10 Changes to Expect on Testosterone and TRT at 6 months

Summary

This video discusses the top ten changes men can expect between 12 weeks to six months on testosterone replacement therapy (TRT). It covers improvements in sex drive, mood, energy, and muscle mass, as well as potential side effects like acne, body hair growth, and changes in testicle size. The script also addresses the importance of diet, exercise, and addressing underlying health issues like sleep apnea and lipid levels for optimal TRT outcomes.

Takeaways

• 🚩 The first noticeable change in TRT is often an increase in sex drive, typically around the 12-week mark.
• 🌡️ Some men might experience a surge in mood and energy early in TRT, but for many, significant changes occur around the six-month point.
• 🩺 By 12 weeks into TRT, patients usually have their first blood test to check hormone levels and make adjustments to their treatment.
• 🔄 It's important not to expect linear, consistent progress in sex drive or other areas; there will be fluctuations.
• 💪 Around the six-month mark on TRT, many men notice improvements in muscle mass and strength.
• 🏋️‍♂️ Gains in muscle mass can be influenced by diet, exercise, sleep, and overall health, not just hormone levels.
• ⚡️ Energy levels can vary greatly; some men feel an early boost, while others may take longer to see improvements.
• 🌀 Anxiety and stress can affect how men respond to TRT, including their sex drive and energy levels.
• 🌙 Improvements in sleep are common with TRT, but what constitutes 'good sleep' can be subjective and may change.
• 🧠 Mood often improves on TRT, with many men experiencing less depression, anxiety, and brain fog.
• 🥩 Testicles may shrink or atrophy on TRT, but this varies and can be managed with medical supervision.

Q & A

What are the top changes to expect in the first six months of TRT?

The top changes to expect in the first six months of TRT include improvements in sex drive, mood, energy, and muscle mass and strength. There may also be changes in testicle size, skin condition, body hair, and lipid levels. Additionally, some men might experience better sleep quality and improved bone density.

How soon can one expect to see changes in sex drive on TRT?

Some men may start noticing changes in sex drive as early as six weeks into TRT, but for many, significant changes begin to occur around the 12-week mark. However, it's not a linear process and can vary greatly from person to person.

What role do blood tests play in the first six months of TRT?

Blood tests are crucial around the 12-week mark on TRT to check blood markers and assess how a patient is responding to the treatment. Doctors use these results to adjust the treatment plan accordingly.

Can TRT improve erectile function?

Yes, TRT can improve erectile function in many men. It's common to see improvements around the six-month mark, although the timeline can vary based on individual health factors and the duration of testosterone deficiency.

What is the relationship between TRT and muscle mass?

Testosterone plays a significant role in muscle mass and strength. Generally, men can expect to see an increase in muscle mass on TRT, especially if they are also engaging in regular exercise and have a proper diet.

How might TRT affect a man's energy levels?

TRT can lead to increased energy levels for many men. However, it's important to note that energy levels can be influenced by various factors such as diet, sleep, and overall health, so improvements may not be uniform across all individuals.

What should one know about testicular atrophy on TRT?

Testicular atrophy, or shrinkage, can occur in some men on TRT, particularly if not using human chorionic gonadotropin (HCG). However, the extent of atrophy can vary, and for some men, it may not be a significant concern.

How common is acne during TRT and how can it be managed?

Acne can be a side effect of TRT due to increased sebum production. It's more common in those who are prone to acne. Management strategies include proper skin hygiene, using specific soaps, and in some cases, topical or oral medications.

Can TRT lead to hair loss and what can be done about it?

TRT can contribute to hair loss in men who are genetically predisposed to it. Options to manage hair loss include topical treatments like minoxidil or prostaglandin analogues, but it's important to balance these with the benefits of TRT for libido and erectile function.

What changes in blood lipids can be expected with TRT?

TRT can lead to improvements in blood lipid profiles, including potentially lowering LDL cholesterol and triglyceride levels, and sometimes increasing HDL cholesterol. However, these changes can be influenced by lifestyle factors such as diet and exercise.

How does TRT affect sleep quality and what is sleep apnea's connection to TRT?

TRT can improve sleep quality for many men by reducing insomnia and night sweats. However, it can also unmask sleep apnea in some individuals, potentially worsening sleep quality. If sleep apnea is suspected, medical evaluation and adjustment of any current therapy may be necessary.

Outlines

00:00

🔬 Changes in Sex Drive from 12 Weeks to 6 Months on TRT

The paragraph discusses the anticipation of changes in sex drive between 12 weeks to six months into Testosterone Replacement Therapy (TRT). It highlights that while some people might experience a surge in sex drive early on, the majority begin to notice changes around the six-week mark. By 12 weeks, patients typically have their first blood test to check hormone levels and adjust treatment accordingly. The speaker shares anecdotal evidence that from 12 weeks onwards, improvements in sex drive become more consistent, although not necessarily linear. The importance of not expecting a perfect, daily improvement and the multifactorial nature of sex drive are emphasized, including the impact of anxiety and stress on sexual function.

05:01

💪 Impact on Erections and Potential for Rehabilitation

This section delves into the effects of TRT on erectile function, noting that it can be highly variable based on an individual's starting point and underlying health conditions. The discussion covers the potential for erectile function to improve after six months of treatment, especially for those with erectile dysfunction due to low testosterone. The role of PDE5 inhibitors, like Viagra or Cialis, in conjunction with TRT for rehabilitation purposes is mentioned, along with the importance of not viewing these aids as a lifelong crutch but as a tool for recovery. The paragraph also touches on the psychological aspects affecting erectile function and the distinction between nocturnal, spontaneous, and on-demand erections.

