9/4/14 — G.L.’s experience with TRT
“I’m 37, and I’ve been on TRT for almost a year now. I think it’s important that more men be educated on this topic, so please forgive me for the thorough write up here. I hope you find it useful.
I work in a high stress white collar profession in the city, and during the two years prior to starting TRT, I noticed that I was feeling tired no matter how much sleep I got, and that my sleep was getting very restless. I remember having bad dreams (some of them were pretty awful) at least 3-4 nights a week, and waking up feeling exhausted even after 8 or 9 hours of being in bed (which is also not usual for me to sleep in so long).
I also noticed a vague feeling of not feeling like myself more often than I was comfortable with, and when I paid attention to what was causing that feeling, I realized that I was so much more anxious and stressed out over things that would normally not bother me at all. I’ve been very good at dealing with stressful situations my whole life, but suddenly I was anxious about even the most minor of concerns in a way that I wasn’t able to control. It never affected my work, but it was exhausting, and I don’t think I was much fun to be around at home. I always felt like something was wrong, even when there was nothing to worry about. I didn’t feel depressed necessarily, but it definitely felt like something wasn’t right, and that feeling became more and more frequent as time went on.
I lost my motivation to get to the gym (and this is coming from a guy who was an elite athlete in college and known gym rat to his family and friends), so I started gaining weight. Nothing dramatic, but I definitely put on 15-20lbs over a year or so, and I completely lost the body I was proud of my whole life. I went from feeling like a gym rat to one of the normal guys that never looks like he wants to be there, and then to one of the guys who never comes back. Even when I could get myself to the gym, I had a hard time generating the kind of intensity that I used to love only a few years before that. I used to crave intensity in the gym more than I craved pizza, but that was now the opposite. That was the turning point that started to make me feel depressed, which made me anxious, which made me more depressed. It is indescribable how quickly everything fell apart, and I had absolutely no explanation for it at the time… that was the worst part… not knowing what was going on.
The culmination of all of this was a total loss of interest in sex. I felt fat, weak, tired, anxious, lazy, and depressed more often than I felt good. That’s when I started researching TRT, and whether or not that was my problem.”
Before I started TRT
“I researched TRT for hours and hours and hours (probably days) before I decided to try it, and I did so very reluctantly because of some of the stuff I read online. Most of what I found was either cookie cutter information on semi-anonymous corporate sites that seem like they would sell TRT to anyone who will pay for it, or busy forums with years worth of comments from bodybuilders, or guys who seemed to be very confused by the discrepancy between the advice they were getting from the guys on the forum vs the advice they were getting from their doctor. What bothered me the most about what I read was the frequent trend of starting meds, adding more meds, having side effects, adding more meds to counteract the side effects, having more side effects from the side effect meds, adding more meds to counteract the side effects from the side effect meds, and on and on and on. After a while, I did fine a few forum threads where the bodybuilders weren’t confusing the issue so much, but instead, the doctors were either too conservative to produce meaningful results, or too regimented to consider making adjustments to their protocols if it wasn’t working.
The other thing I found more often than I wanted to was this total obsession with lab results, to the point that it worried me that my life would become like a diabetic who lives day to day based on their blood sugars. The intensity of some of these guys’ obsession with their numbers worried me too… in some cases it seemed like their obsession was making them more miserable than they were before they started TRT. If I could go back in time, I wouldn’t spend this much time online. I should have spent more time researching who I wanted to see in consultation instead of reading through forums, and that’s what I decided to do. I wanted something that was conservative and simple in the approach, with enough personal attention that I would feel comfortable about what I was doing, but not so much that I would be forced to become obsessed with a routine the way I saw it happen online. I found this site and decided to give it a try with Dr. Vendemia.”
“The consultation ended up being exactly what I wanted. We spent the majority of the time taking about how I felt, and how that was different from how I used to feel. I had labs drawn before the visit so we knew that my free T value was in the 400’s beforehand. That value worried me because it’s actually in the normal range… on the lower side, but still totally normal. It worried me because I expected to be told that I wasn’t a candidate for TRT with a normal T value, and I couldn’t imagine the possibility of not being able to get my issues back under control somehow. For the first time in my life I felt like I needed help, and I was expecting to hear that I wouldn’t qualify for it. It didn’t turn out that way though. Because we had no way to know what my free T was 4 or 5 years ago when I felt great, Dr. Vendemia said that it was impossible to say whether that T value was “normal” for me personally. He said that based on my age and the problems I was having, he would consider a conservative trial of TRT, which is what we did.”
