My Personal Experience on TRT - what to expect on TRT.

Summary

This video script discusses personal experiences with Testosterone Replacement Therapy (TRT), highlighting benefits like improved motivation, energy, and muscle gain, as well as potential side effects such as acne, increased estrogen levels, and hair loss. The speakers share their journeys from diagnosis to treatment, emphasizing the importance of proper dosing and frequency to minimize side effects and maximize TRT's positive impact on quality of life.

Takeaways

• 🧪 Testosterone Replacement Therapy (TRT) can have immediate and noticeable effects on energy levels, confidence, and social anxiety, contrary to the common belief that it takes weeks for changes to be felt.
• 💉 The initial experience with TRT can vary greatly, with some individuals noticing improvements in gym performance, muscle gain, and reduced anxiety within the first few weeks of treatment.
• 📉 Chronic low testosterone can diminish the body's ability to recover from and resist stress, highlighting the importance of this hormone in stress resilience and overall well-being.
• 🤔 Misdiagnosis and misunderstanding of low testosterone symptoms are common, with many men being incorrectly told their symptoms are psychosomatic or related to depression rather than hormonal imbalances.
• 🚫 Some General Practitioners (GPs) may dismiss low testosterone concerns, especially in younger individuals, due to misconceptions about the hormone's role and potential for abuse.
• 🏥 The NHS and some clinics may use outdated or ineffective TRT protocols, such as high doses of testosterone injections given infrequently, which can lead to spikes and dips in hormone levels and associated side effects.
• 🚨 Side effects of TRT can include acne, increased estrogen levels, water retention, and potential hair loss, which may be mitigated by adjusting dosage and frequency of injections.
• 💊 TRT is not a one-size-fits-all treatment; individual responses to therapy require personalized dosing and monitoring to minimize side effects and maximize benefits.
• 🧘‍♂️ The benefits of TRT extend beyond physical changes, with improvements in mood, sleep quality, and overall mental health being significant aspects of treatment.
• 🧬 Testosterone's role in the body is multifaceted, including its antagonistic relationship with cortisol, which influences the body's stress response and recovery capabilities.
• 🌐 The understanding of TRT and its effects is rapidly evolving, with ongoing research and clinical experience leading to improved treatment protocols and better patient outcomes.

Q & A

What is the primary reason the first speaker started experiencing social anxiety?

The first speaker experienced social anxiety due to chronic deficiency in testosterone, which is known to affect confidence and stress resilience.

How does testosterone relate to stress resilience?

Testosterone is the primary glucocorticoid receptor antagonist, which helps the body recover from and resist stress. When testosterone levels are low, the body's ability to handle stress diminishes.

What was the cause of low testosterone for the second speaker?

The second speaker had low testosterone due to a testicular torsion caused by an injury to the nether regions, which led to damage to the testes and impaired testosterone production.

Why did the general practitioner (GP) initially dismiss the second speaker's symptoms as psychosomatic?

The GP dismissed the symptoms as psychosomatic because the second speaker's testosterone levels were within the normal range, albeit at the very bottom, and the GP was hesitant to attribute symptoms to low testosterone given the patient's young age.

What is the role of dopamine in the context of testosterone?

Dopamine, often referred to as the 'feel-good hormone,' is potentiated by testosterone, which can quickly increase dopamine levels in the central nervous system, driving motivation and the execution of goals.

How did the third speaker's experience with TRT (Testosterone Replacement Therapy) begin?

The third speaker started TRT after noticing symptoms like low energy, mood swings, and erectile dysfunction. A friend recommended a company for blood tests, which revealed low testosterone levels, prompting the start of treatment.

What immediate effect did the third speaker notice after the first injection of TRT?

The third speaker felt a significant improvement in energy, confidence, and reduced sleepiness within a few hours of the first injection, suggesting a rapid impact on physiology, possibly due to both the propionate in the injection and a placebo effect.

What are some common side effects of TRT mentioned in the script?

Some common side effects of TRT mentioned include acne, increased estrogen levels leading to mood changes, water retention, and potential hair loss acceleration.

Why might a man on TRT experience acne or greasy skin?

Acne or greasy skin can occur due to increased sebaceous gland output caused by high levels of testosterone, which can make the skin oily and prone to spots, especially if the dosing protocol is not optimal.

How does high estrogen level affect a man on TRT?

High estrogen levels can cause mood changes, water retention, potential gynecomastia, and increased risk of blood pressure issues, which can be mitigated by adjusting the TRT dose and frequency.

What is the potential impact of TRT on hair loss?

TRT can potentially accelerate hair loss in men who are genetically predisposed to it. However, some men may choose to use treatments like finasteride sprays to counteract this side effect without systemic absorption.

