48 and about to start TRT

I posted this in the QA forum, but it should be posted here.

I just got labs back today showing my Test at 152 (norm 300 - 890) and my prolactin high at 17 (norm 4 - 15.2). I meet with the endocrinologist in two days to set up my TRT. I have done some cycles in my past of Test/Deca and Test/Tren, but that was over 10 years ago. I had to take time off the weights for personal reasons and family stuff, but I used to compete in bodybuilding contests and power lift in the off season. I want to get back to that, I was away from weights for about 3.5 years getting another degree (I also have a medical degree) in computer science. I started training 9 months ago and was ~200 lbs and couldn't see my damned abs. I made a beeline for the gym. Slow at first then about late March I hit it full-tilt. But I could already tell things were out of whack and my recovery was terrible, constant nagging injuries and sore spots and my sleep was all jacked and I wasn't responding like normal. I still managed to get down to 175 ~ 13% BF (my abs are back).

I'm incredibly relieved to find my Test low, so I know what's wrong with me (as I used to recover and grow when I wanted, and lose fat when I wanted). I've been going over the posts and will incorporate HCG and shoot for a higher-end on the range of Test and lay off any estrogen blockers, AI's, etc. I'm a die-hard lifter. It's my passion. I don't just want to be average, I want to push the upper end as much as possible. The clinic also has GH, and I'd like to add that to the regimen if I can. Once I'm on track I would like to add small doses of AAS, but I'm not sure what would be best on TRT or how best to implement it. I know I have to wait a while to get the dosages dialed in, but any suggestions to steer me in the right direction of hitting my goals to possibly compete again?

Any thoughts would be appreciated.

I'm 5'7" and used to carry up to 225 in the off season just for reference. Lift 5 - 6 x week, and cardio in mornings for an hour 5 times a week. Diet is clean and ~2350 Cals/day.

The difference with traditional cycling vs being on TRT is PCT doesn't apply anymore, you just go back down to your TRT dose. Do you have an endo to support you or are you limited to just the HRT Clinic? What dose was prescribed to you ? 100mg/week is typically the base line with 200-250mg/week being the top end.

I'm not too familiar with clinics but I would be shocked to see GH given out willy nilly without a legitimate medical reason.

Youthful has a thread on starting TRT - I would strongly recommend reading through it.

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Originally Posted by Windex

The difference with traditional cycling vs being on TRT is PCT doesn't apply anymore, you just go back down to your TRT dose. Do you have an endo to support you or are you limited to just the HRT Clinic? What dose was prescribed to you ? 100mg/week is typically the base line with 200-250mg/week being the top end.

I'm not too familiar with clinics but I would be shocked to see GH given out willy nilly without a legitimate medical reason.

Youthful has a thread on starting TRT - I would strongly recommend reading through it.

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I'll have a clinic and an Endo (I also have the backing of my PCP who has Endo training). I don't meet with the Endo until August, but start with TRT and the clinic this Friday. I presume my dose will be 100 to 150/wk. Which is fine, but I would like to shoot for the upper end of normal. I'll let things settle in before I try any type of blast. So that's probably 3 to 6 months out, if not longer. The clinic does give out GH, but it's the sermorelin (more of a precursor to GH) and I'm not too familiar with it. If it is available to me, and I think it will get me some gains, I'll give it a go, but I just don't know enough to say yet.

Thanks for the tip on Youthful's post, I'll give it a read.

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Originally Posted by Amuuzen

I'll have a clinic and an Endo (I also have the backing of my PCP who has Endo training). I don't meet with the Endo until August, but start with TRT and the clinic this Friday. I presume my dose will be 100 to 150/wk. Which is fine, but I would like to shoot for the upper end of normal. I'll let things settle in before I try any type of blast. So that's probably 3 to 6 months out, if not longer. The clinic does give out GH, but it's the sermorelin (more of a precursor to GH) and I'm not too familiar with it. If it is available to me, and I think it will get me some gains, I'll give it a go, but I just don't know enough to say yet.