10:03

💪 Gains in Muscle Mass and Strength

The focus of this paragraph is on the anticipated increase in muscle mass and strength during TRT. It underscores that these gains are dose-dependent and can be more noticeable around the six-month mark. The narrative distinguishes between those who are familiar with resistance training and those who are new to it, suggesting that the latter group might be more surprised by their progress. However, it also cautions against the misconception that TRT alone can lead to significant muscle gains without proper diet and exercise. The paragraph concludes by stressing the importance of maintaining muscle mass for overall health as one ages.

15:04

⚡️ Energy Levels and Lifestyle Factors

This section addresses the variability in energy levels among men on TRT. While some may experience increased energy early on, others might not due to long-term hormonal deficiencies or other health issues such as low cortisol or thyroid problems. The paragraph stresses the importance of a balanced diet, regular exercise, and adequate rest for optimal energy levels. It also shares a personal account of overexertion and inadequate nutrition leading to a dip in energy levels, highlighting the need for a balanced approach to lifestyle changes while on TRT.

20:04

🌡️ Mood Changes and the Influence of Testosterone

The discussion here centers on the potential for improved mood on TRT, particularly after six months. Testosterone's impact on dopamine levels, which are associated with pleasure and mood elevation, is mentioned. The paragraph acknowledges the existence of anxiety and mood swings during the initial stages of TRT but suggests that these should stabilize over time. It also touches on the role of external factors, such as diet and exercise, in contributing to overall mood and the importance of managing expectations to avoid unnecessary anxiety about treatment outcomes.

25:05

🍇 Testicular Atrophy and Its Management

This section discusses the possibility of testicular atrophy, or shrinking, during TRT. It explains that while some men may experience this, the use of human chorionic gonadotropin (HCG) can mitigate the risk. The paragraph shares personal experiences with testicular changes on and off HCG, highlighting that atrophy was not as severe as feared. It also humorously notes the potential aesthetic benefit of smaller testicles making the penis appear larger. The narrative concludes by emphasizing the importance of working with a doctor if testicular size is a concern.

30:05

🧏‍♂️ Skin Changes and Acne During TRT

The focus of this paragraph is on the changes in skin condition that can occur with TRT, such as increased oil production leading to acne. It provides advice on managing acne during TRT, including dermatological treatments and maintaining good hygiene. Personal experiences with acne flare-ups are shared, and the paragraph suggests that while acne can be a concern, it is manageable and does not affect everyone on TRT equally.

35:06

🦲 Hair Changes: Loss and Growth

This section addresses the impact of TRT on hair, including potential hair loss and increased body and facial hair growth due to rising androgen levels. It acknowledges the genetic predisposition to hair loss and suggests that TRT might accelerate hair loss in those already genetically inclined. The paragraph also mentions the use of minoxidil as a potential treatment for hair loss and the personal acceptance of hair loss as a trade-off for other benefits of TRT.

40:08

🩸 Lipid Profile Changes and Cardiovascular Health

The discussion here is about the effects of TRT on blood lipid levels. While TRT can help balance lipids, leading to potential improvements in cholesterol and triglyceride levels, it also cautions that poor lifestyle choices can negate these benefits. The paragraph emphasizes the importance of a healthy diet and exercise in conjunction with TRT for optimal cardiovascular health. It also mentions the potential for improved glycemic control and blood pressure as additional cardiovascular benefits of TRT.

💤 Sleep Improvements and Sleep Apnea

This section discusses the relationship between TRT and sleep quality. It notes that while TRT can improve sleep, especially in those with poor sleep due to low testosterone, it can also unmask sleep apnea in some individuals. The paragraph explains that TRT might lead to an increase in red blood cells as a response to low oxygen levels during sleep apnea episodes. It concludes by suggesting that if sleep issues persist or new symptoms arise, individuals should consult their doctor, as it might indicate the need for adjustments to their TRT or other treatments.

📈 Monitoring Progress and Anticipating Future Changes

The final paragraph summarizes the previous discussions and hints at future content that will cover changes beyond the six-month mark of TRT. It encourages viewers to like, subscribe, and comment for more information and acknowledges that the journey on TRT is an ongoing process with many factors to consider.

Keywords

💡TRT

TRT stands for Testosterone Replacement Therapy, a medical treatment designed to raise the level of testosterone in individuals who have a deficiency. In the context of the video, TRT is the central theme as the script discusses various changes and expectations one might experience while undergoing this therapy over a period of 12 weeks to six months.

💡Sex Drive

Sex drive refers to an individual's interest in or desire for sexual activity. The script mentions that an increase in sex drive is a common expectation among people starting TRT. It highlights that while some may notice changes early on, for many, it becomes more noticeable around the 12-week mark.

💡Erections

Erections are discussed in the script as a health indicator often associated with testosterone levels. The dialogue notes that improvements in erectile function can be variable but are generally expected within the first six months of TRT.

💡Anxiety

Anxiety is a feeling of worry, nervousness, or unease about something with an uncertain outcome. The script suggests that anxiety is common among those starting TRT, potentially due to the stress of beginning a new treatment and the uncertainty about its effects.

💡Muscle Mass

Muscle mass refers to the amount of muscle in the body. The video script indicates that an increase in muscle mass is a typical outcome of TRT, as testosterone is known to promote muscle growth.

💡Energy Levels

Energy levels refer to the amount of vigor and vitality a person feels. The script discusses how TRT can lead to increased energy levels, although the experience can vary widely among individuals.

💡Mood

Mood pertains to a person's emotional state or the general atmosphere of a setting. The dialogue in the script suggests that TRT can lead to an improvement in mood, often attributed to the effects of testosterone on neurotransmitters like dopamine.

💡Testicular Atrophy

Testicular atrophy is the medical term for shrinkage of the testicles. The script explains that this can be an outcome of TRT, although the extent varies and can be mitigated with additional treatments like HCG.