Outlines

00:00

🚹 Testosterone's Impact on Social Anxiety and Stress Resilience

The speaker discusses their personal experience with social anxiety and how it was alleviated after addressing low testosterone levels. They explain that chronic deficiency in testosterone can reduce one's ability to handle stress due to its role as a glucocorticoid receptor antagonist. Upon restoring testosterone levels, the individual noticed an immediate improvement in confidence and resilience to social situations that previously induced anxiety. The paragraph also introduces a video about personal experiences with Testosterone Replacement Therapy (TRT), including its benefits and potential issues.

05:02

💉 The Journey to TRT and Initial Physical Challenges

This paragraph delves into the personal stories of individuals who started TRT due to low testosterone levels caused by various reasons, including a physical injury that led to testicular torsion. The speakers share their symptoms such as decreased motivation, mood swings, erectile dysfunction, and the struggle to maintain physical fitness. They also discuss the challenges faced when trying to get a correct diagnosis and the common misconceptions by general practitioners that attribute these symptoms to depression or psychological issues instead of recognizing the need for TRT.

10:04

💪 Immediate and Long-Term Effects of TRT on Physical Performance

The speakers describe the immediate positive effects of TRT on their physical performance, such as increased energy, improved gym performance, and enhanced muscle gain. They also touch upon the non-genomic actions of hormones, explaining that while most changes due to TRT take time to manifest, some effects can be felt almost immediately due to testosterone's influence on dopamine levels in the brain, which can increase motivation and reward pathways.

15:04

🌙 Improved Sleep and Reduced Anxiety from TRT

In this paragraph, the benefits of TRT on sleep quality and anxiety levels are highlighted. The speakers share their experiences of falling asleep more quickly and waking up feeling refreshed. They attribute these improvements to testosterone's anti-stress effects, which enhance the body's ability to recover from stress and maintain a more balanced mood. The paragraph also discusses the hormonal balance's impact on the body's physiological state, including the reduction of social anxiety and general edginess.

20:05

🧬 Testosterone's Biological Role and Side Effects

The discussion shifts to the biological role of testosterone as an antagonist to cortisol, the primary hormone responsible for stress responses. The speakers explain how chronic testosterone deficiency can impair stress recovery, but TRT can restore this ability. They also address potential side effects of TRT, such as acne and oily skin, which may occur due to increased sebaceous gland activity from high testosterone levels. The paragraph emphasizes the importance of correct dosing and frequency in TRT to avoid such side effects.

25:06

🚨 TRT Side Effects: Estrogen Levels and Physiological Responses

This paragraph focuses on the side effects related to elevated estrogen levels in TRT, such as water retention, potential gynecomastia, and emotional sensitivity. The speakers share their personal experiences with these side effects and discuss the importance of adjusting TRT protocols to manage estrogen levels effectively. They also mention the use of aromatase inhibitors and the need for a balanced approach to TRT to avoid adverse effects on the body.

👨‍🦲 Hair Loss and Acceptance of TRT Side Effects

The final paragraph discusses the potential acceleration of hair loss as a side effect of TRT and the personal decisions individuals make in response to this issue. The speakers share their approaches to hair loss, including the use of finasteride sprays and the acceptance of hair loss as an inevitable part of aging. They conclude the video by inviting viewers to share their experiences and questions about TRT and by promoting a hair loss solution offered by their company.

Keywords

💡Social Anxiety

Social anxiety is an intense fear of social situations that may result in scrutiny or judgment by others. In the video, it is discussed as a common issue that can be alleviated through testosterone replacement therapy (TRT). The script mentions how the disappearance of social anxiety was unexpected and almost immediate for the speaker, highlighting the profound impact TRT can have on mental health.

💡Testosterone Deficiency

Testosterone deficiency refers to a condition where the body does not produce enough of the hormone testosterone. The video script describes the negative effects of this deficiency, such as reduced motivation, mood changes, and erectile dysfunction. The speakers share their personal experiences with low testosterone levels and how TRT helped them recover.

💡TRT (Testosterone Replacement Therapy)

TRT is a medical treatment aimed at restoring testosterone levels in men who have deficiency. The video's main theme revolves around the personal experiences of individuals on TRT, discussing its benefits, such as improved confidence and stress resilience, as well as potential side effects. The script provides insights into how TRT can significantly change one's quality of life.

💡Stress Resilience

Stress resilience refers to the ability to withstand or recover from stressful situations. The script explains that testosterone plays a crucial role as a glucocorticoid receptor antagonist, enhancing one's stress resilience. The speakers discuss how TRT helped them manage stress more effectively, which is central to the narrative of overcoming challenges posed by low testosterone.

