Objections Regarding Testosterone Replacement Therapy (TRT)
A lot of you have been asking for an update on my Testosterone Replacement Therapy, or TRT. Itās been several years since Iāve given a detailed update regarding this, so itās time.
For those of you who donāt know what Iām talking about, a manās testosterone decreases every year once he hits about age 30. This is very bad. As a man, testosterone is a strong part of what gives you your passion, drive, health, focus, quality sleep, masculinity, sex drive, decent muscles, Alpha Male frame, a hard cock during sex, and many other things. Having lower than optimal testosterone is a very serious problem, particularly if you seek the Alpha 2.0 lifestyle, in which a healthy level of testosterone is required.
TRT is a procedure by which you regularly place the testosterone you once had when you were younger back into your body so you can maintain or regain that drive, muscle power, excitement, and motivation you had back in your early 20s. You do this under the close supervision of an experienced doctor.
TRT is not steroids. āSteroids,ā as the term is normally used, is when you boost your testosterone levels into the super-human range where they were never designed to go. A healthy total T range is 800-1200 or so (though opinions on this vary). Below 800 (or so) is problematic. Above 1200 is not healthy. Steroids blast your T levels to 3,000, 5,000 or even more. Very stupid. I do not recommend steroid use for any man under any conditions.
Instead, I recommend TRT for men over the age of about 35 whose T levels are well below 800. Work with a doctor and get them in the 800-1200 range but no more. You will feel better, be happier, be more focused, have better sleep, be hornier, be more motivated, have better sex, get bigger muscles when you work out, and increase your income. All of these things have happened to me since being on TRT.
I wrote all about my experiences when I started with TRT way back in 2014. There are links to all of these articles here, and I strongly recommend you read them if you are over the age of 35 or so.
When I went on TRT, the change was amazing. I was more focused at work, got better results from weight lifting, had better sex, had better sleep, and, amazingly, my average monthly income increased by 80%(!). This more than paid for the cost of the TRT, making my TRT yet another profit center in my life.
This article is simply an update of my experiences with TRT since I really havenāt talked about it in detail in about four years. Itās also to address some concerns and objections men have regarding TRT.
Here they are, in no particular order.
1. I heard your balls shrink if you do TRT! Oh no!!! Did your balls shrink into little pebbles???
This came up in my research as well. The answer is yes, my balls shrank a little, but my balls were so large that I actually wanted them to shrink. Iām not making a joke. I had more than one woman comment about how large my balls were. Way back when I was dating HBM, her family had a nickname for me: āEggs.ā Because she told them my balls were as large as eggs.
Once on TRT my balls shrank a little, and now they are normal-sized. Lucky me. During a doctor visit about a year ago the doctor measured them and said they were on the high side of average. So yeah, they shank a little, but Iām glad they did.
TRT may cause your balls to shrink at least a little, yes. If you have average-sized balls and are worried about thisā¦ why? Why do you want large balls? Women donāt give a shit, trust me. Also, TRT is for older men, and older men tend to get more saggy balls, and the larger they are, the more they will sag. Is that what you want?
2. I heard you might get hypertension if you go on TRT! Oh no!!! Did your blood pressure go up???
No. I have the same blood pressure Iāve always had, both now and pre-TRT.
3. I read a thing on the internet that said that guys increase the risk of prostate cancer if they go on TRT! Oh no!!! Arenāt you worried about that???
You’re a dumbass and you need to do some further reading. These reports are based on some very silly studies some doctors did way back in the 1970s where they took a bunch of really old men and jacked their T levels to way beyond 1200. And yeah, some of them got sick. Duh.
When you go on TRT, you donāt just start shooting up testosterone and then doing nothing else. You have to get regular and frequent blood tests to ensure everything is going fine, and get off the TRT (or reduce the dosage) if thereās a problem.
While on TRT, you need to get regular PSA tests at least twice a year (a blood test that shows your propensity for prostate cancer) and get annual DREs (digital rectal exams, when the doctor sticks his/her finger up your butt and checks your prostate; something most men over 40 should do anyway). Iāve been on TRT for five years now, and my prostate is 100% healthy (and the correct size) and my PSA is an amazing 0.9 (it needs to be around 1.0).
If your body is weird and your PSA shoots up to unhealthy levels when you do TRT, then you can drop the dosage or go off TRT. (And yes, there is a protocol for going off TRT if needed.) Your doctor (which you need!) will help you with this.
There is a massive amount of data and men who have been on TRT for 30 and 40 years have been perfectly healthy the entire time (or else I would not have done this). Prostate cancer is not a risk as long as you follow the correct protocols.
4. Isnāt TRT like doing steroids?
No. It’s literally nothing like doing steroids. I already described why in the first section above.
5. Isnāt TRT unnatural?
No. The R in TRT stands for replacement. You are replacing the testosterone you already had naturally. Youāre not adding anything new to your body that your body wasnāt designed for. Youāre also not adding more T to your body than it is designed for. (And if you do, that would be steroids, which would be very stupid.) Also, the testosterone you’re adding is the same exact stuff that was in your body, literally down to the molecular level.
6. So you have a rock-hard cock during sex all the time now?
Thatās an overstatement. I never really had a problem with cock hardness pre-TRT and that wasnāt the reason I did it. I did it to keep that Alpha Male edge (motivation, drive, focus). My cock during sex is ānormal.ā Not amazing like a 13-inch fluffed rock-hard porn star and not soft at all. Just good. TRT will help cock hardness during sex if you have that issue, but it may or may not make you 100% hard at all times like you just popped a Viagra.
7. Have you felt or experienced any changes in the last five years since your TRT began?
Not really. It worked great and continues to work great every day. My new level of drive and happiness is normal to me now. My blood work has all maintained pretty steadily; nothing new bad or good in the last five years. All is well, TRT has done its job, and I will continue to be on TRT (or its future equivalent) for the rest of my life.
8. What kind of TRT are you doing right now?
I take shots with syringes. It takes me less than 2 minutes 3-4 times per week. They do not hurt since I use insulin needles that are very tiny. For my shots I also take HCG (to help maintain my remaining, body-produced level of T) and vitamin B shots (since you only get 30% absorption swallowing vitamin B but 100% if you take a shot), both of which are purely optional.