💡Sebum

Sebum is an oily substance produced by the sebaceous glands in the skin. The video script mentions that TRT can increase sebum production, potentially leading to skin issues such as acne.

💡Lipid Panel

A lipid panel is a group of tests that measure the levels of fats, or lipids, in the blood. The script indicates that TRT can lead to changes in lipid levels, which may include decreases in total cholesterol and triglycerides.

💡Bone Density

Bone density refers to the strength of bones as determined by the amount of mineral content. The dialogue in the script suggests that TRT can improve bone density by influencing the levels of sex hormones, which are crucial for bone health.

💡Sleep Apnea

Sleep apnea is a potentially serious sleep disorder in which breathing repeatedly stops and starts. The script mentions that TRT might uncover or worsen sleep apnea, possibly necessitating adjustments to existing treatments.

Highlights

Discussion of changes in sex drive from 12 weeks to six months on TRT.

Explanation of why some people might experience a surge in sex drive early in therapy.

Importance of blood tests at the 12-week mark to adjust treatment direction.

General increase in sex drive for many people by 12 weeks on TRT.

Acknowledgment that sex drive changes are not linear and can vary day by day.

The role of anxiety and stress in potentially affecting sex drive during TRT.

Discussion on changes in erections and the potential for them to improve around six months on TRT.

The variability in erectile function recovery based on individual health history.

Mention of using low dose cialis alongside TRT to help with rehabilitation of erectile function.

Differentiation between nocturnal, spontaneous, and on-demand erections.

The psychological aspect of erectile dysfunction and its treatment.

Expectations for muscle mass and strength changes on TRT.

The impact of diet and exercise on muscle mass gains while on TRT.

Potential for increased body weight due to muscle mass increase, not fat.

Discussion on energy levels and how they can be affected by various factors on TRT.

Importance of proper rest, diet, and not overdoing it at the gym while on TRT.

Mood improvements and how they relate to dopamine levels on TRT.

The possibility of testicular atrophy and its management with HCG.

Changes in skin and potential for acne while on TRT.

The impact of TRT on body hair and potential increase in facial hair.

Discussion on hair loss and its relation to TRT.

Changes in lipid panels and potential improvements in bloodwork while on TRT.

Improvement in bone density due to TRT and its role in maintaining bone health.

Changes in sleep patterns and potential unmasking of sleep apnea on TRT.

Transcripts

today we're going to talk about the top

ten changes to expect in 12 weeks to six

months on trt to keep watching

[Music]