My first injection
“I’m actually a physician also, so I had plenty of experience with injections, and a good working knowledge of the physiology involved with what we were trying to achieve, but this was the first time I ever injected myself. It was more strange than I thought it would be, but I can’t imagine anyone having a problem with it. The hardest part is making sure that you are calculating your dosage correctly, not the actual injecting. The office gives you everything you need though, and you do the first several injections with them, so it’s second nature by the time you’re ready to do it on your own. They give you 27G and 30G needles, which are incredibly small in case you’re not familiar with needle sizes, so you hardly feel a thing. Personally, I wanted to take advantage of the possibility of local muscle growth at the sites of injection that some people believe to be true, so I chose to inject my lateral deltoids (shoulders) since having a wider shoulder girdle was the thing I missed most about my pre-low-T body. I wasn’t expecting miracles here, so even if the chance of this happening was nearly nonexistent, I was willing to give it a try. I’m only mentioning this because I think the shoulder is more sensitive than the more typical injection sites like the thigh or glute, so just be mindful of that.”
“We started with 60mg of testosterone cypionate injected in the early morning on Friday, but I didn’t notice any difference in how I felt. Neither of us were surprised about this given that it was a very conservative dose, but we both agreed that it was the right way to start. it’s much easier to build up slowly than it is to start too aggressively and wind up dealing with side effects right off the bat.”
“The following Friday, we increased the dose to 75mg. On the 3rd day after that injection I thought I felt a little better, but it certainly wasn’t dramatic enough that I could specifically describe it. In fact, I’m not even sure if the way I was feeling at that time was from the T, or just from having a good week.”
“We adjusted the dose up to 100mg this week, but I made the decision to inject 120mg because I was getting impatient (which is my nature). The extra dose turned out be a mistake though, although not a disastrous one. I actually felt quite good on days 1 and 2 after this injection, but on days 3 and 4 I felt way to amped up… like I had two cups too much coffee, plus this sensation of irritability (while still feeling good, which is hard to describe), and a wicked headache. When I laid down, I could hear my pulse in my ears and I knew that was a problem. It felt like my blood pressure was high, and in fact it was. It’s that flushed, full sensation you get in your head and neck when you’re really angry or pushing through heavy set in the gym, but with this strange sensation of feeling like everything is fine attached to it. In any case, it didn’t feel natural, so I knew 120mg was too much. I admitted the mistake to the doctor on the following Friday’s visit, and by that time my BP was fine and I felt better, although still not quite normal. I thought he would want to check a T level then, but surprisingly he didn’t. He said that it wouldn’t change the next step, which was to back off to the dose her originally recommended, which not only made sense, but kept things simple, which is the way I was hoping it would be.”
“This Friday, I followed his advice and stayed with 100mg. This time I was sure that I felt better overall. Less anxiety. Less worry. I didn’t feel like I needed a nap at 11am. My appetite wasn’t as abnormally intense as it had been. And I actually felt rested when I woke up, although I was still sleeping about 8 hours. I wouldn’t say that I had a better sex drive, but the thought of sex didn’t turn me off like it had before. On the 3td and 4th day after this injection, I had a minor version of that amped feeling I had after 120mg, but it was no where near as powerful as that, and actually felt good in a good way instead of good in a bad way. It felt more akin to having a really good day and a nice cup of coffee than the unnatural feeling from last week. I didn’t mind it at all, but I checked my BP to be sure, and it was fine. Since this was the 4th week of this, I got a little nervous about awful things like gynecomastia and testicular atrophy, only because I spent too much time reading forums in the past. I checked myself out every day, but everything seemed fine.”
“Since 100mg seemed to be minor victory, we decided to stay with this dose for another week for confirmation. This week felt very similar to the last, and possibly a little better. I still didn’t feel like I needed naps, I felt refreshed in the morning even though I naturally woke up an hour or so earlier than usual, and I definitely had a real desire for sex again (although it was still much less than I remember from when I was in my late 20’s/early 30’s). Overall, it was a big improvement with very little hassle, and within five weeks of my first visit, which I don’t think is too bad.”
“This week Dr. Vendemia recommended adding 150IU of HCG 24-hours before the Friday morning T injection, and backing the T off to 80mg to compensate for the T that would be produced naturally as a result from the HCG stimulation. In all honesty, I was quite leery about making this change because I felt so good with the 100mg of T alone, and I wasn’t crazy about the idea of adding another injection and making the routine more complicated. He insisted that it would be critical to completing the transition into a long term maintenance program that’s maximally effective and sustainable though, but I decided against it. On the second day after this Friday’s injection of 100mg, a felt a slight dull ache in my testicles, they felt smaller and softer to me, and over the next few days my scrotum got tighter and higher to the point of being very uncomfortable. I still felt fine, but it definitely freaked me out. I remembered a few random forum threads that I read before where some of these bodybuilder types said that no one should ever worry about testicular atrophy because it’s just a cosmetic problem and not a big deal. Well, I’m here to tell you that it is a big deal. It looks bad, it feels awful, and it’s something that I was definitely NOT willing to accept.”