Other TRT options are:
- Creams that you put on your balls (I donāt recommend this)
- Pills / troches that you put under your tongue (I donāt recommend this either)
- A pellet they implant in your body (I didnāt want to do this but I know guys who have this and love it)
I prefer syringes because I can precisely control exactly what Iām putting in my body at all times.
9. Isnāt it hard to travel with a bunch of syringes?
Nope. I just pack āem in my bags. Theyāre small.
10. In all of your world travels, have you ever had any hassles at any airports with all your syringes and weird-looking medication in your bag?
Never. Not once. As you know, I travel all over the world, spending weeks abroad at a time. I have literally never had any problems at any airports, even when I had a bag of 25+ syringes and my testosterone, HCG, and vitamin B bottles. And Iāve been to places many men are scared about in regards to bringing in medications (Colombia, Australia, Dubai, and so on). Never had a problem. You wonāt either.
11. What about Human Growth Hormone (HGH)? What is your opinion on that?
I didnāt want to do that back when I was 42. Now that Iām almost 47, Iām looking into that this year and will probably start this year. HGH keeps you looking young and strong as you age. Thatās why Sylvester Stallone looks so young even though heās in his 70s.
The problem is that HGH is complicated and expensive ($1000 per month or more). So as always, I will do a lot of research, talk to a lot of doctors, get all the data, and proceed very slowly, methodically, and carefully. I will keep you updated on this as I go along.
12. How much does TRT cost?
That varies wildly based on your age, goals, and options you choose. I broke down exactly what I pay here, but I added a lot of options that you may not want or need. Itās best to budget around $200-$500 per month for TRT once you get all the initial stuff done. And if that sounds like a lot of money, keep in mind:
A. Your income will probably increase, thus paying for the TRT. Mine certainly did.
B. TRT is only for older guys. Yeah, younger guys tend to be poor, but older guys should have no problem coming up with a few hundred bucks a month.
13. Iām over age 40, and when I went to my doctor and told him that I feel more lazy, sluggish, less motivated, and my cock isnāt nearly as hard as it used to be, he said that was normal, and that all guys have those issues as they get older, and that there was nothing to worry about. I even got a testosterone blood test that showed my total T at around 300, and he said that was normal too.
Your doctor is a piece of shit and you need to fire him immediately. There is no excuse for low T. There is no excuse for putting up with laziness, unhappiness, or shitty sex. Again, TRT is not unnatural. Your body was naturally designed to have T levels between 800 and 1200, not fucking 300.
Now if youāre 92 years old or a recovering cancer patient and your doctor says going on something like TRT would be dangerous for you, then of course I agree. But if youāre in your 40s, 50s, 60s, or whatever, and youāre healthy but feel like you donāt have that edge anymore, then fucking go on TRT (under the close supervision of a doctor of course) and get back to the man you were physically designed to be.
14. If my testosterone is low, why not just raise my testosterone naturally, through natural methods?
Because if your T is too low you wonāt be able to get it up to optimal levels on natural techniques alone.
There are indeed many things you can do to raise your T naturally and they do work (best article Iāve ever seen on this is here).
The problem is that these techniques will only get your T up by a few hundred points at best. Remember that the optimal range for total T is around 800-1200. So if your T is 650, sure, you could make some lifestyle changes and perhaps get it to 800. Maybe.
But if your T is down around 300, then Iām sorry, but thereās no way in hell youāre going to get your T up to 800 (or beyond) naturally in any lifestyle-sustainable way. Youāre going to have to go on TRT, at least to some degree.
Thatās it for now. As Iāve said in the past, going on TRT is one of the best decisions of my entire life, and I mean that. I consider TRT a requirement for any man over age 40 (or so) who wants to live the Alpha Male 2.0 lifestyle to the fullest (unless heās a genetic freak and already has naturally high T post age 40; thatās quite rare though).
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After reading your experiences in the earlier blog posts, I got hold of the Testosterone Optimization Therapy Bible, which was recommended by a frequent poster here who is a doctor involved in providing this kind of therapy, to become a bit better informed. Following that, I went on a trip to India for several weeks. Blood tests of all kinds are dirt cheap there, while they are difficult to get and outrageously expensive where I live. So I got that test done, together with a whole bunch of other tests recommended by Life Extension:
https://www.lifeextension.com/Magazine/2006/5/report_blood/Page-01
For a 55 year old man, my total T was quite high, just a bit under 600, with a reasonable free T ratio.
Most of the other test results were good, the ones that show long term blood sugar levels (Hemoglobin A1C) and so on, but my DHEA levels were way below optimal and homocysteine (an inflammation marker) were very high.
I decided to address those two issues first (DHEA supplements and some alternative forms of vitamin B that are more bioavailable than the ones usually contained in supplements; read the Life Extension article). I’m also making some other life style changes to promote testosterone. I’ll get another test done in six months to see how I’m going.
Frankly, it was a bit frustrating to fall in the high-middle range. If it had been a couple of hundred points higher, I would have clapped myself on the back. If it had been a couple of hundred lower, I would definitely have gone for TRT. At the present level, I just wonder if it’s worth the expense and the commitment.
Thanks for your information and posts on this subject. They are what got me on the path to check these things out! Good luck with your own therapy!
PS I was interested to note that the reference range for T in India was considerably lower than it usually is in America. The reference range is based on population averages, which suggests that the average level in India is relatively low. Funny! Must be all that ridiculously sweet and high-starch food they gorge on!
I’ve been doing TRT for about 18 months. Similar to BD. About 250mg per week. I do crazy intensive Crossfit 4 to 6 days a week. I was always at a similar level to the 20 y0 guys in my box. Way better than a lot of them. But around 48 I really started to struggle to cope with the workouts. Recovery was a bitch. Like IĀ was smashing their times. But would take me days to get over it!
Since I’ve been doing TRT things have been much better. I drink way too much so when I do its not so good. But if I stop drinking for any length of time. Holly fuck, I get jacked like you wouldn’t believe. And some of the younger guys call me a cheat if I’m not drinking. š
My balls have shrunk a lot. But I don’t care as I plan to be on TRT forever now. I’ve even stopped HCG because I don’t care anymore.
