15,000 IUs per day (very cost effective).

    For what is worth I was exactly at 480 when I started TRT at your age. Same symptoms. Most physicians (based on anecdotal evidence as well as first hand evidence), will look at your level, which is in range, and tell you that you are in perfect condition. At 480 your insurance coverage may be a challenge as well. Even if you have to pay cash, it is worth it.

    I would strongly recommend you not accept that answer. I was lucky enough to have a physician who was smart enough to know I would be MUCH better on TRT -- health, sex life, energy level, feeling of well being, etc.

    I now run 900-950 on lab days (higher on average since labs are pulled at low points) with free at 375-390.

    Finally, if you do start TRT, in my opinion, you will experience two-three phases:

    #1
    Phase One--you start and onboard Test production drops to zero. Symptoms--you start the gel or injections and start feeling great, then about 3-4 weeks later you will experience a reduced Test level as your onboard production shuts down. You may start feeling tired again, similar to preTRT. This will require additional adjustments.

    #2
    Phase Two--you adjust TRT level upward and offset the impact of no onboard production (remember your scrotum will atrophy). This is the good stuff. You will start benefiting fully from the impact of externally provided Test.

    #3
    Phase Three--Maintenance through routine labs and adjust accordingly.

    This is my personal experience.

    One last thing which you will see over and over here on AM, Get an AI from the very start. Controlling conversion of Test to E2 is vital to your health.

    I hope this helps. I am not a doctor and am only speaking from personal experience.
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    Quote Originally Posted by pappybay View Post
    Get an AI from the very start. Controlling conversion of Test to E2 is vital to your health.
    Completely disagree here pappy. First, most physicians (who don't work for an anti aging clinic) will not prescribe one. Second, if they do, it certainly won't be covered by insurance. Third, e2 conversion can be controlled based on dose and timing of injections - I'm living proof.

    The trick is figuring out dose/timing of injections. It takes a while and can be frustrating at times.

    Adding an ai is just another variable that will confound things. I like to keep it simple and take as few meds as possible.

    When done right, you don't need an ai for trt...
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    Quote Originally Posted by napalm View Post

    Completely disagree here pappy. First, most physicians (who don't work for an anti aging clinic) will not prescribe one. Second, if they do, it certainly won't be covered by insurance. Third, e2 conversion can be controlled based on dose and timing of injections - I'm living proof.

    The trick is figuring out dose/timing of injections. It takes a while and can be frustrating at times.

    Adding an ai is just another variable that will confound things. I like to keep it simple and take as few mess as possible.
    Your approach is clearly the most effective: keep it as simple as possible. For me the AI is critical as I had the signs of gyno sensitivity very early in TRT. Starting without an AI is a smart move; however, having some onhand is a great fallback.

    Getting a `normal` doc to prescribe an AI is probably not even possible since most don`t even understand TRT in general.

    :-)
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    Quote Originally Posted by pappybay View Post

    Your approach is clearly the most effective: keep it as simple as possible. For me the AI is critical as I had the signs of gyno sensitivity very early in TRT. Starting without an AI is a smart move; however, having some onhand is a great fallback.

    Getting a `normal` doc to prescribe an AI is probably not even possible since most don`t even understand TRT in general.
    I've read the logs you started pappy and I personally think you'd do better w smaller, more frequent injections.

    It's a much easier way to keep e2 under control.
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    Quote Originally Posted by napalm View Post

    I've read the logs you started pappy and I personally think you'd do better w smaller, more frequent injections.