💡Erectile Dysfunction

Erectile dysfunction is the inability to achieve or maintain an erection sufficient for sexual intercourse. In the script, it is mentioned as a symptom of low testosterone that can be improved with TRT. The discussion on erectile dysfunction provides a specific example of how hormonal balance can impact sexual health.

💡Insomnia

Insomnia is a sleep disorder characterized by difficulty in falling asleep, staying asleep, or both. The video script describes how one of the speakers suffered from insomnia due to low testosterone levels. The improvement in sleep quality after starting TRT is a testament to the hormone's role in regulating sleep patterns.

💡Glucocorticoid Receptor Antagonist

A glucocorticoid receptor antagonist is a substance that blocks the effects of glucocorticoids, such as cortisol, which can increase during stress. Testosterone is described as a primary antagonist in the script, emphasizing its role in counteracting the stress response and restoring the body's ability to resist stress.

💡Aromatase Inhibitors

Aromatase inhibitors are a class of drugs that decrease the conversion of testosterone to estrogen in the body. The script touches on the use of these inhibitors to manage side effects like gynecomastia and water retention associated with elevated estrogen levels due to TRT.

💡Gynecomastia

Gynecomastia is a condition in males where breast tissue develops, often due to an imbalance of hormones. The video discusses this as a potential side effect of TRT, where high levels of testosterone can be converted into estrogen, leading to breast tissue growth. The speakers share their experiences and concerns regarding this side effect.

💡Finasteride

Finasteride is a medication used to treat male pattern hair loss by inhibiting the conversion of testosterone to dihydrotestosterone (DHT). The script mentions finasteride as a potential solution for hair loss, a side effect that some men may experience as a result of TRT, although it also notes the risks associated with its use.

💡Pharmacokinetics

Pharmacokinetics is the study of how an organism affects a drug, including its absorption, distribution, metabolism, and excretion. The video script criticizes certain TRT protocols for not taking into account the pharmacokinetics of testosterone, leading to ineffective treatment plans and potential side effects.

Highlights

The disappearance of social anxiety after starting testosterone replacement therapy (TRT).

The link between chronic low testosterone and diminished stress resilience.

Testosterone's role as a glucocorticoid receptor antagonist and its cellular impact.

Personal experiences with TRT initiation, including immediate and long-term effects.

The misdiagnosis of low testosterone as psychosomatic issues by general practitioners.

The common misconception that only bodybuilders seek TRT for performance enhancement.

The immediate increase in energy and gym performance after the first TRT injection.

The non-genomic actions of steroid hormones and their rapid physiological effects.

The potentiation of dopaminergic transmission by testosterone and its motivational effects.

The improvement in erectile function as a result of TRT.

The reduction in anxiety and the ability to relax better after TRT.

The rapid disappearance of social anxiety post-TRT and its potential biological basis.

The increase in muscle mass and gym performance due to higher testosterone levels.

The benefits of TRT on sleep quality and morning energy levels.

The potential side effects of TRT, including acne and greasy skin due to increased sebaceous gland output.

The importance of correct dosing in TRT to prevent side effects like acne and mood swings.

The impact of TRT on estrogen levels and the associated side effects like water retention and potential hair loss.

The acceleration of hair loss as a side effect of TRT and potential treatments.

The psychological impact of TRT, including reduced anxiety and improved mood.

The discussion on TRT protocols, including the ineffectiveness of certain dosing schedules and the importance of personalized treatment.

The potential for TRT to improve an individual's quality of life by addressing symptoms of low testosterone.

Transcripts

social anxiety that i used to have in

terms of going into a group of people

and that disappeared for me almost

overnight you would think that that

would be something that you have to kind

of build yourself up to when you are

chronically deficient in testosterone

your actual ability to recover from and

resist stress diminishes because

testosterone is the primary

glucocorticoid receptor antagonist when

you do put testosterone back in that

confidence and stress resilience and

ability to actually go into a social

situation that you know would usually

give you anxiety but be able to resist

that is again because on the cellular

level your body's actual ability to

resist stress has been restored

[Music]