My strength has gone through the roof. But if I don’t drink my cardio is crazy as well. TRT is the shit if you are 50 plus.
This is taken from WebMD.
Are there risks to testosterone replacement therapy?
Yes. TRT has side effects, which may include:
Ā·Ā Ā Ā Ā Ā Ā Ā Ā Acne and oily skin
Ā·Ā Ā Ā Ā Ā Ā Ā Ā Lower sperm count, which can cause infertility
Ā·Ā Ā Ā Ā Ā Ā Ā Ā Increased risk of blood clots
Ā·Ā Ā Ā Ā Ā Ā Ā Ā Shrinkage of the testicles
Ā·Ā Ā Ā Ā Ā Ā Ā Ā Larger breasts
Ā·Ā Ā Ā Ā Ā Ā Ā Ā Increased risk of heart attack and stroke
Ummmmm….. I am not arguing the benefits of it, but not so sure about mandatoryĀ aspect of it for men over 40. More like “definitely consult your doctor if you have low testosterone count and only use it if it is indeed low (not because you simply hit 40 and want to have more focus and energy) and if you have no underlying conditions that can increase the risks”.
Don’t rely on WebMD. That’s very over-simplistic. ALL of those issues could be addressed by a good protocol involving the use of HCG and stuff to reduce estrogen levels (IF you need it). Very simply — but not as ridiculously over-simplistic as WebMD — it’s a matter of coping with your body’s homeostasis process and balancing estrogen and testosterone. Basically, when you introduce exogenous T, your body stops producing it, which you may need to address. Also, estrogen levels can go up excessively, which you also may need to address.
I’m not saying you have to do it (read my post above), but at LEAST it’s worth doing some research so that you are well informed on the subject. The book I recommend costs ten bucks or so and is pretty widely recognized as describing state of the art treatment. You’ll do much better with that than WebMD. Reading a few forums, it seems like the guys who have the most trouble are seriously hypogonadic young males, who may well have really big underlying health issues. Most older guys who experience age-related declines say it works incredibly well.
It’s all about as complicated as the hormone treatment that heaps of menopausal women do without blinking an eyelid, except that it (might) require frequent injections.
Sorry but I’m not messing with anything that “shrinks my balls a little”.Ā But I am the type to avoid man-made drugs and unnecessary surgeries and opt for more natural measures and if something changes the size of my balls, that’s altering my body in a way I am uncomfortable with.Ā Is there a problem with using natural supplements to increase T levels?Ā Did you ever try using supplements first?Ā Do you think supplements are mainly ineffective?
My cringe moment went to a 10 when BD mentioned a few things here….
My background: 44 yrs, on TRT for 3 yrs because of low-T. Several supra-physiological hormone cycles completed. Ex-pharmaceutical wholesaler to R&D firms in the USA. Have made testosterone preparations from scratch. Body Goals: look optimal to date early 20s to late 20s, keep flexible, keep the physique maintainable and keep the heavy squats and deadlifts to the kids so I can stay injury free.
Ā Would suggest Black Dragon go back to basics and look at the drugs he is using and how they work.
Specifically have issues with his HCG use.
***The only reason to be on TRT is that your normal T levels are low or sub-optimal****
The only reason you would take HCG while on TRT is that you do not know what you are doing.
When you take exogenous testosterone or a derivative you shut down the bodyās testicular axis- you stop making testosterone because your body reads it as you have lots of test so you donāt need more. IF you were to go off exogenous testosterone the body would naturally take a long time to get back to making testosterone because of the exogenous testosterone you took- this is why athletes take HCG and Clomid to stimulate their get their testicular axis back, but only for 20 days or so.
Being on HCG while on TRT is like putting your foot on the gas and brake at the same time. Eventually you will run out of gas and wear out your brakes. HCG is ONLY recommended for 20 days as your Leydig cells will be overstimulated and could cease to function properly. Meaning you may have permanently wrecked your bodies ability to create any testosterone.
In addition, mood swings, estrogen accumulation and acne are likely with clomid and HCG. Most body builders hate being on this because they retain water, are bitchy and moody.
Only take HCG when coming off steroids.
Secondly, TRT users are advised to give blood every 60 days. The updrift of RBC, hematocrit and iron accumulate more so as men age and especially men on TRT. High ferritin or iron content in blood can cause heart attacks. Ā Breast growth can be mitigated with 1mg to 0.5mg of arimidex a week.Ā IF you are fat you create more estrogen, but once leaned out- you probably don’t even need arimidex to keep the estrogen in check. Some estrogen is good- have your levels checked by a doc regularly.Ā
On supra-physiological doses
If you are in good health, no reason to take advantage of a clean bulking cycle. Yes, your cholesterol will go up temporarily – but compressed, short several months or very compressed 6 week very high dose cycles can build muscle. AS we age it gets harder and harder to maintain a good physique. Easiest way to do not mess this up- Ask the biggest guys you can find at the gym for a recommendation of a coach/personal trainer.
On Growth Hormone
This is awesome for older guys on TRT. Skin will look younger, old injuries will heal, fat will melt off and recovery time will decrease. Fountain of youth in a bottle. What GH can also will do is create new muscle cells, with test or weights naturally, you can only make the muscle cells bigger, not create new ones. Basically, you are optimising your body to make more cells. Think of this as a muscle bank- when the more GH you put in, for longer, the more cells you will make. Making those bulking cycles much more effective when you do them.
Set against a backdrop of TRT, you can get a 20 year old body if you are 70. Price- varies on dosage. At 2iu a day for 5days, 2days off you can make a 100iu kit last 60 days. Great for all year anti-aging and fat burning. Ā At 4iu to 8iu you are looking at serious muscle building- but it gets pricy and introduces the need to take insulin.
For good, safe Chinese GH figure $250 a 100iu kit. For pharma grade you are looking at $800 to $1200.
Ā On insulin
Lots of misconceptions around this.