    It's a much easier way to keep e2 under control.
    Obviously I am hijacking this thread; however I am not opposed to 3 injections per week plus two for HCG. What are your thoughts on this approach which would be 3 X 60MG per?
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    Quote Originally Posted by pappybay View Post

    Obviously I am hijacking this thread; however I am not opposed to 3 injections per week plus two for HCG. What are your thoughts on this approach which would be 3 X 60MG per?
    In my experience, you'll need less than you think w more frequent injections. What are your peaks and troughs on 180/week?
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    I keep e2 around 20 and test levels around 800 by injecting 3 times a week in small doses. 25, 25 , 30. Works great, I feel great, perfect dosage for me. For the hell of it I went to 30mg 3 times a week, and it causes my e2 to rise just above the fine line I'm balancing, causing irritability, getting out of breath, low sex drive/weaker erections, poor morning wood. 20, 20, 25 might even work better.
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    Quote Originally Posted by lexmuscle View Post
    I keep e2 around 20 and test levels around 800 by injecting 3 times a week in small doses. 25, 25 , 30. Works great, I feel great, perfect dosage for me. For the hell of it I went to 30mg 3 times a week, and it causes my e2 to rise just above the fine line I'm balancing, causing irritability, getting out of breath, low sex drive/weaker erections, poor morning wood. 20, 20, 25 might even work better.
    I like that protocol, I just don't feel like sticking myself 3x/week...
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    thanks for all your advice. i will be making an appointment with another doc. a friend of mine saw him and got on TRT at the age of 46 with his total test over 600. i told him that was high but he claimed chronic depression and fatigue that didn't respond to antidepressant medication. watching his activity levels explode and outlook on life improve drastically is almost frightening. i will be requesting more in-depth bloodwork and i'm hoping the will be able to make suggestions if i elect to not go on TRT.

    the symptoms i want addressed are in this order:
    1) libido is lower than low. like WTF low.
    2) fatigue after work and a general lack of motivation at work (i was always lazy at work but it's hit new lows - could be burnout).
    3) and the last is slowwww progress towards my fitness goals (losing fat, gaining lean muscle mass, increasing strength). i know this can be diet-related and dependent on my routine but the past 2+ years have been mildly frustrating. my friend's body recomp on TRT has been nothing short of amazing. this is really not that big of a deal for me - the first 2 are really important. my fitness path has been a good, healthy struggle that has made me mentally tougher and a better person overall so i'm ok if my progress stays slow.

    everything got tough after my son was born so i'm wondering if it's more mental and self-generated stress. might just be a part of being a daddy - especially at such a late age lol. won't hurt to get tested though.

    and if i got on TRT, i can have our medical staff stick me at work. i don't know if i'd like to do that myself and i don't want the gel since i play with my son so much.
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    Quote Originally Posted by goobypls View Post
    thanks for all your advice. i will be making an appointment with another doc. a friend of mine saw him and got on TRT at the age of 46 with his total test over 600. i told him that was high but he claimed chronic depression and fatigue that didn't respond to antidepressant medication. watching his activity levels explode and outlook on life improve drastically is almost frightening. i will be requesting more in-depth bloodwork and i'm hoping the will be able to make suggestions if i elect to not go on TRT.

    the symptoms i want addressed are in this order:
    1) libido is lower than low. like WTF low.
    2) fatigue after work and a general lack of motivation at work (i was always lazy at work but it's hit new lows - could be burnout).
    3) and the last is slowwww progress towards my fitness goals (losing fat, gaining lean muscle mass, increasing strength). i know this can be diet-related and dependent on my routine but the past 2+ years have been mildly frustrating. my friend's body recomp on TRT has been nothing short of amazing. this is really not that big of a deal for me - the first 2 are really important. my fitness path has been a good, healthy struggle that has made me mentally tougher and a better person overall so i'm ok if my progress stays slow.

    everything got tough after my son was born so i'm wondering if it's more mental and self-generated stress. might just be a part of being a daddy - especially at such a late age lol. won't hurt to get tested though.

    and if i got on TRT, i can have our medical staff stick me at work. i don't know if i'd like to do that myself and i don't want the gel since i play with my son so much.
    Sounds like you are very focused on specific goals. That is excellent. I have different fitness goals than you in that I wanted to put on 45 lbs of muscle and be very healthy with a reasonable BF.

    You are also on a great path finding a physician that will work with you. If you will spend the time reading on AM the pros like Napalm and others can really help you, but just reading bread after thread is a great teacher.

    Keep everyone up to speed on your progress! It is worth the effort.

