Overweight TRT Considerations

msyntakz

msyntakz

GLP-1 Apprentice
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Apr 13, 2026
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Michigan
37 years old, 6'4", CW: 310lbs, GW: 225lbs

Current meds: 2mg Tirz, 1mg Reta, 5mg Tadalafil (Cialis) daily for cardio health and gym pumps

I have never had my hormones tested. I don't have any dramatic symptoms of low test, but basically general mental health issues, no morning wood, low energy and motivation... generally mid-life attributed types of things. I have always been overweight, diagnosed Bipolar at my heaviest of 390 in 2022. I have always attributed a large portion of my mental health issues to my weight, and they have greatly improved with the weight loss so far. So, I am assuming things will only get better as I lose more fat mass.

My question: Should I wait until I get leaner before exploring hormones/test issues? As in, will my current fat content largely influence my hormones to a point where I could have decently stable levels once leaner? I worry about going on TRT and ruining my natural production before getting to a point where I could have possibly been fine on my own. Do docs take this into consideration?

My trials through dealing with Bipolar disorder have greatly shaken my confidence in the medical world, the definition of darts at a dart board, shoulder shrugs when things don't work, and poor response to regular blood testing that indicated issues but still had me stay the course, which led to acute liver failure. And this has been my experience with a variety of providers. So, I am not super trusting of white coats alone.

Appreciate any input.
 
I'm 39, 40 next month. Started Tirz in December at 282lb, switched to Reta in January, currently 235lb.

I had a Dx of low T back in 2021 but didn't comply with sticking the drinking straw in my thigh for IM injections.

You can test your hormones without seeing a doctor using a place like Fitomics (who I use) for discount labs that you can take to a TRT provider (which can be online, I use TRTNation). Without knowing your levels, it's hard to offer advice. More fat will convert more to estrogen, but that's not a reason to not do it, IMO.


If you have low T, being on TRT will help preserve lean mass as you drop weight... not to mention the typical benefits of having in range test levels.

I took 40mg 3x weekly for the first 8 weeks, labs came back with everything being good except my DHT. I bumped my dose to 60mg 3x weekly and will retest next month if not before. I'm expecting my hematocrit to be elevated and require corrective action.



The main thing that stuck out to me in your post was the low dose of both Reta and Tirz. Typically low doses are more commonly touted as effective by the smaller portion of the population.
 
woundcarping said:
I'm 39, 40 next month. Started Tirz in December at 282lb, switched to Reta in January, currently 235lb.

I had a Dx of low T back in 2021 but didn't comply with sticking the drinking straw in my thigh for IM injections.

You can test your hormones without seeing a doctor using a place like Fitomics (who I use) for discount labs that you can take to a TRT provider (which can be online, I use TRTNation). Without knowing your levels, it's hard to offer advice. More fat will convert more to estrogen, but that's not a reason to not do it, IMO.


If you have low T, being on TRT will help preserve lean mass as you drop weight... not to mention the typical benefits of having in range test levels.

I took 40mg 3x weekly for the first 8 weeks, labs came back with everything being good except my DHT. I bumped my dose to 60mg 3x weekly and will retest next month if not before. I'm expecting my hematocrit to be elevated and require corrective action.



The main thing that stuck out to me in your post was the low dose of both Reta and Tirz. Typically low doses are more commonly touted as effective by the smaller portion of the population.
Click to expand...
Appreciate the in-depth response and the advice for different labs and TRT providers besides a PCP. I'm really new to this side of things. You're right, having more information can't hurt. I'm definitely one who likes to have data. I think most of us do, I just don't want to be railroaded in a specific direction without doing my own due diligence, which has been my experience with PCPs. My way or the highway kind of thing.

Also, a good point on preserving lean mass during fat loss.

Regarding the low doses of Tirz and Reta, I have been responding to it so well, I have almost thought of backing one of them down from where I'm currently at. I'm 5 weeks in, and food is a chore currently. I'm glad for it, so I can stretch the meds out longer. Thanks again for the tips. I'll look into testing to get some accurate numbers at least.
 
