Be careful with AIs. I’m on TRT and I’ve felt great with estradiol as high as 50. My other bloodwork is great. Some TRT docs automatically prescribe AIs if your levels are not in the 20s. I also take HCG and feel better with it (not trying to maintain fertility).
I'd like to throw a personal anecdote into this conversation; one I usually wouldn’t because I’m a private person by (near-autist) nature. But, I’m just an anon cartoon character anyway, so WTH.
I suffered from fatigue, inability to concentrate, worsening depression, lack of desire for, well anything positive, in my life for a decade. Doctors couldn't find anything wrong, so they started the normal routine of medicating to fight all the various symptoms – that’s Wester Medicine’s go to for everything.
After leading a far less than optimal (ruinous and demoralizing in so many ways) decade of my life, my primary care physician retired and a new hire took their place. First thing we discussed was the diagnosed mental health issues (i.e., severe depression / anxiety) and associated physical degradation over such a lengthy period of time. I was referred to an endocrinologist.
One full blood panel and Cat Scan later and the verdict comes back as previously undiagnosed secondary ESS (Empty Sella Syndrome). Use your Google Fu for a full explanation, but basically my pituitary gland was shrunken to a fraction of its size due to pressure exerted upon it by cerebral spinal fluid entering the structure that contains it – that isn’t supposed to happen). The pit-g runs your entire endocrine system. Every hormone every other gland my damaged one commanded was somewhat off, but the greatest impact (so far, for I’ll have other battles to wage as I age) was that my testosterone level was only above 200. Way outside the range for a guy my age throughout that hellish period.
6 months of increasingly dosed creams didn’t move the needle. But sticking a 21g needle INTO myself weekly and finding the sweet spot of ml of Cypionate did and still does. It’s been a little over a year and I’ve gradually (it did not happen quickly for me because I had to slowly titrate off a number of meds that were now unnecessary but dangerous to just cold turkey quit, especially simultaneously) improved to having energy and far improved cognitive state.
Best guess when asked to document any significant injurious incidents in my past was head trauma from a well-connected punch/kick/takedown. I’d been involved in the martial arts for most of my life up to the point when I started initially feeling the symptoms. That really sucked because I eventually even had to stop instructing because of the side effects of ESS and the prescribed meds.
There’s numerous morals to my story but the top one I’d offer up is to simply back up Ox on his belief in HRT. It can positively impact your life, especially if your T level is significantly off. Just DYOR. For me, it was, probably, literally, a life saver.
Second moral I’d offer? Second chances are meaningless unless you put in the work - consistently. Be disciplined. Even if HRT gets you to a place where your body is at or near optimal hormonally, that doesn’t absolve you of taking supplements, eating healthily - and doing it smartly like making smoothies to ensure your proper intake of nutrients from fruits and vegetables – aerobic and anaerobic exercising, etc. That’s what I started doing and now I’m remodeling the 500 sq ft spa room at my hobby farm. Putting the hot tub outside, bought some wrestling mats, getting a heavy bag, adding kettles to my free weight rack, etc. I’m not 100% - not even close - and I know it, but I’m coming back.
And while I may choose to continue to live for as long as I can in the middle of God’s country (that’s a WORKING hobby farm with an extremely well stocked pantry, plenty of likeminded family members available, and a sufficient armory) where my nearest neighbor is a quarter mile away instead of heading immediately to DeGen Island 10-15 years from now – I absolutely refuse to eat bugs.
Great write up. I started 1.5yrs ago after hovering at 250-400ng/dl for years. Life changing.
One thing to add: The 2x/day transscrotal cream is a good way to administer for those who aren't a fan of needles. Since its done so frequently, levels stay nice and balanced vs. the peaks and valleys that some ppl experience when injecting too infrequently.
Seems to be conflicting info out there about ease / consequences of efercstopping TRT. Your posts make it out like a once ever decision to start. Would appreciate more detail on what stopping is like (or why philosophically that's a wrong question) - because that's the part that weighs heaviest on my mind.
Been on TRT for health reasons for seven years (post-cancer)
Personal lessons learned:
- SubQ injections with an insulin needle work well and are far less painful than IM, and don't build up the same scar tissue with long term use. You may need to bump the amount up a little
- Inject, no creams.
- do not inject less frequently than once a week. I inject every 3 days. This evens out the T-curve.
- Get your scrip filled at Amazon Pharmacy. They will give you one 1ml vial for each dose. For me, they send me four vials/mo not two like my regular pharmacy does. They do this because they are legally single use vials. But you can use them as multi use vials just fine. This lets you play around a little with your dosage and not have to bother your doc for a new scrip
- Related to the last one, this lets you build up a supply in the cabinet .... at least once a year I have a hard time getting a scrip filled due to supply issues.
Honestly, thank you for this research. I'm 33 and my diet is spot on and I have lifted weights for 15 years.
Recently found out I'm 12nmol which is pretty low and this is why I've been having so many debilitating symptoms. I hope I can get TRT in the near future but due to my job they see the normal levels as 5-29nmol!
What you said about "normal" versus optimal testosterone levels is right on the money. Low testosterone levels make men feel like crud and severely impact their health. There isn't anywhere near enough attention being paid to this right now and it's a real shame. In addition to the natural methods you've mentioned above, I've found that red light can really help raise testosterone levels: https://mattcook.substack.com/p/raising-testosterone-using-red-light
Do you feel as if your need for hydration has increased since beginning?
"Anything below this is inimical to your lifestyle."
Thank you Ox!