    BTW you will quickly move to self pinning based on convenience alone.
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    Quote Originally Posted by napalm View Post

    In my experience, you'll need less than you think w more frequent injections. What are your peaks and troughs on 180/week?
    I can't answer your question a I don't have labs run that often. Maybe I should try pulling labs three days in one week and check.......

    I can tell you that I don't "feel" like I am experiencing highs and lows.
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    Quote Originally Posted by pappybay View Post

    I can't answer your question a I don't have labs run that often. Maybe I should try pulling labs three days in one week and check.......

    I can tell you that I don't "feel" like I am experiencing highs and lows.
    Nah, just get some labs done like 3-4 days after injection. Do you pin once a week?
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    Quote Originally Posted by napalm View Post

    Nah, just get some labs done like 3-4 days after injection. Do you pin once a week?
    Two times a week for Test C (Wed & Sun) and two times a week for HCG (Thurs & Monday).
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    Quote Originally Posted by pappybay View Post

    Two times a week for Test C (Wed & Sun) and two times a week for HCG (Thurs & Monday).
    I think you'd be surprised how much more stable levels are at 60/twice a week.
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    I wish every doc would explain to patients that less is more, it makes a dramatic difference in some men. I would try less just out of curiosity, but 25,25,30 keeps my energy way up, strength is equal to or more than the 8 week 500mg blast I tried, I have absolutely 0 negative/sad emotions, I even have a difficult time getting angry! And the spontaneous erections throughout the day are awesome as well. That wouldn't happen on anything above 30mg. I'm so glad I didn't just stick with the 50mg twice a week protocol, and discovered what works best for my body.
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    Quote Originally Posted by lexmuscle View Post
    I wish every doc would explain to patients that less is more, it makes a dramatic difference in some men. I would try less just out of curiosity, but 25,25,30 keeps my energy way up, strength is equal to or more than the 8 week 500mg blast I tried, I have absolutely 0 negative/sad emotions, I even have a difficult time getting angry! And the spontaneous erections throughout the day are awesome as well. That wouldn't happen on anything above 30mg. I'm so glad I didn't just stick with the 50mg twice a week protocol, and discovered what works best for my body.
    You're stronger on your trt dose than 500 mgs s week. That's hard to believe. I mean I get that you feel better with regard to libido and energy levels. But strength should be much better when you mega dose 500 mgs.
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    Quote Originally Posted by Vinnyboombots View Post

    You're stronger on your trt dose than 500 mgs s week. That's hard to believe. I mean I get that you feel better with regard to libido and energy levels. But strength should be much better when you mega dose 500 mgs.
    There's a good chance it could have been because I didn't keep my e2 in check during the blast (no AI). If I ever blast again, I won't let my e2 go above 40 (it was 136 by the end of the blast).
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    Quote Originally Posted by napalm View Post

    I think you'd be surprised how much more stable levels are at 60/twice a week.
    I am still in the "just a little more" phase of my education. I am at 180 per week and I predict I get a 30 kicker from the HCG for a total of 210. I know,I know, what the H am I thinking! I really don't have a good answer to my own question.

    I guess I am somewhat impatient to add muscle mass and strength, having seen good results to date. I swear I think this level is the "magic point" for me as I feel stronger and my weights are going up each week.

    I sound like a teenager not listening to sound advice,even though I am an old man.

    One thing I will say is I feel a high level of confidence you guys will not pull any punches in expressing your opinions,and I truly do value your input greatly. I am just not ready to drop from where I am to 120 per week.....yet.

    Respectfully posted
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    Quote Originally Posted by pappybay View Post

    I am still in the "just a little more" phase of my education. I am at 180 per week and I predict I get a 30 kicker from the HCG for a total of 210. I know,I know, what the H am I thinking! I really don't have a good answer to my own question.

    I guess I am somewhat impatient to add muscle mass and strength, having seen good results to date. I swear I think this level is the "magic point" for me as I feel stronger and my weights are going up each week.

    I sound like a teenager not listening to sound advice,even though I am an old man.

    One thing I will say is I feel a high level of confidence you guys will not pull any punches in expressing your opinions,and I truly do value your input greatly. I am just not ready to drop from where I am to 120 per week.....yet.