hello again everyone today we're going

to be talking about our personal

experiences on trt how we got started

why we started trt and a little bit

about what it feels like when you

actually start for the first time some

of the issues you might experience and

hopefully some of the benefits as well

when you first get on trt and also

longer term after you've been on trt for

a year or two so tom do you want to

start off with a little bit about

yourself and why you felt like you

needed to start trt in the first place

yeah so unlike most people i had a very

clear cause for my low testosterone i

took a blow to the nether regions and

that caused something called a

testicular torsion and for those who

aren't aware probably make you cringe

but it's where your testes actually

twist around themselves when it cuts off

the blood supply that can lead to local

ischemia and damage to the tissues which

in turn can lead to impairment to their

function and by proxy testosterone

production so um that happened when i

was about 18 had to go in for surgery i

was perfectly healthy before that no

problems whatsoever a few months after

the surgery i just noticed all of a

sudden that motivation was declining i

wasn't really recovering from the gym

anymore just mood in general was a

little bit low and then a few months

after that i started to develop erectile

dysfunction but more so disappearance of

my sex drive and you know for a for an

18 year old guy that is very abnormal

very very abnormal i went to my gp like

most young men would and they tested my

testosterone levels thankfully i think

that they were very hesitant to do that

because of my age but because of my

history

they did it and my levels came back

within range but right at the very very

bottom i think from recollection i was

about 10 11 animal policer so below the

british society for sexual medicine

guidelines but because i was within

range i was told that it had nothing to

do with testosterone and it was all

psychosomatic in nature and i was just

depressed well that's the crazy thing

isn't it you had an obvious cause and

all of the symptoms but they still were

just like oh 10 animals police so that's

fine because it's above 8.4 nanomoles

per liter which is what it says on the

lab report even though the lab reference

range has nothing to do with symptoms at

all yeah exactly and again you know

there exists medical guidelines like the

bssm guidelines that state that levels

below 12 can be classified as

hypogonadism as low testosterone and

even then my gp was very much trying to

steer me in the direction that i was

just depressed and and i needed to take

some search lead and forget about all my

problems essentially so i think a lot of

men can empathize with that i think the

vast majority of men that end up coming

to us have been through that same

process of just knowing there's

something inherently wrong with them

they don't feel good they've got the

symptoms the blood tests show that

they're essentially low but not low

enough to be below range and they're

rejected and made to feel like their

symptoms are in their head or that

they're crazy for thinking that

testosterone could be the cause yeah or

even worse that they're just trying to

get testosterone for free so that they

can body build or something like that

yeah especially another common one

especially if one of the symptoms they

report is that their performance in the

gym has gone down or they're gaining

weight or whatnot and and the gp the

vast majority of gps i shouldn't speak

in absolutes but we'll immediately

associate that with ah this person you

know anabolic steroids testosterone no

no no no it's just depression well i

mean my initial kind of story of

realizing i had low testosterone was

quite similar apart from i didn't have

an obvious physiological cause but i was

you know i had all of the same symptoms

and i was struggling at work i was

working as a physio in the nhs and i was

really struggling at work unable to

basically stay awake i had insomnia i'd

had that for quite a few years but it

was worse and worse so even though i was

knackered all day and i was yawning all

morning and basically propped myself up

with loads of coffees all day long

despite that i couldn't sleep by the

time i got to bed i'd been regularly

exercised similarly to you tom you know

i was going to the gym six days a week

and then just suddenly i just couldn't i

was dragging myself to the gym like just

dragging myself there and i couldn't do

anything i remember just sitting down on

the bench halfway through a gym session

and being completely knackered and i was

like what is going on why have i got no

energy at all doesn't make any sense

mood was all over the place i was like a

grumpy old man basically you know felt

rough the whole time and i was losing

muscle and putting on fat at the same

time so it started to look terrible at

the same time you know if i'd walked

into a gp and tried to explain these

symptoms to them i'm sure they would

have looked at me and said you're quite

big you obviously go to the gym so you

don't have low testosterone and that's

something we hear so often because

really the guys who actually are aware

of this issue most often are the guys

who go to the gym because they know what

testosterone is they're aware of

steroids and they know about trt and all

that kind of stuff i think there's a

correlation and that probably doesn't

actually help in some ways because the

people who go in to see the gp is

probably the ones who look like they go

to the gym and obviously gps associate

testosterone with guys who want to put

on muscle and that's it really yes i

mean it sounds like we had very similar

kind of symptoms before we started mine

was different in that i didn't actually

go to a gp one of my friends recommended

a company got blood tests from them i

had very similar levels to you i think i

had 10 animals per liter total and my

free was like 0.17 nanomoles per liter

which is pretty low and i couldn't wait

to get started on treatment within about

six to eight hours of having my first

injection of sustain on i did it in my

quad which was a terrible idea because i

then cycled to work which was like quite

a long it was about an hour cycle to

work in the morning at like six in the

