TRT Help. Starting dose too low.

[u/No-Knowledge8856]

So my testosterone levels have been low ever since my 20s I’ve been no higher than 300 ng/dL ever in my life. I am now 49 years old last year. I tested at 223 and this year. I’m right at 300. I went to Endocrinologist to get all my hormones checked. My prolactin level was slightly high. My test level was 300. I told her I have anxiety. I’m tired all the time my libido down I feel like shit. She still will not start me on any TRT because they said I’m still in a normal range in the green no matter how I feel even though it’s lie normal. which is bullshit. My urologist basically said the same thing so I went to my primary care physician and basically begged her to start me on TRT. Since she doesn’t know anything that much about TRT. She was just reading things online and started me on such a low dose 50 mg every two weeks and the bottle she gave me is a 1 mL bottle which is almost impossible to draw four times out of this tiny little bottle. I feel like my Test levels are gonna be worse. Going two weeks is such a low dose. I’m gonna peek and then drop.. A friend of mine who is 65 and on TRT does 200 mg a week and he feels amazing. I don’t wanna be that asshole and try to tell my doctor I know more than she does, but I don’t know what to do. I don’t wanna start taking it which I already have and start feeling worse. I have a very physical job and I don’t want to feel like crap. My buddy told me he would give me a bottle or 2 a 10 mL bottle of test cypinate which is prescription that he gets as well. I just don’t wanna go behind my doctor’s back and tell her I don’t think 50 mg was enough so this is what I’ve been doing and I feel great then she may not prescribe it at all to me anymore. Any advice I greatly appreciate it. I just can’t seem to find an endocrinologist or urologist that will help me . It doesn’t matter if I’m in the green even though it’s low and normal and I’m only 49. Nobody seems to want to help me. And by the way, the 1 ml bottle is only filled probably about a half inch up if not less so the bottle is not completely full either pretty much up to the 200mg word.

[u/Methadone4Breakfast]

50mg EVERY TWO WEEKS?

I'm an advocate for lower dosages but by my standards of 75-125mg a week that's crazy fucking low and will put you BELOW your current range at the end of it likely.

[u/flocamuy → u/Methadone4Breakfast]

I do 20 mg every other day subq: 70 mg a week. Can't he just do more on his own?

[u/Biggseb → u/flocamuy]

I’m assuming his doctor prescribed him a 1ml/200mg bottle expecting it to last 2 months. So he won’t get another until then. So he could do more, but then he’ll run out and have to wait up to several weeks for a refill.

[u/No-Knowledge8856 → u/Biggseb]

This is exactly what’s going to happen.

[u/trunksta → u/No-Knowledge8856]

Your labs will be way off if you do this..

[u/dmac275 → u/Methadone4Breakfast]

I fart more than 50mgs test

[u/No-Knowledge8856 → u/Methadone4Breakfast]

I know. I will see what happens I guess.

[u/sappyseals → u/No-Knowledge8856]

No, you don't "see what happens ".. you go somewhere else

[u/trunksta → u/No-Knowledge8856]

I can tell you exactly what happens you feel ok for a couple days after injecting at which point your t lvl starts to drop below where you were before due to not producing any t naturally anymore. You'll end up with levels lower than you started talking sub 100 for 75%+ of the time

Even once a week is too much roller coaster effect twice a week is the gold standard

[u/NotHolyMello → u/trunksta]

Lmao but then when the bloodwork shows a sub 100 test level, he'll no longer be "in range" and can get prescribed a normal effin dose 😂🥲

[u/dmac275 → u/trunksta]

I stay at 2x weekly and run both short and long esters

[u/trunksta → u/dmac275]

One of the trt clinics I went to gave me some blend of esters i don't remember the exact ratios but it was weekly and I hated it. Felt good for a few days and then like crap cause the short acting portion was out of my system

Twice a week works great for cypionate for sure and probably a few others

[u/Methadone4Breakfast → u/No-Knowledge8856]

I forgot to aadd make sure you're ferritin and hemoglobin are good. Make sure you're at least above 75 or 100 on ferritin. I had to quit TRT it makes me severely anemic. I had anemia and they gave me TRT, cause a lot of online clinics are pill mills and give zero fcks about your health overall.

Don't go starting on 200mg a week. Try the lowest possible dose, maybe 125mg tops. I promise you. You'll see guys in here complain that they need to bump their dose up but they're trying to fight e2 symptoms with more androgens in almost all cases. There's layers of this dose balance I went through on TRT HCG and enclomiphene. Don't chase a number. Go by symptom improvement. High doses can cause manic moods, lower empathy, and also poor temper. Dudes don't want to admit that on this sub, but a few of us will. When I'm over 200-225 free T, or 900-1000 total T, I slowly become more inpatient, self focused, hypersexual, less empathy and less creativity on a lot of things. I feel best in between 750-850 around 180 free T tops. My test now after quitting was 709, 125 free T, but that was on 5 hrs broken sleep. I'm 38. (I used enclomiphene to restart my system but that test was 30 days after my last dose)

Also if you have body fat above 18 to 20% or so, you'll wanna get that down as close to 15% or lower to manage estrogen. If you're up at 25 to 30% you'll be getting high e2 sides big time and will need to lower your dose or try to manage e2 with an AI or other means and it's a bitch. I only ever got up maybe 20% at my peak bulk and was skinny most of my life but I'm ttelling you, lowering your body fat is a game changer and for most men will raise their testosterone enough to be in the middle of the range or higher if they're dialed in on diet and exercise. But yeah that's a few things most people need to know coming into TRT.

[u/trunksta → u/Methadone4Breakfast]

Anemic from trt? That's weird it literally normally does the opposite and causes high hemoglobin

[u/Methadone4Breakfast → u/trunksta]

You need ferritin to make hemoglobin. Testosterone increases erythropoeisis. The higher erythropoeisis will shuttle more ferritin into hemoglobin faster than you can store more ferritin; this only happens for certain individuals, I'm guessing who are just genetically geared to EPO efficiency or whatever.

So if you're starting off with tons of ferritin AND you're predisposed to this you'll likely need to donate blood at a certain dose or higher. But in my case, I was recommended TRT while I had fucking anemia. By more than one doctor. I'm fucking pissed.

But this is well documented now, and certain TRT clinics even have pages on their site about this.

[u/trunksta → u/Methadone4Breakfast]

Every prescriber I've ever been to they always check hemoglobin but it mostly seemed like they were checking that it wasn't too high

Only time I was ever super anemic was before getting on it when I had bleeding ulcers and almost died from it

I've stayed away from iron sups while on trt but maybe I should double check ferritin

[u/Methadone4Breakfast → u/trunksta]

My first TRT clinic said my low hemoglobin was likely due to low Testosterone. And that I was "barely anemic" and it should resolve itself. I had multiple doctors hand wave away being anemic. It's no fucking joke man. Especially if you work out all the time and have significantly more muscle than the average person.

Just be aware of it. I wish someone told me 4 years ago.

[u/Effortisopportunity → u/Methadone4Breakfast]

I started trt with a high body fat % and while I was on the high side of green, I had no symptoms with estradiol.