    Respectfully posted
    Pap,

    I have to think about this. I'll let you know my thoughts tomorrow.
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    Quote Originally Posted by pappybay View Post
    I am still in the "just a little more" phase of my education. I am at 180 per week and I predict I get a 30 kicker from the HCG for a total of 210. I know,I know, what the H am I thinking! I really don't have a good answer to my own question.

    I guess I am somewhat impatient to add muscle mass and strength, having seen good results to date. I swear I think this level is the "magic point" for me as I feel stronger and my weights are going up each week.

    I sound like a teenager not listening to sound advice,even though I am an old man.

    One thing I will say is I feel a high level of confidence you guys will not pull any punches in expressing your opinions,and I truly do value your input greatly. I am just not ready to drop from where I am to 120 per week.....yet.

    Respectfully posted
    The problem I have with this line of thinking is this; you have no idea where you're really at, so IMHO you're making ill-informed decisions across the board.

    You're stuck in the "more is better" mentality, even though you don't really know. You need to think about "optimal" vs "excess".

    Start getting bloodwork done and optimize your hormones instead of making blind guesses.

    Just my opinion, I could be wrong.
    Don't worry, man, someday I'ma be nobody too.
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    Quote Originally Posted by pappybay View Post

    I am still in the "just a little more" phase of my education. I am at 180 per week and I predict I get a 30 kicker from the HCG for a total of 210. I know,I know, what the H am I thinking! I really don't have a good answer to my own question.

    I guess I am somewhat impatient to add muscle mass and strength, having seen good results to date. I swear I think this level is the "magic point" for me as I feel stronger and my weights are going up each week.

    I sound like a teenager not listening to sound advice,even though I am an old man.

    One thing I will say is I feel a high level of confidence you guys will not pull any punches in expressing your opinions,and I truly do value your input greatly. I am just not ready to drop from where I am to 120 per week.....yet.

    Respectfully posted
    Ok, I'm kinda w Swanson in that I think you're still in the more is better phase. I can say w a good deal of confidence more is not better. When I was at the higher doses, yeah, my body weight was higher and I was getting stronger every week. But, my labs were screwed up - hgb 20, hct 60, e2 76 etc... It just wasn't worth it to keep pinning 150/week. So, I dropped my dose by a third and guess what? I was (am) still getting stronger.

    And why the hcg? Are you planning on having kids? Also, IIRC you're on an ai as well. If not I apologize. My point is that all of this can be managed w/o an ai/hcg. Me, i want to take a few drugs as possible. Have you had labs done recently? I'd be interested to see what your hgb and hct are. I'm telling ya, that is what got my attention and forced me really to reevaluate my trt. When the doc says you're a stroke waiting to happen, it kinda gets your attention.

    To me, the negatives of being on high dose trt, and lets face it: 180 is a pretty hefty trt dose far outweigh the positives. I don't want to be a stroke waiting to happen for a couple extra pounds of muscle.

    You can still make plenty of gains, and lower the risk of other trt related issues on a lower dose.
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    I am running labs on Monday morning.

    Last labs were in early May.

    HCG is pure vanity BTW.
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    Quote Originally Posted by pappybay View Post
    I am running labs on Monday morning.

    Last labs were in early May.

    HCG is pure vanity BTW.
    If you don't mind sharing the results that'd be great...
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    i have my appointment set for july 19 with the anti-aging specialist. i had to be very persistent. it seems that they weren't looking to take on new clients.
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    Quote Originally Posted by goobypls View Post
    i have my appointment set for july 19 with the anti-aging specialist. i had to be very persistent. it seems that they weren't looking to take on new clients.
    good lord..
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    Quote Originally Posted by lexmuscle View Post

    good lord..
    It's all about the $$$

    As traditional medicine reimbursement drops, ie, sequestration in February was a good example of a 2% cut in Medicare, physicians are looking for other income sources. If they set up their practice in a traditional way RE TRT, they don't make a lot of money.

    Most physicians may be intelligent, but that doesn't mean they are smart or have good business acumen.
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