in previous videos we've discussed what

to expect on trt at two weeks and what

to expect in six weeks

so today from 12 weeks to six months

we're going to go through these ten

things that you can expect change wise

so first one sex drive yeah that's kind

of the common one most people hope to

improve in the first six months if not

sooner so six weeks we discussed how

some people may start noticing some

changes in sex drive it doesn't happen

for everybody there are some people that

very quickly at the start of therapy

they can have a surge in things like

mood and energy and sex drive but for

the majority of people about six week

point things are beginning to change a

little bit so when you get to 12 weeks

you know you would have had your blood

test already the doctor would have

checked your your your blood markers

seeing how you're feeling and made some

changes to sort of steer you in the

right direction or all you know or

giving you advice to stay on track where

you are with the aim of heading in the

right in the right direction so by 12

weeks you know it's been a bit of time

since that point this I'd say the sex

drive is where this this begins to

change in some way for a lot of people

so not everybody and that's something

you know there's still outliers with

this general sort of consensus of things

but the feedback that I get is that sex

drive starting from this point onwards

is when more consistently it begins to

happen not necessarily like a switch

that turns on that is you know I'll have

you know out of a month maybe instead of

a day where I have a better sex drive

it's now 5 10 15 and it's improving

people's thing they have more sexual

thoughts that obidos starts to go up I

mean is that what you sort of experience

well I don't think it's always a linear

in planet I think there can be times

when you know even after 25 years on

tier 2 yeah there are days that your sex

life isn't always getting better and

better every day

you might have a day that it's not good

and there's so many factors it affects

sex drive and it's not just for monel

yeah in general things that we've seen

that you could expect from trt would be

a Generalissimo generalized way to say

sex drive improvement but you can't

expect every day and keep a scorecard in

a few you didn't fall into that very

highly strong sexual day then then

somehow the treatment failed yeah so you

may be one of those guys where your sex

drive isn't changing massively at this

point you may be one of those guys so

it's not if you're not in that group

something's wrong you know that you're

working with the doctor and steering you

you know in the right direction you may

have really great levels it may just be

that you need to be on therapy you know

longer to have that effect you say that

yeah I think so

so you you when you started knew about

this point you in noticing some changes

sex five wise yeah at six months oh I

noticed before six months that the sex

drive was improving so I was perhaps an

outlier where you know things seem to be

working in the right direction nearly

the beginning hmm yeah see for me I mean

you know my talks about things being

multifactorial with with sex drive I

mean I think the initial this happens

for for call of guys the initial part of

starting therapy if you've been feeling

pretty anxious or stressed about the

whole situation

you know running out sort of finding out

your potential this is why you've got

symptoms I've been starting therapy you

can still feel anxious you know so lots

of guys an anxiety can be triggered by

you know just I suppose your normal

thought process is why am i starting

this is everything right I don't want

this take to work I've heard and this is

this I think is real big cause of

anxiety is like forum spaces and things

that I mentioned that before but if you

if you're if you're constantly reading

about people that are having problems or

are having great changes then you start

questioning where they should be

happening for yourself so I think that

happened for me realize you know twelve

twelve weeks onwards there are people

you know saying things are going really

well for them and like why is that not

happening for me and I think just the

stress of of thinking that it wasn't

happening that can affect sex drive you

know you're not focus you know you're

not mindful of what's going on around

you you're in sort of you know thinking

what might be happening or should be

happening so that's definitely something

you know to be aware of the review and

it's not abnormal to not yeah it's a

feel anxious you know the start of

therapy so here's a new venture as it

were new treatment you know the of a

hormone therapy that is is lifelong

right absolutely yeah so I think the

second item to consider of the top ten

things that may be you may want to

expect on trt at six months would be

changes in your actions so it many times

and what we've heard in patients is the

directions may be the the last thing to

come online but I think it's so variable

based on where you started from when you

start a treatment so if you had other

sclerosis cardiovascular issues

epithelium problems you've gone a long

time with erectile dysfunction which may

also go hand-in-hand with having a long

time with low testosterone there may be

damage that takes longer to heal and

repair then if you know you you didn't

have those issues for as long so in some

people it may had a dip in the

testosterone levels a short term

erectile dysfunction and that gets

corrected and sorted yes quite quickly

within the TRT treatment about six

months you should start seeing erections

starting to come back yeah yeah like you

say it's very uh something I think about

is I'm everyone's variable like you said

but if you've had let's just say for ten

years you've not had sufficient levels

of your hormones that means that you've

not had regular erections right so let's

just say in your prime of a feeling

feeling great you had worn a day you

know and then you've gone from that to

to every six months and then over the

years that frequency of blood in and out

the penis you know and that the

functionality of the organ is now

changed because you've not had that

function happening if you then start TRT

and okay maybe the hormones you know

improve how you feel obviously they can

improve blood flow and you know you know

the hormones have that effect and

they're the cascade is is is needed to

get that going

it doesn't necessarily mean that

suddenly everything is going to start

working again

you know and that's where things are low

dose cialis you know some guys have you

know use low dose cialis tadalafil you

know pde5 inhibitor alongside yeah their

trt and that could actually have seen

that that's helped to restore function

and get things back faster and some guys

have been not needed to be on it after

that you know once things get going I

mean loss keep going it for sort of

their own confidence I mean other people

could help rehabilitate the the weaker

erections in the past or if you're

frustrated because your morning

erections aren't coming on as as quickly

or strongly having some basil dilation

occurring because of increase nitric

oxide from the pde5 inhibitors the

viagra cialis two dollar filled Sedona

Phil these can help with rehabilitation

and we've you know we've some studies

out there that talk about men who have

had nerve crush after prostate surgery

and as a result part of the

rehabilitation treatment is some is pde5

inhibitors so for these men some people

have this thought that if I'm on this

erectile aid I'm always going to need it

or I guess I have II D which can be

quite embarrassing

yo or you need to have the tablet to

function right and if they feel like all

I won't take that because then I'm it's

a crutch and I'm responsible on it but

the rehab part but the rehab part is

important I mean I used to know an

opthamologist of all people and she

would say that it should be put viagra

should be put in the water supply so you

know because it has such an impact and

an improvement on health or maybe it was

just er yeah make enough viagra was

happy but weirdly like guys with

autoimmune conditions that Raynaud's and

things like that I know you know few