morning in the cold by the time i got to

work i could barely walk on my leg the

amount of post-injection pain they had

was pretty bad actually and i was like

this is quite a lot i've done it in my

quad because i thought that'll be a lot

easier than doing it in my glute for the

first time

so anyway i got to work and by about six

hours or four or five hours after my

injection i felt great i felt myself

again like quite energetic and you know

i had confidence and i wasn't sleepy at

all felt amazing i don't know if that's

just placebo or if it's because the the

propionate and the sustain really kicked

in that quickly i think um

it's probably a mixture of the both

a lot of people will say things like you

will not notice anything from

testosterone because one it takes five

to six weeks to build up a new system

and two because it acts through genomic

pathways the androgen receptor alters

the expression of genes and that can

take quite a while it's not a process

that you notice immediately but what a

lot of people don't understand is the

androgen receptor or receptors in

general are only one mechanism through

which hormones all derive physiology and

there are numerous review papers about

the non-genomic actions of steroid

hormones and even if you look at in

vitro studies you can notice changes to

physiology within seconds of applying

any steroid hormone to a tissue even if

said tissue has been genetically

modified to not express the receptor so

whilst the bulk of of the changes that

you you will see do take time and it's

it is a treatment that the effects build

you can still notice things straight

away so it's probably a mix of both yeah

i mean it didn't feel like a placebo it

felt like suddenly i was like okay and

then for the next several weeks to

months i felt very very similar which i

think is quite common when you first

start trt in particular but as you said

perhaps it has an almost immediate

impact as soon as because it's obviously

absorbed into your blood fairly quickly

particularly the propionate with an

intramuscular injection so you'd imagine

that that could go around your

bloodstream and impact your brain yeah

it's thought to be due to testosterone's

potentiation of dopaminergic

transmission so it can rather quickly

increase the amount of dopamine that

that's within your central nervous

system with dopamine some people call it

the feel good hormone current research

is pointing towards it not being feel

good per se but more so motivation and

reward it's what drives you to do things

that you know are productive and good

for you in the long run even if they're

hard so it helps you to just go out and

actually execute on your goals instead

of sitting at home and being rather low

energy or just having no actual desire

to go out and try and pursue whatever

sex you're interested in or try and get

that promotion at work or go to the gym

or whatnot so did you inject when you

first started treatment thomas did you

you said i did so unfortunately when i

started treatment i've been on trt about

five years now this space is so new it's

evolving so rapidly that even just

within those five years current

treatment protocols have changed

enormously so when i started i was

placed on 250 milligram of sustanon

every two weeks which as you know and

i'm sure a lot of people who are

watching this know is extraordinarily

ineffective for numerous reasons that

i'm sure we'll cover in a different

video at some point i was administered a

one milliliter injection into my outer

quadricep in the doctor's office with a

21 gauge harpoon um

yeah it was a standard nhs model i had

injected a needle and i i had the exact

same pulse injection pain to the point

that as i was as i was leaving the

doctor's office walking to the train

station i just noticed my leg going

deader and deader and deader to the

point where i was actually sat on the

train and i couldn't even feel my outer

quadricep anymore just because for those

who don't know the first time you inject

into a muscle it usually triggers a bit

of an inflammatory response anyway that

does attenuate over time the larger the

needle you use the larger the volume of

liquid you use and then the type of

liquid too with sustain being

particularly bad for post-injection pain

due to the proprionate ester and also

the high benzyl alcohol content all of

those submitted to

essentially crippled me for a day or two

so that that was my first yeah i mean i

was the same i really struggled to cycle

home after work i was hobbling around

work it was like having the worst dead

leg i've ever had yeah so i didn't

inject into the quad again after that i

actually carried on injecting for the

into my outer quadricep for about two

years but i switched to 29 gauge insulin

syringes when i moved to daily

injections it wasn't too bad still not

pleasant again i'm sure we'll come on to

this but it's it's yeah much worse than

subcutaneous injections which is now in

the vast majority of men that tolerate

that the best way to administer trt

apart from with sustain and i would add

in there because it really stings if you

try it with sustanon at least it did for

me and i think for a lot of men because

of the bends of alcohol and the

propionate in it what were your kind of

initial effects from the starting trt

we've talked about maybe two to three

days but longer maybe in the first three

months the first three months i

immediately noticed that without a

significant change to my training or

diet i was already lifting three to four

days a week compound lifts focusing on

progressive overload eating in a caloric

surplus so i was already gaining weight

and adding weight to the bar and

training in a way that was conducive to

building muscle and getting stronger but

even with all that in place i

immediately noticed that my results just

tripled overnight essentially i say

overnight within the first few months to

the point where i just completely broke

through all of my plateaus and i was

plateauing at weights that in relation

to my body weight and my time lifting i

should have been breezing through you

know they call it the newbie gains or

the novice gains and mine stalled out

very quickly that was one of the first

things i noticed not only did my results

