Overweight TRT Considerations

JimGainz said:
That first two months is awesome. I think half of it is psychological (the relief/satisfaction of finally being on it) and the other half physiological (your body still producing while TRT is poured on top). As your body's production winds down, the honeymoon period also winds down. Keeping a journal helps you remember what you felt like before starting so you don't somehow believe it's no longer working at 6 mos. Many guys expect that honeymoon high to be permanent and then, when things level out and they feel just normal, they begin to think "this is expensive" and/or "this routine is inconvenient" and they quit.
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Damn, I had never heard of TRT's honeymoon phase. I have only noticed a slight improvement in sleep and tone, but no increase in libido.
 
msyntakz said:
When getting testing through Goodlabs, which labs are you most commonly getting? Do you do the "Men's" panel, or a la carte selections of specific tests?
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I live in way upstate NY; I’ll have to check if they have any close by.
 
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.
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Get your blood/hormones done before you even consider trt especially if you don’t know what you’re doing. Keep on losing weight as the weight is what causing the problems you’re encountering. Eat clean start training.


Whilst it is true that test gives you a great feeling especially confidence take it from me (yes a stranger on the internet) I messed up a post cycle therapy and have screwed my fertility. It’s reversible but gonna take a while.
 
Moonshine72 said:
Damn, I had never heard of TRT's honeymoon phase. I have only noticed a slight improvement in sleep and tone, but no increase in libido.
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Interesting. Well, everyone's different. At the end of your first 90 days, you need to review the ADAMS questionnaire https://www.nature.com/articles/ijir200935 and see how you feel. Those results can be read against your blood lab work and the Dr will adjust your protocol.
 
Moonshine72 said:
No, I was subscribed to a 1 mg tablet of anastrozole by TRTnation in case I noticed any estrogen or titty pain.
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Are you sure they prescribed you 1mg? That is a heavy dose. For small e2 adjustments, smaller dosages of .125mg are common. Crashing e2 is worse than high e2.
 
Moonshine72 said:
Damn, I had never heard of TRT's honeymoon phase. I have only noticed a slight improvement in sleep and tone, but no increase in libido.
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I am about 6 weeks into my TRT and libido is through the roof! Started building about 2 weeks ago. I had heard about this as well. My wife is loving it, I just hope it doesn't wane too much. How long have you been on it and what dose?
 
My consult with TRT Nation is today. Already paid for 2 months. This appointment took 2 weeks. During that time, I have done exhaustive daily research on the pros/cons of TRT. There is a lot to pay attention to, especially constant bloodwork and possible add-ons to minimize the effects of Estrogen. This is a completely different rabbit hole than GLP or Peps. Not sure if I want to really commit to this. My biggest fear is to unwind the last year of dramatic success with Tirz and other peps. At the same time, I do not want to waste this window of momentum in my body recomposition. Still 50/50 whether I will start. Total test is 417, and free is 5.7.
 
chewonmysac said:
... There is a lot to pay attention to, especially constant bloodwork and possible add-ons to minimize the effects of Estrogen. ... Total test is 417, and free is 5.7.
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I was in the low 300s TT and my Uro started me at 70mg/wk and the first couple months was a noticeable improvement! After 90 days I moved up to 100mg/wk and held there for 5 years and just moved up to 150/wk. I have never needed to manage estrogen. Just my honest opinion, if your clinic puts your weekly dose at a level that involves a Rx for an AI "just in case you need it" then that clinic is pushing the envelope on the dose.
 
Llanitox said:
Get your blood/hormones done before you even consider trt especially if you don’t know what you’re doing. Keep on losing weight as the weight is what causing the problems you’re encountering. Eat clean start training.


Whilst it is true that test gives you a great feeling especially confidence take it from me (yes a stranger on the internet) I messed up a post cycle therapy and have screwed my fertility. It’s reversible but gonna take a while.
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I am in my 4th week right now, 120mg/week test cyp. I was tested, and my total test was 285 ng/dL, and free was 9.4 ng/dL. So, I decided to move forward. I agree that a large portion of my issues are from the weight I am carrying. I am now 90 lbs down from my heaviest, and there are big improvements for sure, but I am seeking more mental improvements. The physical benefits are a nice bonus.

I am injecting 4 times per week for more stable blood levels, and it seems to be working well. I have had no sides to speak of in these 4 weeks, even at my body fat percentage. Never touched the AI.

I am guessing my endogenous supply must be reducing by now, as I hit the honeymoon phase for about a week, and now it's leveling back. But sleep is great, mood is stable, pumps in the gym are great, and weight is still trending down. The scale slowed a bit, but I am assuming some water retention, as calories are unchanged.

As far as fertility, I am 37 with two kids, and I am done. I was entertaining a vasectomy anyway, so maybe chemically it will get the job done haha.
 
woundcarping said:
...I started at 120mg/weekly SQ, split 3x. My 8 week labs were great, aside from DHT being low. I bumped my dose to 180mg/week. My labs Monday showed my hematocrit is up to 51.1, I didn’t do a hormone panel, that’ll be next month....

...I haven’t done anything to control estrogen although I have AI on hand. Unless I find symptoms, I’m not particularly worried about my E2. The only current symptom I’m have, in the last couple weeks, is my Oura ring being tighter when I sleep. Same thing happened when I started, gained 3lb overnight, classic signs of water retention. It resolved in early March, as expected. I’ll have a hormone panel done next month at 8 weeks at this dose and see how I’m doing.
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msyntakz said:
...Also the symptoms to watch for regarding E2 is helpful to know, and watching for water weight swings. Appreciate all that!
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Still waiting on my DHT results from last Monday's labs, but going from 120mg/week to 180mg/week raised my hematocrit to the point of donating blood Tuesday. I'll go tomorrow to see what my levels are after donation.


