Results Trt
Unlike some medications Testosterone generally doesn’t provide instant results. Rather your body goes through a series of changes as the testosterone in your body builds back up to normal levels. I was reading an article written by expert Lee Myer over on Peak Testosterone about his first experience being instantly noticeable. My personal experience was similar. My Testosterone levels came in around 230 when I first had my blood work pulled. After deciding on a course of action with the doctor, I bent over and took my first 200mg of Test. at the doctor’s office while my wife observed the procedure for future injections. Within 10 minutes I felt a difference. Within a few hours I could tell the Testosterone was working within my body.
For most men the process is much longer, usually 8-14 weeks. Let’s take a look at some of the symptoms you might be experiencing:
- Mental Fog (This was especially noticeable for me as a web developer)
- Erectile dysfunction (in more extreme cases)
- Decreased morning erection
- loss of muscle and an increase in body fat
- Fatigue
- Depression
- Low Labido
- No desire for sexual intercourse or a lack of interested in the opposite sex (or the same sex I suppose. I can’t relate to this personally)
Proof that Qualification Standards have been met must be verifiable by official race results on Ultra Signup or results listed in Ultrarunning Magazine: 1. 50 miles in less than 15 hours or the TRT 50-Miler in less than 17 hours,or 2. 100 kilometers in less than 20 hours, or 3. This has allowed me to see the huge difference in blood results from before and after TRT. I recognized early on that my health was my duty and sole responsibility. Too many people rely on others to be the guardians of their health.
- If you want exceptional results on TRT, you need be prepared to live an exceptional life! A life filled with choices that require effort and diligence. Lazy, unmotivated, unwilling to grind Men should stop reading now.
- Usually, patients feel the results of Testosterone before they start to see the effects of their treatment. Most men taking testosterone report a boost in sex drive, increased energy, improved mood and sense of well-being with the first week or two of TRT. Learn more about Testosterone Replacement - Testosterone Therapy.
The general consensus is that the following timeline will roughly estimate how your therapy will progress:
- Effects on libido, sexual desire, sexual thoughts and satisfaction with sexual life manifest after 3 weeks and plateau at 6 weeks
- Changes in erections and ejaculations, sexual performance and satisfaction with erections usually achieved within 3–6 months
- Effects on quality of life evident within 3–4 weeks and continue to develop for up to 18 months
- Effects on depressive mood noted after 3–6 weeks but may reach a maximum only after 18–30 weeks
- The time course for improvements in lipids varies:
- Decreases in total cholesterol and triglycerides appear as quickly as after 4 weeks, but more commonly after 3 months or longer; a maximum may be reached after 12 months
- Decreases in low-density lipoprotein (LDL) cholesterol may be slower, occurring after 3–12 months, with a maximum reached after 24 months
- Increases in high-density lipoprotein (HDL) cholesterol may occur after 3–12 months, with further improvement for 12–24 months
- Effects on glycaemic control become evident after 3–12 months, although insulin sensitivity may improve within a few days
- Changes in fat mass, lean body mass, and muscle strength occur within 12–16 weeks and stabilize at 6–12 months, with marginal further improvements possible over years
- Effects on bone mineral density are detectable after 6 months and continue for at least 36 months
- Effects on inflammatory factors and endothelial markers noted within 3–12 weeks
- Stimulatory effects on erythropoiesis are dose-dependent and apparent at 3 months, peaking at 9–12 months
- Prostate-specific antigen (PSA) and prostate volume marginally rise, plateauing at 12 months; further increases may be related to aging rather than testosterone replacement therapy.
While the above is a collective set of guidelines it should give you a better understanding of what to expect. Note that the above study shows a minimum time of 3 weeks before you notice any significant changes. Patience is a virtue when it comes to TRT. I know you’re probably looking for faster results, but if you’ve gone this long without realizing you have low testosterone a couple months is manageable. Trust me when I say the end result will be worth the wait! In the mean time I highly suggest looking into a workout regime that’s easy for you. (When I say easy, I mean anything that gets the ball rolling) You’ve already started researching how Testosterone affects the male body, why not learn how the food you eat does too. High fat levels in men not only affect your T levels they also help the enzyme aromatase convert what little testosterone you have into estrogen.
Beware of the bi-weekly and monthly large dose schedule
I’m unsure as to why this is so common but I’ve read it time and time again where a doctor prescribes a rather large dose broken into a 2 week schedule or worse – monthly. Let’s say John visits his doctor, the doc runs a few tests and the results confirm what John expected: he has low testosterone. The doctor prescribes 1ml of 200mg test twice per month. Great! Right? Not usually. John is very likely to experience what we call “high’s and low’s”. The first week John feels pretty good and the second week, just shy of his next injection John feels miserable and most of his symptoms have returned. He takes his next injection, feels great and so the roller coaster ride continues. A monthly dose can prove to down right horrible. I’ve personally experienced highs and lows on a biweekly schedule but thankfully my doctor was quick to remedy the situation. (My personal doctor had been extremly helpful during my beginning stages)
So why does this happen? Cypionate has a half-life of around 5-8 days for the majority of most men, so John had little testosterone in his system after about 10 days. Furthermore larger doses spread out over long periods of time can lead to estradiol spikes which will welcome you into a world of symptoms far worse than you’ve ever experienced before.