Thanks for the tip on Youthful's post, I'll give it a read.

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Sermorelin is not the same thing as HGH. Two completely different things. TRT at 100-150 is more than enough in my opinion from my own personal experiences. I'm on 150mg/week and I'm always 30-40% above the max in the range. For example if the range was say 60-100 I will usually score 130 or 140

I wouldn't get hung up on the timeframe for how long before you can blast/cruise. This journey is a marathon not a sprint. Everyone's different and body acclimatized differently. I was on TRT for a year before I felt my body was "in sync"

While getting set up, I would recommend posting your diet in our Diet and Nutrition section. Most people think they have a strong diet but often has room for improvement.

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Originally Posted by Amuuzen

I'm 5'7" and used to carry up to 225 in the off season just for reference. Lift 5 - 6 x week, and cardio in mornings for an hour 5 times a week. Diet is clean and ~2350 Cals/day.

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Wow that’s really impressive that you can maintain 225 with only 2350 calories!

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Originally Posted by kaptein_hook

Wow that’s really impressive that you can maintain 225 with only 2350 calories!

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Haha, hell no. I'm 175 now at ~ 13% BF. I used to hold that amount of weight. Once I'm on a maintenance dose of T and get below the 10% BF mark, I'd guess Ill weigh 160 something, I'll let my weight go back up. I don't know if I'll 225 for a couple of years. That was 10 years ago I was at 225 and my calories were 4K + daily. I need to hit my diet, and levels before I think about gaining again.

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Originally Posted by Windex

Sermorelin is not the same thing as HGH. Two completely different things. TRT at 100-150 is more than enough in my opinion from my own personal experiences. I'm on 150mg/week and I'm always 30-40% above the max in the range. For example if the range was say 60-100 I will usually score 130 or 140

I wouldn't get hung up on the timeframe for how long before you can blast/cruise. This journey is a marathon not a sprint. Everyone's different and body acclimatized differently. I was on TRT for a year before I felt my body was "in sync"

While getting set up, I would recommend posting your diet in our Diet and Nutrition section. Most people think they have a strong diet but often has room for improvement.

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I'm honestly not sure on Sermorelin. It's a potential, but at this point probably the last thing on my mind. It was mentioned to me by them initially, but nothing yet suggested. I'll get TRT first then think about whether Sermorelin is worth it or not (at this point I'm more skewed to not).

Right now I'm so lethargic, I'm about to increase my calories just to get some energy. I've been upping my cardio and not a day goes by I'm not freaking sore from some nagging body part (today is my upper hamstring, and calf) that just takes way to long to heal. I'll hold until TRT starts and adjust from there.

I'll post my diet up when I have time. Busy week for myself, so most likely next week. I'll also post up my TRT when I start it for some feedback.

Quick question, my prolactin was elevated at 17 (norm 4 - 15) and I'm guessing my E2 is elevated... I presume just keep my eye on the level (check my estrogen levels), and that it's too early, furthermore, not significant enough to merit any kind of intervention?

Figured I'll post my clinic visit. I initially had my labs drawn from my PCP who then referred me to an Endo and suggested the clinic I went to.

The clinic... well, let's just say the money grabbers do take insurance, but to do the at home injections (mailed to you--I wonder on this point and I'll post what comes in), it's $200/month beyond insurance. Since I have my endo appointment scheduled still, I'll start with the clinic to get going now, then change to a written Rx from my Endo when I see him. The clinic supplies the Test C, syringes, hCG, and an AI (why they give you an AI is just bad science imho). I get the package next week at the clinic and I'll see what all comes with it, but I can already tell they'll practically drop for drop the test supply. This wouldn't be a big deal if it was all covered by insurance, but it's not, and I know the real prices of the meds (or used to anyway--like I said in my intro, I used to work in the medical field but transitioned to software engineering). Anyway, I see no use for the AI (except perhaps for some day in the future) and if the Test supply is skimpy, this will be a one time deal as I switch to the other Endo. Their testing panel seems complete and I'll review the results next week, then post anything relevant.