Unlike testosterone and thyroid the pancreases doesnāt need time to spool back up again if you take external insulin. Ā On higher amounts of GH you need to take insulin as the GH stunts insulin sensitivity. As an anti-aging product this is tops- see the beta cells in the pancreases get pretty beat up from working 24/7 and by taking insulin shots, you can give these cells a chance to take a break and regenerate- very cool. Being the king of hormones insulin has some interesting muscle building capabilities that are beyond this comment. I do 60 days a year of insulin to give the cells a break and build some muscle.
I’m newly 30 so I ain’t worried.
Does Insurance cover TRT or is it considered Cosmetic/Elective?
Great post as always.
What is eveyoneās Thoughts on what your the optimal free testosterone levels should be?
my total T is well over 800 but my free T hovers around 10-15
Comment deleted for violation of Rule Number Three.
Grandfather and father both had/have prostate cancer, so am a little wary but will look into it (only low 30s right now). T is low 400s but no problems with libido or muscle mass (quite the opposite). A little light on energy/vitality/risk taking though (or at least used to be- fixed this a lot through two medications prescribed by a sleep physician). Appreciate the post!
I’m not sure where I heard about this, I think it’s from Charles Poliquin (the strength and conditioning coach that Tim Ferriss interviewed in his podcast); but basically, I heard that once you get into testosterone replacement therapy, you have to be on it for the rest of your life because your body will never produce testosterone naturally ever again. Any validity to this? This is my biggest objection to eventually getting into TRT when I’m older.
On TRT for about 8 months now.
Life changing for sure!
BD, side effects I’ve had is producing pre-cum for the first time ever in my life, and not lasting as long during sex before ejaculating (not premature, just less control). Have you seen any changes in those areas?
My doc says it is normal, but he’s an idiot.
For the guy asking about insurance…my insurance covers it but I had to get my doctor to diagnose me as low…meaning below 300 (I tested at 273 total T, at age 36)
I am almost 55, been on TRT for almost 3 years. Way back when, my GP tested me and my T was in the low 300s. His attitude was “eh, low normal, you’re good.” I went to a specialist, had two more tests (in the 200s) and went on TRT. Now I inject T Cypionate once a week, and take Arimindex, and my T is consistently about 1,200. I feel great! Can kill it at the gym four times a week. Rock hard morning wood.
My balls did not shrink. (Nor are my balls sagging yet, far as I can tell.) Sometimes I get some zits on the torso. I mitigate blood clot risk by donating blood every 8 weeks (which you should do anyway when you get older, because iron accumulates in your body and too much of it is bad for you). No breasts. No prostate problems so far. I don’t care what my sperm count is, I’m done having kids.
A lot of the ways “they” say to raise T naturally (like taking vitamin D and zinc), I was doing anyway, and they weren’t raising my T at all.
Cost: $200 a month all told, mostly consisting of cost of quarterly doctor visit / blood draw. The T is $60 for a 10mL vial (I use 1.25 mL per week) and syringes are dirt cheap.
I should have started it 10 years before I did.
Maybe I’d worry about this if I were under (say) 40. As it is, 5 minutes a week for the rest of my life is no big deal, especially in exchange for the benefits. Furthermore, let’s say I could quit and be guaranteed that I could return to the normal T level of an over-50 man. That would suck. Not acceptable! I’d rather inject for the rest of my life and be at 1,200 than stay on the “natural” sub-300 right side of this curve.
My other concern is availability of TRT outside of North America. I live in Canada right now but I am working on the Five Flags Theory that Caleb talks about in detail in his Caleb Jones blog and if I end up living overseas in the future to significantly reduce the amount of taxes I pay, will these TRT injections be readily available in Asia or South America? I would assume that if you don’t have insurance that these TRT injections are quite pricy?
Thanks for putting the link to the natural to stossel boosting article.
You can safely ignore any comment made by Vsmilex. It’s already been shown (and he’s more or less admitted it himself) that he’s the guy who just comes here just to disagree with everything because it’s fun for him.
Then you will (likely) have a vastly reduced level of happiness and lifestyle post age 45. Have fun with that.
Of course I tried them. Outside of taking extra vitamin D (which I was already doing) supplements won’t do shit. At best they might make a 5% difference plus or minus, not nearly enough to get your T up to 800+.
Insurance does not cover it unless you are a lucky and rare exception to the rule. However, Americans using an HSA account can make it tax deductible.
I have spoken with at least one guy who was on TRT and went off of it. I’ve also talked to at least three doctors who have said they’ve had patients go off of it. It’s true you can’t just suddenly go off; there’s a protocol to follow and it takes a few weeks.
So no, it’s bullshit.
(Gross sexual details time!) My pre-cum has definitely gotten more watery and I produce more of it, yes. But I’ve had no problems with not lasting as long. Sex feels WAY better though! Even with a condom.
If he’s an idiot he should not be your doctor, so that’s your fault.
Yeah, if your T is super low and you can get a doctor to diagnose you as “extremely low”, you might be able to get insurance to pay for it.
I’m on a catastrophic health insurance plan with an HSA so it wouldn’t matter to me; either way I’d have to pay for it.
I will face the same issue when I leave the country in two years. It’s not a problem. I’ll just keep buying them from my USA sources and have them shipped to me overseas and/or pick them up during my frequent visits to the USA. If I can find other sources overseas that would be fine too, but I don’t need them. Not a big deal. The price won’t change (except for a little extra shipping costs).
Would you recommend a guy in his 20s (who suffers from low T and has already tried natural methods to increase it, to no avail) to go on TRT? Or would you still think he’d need to wait until he’s in his 30s/40s before getting on it?
Is it possible to do HGH combined with working naturally to raise T-levels instead of doing TRT?
Also,I know its not advisable for young men to go into TRT(unless they have serious medical problems causing low T),but is HGH under the supervision of the doctor(assuming you can find one who permits it)all fine and dandy?
Not sure about other places. But a lot of guys like to retire in Thailand. That’s my plan. I know from the guys who are already living there it is very easy to get over the counter at lots of pharmacies. Lots of Doctors there are very familiarĀ with TRT and have a way more progressive attitude to it than the west.