Results Tracking
So, What was my experience like?
Every guy goes through TRT a little differently but I’ll share my personal experience. After going through the blood work and the usual doctor’s visits I started on 200mg of Test. Cypionate biweekly. The first week I noticed changes right away. They were what you’d call small to most men but were huge to me. First I started waking up after only 7 hours of sleep and feeling pretty great. (I used to sleep upwards of 10 hours a day. These days 7 hours is more than enough sleep for me)
4-5 weeks pass and I start to notice more changes, specifically women. Or at least being more hyper aware of them. At the time my wife and I were still dating and I always prided myself on not being “one of those guys” that constantly checked out other women. I could never relate to the jokes in movies or insults about men checking out other women while being with their significant other. I started noticing women everywhere. In Wal Mart, at the mall… my instinct was telling me “make babies with all of them!” ok perhaps not that bad, but it was a noticeable change. The second noticeable change was what I can only describe as a courageous almost bodyguard like instinct. Now I’m not saying I turned into Jason Bourne but I wasn’t just aware of women in my presence, I was more aware of other men. I used to be a fairly non confrontational guy (still am mostly unless it involves family) and felt fairly uncomfortable walking through a dark parking lot at night. After 6-8 weeks on TRT the opposite was true. In fact I could say I almost welcomed the experience of being in a slightly shady area than normal. If I was with my children or my better half and another man walked by gazing at what I felt was too long, I had zero issues stopping in my place, turning my head with a “The’ hell are you looking at” face. (This eventually mellowed out a bit) But the confidence I gained was extremly noticeable. I’ve never been a writer and perhaps my wordage here isn’t great but the point I’m trying to make is testosterone just make you feel more aggressive.
And of course there were improvements in my labido and general interest towards sex. I’ve never had issue with my soldier standing full salute but these days it’s gone from full salute to wrath of the titan. My wife is particularly pleased with the results.
So overall I had very positive results far too many to list here. Unfortunately this was short lived as I started experiencing symptoms of high estriol. This was true even after switching to a weekly schedule. Thankfully that dark period of uncontrolled estrogen has seen be resolved. You can read more about estrogen and E2 control here.
Men Taking Testosterone Are Often Way Overdosed
A good percentage of men who are undergoing 'testosterone replacement therapy' are fooling themselves. They think they're merely 'replacing' the testosterone that has been lost to time and aging. Many of them, though, while they are loathe to admit it, are actually on mild steroid cycles.
Look, by definition, testosterone REPLACEMENT means putting back what was lost – bringing testosterone back to normal or even high-normal levels.
Here's the problem: The average adult male produces 6 mg. of testosterone per day. That is 42 mg. per week. The normal production range is from 5 to 10 mg. per day. Even at the highest production level, we're only talking about 70 mg. a week.
A replacement dose should therefore fall between 40 and 70 mg. a week. Up to roughly 90 mg. would still be within the realm of normalcy. How much an individual man would need, though, depends on many factors, including levels of steroid hormone binding globulin (SHBG), albumin, and aromatase, but by and large, the ranges listed apply to the vast majority of men.
The issue is that many men have cajoled their doctors into giving them 200-300 mg. a week, and that's actually a mild steroid cycle and not testosterone replacement therapy.
It's time for these guys to acknowledge that the great gains they've been making in the gym are often largely due to their faux TRT and not their great knowledge of training or nutrition or their heroic intensity.
'Yeah, But if a Doctor Gave it to Me, It's TRT!'
I think the problem is that some people automatically assume that if it's prescribed by a doctor, it's legitimate TRT.
I know plenty of guys who went to doctors and were able to get a prescription for 200-300 mg. a week simply by doing some Academy-award worthy acting. They claim they just didn't feel like their old selves on 'meager' doses of 100 or 150 mg. a week.
I even know one guy who convinced his doctor to give him a prescription for 600 mg. a week! Regardless, that doesn't change the fact that 200-300 mg. a week is up to 5-7 times the male weekly testosterone production and cannot be called replacement.
Of course, the perception that 200-300 mg. a week constitutes a replacement dose might come from how a lot of doctors prescribe TRT. A very common approach is to give a patient one 200 mg. injection of testosterone cypionate or enanthate every two weeks, causing some patients to conflate that two-week dosage with a one-week dosage.
Some of these problems were initiated by the doctors themselves. They sometimes erroneously prescribe doses that are high because they measure blood levels of testosterone at incorrect or unrealistic times. This may result in a 'low' reading, even when doses are fairly high.
Testosterone cypionate and enanthate, the most commonly used versions of testosterone in TRT, have a release time of around 10 days. Hence the original bi-weekly injections.
It's often believed that the absorption is gradual and linear, meaning that the body will cleave off enough of the ester to free 1/10th of the dose per day, thus allowing levels to remain 'normal' or 'high normal' for 12 days or so.