It never hurts for a man to know his testosterone levels. I have learned from my mistake from listening to a gym bro. He talked me into taking his "low maintenance dose" of testosterone. A month into it my son demanded that I get tested to see if I really needed it. It took a few more weeks to notice that I was screaming at other drivers on the road. I was thinking roid rage, I should get checked. I tested at 1800 ng/dl which is 800 more than an athlete a third of my age. I hadn't had a shot for a week at that point. Two weeks later I was down to 1300, then three weeks after that it was 224. My body had quit making it's own testosterone and I was way low.
Since then I've watched it slowly go back up as my body started making it's own again. I'm mid-range for a man my age today. I should have had the information before I started. Your needs are probably different than mine, however having test results first helps in making the right decision.
 
I am currently searching, but if anyone has go-to testing providers that they use for this, I would appreciate the recommendation.
 
msyntakz said:
I am currently searching, but if anyone has go-to testing providers that they use for this, I would appreciate the recommendation.
Click to expand...
Like I said, I use Fitomics Labs to get Labcorp lab work done.

My last test was a cbc, cmp, amylase and lipase test for something like $13 with my membership and the Easter discount.

I like data, happy to pay for quality, actionable data.

There’s at least one thread about Fitomics here.
 
woundcarping said:
Like I said, I use Fitomics Labs to get Labcorp lab work done.

My last test was a cbc, cmp, amylase and lipase test for something like $13 with my membership and the Easter discount.

I like data, happy to pay for quality, actionable data.

There’s at least one thread about Fitomics here.
Click to expand...
Ok, great! My bad, when I checked it initially, I missed the portion about the membership and all those benefits. I was seeing a local provider/location, thought it was a more localized provider. Appreciate you!
 
msyntakz said:
Ok, great! My bad, when I checked it initially, I missed the portion about the membership and all those benefits. I was seeing a local provider/location, thought it was a more localized provider. Appreciate you!
Click to expand...
fitomicslabs.com

Fitomics Research Labs | Order Blood Work & Biomarker Testing Online

Shop blood work panels and biomarker tests with convenient nationwide lab access and actionable result reporting.
fitomicslabs.com fitomicslabs.com

You don’t have to have a membership to order, but it can be worth it.
 
Fitomics lab orders made for Men's Hormone Panel and HB A1c, to cover hormones, blood panel, lipids and blood glucose numbers since I am doing the GLP-1 thing. Will update here with hormone levels when I get results. Will be interesting to see.
 
My brother I wish you luck. TRT definitely helps you even if your fat. I was fat when I started. I started TRT and Sema at the same time 2.5 years ago. I am 6’3 and was 269lbs 30% body fat when I started. My weight now fluctuates between 220-230 and my body fat is 15-18%. I bet I could have healthy natural T levels now that I’m not fat and also when I started this health journey I got diagnosed with sleep apnea and I use my cpap every night. Untreated Sleep apnea lowers T. Don’t be afraid to go grey for testosterone 🤣 more like UGL.
 
woundcarping said:
I'm 39, 40 next month. Started Tirz in December at 282lb, switched to Reta in January, currently 235lb.

I had a Dx of low T back in 2021 but didn't comply with sticking the drinking straw in my thigh for IM injections.
Click to expand...

What size needle you using for your IM trt? Personally I use 25ga in the glute
 
Volkswagen57 said:
What size needle you using for your IM trt? Personally I use 25ga in the glute
Click to expand...
I like 25g to draw and 27g to inject. Delts are my favorite spot and sometimes I do thigh. Sometimes i also just use a 27g insulin syringe. A real game changer is get a mug warmer and heat your oil up before injection it makes it super smooth and draws up fast even with the slin pin.
 
Volkswagen57 said:
What size needle you using for your IM trt? Personally I use 25ga in the glute
Click to expand...

29ga SQ😂

I did a thigh IM with a 29 gauge last week but it was sore like before with the 25ga so meh on that.