Pharmacies in Bangkok in the tourist areas positively thrust T, usually gel or patches, at male tourists who use it under the sad illusion that if they try it for a few days, they’ll be able to fuck more prostitutes. But there are also highly qualified doctors who cater to the medical tourism market, so I’m sure you’d be able to work out something.
Only if you have very, very low T, and you do so under the recommendation and very close supervision of a good doctor.
I don’t know. Good question. My guess is the answer is “it depends on the individual case.”
HGH for a young man? Jesus no, that sounds like a very bad idea.
I agree with most of what BD has recommended above, if you really need TRT. ItĀ may not be necessary for every older man. I’m late 50s, completely natural (never done steroids or TRT) and my total T is near 1300. But what’s more important is free T. Mine is about 15. Not bad, but I’m no raging bull either in the bedroom or the gym. Just goes to show that T level is not the whole story when it comes to the biological side of masculinity. I do manage to keep three MLTRs and myself happy, though. š
It’s possible that many men can keep their T high by natural methods – eating and exercising right. Look out for a document called Testosterone IO by Christopher Walker. Without knowing, I have pretty much duplicated his recommendations over the last few years. The main thing is lower body fat – mine is around 13% and could do with being lower still. Body fat is the enemy of T.
Some experts say that DHT is more important than T for libido. I’m thinking of experimenting with T cream on my balls, where it rapidly gets converted to DHT, just to see what happens. (Some men have a genetic susceptibility to balding due to DHT, but I have a full head of hair still, so I think I’m not one of them.)
Prostate – PSA is not a very sensitive test; there are many false negatives and positives. Better tests are coming. Don’t ejaculate during the 48 hours preceding the test – it will increase the result. There are two forms of prostate cancer: aggressive and non-aggressive. The former can kill you, fast. The latter will be contracted by most elderly guys, but most of us will die *with* (undiscovered) prostate cancer, not *of* it.
If you have erectile problems, don’t be shy of taking low dose Tadalafil (with your endo’s advice, preferably). It’s FDA approved for daily use at 5mg and is also good for Lower Urinary Tract Symptoms (LUTS). Cialis is hellish expensive but you can get a compounded generic without too much trouble in the US, I understand. Viagra, well, I guess we’ve all tried it.
Good luck, gents!
By the way, BD, I presume you read “the Bible”? Those guys are really into metformin as a life extension tool. Basically, it seems to make the body respond in the same way that it does to calorie restriction and lowers blood sugar. I remember you said you had a family tendency towards diabetes.
Any thoughts on that?
If T levels come down in men with age there should be a (good) reason for that. Medicine and biology is still in its infancy and we still don’t know how body works completely and how things are balanced with respect to each other. when you increase something more than its natural course it may have potential adverse effects. for ex, just by very recent research; breast cancer is linked to some drugs women used for birth control etc. you may say TRT treatment is natural. i don’t think so. it’s still an intervention on the natural course of your body concentration. you always pay a price. nothing is never free. and that price might be more than we already know since we are not there yet in terms of biological knowledge. just my 2c
Hopefully laws have changed in Sweden in 15 years when I am 40. Right now Swedish doctors are under strict governmental control and TRT is prescribed very very rarely.
Sounds like something that is almost a necessity once you go older if wanting to continue poly lifestyle.
I’m not interested at all in using TRT and prefer using all natural methods, which I won’t share here, as people aren’t interested.
Here are some useful comments about metformin:
http://roguehealthandfitness.com/is-metformin-really-an-anti-aging-drug/
Also, regarding glucophage I’m not sure most people are aware it can easily kill you. Like the article above stated not being hyperglycemic all the time is of course going to prolong your life.Ā Most elderly people have rather high levels of body fatness.
Regarding point one… Glucophage inhibits glucose absorbtion, while also increasing uptake. So you can get hypoglycemic just like if you were taking actual insulin. You live alone and become confused because of hypoglycemia…. Well game over, you die.
As far as I’m concerned (and IANAD) it’s not something I’d want to fuck with at all. Like pretty much everyone says…one of the best ways for prolonged life and vitality is to be fit and not fat.
If you’re fit and not fat, the chances of needing antihypertensives (lowers blood pressure) or, antihyperglycemics (lowers blood glucose), or most other “age” related things (which are actually more fat/sedentary related things) drastically decreases.
I just went off mine over the summer for other unrelated issues I was having and went back to my normal levels which are over 500 at 49.Ā Yes it’s worth it.Ā The difference is night and day.Ā That is under 2 circumstances.Ā 1.Ā You work out 5-6 days a week.Ā 2.Ā You eat right.Ā Ā 3.Ā Want to pursue a lot of good sex.Ā If you don’t do or plan to do those things don’t touch TRT.Ā It’s like putting a v8 in a pinto.
1.Ā If you don’t workout there will be some stored up energy and the weight gain won’t be as optimized.Ā Sleep could be an issue.Ā If I don’t workout 5-6 days I have sleep issues at times.
2.Ā Eating right.Ā There are issues with higher levels of estrogen with T.Ā Having a higher body fat percentage will effect Estrogen.
3.Ā Back when I was going thru my divorce I went periods of a few weeks without sex.Ā I would have fucked almost anyone I was so backed up and I did.Ā I can’t explain how horny and ravenous it makes you feel if you don’t have sex at least a 2-3 times a week.Ā You start to lose your mind and jacking off just doesn’t do it..
With that being said I double mine.Ā I am over 1000 and try to stay no higher than 1100.Ā Workouts are better, sex is better, mood is better..Ā I’m sweeter, kinder to women I want to fuck or am fucking.Ā I don’t have to implement a bunch of techniques to keep them around.Ā I can just be sweet, gentle to them, eat them up like a hungry beast on the regular, not let them tell me shit (calmly let them know) and then not take shit off anyone else and its all good.Ā Attraction is always strong and they all keep coming back for more.Ā As you can tell I love TRT.Ā It’s a game changer.
I just went off for 6 weeks and my balls went back to original size and went back to my normal T…Ā I ‘ve been doing it for 3 years straight without stopping..