I started supplemental creatine at the end of April... I'm expecting I've got an extra 3-6lb of lean mass from that, but haven't confirmed that with a DEXA yet.

Marker03-16-202605-18-2026Change
Weight247lb227lb-20
Total Testosterone680.8 ng/dL774 ng/dL+93.2
Free Testosterone23.4 pg/mL24.4 pg/mL+1.0
Estradiol Sensitive26.2 pg/mL21.0 pg/mL-5.2
SHBG18.6 nmol/L24.3 nmol/L+5.7
DHT20ng/dLPending—
Hematocrit48.3%56.4%+8.1
 
woundcarping said:
Still waiting on my DHT results from last Monday's labs, but going from 120mg/week to 180mg/week raised my hematocrit to the point of donating blood Tuesday. I'll go tomorrow to see what my levels are after donation.


I started supplemental creatine at the end of April... I'm expecting I've got an extra 3-6lb of lean mass from that, but haven't confirmed that with a DEXA yet.

Marker03-16-202605-18-2026Change
Weight247lb227lb-20
Total Testosterone680.8 ng/dL774 ng/dL+93.2
Free Testosterone23.4 pg/mL24.4 pg/mL+1.0
Estradiol Sensitive26.2 pg/mL21.0 pg/mL-5.2
SHBG18.6 nmol/L24.3 nmol/L+5.7
DHT20ng/dLPending—
Hematocrit48.3%56.4%+8.1
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Hema is very high... Donating will get it down maybe 5 points but it will creep back up.
Did you take the lab after pinning? If you did that could be a peak.
You need pound water like your life dependent on it.
How frequent are you pinning?
 
sfkid said:
Hema is very high... Donating will get it down maybe 5 points but it will creep back up.
Did you take the lab after pinning? If you did that could be a peak.
You need pound water like your life dependent on it.
How frequent are you pinning?
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I increased my dose from 120mg/week to 180mg between those labs based on the DHT being low. I've cut the dose back to 150mg based on the hematocrit peaking and the total/free basically shrugging it off.

I take TRT labs the same point in every week. Like the quoted post said, I pin 3x weekly.

It's possible I had less than ideal hydration the day before May's labs, although I drank my usual amount of water before the draw.

I started TRT on 1/19. Dose increase on 3/25. Dose reduction on 5/20. I have labs planned for tomorrow, June, July, August, and Oct/Nov... data comes in, I'll adjust my monitoring schedule.
DateHCT
12-30-202549.4
03-16-202648.3
04-07-202653.3
04-20-202651.1
05-18-202656.4
 
Well, got my partial 6-week blood results back, and the blood is indeed thickening:
1781357100258.webp

It's possible that it's an elevated level from dehydration. I have such a hard time with it on these GLP1s. This is on 120mg test cyp split shots, 4x 30mg per week. Yet to see what the hormone side looks like, but wanted to see what success folks have had lowering hematocrit without donating. I really don't want to get into that rebound cycle.

EDIT: Hematocrit was 46.6 previously, for context.
 
msyntakz said:
Well, got my partial 6-week blood results back, and the blood is indeed thickening:
View attachment 27360

It's possible that it's an elevated level from dehydration. I have such a hard time with it on these GLP1s. This is on 120mg test cyp split shots, 4x 30mg per week. Yet to see what the hormone side looks like, but wanted to see what success folks have had lowering hematocrit without donating. I really don't want to get into that rebound cycle.

EDIT: Hematocrit was 46.6 previously, for context.
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if your drinking enough water and doing enough cardio then the next thing to change is to switch to subq injections from IM. Subq will have slower up take than IM and produce more steady levels.
How long was your last injection from the blood test day?
Typically injections are Mon,Wed,Friday and test days are Monday. This way you give 2 days for levels to stable out, not to capture peaks levels, before doing blood work.
 
sfkid said:
if your drinking enough water and doing enough cardio then the next thing to change is to switch to subq injections from IM. Subq will have slower up take than IM and produce more steady levels.
How long was your last injection from the blood test day?
Typically injections are Mon,Wed,Friday and test days are Monday. This way you give 2 days for levels to stable out, not to capture peaks levels, before doing blood work.
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I’m doing 4 sub q per week already. I tested yesterday (Friday) before my injection, last injection was Wednesday morning. I definitely need to up my water and I can always use more cardio. I guess those are my next goals.
 
msyntakz said:
I’m doing 4 sub q per week already. I tested yesterday (Friday) before my injection, last injection was Wednesday morning. I definitely need to up my water and I can always use more cardio. I guess those are my next goals.
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What did your total test/free come back as on 120mg?
 
I was scheduled for blood work on Thursday but ended up having entirely too much whiskey on Wednesday so was concerned as that can affect hematocrit levels.

I also take a diuretic for blood pressure which can be a contributing factor.
 
sfkid said:
What did your total test/free come back as on 120mg?
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Still awaiting those results. I am anxious to see where I'm at as I am nervous to increase dosage with these results on the blood thickness. Again, there are still levers I can pull to correct, but we shall see.

The overall advice I keep hearing is not to donate if possible.

I really want to focus on good hydration and fitness the next six weeks and recheck CBC and see where it lands.
 
msyntakz said:
Still awaiting those results. I am anxious to see where I'm at as I am nervous to increase dosage with these results on the blood thickness. Again, there are still levers I can pull to correct, but we shall see.

The overall advice I keep hearing is not to donate if possible.

I really want to focus on good hydration and fitness the next six weeks and recheck CBC and see where it lands.
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One thing thing is to check your blood pressure. If you have good read outs then hema levels become less worrisome.
But overall , yes , pound lots of water and do more walking daily....
 
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