First off, if you are thinking about TRT, I highly recommend you check out my TRT Diaries to see what my experience was like. The pros and cons and a very in-depth weekly recap.
No surprise here, the question I get ask the most:
Should I Start TRT?
This question is very general and I can’t possibly give an answer that is right for just about anyone.
Instead, I will give you my step-by-step strategy – exactly how I would approach this topic and structure my decision-making process.
STEP #1 – What’s Your Problem?
There are 2 parts to this question. The first part has to do with what your problem is – either physically or mentally.
Maybe you are feeling tired all the time. Maybe you feel depressed. Low libido would be another common issue.
The second part has to do with your blood work. You should waste no time and get an extensive blood panel done.
Then you look at all the parameters to determine what your specific issue is. If you need help with this, you can book a consultation and have me analyze your lab work.
Maybe your total testosterone is high but free testosterone low. Maybe you don’t even have low testosterone but estradiol, prolactin or SHBG are all out of whack.
Maybe testosterone is low but LH and FSH are low also.
Once you are able to answer both parts of the ‘What’s Your Problem’ question, you can take the next step.
STEP #2 – Low Risk Approaches
You’ve had a look at your blood work. You know what needs to be improved. Now it’s time to figure out HOW.
Start by looking at your lifestyle. Is there anything that is currently negatively impacting your hormones? Are you working out too much/too often?
Easy fixes which drastically impact hormones/lower testosterone:
- Calorie Restriction
- Lack of Sleep
Besides lifestyle, specific herbs and supplements can help in regards to optimizing hormones.
- Boron to lower SHBG
- L-DOPA to lower prolactin
- DIM to lower Estradiol (E2)
In my experience, issues that feel like a big deal are often easily fixed. Take low sex drive for example.
Many guys would conclude that their testosterone is low (it might be), but it could also be that you are stressed out, that your diet is lacking or you need to optimize your dopamine receptors.
If you don’t feel good about your life in general, low sex drive is often times a natural consequences of that – not a hormonal issue.
STEP #3 – Test Run Testosterone
You put the low risk approaches to the test first and see if you feel a difference. If not, you may up the ante (via a doctor).
- hcG (Human chorionic gonadotropin)
- Testosterone (hCG optinal)
If you decide to start with testosterone, I would probably recommend to also use hCG to keep your natural production up and running.
That way, you can ‘test run’ testosterone and if you notice it’s not for you, the risk of testicular shut-down/atrophy is lower.
This is the exact protocol I have followed and I have no suppression of my testosterone production.
To be clear, the decision to go on TRT should not be taken lightly, however, in my experience testing it for a month or so is not as ‘risky’ as many make it out to be – assuming you really are doing TRT dosages.