I actually last longer now (after 3 years).Ā Sometimes up to an hour and sometimes I don’t even cum.Ā You just have to learn all over again techniques on how to last since you’re kind of ready to blow like a teenager.Ā I make the sex more like a workout so I’m a little exhausted and less likely to cum, change positions regularly, pull out and start sucking on their pussy if I’m about to cum, turn them over and really go hard and fast to maybe make it hurt a little for me, or slow down if the friction is causing me to cum early.Ā I also do the whole finger in ass, dick in pussy, and other hand rubbing the clit at the same time while fucking them as fast and hard as I can (they’re laying on top of me, not moving, and small).Ā Makes it difficult for me to cum with all that going on.Ā Ā Like a workout.
You didn’t mention boners.Ā When I was at 8 months I would get them in random places if the wind blew.Ā I got over that eventually.Ā This is all different of course for everyone.
No.
No data, no opinion.
30+ years of long-term field-tested data disagree with you.
Ah, Scandinavia. Pay 70% in taxes so the government can tell you how to run your own body while importing mass amounts of violent third-worlders. Where do I sign up?
Slightly disagree. While I was doing carb nite, I wasn’t exercising at all for several months (to manage cortisol levels). It was a mistake and I’m never doing that again, but my TRT was just fine during that time.
All men should exercise a few times a week, but if they work out less than “5-6” times per week, TRT is still valid.
Very true, but if you’re on Ansatrazole / Ameridex with something like DIM+ (as most TRT users are), estrogen is a non-issue.
Haha I was already like this pre-TRT, but I realize I have a higher sex drive than most guys.
Yep. It’s not a the big deal some in this thread are making it out to be.
Yep, me too. And that’s with sex 4+ times a week right now.
On days I don’t have sex it’s hard to sleep because of random boners lol
Hard time focusing sometimes too. Working with a client yesterday…about 20 years old and she was looking GOOD. Had to really focus on the deal and not her…
Haha, thanks for answering though. This is the kind of shit most people are too squeamish to talk about (even my doctor), but hell, a side effect is a side effect.
I think my problem is having new women to fuck post-divorce is exciting. Amazing how being married fucks with your head.
This would still be at least a decade away for me so Im asking this mainly out of curiosity.
Would most physicians be fine putting an older man on TRT just so he can increase his sex drive, motovation and weight lifting results ?
Of course players and alpha 2.0 men prioritize those things but most doctors don’t fall into that category.
Who cares? Keep doctor-shopping until you find one that will. Such as one of the clinics that specializes in TRT!
I found it.
It’s typically from wild yams or soy. Synthetic testosterone is chemically identical to that produced by the body. The way they tell it apart (for drug testing purposes) is from the isotopic composition, specifically the carbon-12/carbon-13 ratio.
The difference in the isotope ratio is pretty darn small (carbon-13 makes up only about 1% of carbon atoms anyway, and then you get a small variation on that 1%), but can be measured with a modern mass spectrometer. You wouldn’t expect any difference physiologically from the testosterone itself (although other components, concentration, etc. etc. could affect the physiological response)
Thanks for your help.
There’s a lot of variation in doctors attitudes. But in America and most of the developed world, the medical model is about treating disease, not optimizing mental and physical performance, with that written into the formal guidelines. So you make it easier for your doctor if you say that you are suffering from loss of libido and lack of energyĀ (disease) rather than saying you want to increase sex drive and performance (optimization). Some doctors who are really sympathetic may subtly coach you in that direction. But they don’t want to get struck off, so you gotta understand the limits the system puts on them.
Well, consider investing two minutes of your valuable time and Google “metformin” + “life extension”. It’s a hot research topic at the moment, with a lot of buzz and with researchers explicitly challenging the disease model by defining “aging” as a medical condition.Ā Some large five year study called TAME currently in progress.
Holy crap that is not normal at all. Then again I might be there too, seeing as I poisoned my body with all kinds of T-Lowering substances and activities (processed food, inactivity, alcohol, happy pills, trolling on the internet while jerking it to porn) in my 20s. I’m also 36, will be 37 in July. I’ll probably get on TRT when I enter my 40s.
Ever since I turned 30 I stopped doing most of that stuff and still perform pretty well during sex. And this was with meh and bad looking chicks. Hell if I don’t masturbate for a couple of days it’s difficult for me to not get hard in public haha. Like if I don’t jerk it for 48 or so hours, pretty much anything with a vagina will make my dick hard. So maybe I gained back some T that I lost…? lol
Are there telltale signs of low T in a person? Other than the stereotypical ones? What should I watch for?
And when it comes to HGH, one of my buddies was on HGH in his adolescence. Does that cause really bad long term effects? He’s autistic, needed one of his balls removed, and is diabetic. Was all that cuz he was on the HGH so early in life? I’m inclined to think so but I really don’t know.
America is still better than Australia. The Australian GovernmentĀ has banned doctors from giving prescriptionsĀ for TRT unless your count is ridiculously low. Like under 200. It’s crazy. The one Dr I found who was willing to do it was going off about how he thinks it’s a Government conspiracy to make sure guys are all low T. He reckons all the guys out there being treated for depression, anxiety and everything are just low T and that would fix a large % of it. But he can’t write you a prescription to get it from the pharmacy as that’s illegal unless you can show the low test results. The only way he could treat patients was to buy the stuff himself and give it to you in the consultation as a treatment. Made it very expensive. So the only way to do it cost effective over here is doing it on the black market like the roid guys at the gym. Crazy.
That comes up a lot in “the Bible.” The authors make an argument that SSRIs are used to treat “psychiatric” conditions that are actually really hormone imbalances, mainly low T .
Ya, kinda like Indonesia. But easy to get the substances. You’d have to take a huge amount of responsibility for managing your own treatment. But that’s true for any medical treatment here, you always gotta research to check that the prescriptions you’re given are appropriate, check the test results yourself, do some research to interpret them.
I just take it for granted now that I need to check and research anything a doctor tells me, and that I have to go in with a plan for what I want them to prescribe me and so on. Pain in the arse not to ever be able just to trust that a doctor knows more than I do.
He isn’t wrong. I imagine that sometime in the 2020s it’s gonna be like that here in the US and probably worse even. I’m predicting that TRT won’t even be an option, prescribed or not, in the US come 2025. You’ll have to buy it from the “terrorists” who attack us haha.