“Dr. Vendemia gave me a very polite ‘I told you so’ when I told him about the atrophy, and reminded me of his recommendation to start HCG and back off on the T. This time I did exactly that… 150IU of HCG on Thursday morning, followed by 80mg of T on Friday morning. I don’t want to sound cliche here, but I don’t have any better way to describe this… HCG is really a miracle…. the icing on the cake for sure. Within 4 hours after the injection, my testicles felt normal again, my scrotum relaxed, and I felt ‘young’ again (also cliche I know, but it’s the truth). I felt great on 100mg of T alone, but this was different… I actually felt younger… not an unnaturally amped up version of my old self. I didn’t feel depressed or anxious, my focus and concentration was better, my head was clearer, and I felt like everything was fine (not euphoric, just fine). My sex drive was back to about what I remember it being when I was in my early 30’s, and my erections were just like they were back then… not Viagra hard, but definitely younger man hard (which felt fantastic). My motivation to get to the gym came back, and I got myself there 4x’s during the week with decent workouts (although I had some catching up to do on getting back in shape). I didn’t feel like napping or snacking (ever), and my sleep was so deep that i didn’t even remember falling asleep for the first time in my life. The sleep improvement was particularly surprising because I’ve never been a good sleeper, but I would say that my sleep improved to a point that is actually BETTER than when I was in my 20’s.”
“This week we stayed with 150IU of HCG and backed off the T to 75mg. Everything stayed exactly the same with the exception of the fact that I felt even a little better… a little more natural somehow. It seemed perfect to me.”
“Now Dr. Vendemia recommended that it was time to get a baseline T level and a repeat set of labs to make sure nothing else had changed (cholesterol, liver enzymes, etc). T was in the 700’s, and all other studies were normal, as was my BP. He recommended that we move to Phase II of the program on the current regimen of 150IU of HCG on Thursday morning followed by 75mg of T on Friday morning, so instead of weekly visits, I was given a month long supply and an appointment for one month later.”
“The next month was fine. I didn’t feel the need to make any dosing changes, and didn’t experience anything that I would describe as a side effect. I did notice that I felt my absolute best on the 3rd day after the T injection, and that my energy drained off a bit on the 6th day, but I was probably being too sensitive about that. The variation in how I felt was no more than what I felt during an average week during the time in my life when I felt good but wasn’t on TRT.”
Week 14 Wellness Visit
“I told the doctor that I felt great, and that was that. He gave me the idea that i may want to substitute a T dose with an extra HCG dose every 4th week if I was giving any thought to having children in the near future (I wasn’t), and the option to increase my T dose by 5mg If I felt that I had lost a little progress on how I felt for 2-3 consecutive weeks. He told me that this scenario was likely given that my natural T production would probably drop off a bit as my body moved towards a new homeostasis on this regimen. Sure enough, I did feel that it was necessary to go back to 80mg about 4 weeks after this point in time, but I haven’t had to make any other adjustments since then. Everything has been rock solid stable, very simple, predictable, and excellent.”
“I certainly had my doubts and reservations about doing this, but at the end of the day the only thing I would change is spending less time on the forums and more time meeting with professionals like Dr. Vendemia in the office. The forums not only wasted time, but presented a unrealistic expectation for how complex and problematic this process needs to be. In actual reality, it is incredibly simple as long as you have the right guidance. When I look back on it, having to come to the office every week for 8 or 9 weeks was a pain, but I’m really glad that I had the opportunity, otherwise I would have likely steered myself way off course and delayed my progress even more than I did the few times I chose not to follow his advice. And now that I’m only going in once every 4 months, it feels great. My only concern for the future is how this will all change as I get older, but my doses are all so minimal right now (much lower than what I read online before I started this) that there is plenty of room to grow on this program, so it should be fine. I would recommend this program without hesitation to anyone who finds themselves wondering why they’ve lost their energy and drive in their 30’s or 40’s. It will give you your life back, and it’s not nearly as scary as the forums make it out to be. Also, listen to your doc when he gives you advice… trust me on that one… I delayed my maintenance program by at least a month by not taking his advice and setting our schedule back two weeks each time. I could have easily been on to Phase II by 5 or 6 weeks if I had followed directions.”