Glad to be starting, but this whole "game" is rather irritating. I've already scoped out that my pharmacy can order everything I need--syringes, Test, hCG--and I know my insurance covers most to all of it. I just don't want to wait a month to get started or I wouldn't even consider.

My experience has been pharmacies are the most expensive for needles & syringes. Your local area may have a needle exchange program to give you free needles and syringes. If not, it's cheaper to buy online. $50.00CAD gets me 100 Syringes + 200 Needles, so basically 1 year supply.

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Originally Posted by Windex

My experience has been pharmacies are the most expensive for needles & syringes. Your local area may have a needle exchange program to give you free needles and syringes. If not, it's cheaper to buy online. $50.00CAD gets me 100 Syringes + 200 Needles, so basically 1 year supply.

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This depends on the pharmacy. I haven't actually asked for the price, but they used to be ~ $25/100 from the pharmacy (that was 6 years ago, so I'm sure that has changed) and many insurances if you have the Dr write for it, will pay for the syringes. I'll price this out though.

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Originally Posted by Amuuzen

Figured I'll post my clinic visit. I initially had my labs drawn from my PCP who then referred me to an Endo and suggested the clinic I went to.

The clinic... well, let's just say the money grabbers do take insurance, but to do the at home injections (mailed to you--I wonder on this point and I'll post what comes in), it's $200/month beyond insurance. Since I have my endo appointment scheduled still, I'll start with the clinic to get going now, then change to a written Rx from my Endo when I see him. The clinic supplies the Test C, syringes, hCG, and an AI (why they give you an AI is just bad science imho). I get the package next week at the clinic and I'll see what all comes with it, but I can already tell they'll practically drop for drop the test supply. This wouldn't be a big deal if it was all covered by insurance, but it's not, and I know the real prices of the meds (or used to anyway--like I said in my intro, I used to work in the medical field but transitioned to software engineering). Anyway, I see no use for the AI (except perhaps for some day in the future) and if the Test supply is skimpy, this will be a one time deal as I switch to the other Endo. Their testing panel seems complete and I'll review the results next week, then post anything relevant.

Glad to be starting, but this whole "game" is rather irritating. I've already scoped out that my pharmacy can order everything I need--syringes, Test, hCG--and I know my insurance covers most to all of it. I just don't want to wait a month to get started or I wouldn't even consider.

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For $200 you can buy enough Test for almost a year's worth of TRT at 150mg/wk. Then again, you're getting pharma grade Test with the exact dosage as on the label.

Quote:

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Originally Posted by Amuuzen

I'm honestly not sure on Sermorelin. It's a potential, but at this point probably the last thing on my mind. It was mentioned to me by them initially, but nothing yet suggested. I'll get TRT first then think about whether Sermorelin is worth it or not (at this point I'm more skewed to not).

Right now I'm so lethargic, I'm about to increase my calories just to get some energy. I've been upping my cardio and not a day goes by I'm not freaking sore from some nagging body part (today is my upper hamstring, and calf) that just takes way to long to heal. I'll hold until TRT starts and adjust from there.

I'll post my diet up when I have time. Busy week for myself, so most likely next week. I'll also post up my TRT when I start it for some feedback.

Quick question, my prolactin was elevated at 17 (norm 4 - 15) and I'm guessing my E2 is elevated... I presume just keep my eye on the level (check my estrogen levels), and that it's too early, furthermore, not significant enough to merit any kind of intervention?