There’s definitely an anti testosterone movement going on in the west, which is hilarious because it’s going to backfire like nothing else. It’s going to be one of the most entertaining spectacles ever, it’s going to be like watching a wrestling show 24/7. I’ll be watching it from southeast Asia at that point (2030s).
I personally can’t wait to see chicks and trans people try to run things in the west. It is going to be a 300 million person circus. I’ll feel bad for my buddies who don’t care and who keep telling me I’m catastrophizing, but I’m only gonna have three words for them when things break down: Don’t Come Running.
Yeah because the powers that be and Fem culture would rather see 40+ guys sitting on the couch like zombies watching Netflix than down the gym clean and jerking 100kg, deadlifting 200kg and running 10k in 45min. God forbid they get ripped, look good and want to have a hot 20 something girlfriend to fuck every day. š
I saw a news report about a year ago where they are experimenting with treating guys here in Australia who have a family history of prostate cancer with T blockers. Basically, reverse TRT. Reduce their T to a big FAT Zero! The guy in the study was like “oh yeah there are some downsides. Like I have no motivation, my dick doesn’t work anymore, I’m depressed all the time. But, you know, at least I’m not going to die of prostate cancer!” What? Your already dead you idiot. Like a walking zombie!
This is how bad it is here. Testosterone is considered the same as CocaineĀ as far as the law goes for drugs. Possession of less than 50 grams of Testosterone is a 15-year maximumĀ sentence. Same as possession of less than 2 grams of Cocaine. It’s nuts! As Joe Rogan likes to say. DMT is illegal so everyone’sĀ a criminal. The body makes it naturally so everyone’sĀ carrying!
Me too on the Asia front. But the craziest thing is. The gap is getting very wide. Because of all the information and good stuff on the Internet now, the guys who do work out and look after themselves are crazy ripped, strong and fit. More than ever. And then you have all these morons who haven’t even done basic movement, sit all day every day on some sort of screen and look deformed they are so out of shape. I’ve met 25 yo’s who pull their back picking up 10kg of groceies and are out of action for a week. Meanwhile, at 50 I’m at Crossfit doing multiple 80kg power cleans in between running, doing pull-ups, kettlebell swings and 120 pushups. It’s nuts. The young guys who work out are insanely strong and fit compared to me.
Definitely interesting days ahead. š
Ah, it could go the other way, too. It could become totally mainstream and normal, no one thinks twice. But no denying all this “toxic masculinity” shit works against that.
We are on the cusp. The future is not written yet.
Y’all may have changed my mind about potential side effects of TRT: it seems virtually consequenceless at worst in the grand scheme of things: who cares about prostate cancer after 80?And it’s not even really a problem if aiming at 800ng/dL. Moreover it encourages testing PSA regularly so it helps detecting any prostate cancer early anyways.
Back in July, I did a full blood test, everything is good according to ranges and doctors. Only Transaminases were out of range but since I don’t eat refined sugar nor drink any alcohol the doctor said it’s most probably due to my resistance training session which makes micro lesions to my muscles – that’s how muscle is supposed to be built, except in my case I have no success adding up muscle mass.
I usually have sex 3 to 6 times per week with FBs and MLTRs, but aside from this I am low energy, low focus, mostly lazy as I commented in a previous post. I also have poor sleep quality. Seems like TRT could drastically change things for me at 37.
oestradiol R.I.A.
0.09nmol/l (N 0.08 to 0.18)
25pg/ml (N 22 to 50)
on 2018/July/04 – very good levels as far as I understand
Free testosterone:
38.9pmol/l (N 30.1 to 189.8)
11.2pg/ml (N 8.7 to 54.7)
on 2018/July/04 – I don’t quite understand this measurement, normal range stated in results is completely different than usual free testosterone ranges, but anyways it’s pretty damned low even according to the results range
Total testosterone level (normal range for men on result paper 2.40 to 8.71ng/ml)
3,41 ng/ml=341ng/dl on 2018/July/04
3.59 ng/ml=359ng/dl on 2018/July/24
Again not clinically low, but pretty damned low. BD advises TRT for men below 4ng/ml, his lowest total testosterone ever measured was 5ng/ml, before TRT he measured 5.6, during TRT between 9 and 7, stabilized arround 7.5. It is commonly stated that raising T from 3 to above 6 induces significant gains of muscle mass and loss of fat.
FSH (normal range written on results for men 0.95 – 11.95)
2.21 mUI/ml on 2018/July/24
LH (normal range written on results for men 0,57 – 12,07 mUI/ml)
2.44 mUI/ml on 2018/July/24
I also consulted an endocrinologist.
These 2 doctors are really unhelpful about T levels, they basically all say that my T and free T levels are great. I haven’t yet found any doctor in my city in France who is known for prescribing TRT on my levels, there might be but I have a feeling they are more rare than in USA, or there may be something going on as the commenters said about Scandinavia and Australia.
I spend most of my time in south east asia, mostly Philippines and Thailand. Would BD protocol, including HCG, and all regular blood tests, cost me similar amount? What monthly cost shall I expect from someone’s experience with TRT in SEA? Or can someone here point at forums or articles who talk about that?
Maybe Marty you have some idea at least for Thailand?
@gang
PA is full of guys talking about TRT. Cheap as in Thailand.
I’m not a huge proponent of aromatase inhibitors for TRT protocols..Ā Physician’s are also prescribing these less and less.Ā Sometimes there’s no way around it but if you can avoid them I would.Ā Personally I don’t want to take a breast cancer drugs designed for women if I don’t have to.Ā Ā My ratios are good as long as I have more weekly injections, keep my bodyfat lower, don’t inject too much T, and workout.
@Gang: since you’re french and we have this blog as common interest (and some disagreements too, lol) and since I live in France too, though I’m not french, perhaps we could have fruitful exchanges. Here’s my email ggalad@outlook.fr. Je fais une thĆØse de littĆ©rature franƧaise donc le franƧais passe aussi š I don’t login very often but I think we can def toss some ideas around.