Be careful with AIs. I’m on TRT and I’ve felt great with estradiol as high as 50. My other bloodwork is great. Some TRT docs automatically prescribe AIs if your levels are not in the 20s. I also take HCG and feel better with it (not trying to maintain fertility).
Once starting TRT can your body ever produce its own test on its own if you want to come off?
I'd like to throw a personal anecdote into this conversation; one I usually wouldn’t because I’m a private person by (near-autist) nature. But, I’m just an anon cartoon character anyway, so WTH.
I suffered from fatigue, inability to concentrate, worsening depression, lack of desire for, well anything positive, in my life for a decade. Doctors couldn't find anything wrong, so they started the normal routine of medicating to fight all the various symptoms – that’s Wester Medicine’s go to for everything.
After leading a far less than optimal (ruinous and demoralizing in so many ways) decade of my life, my primary care physician retired and a new hire took their place. First thing we discussed was the diagnosed mental health issues (i.e., severe depression / anxiety) and associated physical degradation over such a lengthy period of time. I was referred to an endocrinologist.
One full blood panel and Cat Scan later and the verdict comes back as previously undiagnosed secondary ESS (Empty Sella Syndrome). Use your Google Fu for a full explanation, but basically my pituitary gland was shrunken to a fraction of its size due to pressure exerted upon it by cerebral spinal fluid entering the structure that contains it – that isn’t supposed to happen). The pit-g runs your entire endocrine system. Every hormone every other gland my damaged one commanded was somewhat off, but the greatest impact (so far, for I’ll have other battles to wage as I age) was that my testosterone level was only above 200. Way outside the range for a guy my age throughout that hellish period.
6 months of increasingly dosed creams didn’t move the needle. But sticking a 21g needle INTO myself weekly and finding the sweet spot of ml of Cypionate did and still does. It’s been a little over a year and I’ve gradually (it did not happen quickly for me because I had to slowly titrate off a number of meds that were now unnecessary but dangerous to just cold turkey quit, especially simultaneously) improved to having energy and far improved cognitive state.
Best guess when asked to document any significant injurious incidents in my past was head trauma from a well-connected punch/kick/takedown. I’d been involved in the martial arts for most of my life up to the point when I started initially feeling the symptoms. That really sucked because I eventually even had to stop instructing because of the side effects of ESS and the prescribed meds.
There’s numerous morals to my story but the top one I’d offer up is to simply back up Ox on his belief in HRT. It can positively impact your life, especially if your T level is significantly off. Just DYOR. For me, it was, probably, literally, a life saver.
Second moral I’d offer? Second chances are meaningless unless you put in the work - consistently. Be disciplined. Even if HRT gets you to a place where your body is at or near optimal hormonally, that doesn’t absolve you of taking supplements, eating healthily - and doing it smartly like making smoothies to ensure your proper intake of nutrients from fruits and vegetables – aerobic and anaerobic exercising, etc. That’s what I started doing and now I’m remodeling the 500 sq ft spa room at my hobby farm. Putting the hot tub outside, bought some wrestling mats, getting a heavy bag, adding kettles to my free weight rack, etc. I’m not 100% - not even close - and I know it, but I’m coming back.
And while I may choose to continue to live for as long as I can in the middle of God’s country (that’s a WORKING hobby farm with an extremely well stocked pantry, plenty of likeminded family members available, and a sufficient armory) where my nearest neighbor is a quarter mile away instead of heading immediately to DeGen Island 10-15 years from now – I absolutely refuse to eat bugs.
Great write up. I started 1.5yrs ago after hovering at 250-400ng/dl for years. Life changing.
One thing to add: The 2x/day transscrotal cream is a good way to administer for those who aren't a fan of needles. Since its done so frequently, levels stay nice and balanced vs. the peaks and valleys that some ppl experience when injecting too infrequently.
Seems to be conflicting info out there about ease / consequences of efercstopping TRT. Your posts make it out like a once ever decision to start. Would appreciate more detail on what stopping is like (or why philosophically that's a wrong question) - because that's the part that weighs heaviest on my mind.
Been on TRT for health reasons for seven years (post-cancer)
Personal lessons learned:
- SubQ injections with an insulin needle work well and are far less painful than IM, and don't build up the same scar tissue with long term use. You may need to bump the amount up a little
- Inject, no creams.
- do not inject less frequently than once a week. I inject every 3 days. This evens out the T-curve.
- Get your scrip filled at Amazon Pharmacy. They will give you one 1ml vial for each dose. For me, they send me four vials/mo not two like my regular pharmacy does. They do this because they are legally single use vials. But you can use them as multi use vials just fine. This lets you play around a little with your dosage and not have to bother your doc for a new scrip
- Related to the last one, this lets you build up a supply in the cabinet .... at least once a year I have a hard time getting a scrip filled due to supply issues.
- Above all, manage your own levels.
May be a bit personal but im curious. What events led to you taking TRT in your 20s?
What's the pricing on this per month, range? Looking at Primebody but they ask for a lot of info before mentioning a price.
Honestly, thank you for this research. I'm 33 and my diet is spot on and I have lifted weights for 15 years.
Recently found out I'm 12nmol which is pretty low and this is why I've been having so many debilitating symptoms. I hope I can get TRT in the near future but due to my job they see the normal levels as 5-29nmol!
What you said about "normal" versus optimal testosterone levels is right on the money. Low testosterone levels make men feel like crud and severely impact their health. There isn't anywhere near enough attention being paid to this right now and it's a real shame. In addition to the natural methods you've mentioned above, I've found that red light can really help raise testosterone levels: https://mattcook.substack.com/p/raising-testosterone-using-red-light