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Don't self medicate before you stabilize your TRT regiment. Additional compounds before the TRT could complicate the entire process. Spend the 6 months to 9 months it takes to work through the TRT dose. You want to take enough Test to maximize your numbers but minimal or no AI, if possible. Once have have this number, this is your baseline. Let's say that number is 100mg/wk and this will get you to 600 on the 300 - 890 scale. This is enough to maintain your gains but not enough to build real muscle and shred fat. For that you have to run a cycle. If you run 100mg/wk for TRT + 500mg/wk Cycle = 600mg/wk your Test number could run as high as 2000 or higher. You need numbers like that to be anabolic and build muscle. Run that cycle for 12 weeks and then just go back to TRT dose. No PCT necessary. That's one thing great about TRT.

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Originally Posted by ScotchGuard02

Don't self medicate before you stabilize your TRT regiment. Additional compounds before the TRT could complicate the entire process. Spend the 6 months to 9 months it takes to work through the TRT dose. You want to take enough Test to maximize your numbers but minimal or no AI, if possible. Once have have this number, this is your baseline. Let's say that number is 100mg/wk and this will get you to 600 on the 300 - 890 scale. This is enough to maintain your gains but not enough to build real muscle and shred fat. For that you have to run a cycle. If you run 100mg/wk for TRT + 500mg/wk Cycle = 600mg/wk your Test number could run as high as 2000 or higher. You need numbers like that to be anabolic and build muscle. Run that cycle for 12 weeks and then just go back to TRT dose. No PCT necessary. That's one thing great about TRT.

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Got my first dose today. From here on it will be from home. I received 150mg dose. Seems a good spot to start. I'll continue there (pin twice weekly however) until my first labs at 5 weeks come back. I will also be switching to my Endo in 5 weeks, so this 3 months is expensive and just a start. Apparently my insurance covers my Test vials at ~$10 a vile which will be a month supply due to the open container only lasting 28 days (I'll keep refilling monthly but only use the correct dosage until I'm stable, THEN I'll do a cycle as you suggested for 12 weeks. I'll be patient and dial in my does before I do a cycle. The 'kit' comes with Arimidex and hCG, which is great, but I will not use the AI unless I feel itchy nipples, but I will save them for when I am able to cycle.

I'm glad to be on and heading in the right direction. Thanks for all the feedback Windex and ScotchGuard, especially about how to run the cycle while on TRT, I'll have more questions as I get closer to that date. I am looking for a potential outside online supply since I have a prescription, and eventually a place to acquire the other compounds.

Quote:

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Originally Posted by ScotchGuard02

Don't self medicate before you stabilize your TRT regiment. Additional compounds before the TRT could complicate the entire process. Spend the 6 months to 9 months it takes to work through the TRT dose. You want to take enough Test to maximize your numbers but minimal or no AI, if possible. Once have have this number, this is your baseline. Let's say that number is 100mg/wk and this will get you to 600 on the 300 - 890 scale. This is enough to maintain your gains but not enough to build real muscle and shred fat. For that you have to run a cycle. If you run 100mg/wk for TRT + 500mg/wk Cycle = 600mg/wk your Test number could run as high as 2000 or higher. You need numbers like that to be anabolic and build muscle. Run that cycle for 12 weeks and then just go back to TRT dose. No PCT necessary. That's one thing great about TRT.

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And after that 12 week cycle.. how many weeks before your back to baseline levels of everything. ( not just test) ?

Kyle

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Originally Posted by macmathews

And after that 12 week cycle.. how many weeks before your back to baseline levels of everything. ( not just test) ?

Kyle

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That's a great question. What would the typical time frame be? I'm guessing it varies for each person. Since you have a baseline (TRT dose) established, how long does it take to recede back to base line? Let's just say an increase in Test dose for 12 weeks. What would it take to get levels back to TRT line assuming the average individual, healthy? Or would increasing T "only" even be an option in the long run since receptor sites will down regulate? I'm thinking use an occasional AAS on top of Test, maybe keep the T dose maintenance level?