people have said that actually women and

men with also means you can use that to

actually help blood flow and a few you

know cardiologists say is one of the few

drugs that systemically increases nitric

oxide and it can have its benefits you

know in the in the blood vessels

absolutely I mean the the recovery thing

I mean that that made sense to me I mean

I when I used to work in the NHS

I asked an old patient of mine he's in

his 90s and I was like what's like the

bet you give me any advice you know that

just

being a person in a different generation

he was it you like look at this he's

like if you don't use it you lose it

fair enough but now you see it that when

guys have not used it for a while you

know you can lose the effectiveness but

it can be restored through those things

right and also I think it's important to

distinguish between more interactions

nocturnal erections

spontaneous erections and erections on

demand when you need them and they think

that kind of all falls into one of the

things that that can improve you know

morning erections are sometimes

envisioned that you know you know you

going to the toilet in the morning and

you've got to fight to keep your boner

down so or you can hang a towel from it

and it won't go down

at that particular point until I mean

myself and Irene when he's got like the

yeah well may happen but many cases

never happens me it may just happen

nocturnally or may happen in the early

hours of the morning and you're still

unconscious to recognize it or you might

kind of have it incorporation into a

dream and so all these are still

positive effects of you getting the

blood flow to your penis and the

erections and I think that could all be

classified as a morning erection yeah

would you agree yeah so I think as a

doctor that said actually morning

erections are just sort of left over

nighttime erections nocturnal erections

actually right so if you don't wake up

with one it doesn't mean that there's

something all four that's not you know

there's not work any base it exactly so

it's not time to panic

yeah then those are the erections that

kind of the on demand as you need them

erections and and that could be

complicated from you know psychosomatic

issues every you have gone through the

past of having the low testosterone it

not working for you when you need it and

you know you mentally you think in the

game you're not sure and your anxiety

gets the best of you then you know even

with a viagra cialis to develop a blood

Vitra any of those it still may not be

enough because your your anxiousness is

going to cause vasoconstriction which

would be the opposite of the

vasodilation that you need well you know

if you've had episodes of edy in the

past so you know talking about this

timelines of things this doesn't matter

you know from in therapy at any point if

you've had the trauma of not having got

an erection before in a situation where

there's associated shame and criticism

and things around it

you know there's always that the risk

that because you've had that traumatic

situation that obviously you're going to

have that negative reaction when

approaching is absolutely self pressure

that happens and I know lots of guys

that actually it can be the you know by

themselves they can get an erection

they're getting nighttime erections

you know semies during the day things

like that but then because of the old

traumatic situations of having you know

it not worked with someone in the past

the pressure then builds up so they're

like I've got IDI issues and the

testosterone may not be working therapy

may not be working HRT may not be

working but actually there can be

definitely a psychological aspect and

that's where guys have seen sexual

therapists you know it's absolutely

something that they can work through so

I call it just work with that as well so

that's just another another part that

consider isn't it of course we could

also not fancy a partner yeah yeah it

kind of becomes a similar becomes

routine but yeah there's lots of factors

but I think you talk about it more when

we get we took run other videos but the

normal expectations here are generally

you should start noticing something but

don't get you know bothered of you if

you don't if you're not if you not

noticing those things right in the same

multifactorial it says so much so yeah

so the next site and that you should be

able to expect as far as a change around

the six month period his muscle muscle

mass and strength and and lots of this

is dose dependent of course based on

certain studies that I think was the

same Bastion had had studied men over 20

weeks who were given various levels of

testosterone and found there was an

increase in muscle mass and strength

especially in the lower leg strength in

particular but in general we kind of all

expected we think of testosterone

what are the biggest targets for the

androgen receptor is its muscle mass

okay so in general we know that muscle

mass

can increase on on trt yeah say yeah I'd

say this is where people start to notice

that difference again and it

particularly though ya know people the

things people either go yep I've trained

before I know what I'm doing I'm eating

right or those sorts of things I've got

a good sleep hygiene and they're like

yeah and now I'm noticing results that

are used to noticed before I had all

these issues so there's that but there's

also guys that maybe it's been so long

or it's unfamiliar to them and they're

and actually lots of guys go I'm not

happy I've put on weight so they're on

the scales and they're like yeah I'm

putting on loads of way and I don't know

what's wrong you know it's a load but a

good a substantial amount way and it you

know it can be that actually because

we've had guys do it where they have

done you know that the scans where it

separates the the fat and the muscle and

the bone and this was things and it's

actually that they put on muscle mass

they don't look massively leaner they

not lost body fat but actually just

starting getting off the small

testosterone just started to put on

muscle mass and some guys you know they

can pon make fat 5 kg in the sort of by

the first 12 we're quite shocking for

sayin yeah because they weren't

expecting that they didn't want to give

that big in particular but that's I

think in the culture of gym goers and

etc it makes people think oh is this

just for muscle mass and strength but

this is very important for your

generalized health as you age to have

the appropriate amount of muscle mass

otherwise you go in the opposite

direction and going to more the wasting

type of disease so having a proper

amount of muscle mass I shouldn't really

talk about you in the ex-officio you

know I think it's one of those things

where I mean there's lots of teenagers

as well right there have great great

testosterone levels there lots of you

know say teenagers there's lots of guys

with great testosterone it was that

aren't doing the right thing so there's

very much you know if you're still not

if you're still eating you know crap and

and not exercising correctly sensibly

you're not sleeping you're boozing a lot

you know those sorts of things

all those are the factors like with any

other normal person with a normal

working hormone system their organ

effect those sorts of things just

because you Adam trt it's not suddenly

gonna magically override all the normal

things that you need to put on muscle

mass no

a calorie deficit and you're just

literally not eating yeah and then you

can't expect to put a lotta muscle mass

but this assumes that all things being

equal to what you're doing before mm-hmm

with a normal kind of diet that you know

you could expect to see some increase in

muscle mass as a function of

testosterone yeah so yeah that's a good

point

so the next thing is energy levels okay

so energy levels I would say again it

would keep saying the same things but

the point has to be driven home that it

is a real mixed bag with this right you

you know you can have start to see

improvements in energy levels like we

said in the other videos earlier on you

know some guys are something about why

I'm I'm up early I feel like I can do

things I can do do more with with with