@BD
Is head hair loss and body hair increase really a side effect of TRT when aiming in the range you are in, of 800~1000ng/dL, below 1200ng/dL? I am not balding so far, but I read that TRT will accelerate balding, I don’t know the basis details of these claims. What do you think? Valid or bullshit?
Also, do you mind sharing your free testosterone and bioavalable testosterone levels, with their respectiveĀ units and labs normal ranges, if you have them please? I have been looking at several results and the units and labs ranges are confusing for these 2 different levels.
About prostate cancer, some studies have even shown correlation between certain low levels of free testosterone and increased riskĀ of prostate cancer. So, maybe I am jumping to conclusions but it looks like maintaining testosterone in healthy range might actually help preventing prostate cancer, as opposed to getting too low levels or overshooting too high levels.
http://www.cancernetwork.com/prostate-cancer/low-testosterone-may-indicate-prostate-cancer-progression
@BD and others, what are your thoughts on this comment from Erik?
@GANG.Ā Eric doesn’t no what he’s talking about.Ā You have leutenizing hormone receptors all over your body.Ā They are there for a reason.Ā When you take exogenous testosterone, your body shuts down the production of leutenizing hormone.Ā When on TRT you are no longer stimulating those LH receptors.Ā That’s what HCG is for.Ā HCG is an LH mimick.Ā You take HCG to replace the LH that your body is no longer producing when you are on TRT.Ā HCG backfills the hormone pathways for the LH so that your receptors are still being stimulated.Ā HCG also keeps your balls from atrophying when you are on TRT.
SOme guys feel fine w/out HCG.Ā Many feel better with it.Ā But it is in no way dangerous if you use reasonable amounts.
TRT is like diets. You can tell people about it, and about the good things it has done for you, but they’ll just come up with a million reasons why it is impossible and dangerous for them. They’ve always read something on the internet, somewhere, that said it doesn’t work. I don’t tell people about doing TRT any more than I tell them about low-carb; I know what the inevitable reaction will be, and I don’t want to waste my time.
Yes for men under 45 who have a propensity for hair loss it is a potential side affect.Ā So basically if you’re going to lose your hair TRT “could” quicken the process.Ā It’s more of an issue with DHT…Ā You can takeĀ Finasteride (Propecia)Ā to block DHT but the side affects for propecia are potentially nasty.Ā Ā
The only side effects of HCG are related to higher levels ofĀ estrodiol and DHT but it is prescribedĀ at very low doses (200-500ius) when administered with Test, if the physician knows what they are doing.Ā I personally do not take HCG becauseĀ 1. don’t need sperm or bigger balls (dick makes up for small balls š ) 2.Ā if I did I would haveĀ to also take anotherĀ drug just to counter the side affects of higher estrodial 3. It isn’t usually covered by insurance.Ā If you are injecting it and aren’t worried about fertilityĀ or the size of your balls I would question my physician on why I needed it but that’s my personal opinion.Ā There’s no peer reviewed studies that show long term harm at such low doses..Ā Ā
25 years old. Building 7-figure business.
T= 460ng/dl (while beeing a professional fitness trainer, so all basics covered).
No drink. No smoke. No Illness. No drugs. No monogamy. No drama. No stress.
My body is simply falling apart while my mind is still strong. I can pay TRT, no problem.
I will build my business even with 0ng/dl of testosterone, BUT, my quality of life SUCKS for my mid-low levels of T. 2 Years ago T=Ā 626ng/dl and I felt way better (even if not good).
Caleb, If you were in my situation, what would you have done?
Get a full battery of blood work done and consult with at least two different doctors. Something is very wrong internally with your body and you need to get to the bottom of why.
I’m 55 and ive been on trt for allmost 10 yrs. except for very infrequently my sex drive is low ,erection problems and when i do have sex im cumming to quickly.Ā all problems i didnt use to have. all my levels look good except my estradiol level is around 40. thats allmost a week after my shot. i take a 100 mg test shot every week. i tried taking anistrazole years ago without any result although i think the dosage he prescribed was way high.1mg a week. ive asked numerous times to try it again but he absolutely refuses. ive also had a thyroid panel done. my tsh is 4 to 4.5 which is high and i also had a low vit D level .ive since started vit d supplements. im lifting in good shape and otherwise healthy. sorry for the long post but i would sure appreciate any advice i could get.
Need to know what your SHBG level and your total testosterone level is.Ā SHBG is especially important.Ā Men with low SHBG often have problems with estrogen.Ā Low SHBG can often indicate that you need to inject more frequently.Ā Perhaps 2-3/week.Ā But without knowing what your SHBG is, we can’t help.
my testosterone levels were 835 and 19.3 free testosterone. none of my blood panels have shgb. to be honest i didnt know about it . i need to request it at the next blood panel test
@Comp.Ā According to this calculator,Ā http://www.issam.ch/freetesto.htm,Ā your SHBG is probably 33.Ā Which is pretty reasonable.Ā Your free T is reasonable as well.Ā At 40 your estrogen is a bit high.Ā Some guys do great at that level but some need lower levels.Ā I don’t see anything horribly wrong with your protocol.Ā You might be on the right track in thinking that your estrogen is too high.
A very easy change you could do to reduce your estrogen without taking anastrozole is just reduce your testosterone dose.Ā Estrogen is produced from testosterone.Ā The less T you have, the less estrogen you will create.Ā Your free T is fairly high.Ā You should still have enough T to do the job even if you reduce your testosterone dose.
Another easy thing to try is to inject 2x/week instead of 1/week.Ā Twice a week is almost always better than once.Ā Just take 1/2 your dose at each inject.
Try injecting 45mg twice a week.Ā Keep this dose for at least 2 months to give your body time to adjust.Ā If you still don’t feel better go down to 40mg twice a week.Ā Again give your body 2 months to adjust before making any additional changes.
Thank you very much for taking the time to reply. I’ve done versions of what you suggested where i just went longer netween injections but never actually tried injecting two or more times a week so I guess that should be my next move
@Comp. If 2 times/week doesn’t do it, try 3 or 4.Ā Some guys report doing better injecting each and every day.Ā Ā Something to think about.
Why not over 1200? Ā Iām currently at 1329 at 35 on TRT. Ā Feel fine.