come quicker but my energy in the gym

itself my ability to actually perform to

my ability within that session also

improved so those were two main things

the other thing that i noticed quite

quickly is that my erectile function had

improved a lot of men are quite

reluctant to disclose these things that

you know they do have erectile issues

and it can be embarrassing for a lot of

men that was one of the big things i

noticed too that my erectile strength

came back and then i think the only

other thing is that my ability to relax

came back i'm not sure if it was because

i was actually able to train harder or

whatnot but i used to feel an edge quite

a lot at night never really sit back

relax just lie on my bed watch tv or

something like that i would always feel

a little anxious and a little on edge

that was the other thing i noticed in

the short term that i could just go home

sit down relax fall asleep and i would

wake up refreshed and recovered to do it

all again as opposed to sitting there on

edge then getting a crappy six-hour

sleep constantly having that low-level

fatigue state yeah i mean i can

definitely empathize with that i mean i

definitely had anxiety

right low testosterone background level

of anxiety pretty much the whole time i

wouldn't say i was depressed but i was

heading that way kind of low mood and

you know when you're not sleeping and

you've got low moods and then eventually

you stop going to the gym

and then you're putting on weight it's

only so long until everything starts

falling apart i think and i was

certainly on that trajectory i think

that's the same for a lot of men that we

speak to because a lot of men don't even

know they have this i was quite lucky in

that i realized within a couple of years

i'm not exactly sure of your timeline

tom but it sounds like it's similar kind

of quite quick that you realize some men

will be like this for eight nine years

before they realize some people don't

realize ever

you know they just kind of deal with it

they've never either seek the right

advice or sought the right advice or

they've been told incorrectly that

they're okay and there's nothing wrong

there or take some antidepressants but

yeah i definitely had anxiety and

depression and and i think that was

another thing that i noticed social

anxiety that i used to have in terms of

going into a group of people i used to

have quite bad social anxiety now i

think about it and that disappeared for

me almost overnight which was incredible

because you would think that that would

be something that you have to kind of

build yourself up to but no it was

almost like it just disappeared and i

wasn't overthinking things anymore i was

like oh i'll just go and talk to those

people and not just that but just

general anxiety and kind of being on

edge definitely i suffered from that as

well so i think in the first three

months i noticed all of those kind of

things improved and i had the exact same

thing as you in terms of having energy

in the gym putting on muscle quite

quickly because we know testosterone

increases your muscle mass i was on

about half a milliliter of satsang a

week when i started does have a big

impact because really on that kind of

level you've got a higher testosterone

level than most people so and it

definitely translates to putting on

muscle in the gym obviously that's not

the main reason for going on trt it

certainly helps with that i think those

were the main things that i noticed

really the other big thing was sleeping

i would just fall asleep within 10

minutes which was completely unheard of

for me i hadn't done that since i was

very young i couldn't remember the last

time i'd fallen asleep in 10 minutes and

that obviously carries over to having

much better rest better sleep you can

wake up earlier you can get more done in

the morning you don't feel groggy and

terrible in the morning you're able to

talk to people you have to do your job

properly yeah and i think that is

predominantly because of testosterone's

quite potent anti-stress effects it

allows you to actually face adversity

and not only face it but recover from it

much quicker too and that's

predominantly thought to be because the

primary steroid hormone of your

sympathetic nervous system which is your

phytoflight system is cortisol it's

essentially breakdown your tissue in

times of stress to be used immediately

but obviously testosterone causes all

antigonus testosterone builds tissue and

and cortisol breaks it down you need

times of both anabolism and catabolism

when you are chronically deficient in

testosterone your actual ability to

recover from and resist stress

diminishes because testosterone is the

primary glucocorticoid receptor

antagonist when you do put testosterone

back in that confidence and stress

resilience and ability to actually go

into a social situation that you know

would usually give you anxiety but be

able to resist that is again because on

the cellular level your body's actual

ability to resist stress has been

restored yeah i mean it's really

interesting putting it back to the

actual biology of it as so many of our

patients as well can see the actual

benefits that they experience day in day

out and how that can relate to what we

see in the biology and the actual impact

of testosterone physiologically yeah

it's very interesting i mean obviously

mechanistic theory like that doesn't

always translate across into the real

world but mechanisms like testosterones

antagonisms cortisol are extraordinarily

well documented and that particular

mechanism is elucidated very well in the

literature

so i mean we've talked a lot about the

benefits let's talk about side effects

because as with all treatments and all

medicines even something that's

naturally occurring like testosterone

there can be side effects i would say

that all of our patients pretty much all

of them will notice something so i would

say the main ones i started noticing

early on and this was because my

protocol wasn't great probably the same

for you tom i was on sustain half a mil

a week that's 125 milligrams per week

which is more than the average more than

even the top men produce per week i

would say i was noticing that i was

getting acne so i was getting quite

greasy skin and quite a few spots

particularly around my shoulders and