you know less sleep but then you know

you've still got guys that maybe they've

been affected for so long from lack of

hormones and lack of recovery and that

their body is just not conditioned right

it's not suddenly going to spring

everything back to life no and they can

also have low cortisol issues so if it

tend to be more tired in the morning

after starting TRT you know then that

could actually drive it down even lower

or they have thyroid issues yeah and can

affect energy levels we talked about TLT

right but actually it's HRT need to make

sure the effects and the other things

are happening you may have thyroid

issues because you've had other hormone

issues so on this particular video we're

talking about just trt but all the other

hormones and have to be considered and

considered absolutely so I think another

really really important PI's because I

saw I did this was the I was got excited

you know a lot of game tests or string

back and my body really issue without

without it for a few years but then got

the testosterone so I was like yep

so got a bit more energy I'm gonna train

like an absolute beast so I was sort of

trying to say that for me five days a

week but yeah I did that an adenine

cardio and I was like but I lift heavy

as well you're just really weak me know

and the say yes a baby what I did was I

was also like I'm carrying a bit fat so

I'm not gonna eat much you know so I was

like you said on a massive calorie

deficit so actually by the time I got to

like 16 weeks I was nakid and I was

really concerned like you know what's

going on here my Energy's gone and I've

you know been doing everything right but

I just not been eating enough I'd

started really at it early because I got

excited

so I actually took a dip between sort of

12 and 6 months wide to be you know it

was actually you actually that said like

you know sort I'm because no question

what I've been doing do everything you

can't expect you're gonna be Superman

after you're doing just toaster on

treatment and then do all these things

your body's still going to be knackered

and so you have to have the proper

recovery the proper rest and diet and

don't overdo it at the gym yeah you know

that we may also need a thank you and

say so yes I think that's important be

aware of those are the things that can

cause you know tiredness and lack of

energy levels you know across the board

you know not enough food not enough rest

all those sorts of things though the

fifth item on the list for what to

expect at six months would be a change

in mood I mean a lot of of men come

looking at trt as an option because

they're either been depressed suffer

from anxiety they've got brain fog and

the generalized mood isn't always where

was when they were younger or at an

earlier state so on TRT at 6 months

we've seen and I can see myself a

noticeable improvement in mood overall

you know feel a bit more uplifted we

know that testosterone can affect the

dopamine levels and the dopamine is the

pleasure hormone and you feel a bit

better with dopamine and so that's one

positive change yeah yeah that's a lot

of guys say so there's lots of guys that

if they are comfortable with the therapy

so I talked about me feeling anxious and

there's there's definitely a whole group

of people so you feel anxious on CRT

initially you're not alone you know your

mood can be lower because all of those

other factors you know the classic

questioning of

you know my hormones all over the place

should I be on there should I be on that

should I be on daily injections should I

be on weekly you know should I be on hgg

all those sorts of things can create

anxiety and actually lower your mood

rise be view it if you're in a in a

place where maybe you're not analyzing

things a lot this is where things start

to change I'd say the most fear of the

mead that's what I've witnessed very

nice yeah I was fortunate but they just

invented the internet when I was still

in great mood because you know there was

a few muscle forums you know you get

some information but I do even it did

not exist like it does today so

essentially I start the testosterone

treatment I just cracked on with it I

didn't know the difference things seem

to be getting better I had more

resilience so everything was as I

thought should be so I I didn't have

anything to compare it with as people do

today and they could yeah so maybe

that's a difference because we talked in

the other video about how quickly you

felt different I mean before I'd even

started I had a view of what may or may

not happen good and bad because of forms

I was like I may feel like I've got

these bad symptoms because my levels may

be too high maybe too low I might get

this that and the other

I'm a feel good I'm eating and why is it

not feeling good so I arrive like a bit

of a wreck ready to go you probably just

cut into me I didn't have all that

no I didn't and that's on both times

because remember my story is you know

the first time I started treatment it

was the back-to-back injections and then

I was just pretty much left stranded by

the doctor who didn't it's okay that's

enough that's all you get your body

should have just ballooned back into

this new level that I got used to so III

had to go through your whole period of

being even lower than when I started

even more depressed and things just

didn't work for good six to eight months

before I was retreated and restarted on

the testosterone treatment with patches

for a while which then improved the mood

and then restarted again on another

treatment with topical scrotal

testosterone cream tested cream so I had

all these different restarts on my on my

trt and every time for me it was you

know without testosterone I felt rubbish

and with testosterone it was just a

continuous improvement you know there

were times that like you know we can go

into another video but you know 12 15

years down the road if something wasn't

right but we now know that there are

other hormone factors at play there like

like thyroid that needed to be adjusted

but overall straight up trt did make a

massive difference in my life and

hopefully makes a difference in other

people's lives as well okay so number

six on the list of things to expect

between 12 weeks and six months is your

testicles may shrink or atrophy is the

medical term yeah right so some men and

obviously there there's a difference

between people anyway and what this

happens to when it happens rather and if

you're on HCG obviously your risk but

from the start your risk of testicular

atrophy is probably lower yeah but some

men if they're over stimulated under

stimulated they don't always meet the

expectation I think there's an

expectation out there that you'll do HCG

or even H and G for that matter it's

going to just balloon up the size of

their testes and they're going to have

these massive egg size testes you've got

those don't you absolutely not never did

but but that's always a case and I've

been prescribed for fertility h energy

and HCG and i'd noticed that especially

after years of not being on any HCG at

all or a laser off SH organelle to open

that felt a bit heavier but to the

actual size and shape changed massively

and I think it was negligible that but

but what I did notice is a fullness a

heaviness if you know to the scrotum and

and in general you could say the testes

and when I got a blood test I found that

in a blood test when I got a fertility

test that that's my testes were were

producing around 156 million sperm of

which 72 percent were motile so they're

moving in the right direction that's on

your LinkedIn account

Instagram yeah so I mean I've been I've

been on HCG and off of HCG and I did did

gay atrophy off HCG

but it wasn't as terrifying was

uncomfortable that I thought it would be

before I started I thought you know they

would do him disappear inside me and and

it was gonna be horrendously pain yeah I

did it wasn't I got I've got some

tightening of the scrotum things shrunk

a little bit made the penis look bigger

which is what lots of guys say is a

women particularly for me was incredible

so so so there's that too as well and

then going on HCG again it didn't get

didn't a huge you know and my sperm tank

is fine now being on HCG but testicles