Saw the Endo today. He wants me to start on the gel. I've done some reading and note that it's effects are variable (even more than the shots) and messy. I'm comfortable with the shots and much rather do a twice a week shot than a gel. As I said, I started with a clinic about a month (clinic = $200/mo) ago, but would rather have an Rx and buy it all 3 months at a time (cash ~ $100/3 month supply). They won't do hCG, and have limited on knowledge on it (he was very dismissive). Seems that (as it was explained to me) if you hit the correct biologic amount that should all self-correct, and I'm inclined to agree but only to an small extent. They drew blood to check my current levels, but I think I'll end the relationship there and continue with the clinic. I just don't get a good vibe from him. Any thoughts to the gel usage?

The gel is hot garbage - it also stinks if I remember correctly and can ruin clothing depending on fabric? Stick to the needle.

I would just find a new endo, even if it means a bit of travel. My observations have been clinics are way more expensive in the long run and are not very helpful, ran like a business rather than a treatment centre.

I use to have to travel 10 hours to see my endo (5 hrs each way). Had to use a vacation day from work every time. Was worth it no questions asked

Quote:

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Originally Posted by Windex

The gel is hot garbage - it also stinks if I remember correctly and can ruin clothing depending on fabric? Stick to the needle.

I would just find a new endo, even if it means a bit of travel. My observations have been clinics are way more expensive in the long run and are not very helpful, ran like a business rather than a treatment centre.

I use to have to travel 10 hours to see my endo (5 hrs each way). Had to use a vacation day from work every time. Was worth it no questions asked

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That's what I thought. He wasn't forcing the gel, but it will be an uphill battle no matter what, and I just do not like him at this point (came off closed minded and way too conservative for me). I have a follow up to review labs, but I'm cancelling it. I thought about discussing gel vs shots with him some more, but it will just be one of many hills to come, which I just shouldn't have to do given the circumstances. Since I do not want to bill the Rx's to my insurance I think I'll see if my primary will write the Rx or in the least suggest another Endo.

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Originally Posted by Amuuzen

That's what I thought. He wasn't forcing the gel, but it will be an uphill battle no matter what, and I just do not like him at this point (came off closed minded and way too conservative for me). I have a follow up to review labs, but I'm cancelling it. I thought about discussing gel vs shots with him some more, but it will just be one of many hills to come, which I just shouldn't have to do given the circumstances. Since I do not want to bill the Rx's to my insurance I think I'll see if my primary will write the Rx or in the least suggest another Endo.

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At the very beginning I told my endo the gel was triple the price and I couldn't afford it. She never brought it up again since.

Update: Ended relationship with Endo, what an ass he was. Luckily my Primary will write for Test, but I have to go in for BW, which is great for me. This will keep me on the injections and keep my dialog open since I have a good relationship with my PCP. So, I should be able to drop the clinic services at this point also ($220/mo is a bit harsh and that's on top of insurance).

Per suggestions (thanks Kel) I'm going to add Tadalafil and perhaps an Alpha-blocker since I have a risk of BPH (family history and couple instances of inflammation of the prostate when I was younger). PSA scores are 0.3 & 0.4 on my last two tests, so they are gtg atm. I'll bring it up when I meet with my PCP and bring in the references to support the use, but I'll defer to his judgement in the end.

I'll be on TRT for life at this point, but I would still like to do a blast 2 or 3 times a year (on the light side), but I still have to figure out the where/when on that. The where is the big hurdle for me. Goal is this Winter to run one. Need to nail down the BW timing and still don't have enough info on my own TRT to say specifics, but it'll happen.

Still on 150mg/week in 2 doses 3.5 days apart (I'm sure this will be reduced a bit)
My last BW:
Total testosterone: 992
Calculated Free testosterone: 29.6 (a little above goal but we will continue to monitor)
Estradiol: 67

Started 0.25mg of Anastrazole per shot day. Making an appt for BW and Rx for next week with PCP. Will update after I meet with him.