First understand that a 200 mg. dosage of testosterone cypionate does not actually contain 200 mg. of pure testosterone. It's 140 mg. of testosterone and 60 mg. of cypionate ester, so an injection of 200 mg. of test cypionate releases around 10-14 mg. of testosterone per day. That's still above 'normal levels' but it's in the realm of acceptable.
But here's the thing: Testosterone cypionate is indeed released over 8-10 days, but the absorption rate is very fast for the first four days. After that, it trails off.
See the graphic below from the textbook, 'Testosterone: Action, Deficiency, Substitution.' Blood levels of testosterone drop dramatically after a few days. As such, if blood levels are measured four days after injection, you get a misleading reading. It's even worse if the test occurs 8, 9, or 10 days later, in which case it will barely be higher than the patient's starting number.
The doctor will likely then increase the dose, and that's another reason why some doctors end up prescribing 200 mg. or more per week. So I repeat, 200 mg. or more is not a replacement dose, but an enhancement dose.
'But I Get No Extra Benefits from 300 mg. a Week!'
Many bodybuilders or former bodybuilders will often defend their high doses by claiming they don't progress faster than someone who is natural. That might very well be true, but consider the facts.
If you're someone who has been using typical competitive bodybuilder doses of steroids (which are all synthetic analogues of testosterone) like 1000-2000 mg. per week (some take a boatload more) for a significant period of time and then go down to 200-300 mg. per week, you won't be able to build much additional muscle.
However, the simple fact that you can maintain the muscle you have on 200-300 mg. week shows that it's having dramatic effects.
But put a lifetime natural, hard-training guy on 300 mg. of testosterone per week and I guarantee that he will progress much faster than when he was natural.
It's Not Wrong, But...
All this having been said, I have nothing against people who use 200, 400, or even 6000 mg. per week. You can do what you want with your body. And if you're smart about it, you can use testosterone very safely.
All I'm saying is that 200-300 mg. of testosterone is not TRT, and by propagating the belief that 200-300 mg. a week is TRT, we are influencing people's perceptions, which can lead to some of them making bad decisions.
Consider that people who take higher doses have an increased incidence of side effects like elevated hematocrit levels, fluid retention, gynecomastia, worsening of sleep apnea, polycythemia, and possible acceleration of benign or malignant prostatic disease.
Whether that last point is absolutely true remains controversial, but it is something every user or potential user of high doses of testosterone needs to take into consideration.
I should also acknowledge that many men use testosterone patches or gels instead of administering injections. These generally represent more appropriate dosing protocols. Case in point, patches deliver 4-5 mg. per day. Gels are dosed at 40-50 mg. per day, but the bioavailability of the gels is 10-15%, which makes the daily dose equivalent to 4-7 mg. That's well within the realm of legitimate T replacement.
The Best TRT Approach
I'm not a doctor, much less an endocrinologist. However, my opinion about what is the best TRT approach sides with the late Dr. John Crisler, which is 7-10 mg. of subcutaneous (injected under the skin near the umbilicus) testosterone (likely propionate) per day.
Results Trt
That roughly equates to anywhere from 70 to 100 mg. a week. That is TRUE testosterone replacement therapy and will bring testosterone levels up to the high-normal range in the aging male. It's unlikely to lead to side effects and will actually be good for your health.
Of course, if you're someone who used high doses of steroids for a long time, this will not be enough to allow you to maintain all the muscle you've built. There is instead a good chance that you will need a 'muscle retention therapy' approach rather than a TRT approach. That means possibly using dosages of up to 200 to 300 mg. a week.
Men who are experiencing mild symptoms of testosterone deficiency and who are not ready to undergo prescription TRT might consider an over-the-counter alternative like Biotest's Alpha Male®. Unlike actual testosterone replacement, Alpha Male will not cause your testicles to go dormant. Instead, it will coax your pituitary gland and testicles into making more testosterone.
Either way, my point remains: Men who are using 200 to 300 mg. of 'TRT' a week are deluding themselves, and that is my unpopular opinion.
Results Trump
Related: The Complete Guide to T Replacement
Related: High-Dose TRT or Mild Steroid Cycle?
Results Track World Championships
References
- Behre, H., Wang, C., Handelsman, D., & Nieschlag, E. 'Testosterone: Action, Deficiency, Substitution.' Cambridge: Cambridge University Press, 2004. pp. 405-444.
- Bhasin S1, Woodhouse L, Casaburi R, Singh AB, Bhasin D, Berman N, Chen X, Yarasheski KE, Magliano L, Dzekov C, Dzekov J, Bross R, Phillips J, Sinha-Hikim I, Shen R, Storer TW. 'Testosterone dose-response relationships in healthy young men,' Am J Physiol Endocrinol Metab. 2001 Dec;281(6).
- Matsumoto AM. 'Andropause: clinical implications of the decline in serum testosterone levels with aging in men,' J Gerontol A Biol Sci Med Sci. 2002;57:M76-99.