aren't like super huge or anything like

that you know but bigger than where they

were before yeah and that's the thing

you may have an image in your mind for

me it's been so long ago it's hard to

remember if they were much much bigger

in the past I was coming it's it's

personal whether your testicles are

gonna shrink and then how much there are

lots of guys that are on just

testosterone alone and that they don't

notice a massive amount of atrophy

sometimes it can happen it can plateau a

little bit but obviously if you work

with the doctor if you're concerned

about that you know there's HCG that can

be used to help with you know testicular

size and not just fertility just for

aesthetic reasons so so that's basically

something that you can I get kind of

expected yeah right so do I go for this

one yep well actually you should talk

about this one this is what happens to

your skin on trt on testosterone

treatment and well for me I I did what

can happen what can happen yeah so

doesn't always happen some people have

no problems at all I think there's a

generalized increase in oil the oil in

the skin or sebum and some people are

more prone to acne with this increase or

on the skin some people have dry skin it

could be a godsend other people it could

be a nightmare because the the amount of

acne really increases I think Sam you

can talk about that more yes has always

been a back knee prone and when I

started CRT had some flare-ups and it

did get worse at one point you know

there's some great stuff on the lifting

dermatologist channel Steven Davis

bites some acne acne things on trt so

you can always look at those videos or

put yeah putting the link up here

something in the bottom but yeah that

that's that's good information lots of

the top cause there's like you know

differ in and retin-a I think is good

and there's obviously like the oral type

medications of it antibiotics if I know

they're sort of going a little bit of

favor with some of the doctors but

there's also accutane and things around

you know we could do a whole video on

that but that happened to me and that I

got a bit more acne on my back in

particular but I did find that when I

started like I probably should have

started I do tell a lot of guys there's

something's of how he's like a

preventative acne protocol so some good

stuff and Excel mail actually about what

guys do and that's the forum Nelson

virgil's forum and there I just find a

good thread a few good threads on there

initially and you it's just making sure

like most guys can't scrub the middle of

their back I definitely can't like you

so I that just getting to that middle

part like you know I'm Santa chair now

that's way there's a bit of sweat just

making sure that during a shower you

give that a bit of a scrub you know we

could do a whole video on on sort of

maybe acne pros schools but there's good

some good soaps like South reso solvers

soap you can use you know that there's

some good sort of combinations of things

but sharing twice a day as it prevents

your mat measure you know washing bed

sheets every week you know that that

sort of thing can be quite helpful by

only prone guys if they're worried about

it but it can happen it doesn't happen

to everyone to be fair I've not heard of

a lot of guys that have acne that's

unmanageable NCERT it's usually just

during the changes spots and the

shoulders someone that had a few on the

back yeah but you know with the skin you

can also get an increase in body hair as

well I've known people of friends that

my new salted TRT that had you know

quite smooth on the chest and they would

grow some more chest hair out of nowhere

so well it's from the antigens obviously

but this is something to look out for I

know when I started I didn't have very

much facial hair and obvious I got

facial hair now so you know I think you

can't thicken that facial hair on some

people if you're prone

having more of a beard so you know yes

androgens testosterone has an impact on

on your skin it can thicken skin as well

I believe I mean I might face has been

pretty like smashed up from from rugby

repetitively over the years I did have

really thin patches of skin and deathly

notices knife thicker you know it's

almost like it's healed healed better

than I know that right there is some

some evidence either showing that it can

thicken the skin and improve skin

increase a little bit so speaking of

they can Ignacio thicken that's for

another video

yeah nothing in my case so so obviously

you may lose it so number talk about

hair I forgot about this but yeah it's

just become part of me now you know I

had her when I was younger in my

twenties and over time I was probably

prone to losing it anyway and you know

by my early to mid 30s oh I started

shaving it so I'm a right slap head now

but I'm you know I'm I own the look and

yeah you know it I had to make I to look

back and say right it's better to have a

healthy libido

you know this amount of a muscle master

to go into Aging and the hair you know

it didn't bother me yeah and you saved

money on haircuts yeah and shampoo yeah

yeah so you can I mean that hair loss is

one of those things where you know the

advice from the doctor is that you you

can get some some hair loss right but

it's basically if you genetically are

predisposed to it you know you mean you

you see lots of guys even abuse hormones

and you know anabolic steroids and

things of that that are very strong and

a very harsh on your hair and they don't

lose their hair maybe you get some that

do and I think the general consensus is

that if you're going to lose your hair

you're gonna lose your head right you

definitely gonna lose yeah but if you go

from a low level of hormones to an

optimal a higher level of hormones it's

gonna you gonna lose it faster right

then you were you you would have reached

the state that you would have reached

had you always had those optimal levels

of hormones so if you were always meant

to have a high level hormones through

your twenties you may have lost your

hair in you you know mid to late 20s if

you're meant to lose it in your 50s

because you like had a little drip field

of testosterone but because it's not

brought up to a normal healthy level you

may you may lose it a little bit earlier

but in general there's a whole lot you

can do there are some topical

formulations of course are the the

approved licensed formulations like

finasteride but that would go counter to

many people having improvements of the

libido and erectile quality and that can

have lasting impact as far as people

having finasteride syndrome yeah I mean

none of the doctors use oral finasteride

it does not usually recommended if

people are already having issues with

their testosterone treatments so some

people may as an option how topical

finasteride yeah or topical finesse why

with the Tanner Proust or by Matt

applause which are prostaglandin

analogues you say minoxidil and regain

uh minoxidil

yeah I'll say over-the-counter as well

as you can use that and guys had some

good good good results with that as well

as they're a bit prone to it so but yeah

I mean that's the sort of some kind of

doing of techniques or options to maybe

how to hold on for if you have a little

bit longer so what's next on all this

time so number eight on the list is

lipid changes so on bloodwork changes in

your lipid panel so these are you can

normally be in the right direction there

are many other factors obviously if you

are they say if you're a high saturated

fat diet you may then increase your LDL

but in general testosterone treatment

replacement treatment can bring your

lapid lipids into into a better balance

layer if you will do you tend to see any

a decrease in overall cholesterol okay

but then sometimes you can also see a

decrease in HDL the so-called good

cholesterol and there's also been cases

or reductions in triglycerides and we've

seen patients who claim within the first

six weeks or six months even a reduction

in triglyceride levels normally at six

months we would see it because that's

when the six-month blood test occurs and

it's a nice drop from baseline it's like

I said if you're still doing the wrong

things you know in terms of drinking