back and more on my forehead than i

would have had previously you think

about teenagers when they're going

through that period of the hormones

going up and down and you're definitely

producing more testosterone around that

period of time it's basically the same

thing i think if you've got a large

amount of testosterone it increases your

sebaceous gland output which makes the

skin oily and then you start to get more

spots some men actually get cysts i

would say i don't have that now because

my dose is better and i'm not doing once

a week injection of suction on which

causes a big spike in testosterone and

estrogen and then it tends to wear off

by the end of the week there's a way of

getting around it that's the kind of

take home from that most guys who have

that kind of issue i would say between

90 of them is because their dose is not

correct some men are just more prone to

it but in general i would say it's

because their dosing is not correct you

shouldn't be experiencing that as a man

who's you know 25 plus really yeah i

think it can be quite common for that to

start even if you are on a proper

protocol per se for the first month or

two months of treatment because you

haven't undergone that huge fluctuation

realistically it shouldn't be happening

at all although it is dopamine at the

start and if it's persisting three four

five six months or beyond into treatment

then yeah it definitely is a sign that

your current protocol isn't correct for

your physiology yeah and i mean the

other thing is there's a lot of clinics

that are still using this protocol once

a week injection of sustain or even

worse

a whole

250 milligram injection every two weeks

or even worse than that is 250

milligrams every three to four weeks

which is what i think the nhs has

normally recommended actually i think

once every two weeks is more frequent

than the nhs normally provide i speak to

a lot of guys that are coming to us

because they've started treatment with

the nhs and the most common protocol

that they come in on is one thousand

milligram of nubido every 12 weeks after

that it is 250 milligrams sustained

every three weeks they're literally just

reading the packet insert seeing that it

says start on 250 every three weeks if

they don't do well move it for every two

weeks and they're just completely

disregarded the pharmacokinetics and

basic physiology in favor of a packet

insert because that's what it is well it

seems to me that the only reason they

have put that in the packet insert as

far as i can tell unless they're

completely incompetent which i'm sure

they're not

is that it allowed them to sell it to

the nhs as a means of providing

injections which aren't being done once

a week nhs doctors don't want to be

doing injections for patients once a

week we'll do the injection for you you

come to us we'll do the injection for

you i reckon that's why they said oh

yeah you can do one of these injections

every three weeks it'll work perfectly

and we've split it up into four esters

and that'll make it better for some

reason otherwise it doesn't make any

sense to me why why you would say that

i think it's predominantly like you said

they want to administer the testosterone

at the doctor's office because they're

horrified of men potentially abusing

them which abusing testosterone for you

know performance benefits which the vast

vast vast vast majority of men don't do

and wouldn't do they just want to feel

normal again and then yes they were just

looking for ways to inject less

frequently and the idea was that you

have the four different esters two

shorter one medium as one's wearing off

the other kicks in that's an idea that

was built in the marketing department

rather than on any actual physiological

basis well they they test it themselves

they tested it themselves and they found

that the average testosterone level in

nanomoles per liter was 76 nanomoles per

liter after three days 76 nanos per

liter that's three times a high natural

testosterone level and then they even

said i think after two weeks it dropped

down to i think it was eight point

something animals per liter it may have

been after three weeks i guess they

could argue by two weeks if it was

dropping to 8.6 it's still within range

but how you can justify having a

testosterone level three times natural

three times a normal natural level is

beyond me really not expect to see any

side effects from that i mean moving on

we could talk about sustain all day as

well we should we'll do a video on that

at some point others kind of side

effects that i noticed and again linked

to this was uh a raised eastern level so

i went from having good confidence and

no anxiety et cetera to noticing that my

anxiety was kind of increasing a little

bit and possibly that i was a bit

bloated in the face as well it became

quite clear that my eastern level was

raised another sure sign of that is if

you start welling up when you're

watching tv commercials which i

definitely had once or twice but you

start feeling like you're gonna start

crying at some stupid tv advert really

stemmed from the fact that i was on the

sustanon and i was getting a big spike

in testosterone that was converting more

into eastern some guys get itchy nipples

even gynecomastia which is when they get

breast tissue growth it can increase

your blood pressure it can cause

swelling around the ankles which is

something that i had as well that can

impact how your heart's pumping it's not

ideal having high estrogen also not

ideal having a very low estrogen i don't

want to get into the aromatase inhibitor

argument today because that's another

long video for most guys if you're a

good body weight you can normally

maintain a good eastern level without

aromatase inhibitors but some guys will

need them if they want to be on a decent

dose of testosterone which improves

their symptoms there are other ways but

again we shouldn't really get into that

now but yeah i'd say high eastern is

another big kind of side effect of

starting trt but again it's easy to

adjust your dose and frequency to

prevent that from being an issue long

term yeah definitely and that was

predominantly the primary side effect

that i experienced at first about a

month in i just noticed that i wasn't