I use a little cup and warm water from the sink for my vial. Expz
 
Volkswagen57 said:
What size needle you using for your IM trt? Personally I use 25ga in the glute
Click to expand...
27g insulin 1/2” - I’m lean enough now that it ends up being IM in my quads. SQ caused sore lumps. Been doing 25 mg daily for 10 weeks now - first follow up labs this week! Was borderline low (453) at baseline before first pins.
 
woundcarping said:
That’s about 50% higher than the typical clinical border line to low (300ng/dl).

I was at 263ng/dl in 2021, 239 at the end of 2025. The 263 met the criteria for insurance to cover it back then.
Click to expand...
Yeah different labs use different reference ranges. Goodlabs calls 300-499 “normal” but color it yellow (makes you think “cautionary”). 500-999 is “optimal” (green). My PCP’s health system calls it all (300-999) “normal.”
 
I've had Low T for decades due to illness. Started with infrequent shots, more frequent shots, Androgel and other prescription topical gels, back to shots, then finally compounded 20% T creme applied daily.

Any of it drives estradiol, red blood cell count/hematocrit way up. I will have to donate a pint of blood this week.

I really need to be over 450ng/dl. But cant tell the difference between 450 and 900 (where I am now)

Bottom line, I wish I did not have to be on T replacement. I'd do just about anything to have normal and natural T levels over 450
 
That's interesting, I've tried 23g and they work best for me. Do you think they're too thick for the glutes? I've even used 21g on my shoulders, and 25g, but it hurts if I use more than 0.5 ml afterwards.
 
I started TRT when I was about 255 pounds. At 5 9 I was very overweight. I had been lifting for almost 2 years and not making hardly any progress. Well the testosterone made a huge difference i started getting stronger right away and hungry! I gained 15 to 20 not good pounds in very little time.

Thats when I started Tirzepatide and lost a bunch of weight over the next 8 months.

So I had good luck doing both at the same time.

Im just under 200 wearing size 31 jeans now. I still use a low dose of tirzepatide to take the edge off of food noise and for the anti inflammatory benefits. Im in more of a slow recomp, long term plan now.
 
latviantower said:
27g insulin 1/2” - I’m lean enough now that it ends up being IM in my quads. SQ caused sore lumps. Been doing 25 mg daily for 10 weeks now - first follow up labs this week! Was borderline low (453) at baseline before first pins.
Click to expand...
I use 1-1/2" needles personally
 
Omxxl said:
That's interesting, I've tried 23g and they work best for me. Do you think they're too thick for the glutes? I've even used 21g on my shoulders, and 25g, but it hurts if I use more than 0.5 ml afterwards.,
Click to expand...
I use 23g on glutes. Used to use 22g for some stupid reason decades ago. I feel like 25g more common now in the glute but many of like the 23 garage for more study needle and easier injection of the oil (especially at over .5ml). Personal preference. That artery in that area would take a 2 inch needle probably to get there, so 1.5 inch 23 garage is just fine for me.
 
If you are severely overweight, I advise to lose some pounds first . Test aromatize to estrogen and visceral fat contains aromatase which cause you to deal with estrogen issues.

After losing weight you might see your test levels rise as a consequence.
 
sfkid said:
If you are severely overweight, I advise to lose some pounds first . Test aromatize to estrogen and visceral fat contains aromatase which cause you to deal with estrogen issues.

After losing weight you might see your test levels rise as a consequence.
Click to expand...
I am 6'4" and 310lbs. I have decent muscle, but yeah, plenty of fat. That's plain and simple at that weight. I have a hormone panel in the works, blood drawn, just awaiting the testosterone portion to come back.

I did get the Estradiol back: 54 pg/ml. Higher than I wanted to see, but we shall see what the testosterone says.
 
msyntakz said:
I am 6'4" and 310lbs. I have decent muscle, but yeah, plenty of fat. That's plain and simple at that weight. I have a hormone panel in the works, blood drawn, just awaiting the testosterone portion to come back.