eating poorly and and to be fair like

you know at this point it could be

pretty hard like you're not feeling

better and people haven't managed to

change their their diet I think is

really important if you haven't managed

to like get your life on track in terms

of right diet and exercise and things of

that it's not this lots of you should be

ashamed of right you've been coming from

like a lower level to to feeling better

again you just gotta like give yourself

time there's there's plenty of time the

rest of life to try and work on it so if

you are someone that has immuno got

improvement in lipids or or blood

profile or even body composition or

things like that or or energy even and

it's because maybe having created some

of those factors yeah I think it's

important to know that you know that you

may not happen you know you should

really be ashamed of it yet you can work

on those things right yeah and also a

side note to lipids you can also talk

about both glycemic control and I start

blood pressure they're known to decrease

when on trt no obviously there's other

factors but in general some of the

studies and some of the things patients

that have come through diastolic

pressure can be lowered as well as

improvement of glycemic control if your

blood sugar was you know usually above

the normal threshold those patients have

tended to see the greatest improvement

in blood sugar levels on trt okay so

number nine number nine is improvement

in bone density but that would go

without saying that testosterone is the

precursor hormone for two metabolites

Eastern oil and dihydrotestosterone

Eastwood I'll be sex hormone that is

known to increase bone density it also

closes the bone plates when when you're

growing into adolescence but yet Easter

doll as an adult can maintain increased

bone density so that's why yeah we guys

that come through and they're like well

I want no Eastridge in please and lots

of testosterone is you know it's not

know how it works no there's plenty of

topics a discussion of the benefits of

Eastridge in so you need that for

bone density I mean bone density you

know even without hormones you know the

evidence is there if you do

bearing exercises you know compound

movements you know there's studies in

elderly people doing that that it can

increase bone density and is very much

dependent on activity you know but if

you're doing those right things you know

those things right rather and you do

have optimize hormones that is going to

be improved if you've got a good amount

of estrogen

so getting multifactorial you know

there's many many factors for the

increase of your bone density and I seen

guys have done scans that have come

through before before and after and and

definitely seen an improvement in in

bone density you know something to

consider there are some people before

they get on TRT they actually have low

Eastern oil which would make sense

because substrate that testosterone is

also low

so if they've gotta know if you have a

low amount of testosterone you probably

have a low amount of Easter tile before

you start which is why there are so many

benefits to the on testosterone

treatment because you can bring your

Easter doll up into and into normal

balance mm-hmm I mean I think young

people if they have a lot of they have a

lot of fractures you know over the

course time hormones they obviously is

one of the factors that they look into

because it is needed to maintain bone

density okay so so finally we've got

number gem so sleep is a really

important one lots of guys before

therapy are affected with Paulie I

remember this

yeah my lovers went low a few times it

just seat was awful in some cases I felt

like I had a little bit less sleep I

couldn't actually get proper good rest

on steep so sometimes I would just wake

up really early and I knew that's when I

was really know something just wasn't

right or I'd have the night sweats

during the sleep before TRT yeah well

yeah when levels got really low a few

times yeah in between so yeah when I was

on treatment I came off and then you

could read it becomes a very noticeable

sleepers not right yeah but auntie

auntie actually can't get better yeah I

mean obviously again sleep has lots of

factors right you've got a good sleep

hygiene and and not being on your phone

and things about all the things we

always we get to told about it but the

if people have poor sleep before

actually

it could be anxiety it could be things

like that and if your anxiety levels

begin to improve at this point on CRT

you might notice an improvement but

there are also guys that their

perception of what good sleep is is is

maybe difference there like I should be

absolutely nailing you know 10 hours

every night I'll be super recovered and

that's what I'm expecting from CRT and

actually it can be that people start to

sleep a bit less they've got some guys

say they wake up at like 5:00 in the

morning you know in the uses of dragging

themselves out there they feel rested

they've slept less but the vehicle in

matter of time they've slept a lot what

I'm not sleeping

I've got insomnia you know so that so

there's that as well and so it can vary

but we're talking about the 12 to

six-month mark and that leads us into

with sleep you may also have sleep apnea

and to say that you may have had an

apnea already but wasn't that noticeable

in some cases it may become unmasked

yeah so just to simplify it just because

so I know some guys don't know sleep

apnea is when you have an apneic episode

in your sleep either you stop breathing

or is classified if you've got

turbulence through snoring where

basically the resistance in your upper

airway causes you to have low oxygen

levels in your sleep right so you keep

waiting and keep waking up and lots of

guys don't notice it but ERT is

associated with sort of unmasking as

mild sleep apnea people obviously may

have suffered through it for years it's

just about bearable got it already

testosterone you know if your habit will

bring it to light yes and so the benefit

is well maybe you can get treated sooner

now because you're now a more obvious

case to you to the NHS for those who are

treating sleep apnea and if you are a

sleep apnea patient that is being

treated and then you start CRT because

of they think because of how you sleep

maybe deeper sleep but particularly

because if you if you have larger neck

muscles and you've got more tissue

because the testosterone is affecting it

you my need adjustments of your current

therapy I mean I've got a deep apnea and

some people say the only tooth

keeping me alive or the CPAP machine and

the testosterone no it's yeah

but yes is this a good point of that if

that's lying you to breathe properly and

sleep and get restful sleep

you know you might need to adjust it of

your current therapy I currently on

therapy and you may um ask something

like that you know if it's mild so to

eat and particularly this point if

people are starting noticing that

they're a bit more tired it's absolutely

something to you know speak to the

doctor about as well as on the blood

test of six months it will pick up if

your hematocrit and hemoglobin and red

blood cells are abnormal if they're

normally high it may be due to a sleep

apnea and after that's happening that

hasn't been corrected or treated yet so

and that's because testosterone you know

through EPO doesn't if you are if you

are going through low oxygen episodes or

hypoxic episodes you will make we should

make more red blood cells to carry more

oxygen in the blood so obviously the

body just doing what it needs to do and

reacting as if you do starts to get a

little you know low action your sleep

you can get higher hematocrit and

hemoglobin so that's why that's

obviously monitored on therapy - yeah

right this was an exhaustive this but we

thought the medications will give you

some of the big topics that you could

expect at six months on TR - what you

expect six months on trt we will do

another video we're always gonna do

another video we keep doing video so

we'll do a we'll do a year we'll do six

months to a year and then we'll do

another one yeah do that I think it'll

be longer - coming up next time

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