getting actual glandular growth actual

gynecomastia but i was getting

inflammation behind my nipple a bit

itchy and a bit sore even if you don't

actually have gynecomastia yet just that

starting can be rather stressful because

you know that theoretically it could

develop into actual gynecomastia so that

was the main thing i noticed i also got

the water attention too which comes

hand-in-hand with the raised estrogen

that's predominantly because estrogen

stimulates the activation of the system

in your body that regulates blood

pressure through retention of sodium

it's called the renin-angiotensin

aldosterone system interestingly

testosterone also activates it too they

can be quite synergistic in that respect

and some men can still even with a

controlled estrogen they will notice

improvements for the first few months or

so even if their estrogen isn't

particularly high you can still notice a

little bit of water attention which for

the vast majority of people does balance

out without any need for aromatase

inhibitors because sometimes you can get

you know a chapel a bit on treatment for

six seven eight weeks and they have

quite a few different side effects you

get their six week bloods back and the

doctor looks at them and there's nothing

inherently wrong with them you know

their testosterones are great players

yeah their estrogen isn't raised their

prolact isn't rage thought isn't raised

thyroid's fine and in that case you just

need to give it time especially if

you're one of the cases where you've had

low testosterone for 10 15 20 30 years

undergoing such a rapid and large change

to your physiology can mean that you

know it takes three four five months to

balance out and we see that all the time

chaps who have some quite unpleasant

symptoms at the start their blood works

fine the doctor keeps them on the same

protocol just tells them to give it a

little time which is hard to hear if

you've got side effects being told that

you just need to wait out whatever

you're going through at the minute it's

not pleasant as humans we inherently

feel better if we're actively doing

something but it is very common that all

of those problems water attention bit of

nipple itchiness things like that just

resolve on their own particularly if the

blood works looking fine too but yeah

those are the two main things that i

experienced and i would say that is what

most guys could play over the start yeah

definitely the case that we've seen guys

with normal eastern levels getting a

little bit of swelling here and there

and it just it seems to dissipate quite

quickly over a few weeks so the going on

to other potential side effects i think

another big one is hair loss i've

definitely noticed that it's accelerated

and obviously you don't necessarily

start losing hair when you're in your

early you know mid-20s but when you get

to early 30s it's quite common to start

losing your hair so i don't know how

much it's accelerated it but i feel like

it probably has a little bit again it's

something that you can reduce

finasteride pills is the most common one

but there's a risk of it causing side

effects that can be irreversible for

some guys so we tend to steer clear of

those but we do have a spray of

finasteride which doesn't go into your

bloodstream quite as much and for me it

seems to be helping quite a bit it's

definitely reduced kind of hair loss i

think i've even grown back some hair

follicles so it's not the end of the

world if you're really prone to losing

your hair anyway it might be the case it

makes it a bit worse and that you're

just going to lose your hair

unfortunately in those kind of cases

it's probably true that you would be

losing your hair anyway it's just

accelerating what you were genetically

predisposed to anyway yeah

and i i went through the same thing i

mean i've grown my hair back now but

typically i just shaved my head on

treatment i'd pretty quickly start

getting a bit of recession but more so

just diffuse thinning and you know like

everyone's going to cross that bridge

where they say if they do experience it

do i want to go down the treatment route

or do i want to just accept it and shave

and for me i just chose the latter i'm

not judging anyone if it means a lot to

them then you know go ahead but for me

it felt somewhat counterintuitive to

take a systemic 5-alpha ductase

inhibitor and remove dht when the whole

point of trt is to increase your

androgens because they are associated

with

feel-good factors for men's sexual

function energy things like that so i

just felt you know why am i taking

something to increase my testosterone

and then remove the most potent androgen

in the body but again you know that

that's just my stance on it and i

understand that people have different

stances but yeah hair loss was i'd say

about two years in i noticed that when i

would dry my hair in the shower i would

always get like strands of hair in my

mind when i was rubbing my hair and then

drying my face and then about a year

i've noticed that i was like wow it is

getting a bit thin i've grown it back

now but to be honest that's more so just

just laziness because shaving your head

every day with a razor gets a bit you

know

a bit tedious after after doing it for a

year thanks a lot for watching our video

today drop us a like and write any

comments below any questions about

starting trt any personal experiences i

think we've covered the main kind of

benefits and potential side effects that

most men see on trt but there might be

some other ones that you want to discuss

with us also if you've got any ideas for

follow-up videos anything that you'd

like to see us talk about then drop us a

comment below and we'll have a think

about which ones we're going to talk

about next if you're interested in trt

then head over to optimal.co.uk

and you can call us you might even be

talking to tom about either getting

started on trt or if you want advice

from one of the doctors about the

current protocol you're on and

ways of switching over to a better

protocol with optimal as an example we

also sell the hair loss spray if you're

interested in a hair loss solution that

isn't the finasteride pills which can

cause some problems so i hope you found

that enjoyable and interesting and we'll

speak to you next time