I did get the Estradiol back: 54 pg/ml. Higher than I wanted to see, but we shall see what the testosterone says.
Click to expand...
For reference, that’s my e2 level running about 400mg of test weekly (with no AI). I’d probably want to take .25 of Armidex on pin days if my e2 were that high (I start to have symptoms at that level). Didn’t that flag high well out of range?
 
Gt3294a said:
For reference, that’s my e2 level running about 400mg of test weekly (with no AI). I’d probably want to take .25 of Armidex on pin days if my e2 were that high (I start to have symptoms at that level). Didn’t that flag high well out of range?
Click to expand...
I think it shows in range for the scale it's on, because it's a broad-use panel, and this one isn't male-specific. But in the key below, the bottom right of the screenshot, it shows out of range for males.
1776734115402.webp
 
msyntakz said:
I think it shows in range for the scale it's on, because it's a broad-use panel, and this one isn't male-specific. But in the key below, the bottom right of the screenshot, it shows out of range for males.
View attachment 20634
Click to expand...
Test levels will be instructive. The first step of all of this is what you are doing - caring about your own blood work. Been at this for 3 decades, and one thing I know for sure, caring yourself and taking the time to research all yourself really matters because I’ve ran into so many pathetic doctors that don’t care, are lazy, incompetent, or some combination thereof. Good luck with it all.
 
Gt3294a said:
For reference, that’s my e2 level running about 400mg of test weekly (with no AI). I’d probably want to take .25 of Armidex on pin days if my e2 were that high (I start to have symptoms at that level). Didn’t that flag high well out of range?
Click to expand...
Damn I'm jealous. I wish I could run that with out an AI. At 200 per week , I needed .5mg of AI.
 
msyntakz said:
37 years old, 6'4", CW: 310lbs, GW: 225lbs

Current meds: 2mg Tirz, 1mg Reta, 5mg Tadalafil (Cialis) daily for cardio health and gym pumps

I have never had my hormones tested. I don't have any dramatic symptoms of low test, but basically general mental health issues, no morning wood, low energy and motivation... generally mid-life attributed types of things. I have always been overweight, diagnosed Bipolar at my heaviest of 390 in 2022. I have always attributed a large portion of my mental health issues to my weight, and they have greatly improved with the weight loss so far. So, I am assuming things will only get better as I lose more fat mass.

My question: Should I wait until I get leaner before exploring hormones/test issues? As in, will my current fat content largely influence my hormones to a point where I could have decently stable levels once leaner? I worry about going on TRT and ruining my natural production before getting to a point where I could have possibly been fine on my own. Do docs take this into consideration?

My trials through dealing with Bipolar disorder have greatly shaken my confidence in the medical world, the definition of darts at a dart board, shoulder shrugs when things don't work, and poor response to regular blood testing that indicated issues but still had me stay the course, which led to acute liver failure. And this has been my experience with a variety of providers. So, I am not super trusting of white coats alone.

Appreciate any input.
Click to expand...
Reread this and seen the bipolar part. All the love your way. I don’t personally have it but a couple close family members do and I have seen the struggles first hand. It’s a sinister disease I wish no one had to suffer. Breaks my heart. Stay fighting brother and never stop advocating for yourself. I saw it go two different ways. One sort of gave up trying 20 years ago after a breakdown, divorce, and took an early disability retirement. The other is a fighter who try’s their best to live a normal life. Both are type 1 with 5+ hospitalizations
 
Fordhayes said:
Reread this and seen the bipolar part. All the love your way. I don’t personally have it but a couple close family members do and I have seen the struggles first hand. It’s a sinister disease I wish no one had to suffer. Breaks my heart. Stay fighting brother and never stop advocating for yourself. I saw it go two different ways. One sort of gave up trying 20 years ago after a breakdown, divorce, and took an early disability retirement. The other is a fighter who try’s their best to live a normal life. Both are type 1 with 5+ hospitalizations
Click to expand...
Appreciate you very much for the kind words! Nothing but hope and love to those dealing with it in your world!
 
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