54-Year-Old Male With Low Testosterone

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Diddif

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I'm a 54-year-old man from the UK, and I'm overweight. I've been using GLP-1's, and over the past 6 months I've dropped 42lbs. Losing that much again would be helpful. My height is 5ft2", and I weigh 13.2 stone.

I got a blood test to look at my Testosterone levels along with other biomarkers. It revealed, among other results, that my total test was low-ish at 240.83ng/dl. Free Testosterone came back at 4.27ng/dl.

So I've begun TRT with HCG. For TRT I'm using Sust 250 @ 125mg total weekly, split into 2 injections. The HCG 5k is @ 250iu three times per week. Fertility isn't really the reason; I just wanted to keep things as natural as possible (well, I wanted my body to keep making what it did before TRT).

Finally, I take 2.5mg of cialis daily.

I don't go to the gym. I don't lift weights. But I do walk 5km every day, and my job as an Electrician can be physical, so I'm not sedentary.

I got my TRT checked because I'd started noticing loss of libido (2-3 years). Loss of get up and go (energy/lethargy). I've had low mood for 20 years and have been on SSRI's for it.

Also, nearly 3 years ago I had a quadruple heart bypass. It came from checks at the doctors, not from a heart attack, so it was lucky it was found before it became a problem.

Thanks for reading, everyone. I'm hoping to learn a bit here. Hopefully get a bit fitter along the way.

Any help/pointers or advice would be much appreciated.
 
Nice work on dropping the weight, starting trt, and aiming to shed even more. Seems like you're heading in a good direction. Don't forget to have your labs done 6 weeks after you begin trt. I received my results just today. Elevated hemoglobin, hematocrit, and rbc are high. I'll be seeing the Dr again shortly.
 
You all make a good point — I will stay on top of the blood tests and labs. In the UK they do not cost much, so there is no reason to rely on guesswork.
 
Since you're talking in stone rather than pounds, my guess is you're located in the UK or Ireland, which means test cypionate probably isn't available to you. Sustanon has a reputation for sides that are tougher to control.

Given your level of body fat, moving over to test enanthate and pinning SubQ every day would serve you really well, because that keeps your E2 from spiking. It also cuts down on thick blood, as this approach comes closer to copying how your body makes testosterone on its own.

Drink plenty of water — really push the fluids — to help keep your blood from thickening further. And like Shittersfull mentioned, don't slack on your blood work.

Do everything you can to avoid needing an AI. Crashing your estrogen is awful, man. Best of luck and God speed, brother!
 
unclebuff702 said:

Since you're talking in stone rather than pounds, my guess is you're located in the UK or Ireland, which means test cypionate probably isn't available to you. Sustanon has a reputation for sides that are tougher to control.

Given your level of body fat, moving over to test enanthate and pinning SubQ every day would serve you really well, because that keeps your E2 from spiking. It also cuts down on thick blood, as this approach comes closer to copying how your body makes testosterone on its own.

Drink plenty of water — really push the fluids — to help keep your blood from thickening further. And like Shittersfull mentioned, don't slack on your blood work.

Do everything you can to avoid needing an AI. Crashing your estrogen is awful, man. Best of luck and God speed, brother!
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Yes, I'm in the UK.

But given that your later suggestion was to micro dose and smooth out my testosterone intake, what would Test cypionate actually achieve for me? (I'm hoping I've understood that right.)

I went with Sust 250 twice weekly, since for that preparation that counts as microdosing. My hope is that this amount and schedule would keep the test steady enough to resemble the natural levels our bodies are meant to have.

Is that right or wrong?

Cypionate and Enanthate are both obtainable here in the UK. The only reason I was pointed toward Sust 250 was as a starting point.

Once more, any advice or pointers would be greatly appreciated.
 
Diddif said:

unclebuff702 said:

Since you're talking in stone rather than pounds, my guess is you're located in the UK or Ireland, which means test cypionate probably isn't available to you. Sustanon has a reputation for sides that are tougher to control.

Given your level of body fat, moving over to test enanthate and pinning SubQ every day would serve you really well, because that keeps your E2 from spiking. It also cuts down on thick blood, as this approach comes closer to copying how your body makes testosterone on its own.

Drink plenty of water — really push the fluids — to help keep your blood from thickening further. And like Shittersfull mentioned, don't slack on your blood work.

Do everything you can to avoid needing an AI. Crashing your estrogen is awful, man. Best of luck and God speed, brother!
Click to expand...
Yes, I'm in the UK.

But given that your later suggestion was to micro dose and smooth out my testosterone intake, what would Test cypionate actually achieve for me? (I'm hoping I've understood that right.)

I went with Sust 250 twice weekly, since for that preparation that counts as microdosing. My hope is that this amount and schedule would keep the test steady enough to resemble the natural levels our bodies are meant to have.

Is that right or wrong?

Cypionate and Enanthate are both obtainable here in the UK. The only reason I was pointed toward Sust 250 was as a starting point.

Once more, any advice or pointers would be greatly appreciated.
Click to expand...
Compared to sus, cyp delivers in a steadier, more forecastable manner; sus is notorious for an initial surge and troughs you can't count on.

With daily cyp, peaks and troughs don't happen — blood levels stay even thanks to a consistent half life. Your own testosterone production follows a diurnal pattern: highest in the morning after waking, lowest at night, with small shifts in between.

If you inject 1, 2, or 3 times weekly, the body receives a large dose, reacts as if alarmed by that spike, and your kidneys release EPO (erythropoietin), signaling the bone marrow to produce additional red blood cells — so hematocrit begins to rise.

Copying the daily rhythm heads off many TRT side effects: thickened blood and aromatization into estrogen.

Weekly shots turn your blood test levels into something resembling a rollercoaster.

2-3x per week leaves your levels looking like mild sea swells.

Daily gives a flat, steady line. Stability is what your body prefers. Homeostasis.

Painting pictures with words turned out to be tougher than I expected, but I hope you catch the idea lol.
 
When someone already has cardiovascular disease, using testosterone replacement tends to be a debated topic. Still, most of the evidence suggests it likely lowers risk instead of raising it — provided the dose stays in the replacement range. That said, you will find a variety of medical views here. Large doses are an entirely different matter. My suggestion is simply to keep testosterone at sensible levels, letting testing guide you rather than pushing above normal, so cardiac risk stays as low as possible. (For what it's worth, I'm 58, use testosterone gel every day — applying it daily is a bit of a hassle, but it gives me fairly steady, reasonable levels. I also have coronary artery disease that was found before the heart attack, though luckily I didn't need bypasses.) Is this self prescribed or through a doctor?
 
I'd suggest starting to work out at a gym, or if that's not possible, using weights or bands at home for resistance training. Since you've already dropped weight and are still losing more, you're probably going to lose some muscle too—resistance training can help you hold onto it. Having more lean muscle brings a range of health advantages and will also help you keep losing weight.

Best of luck with everything.
 
lessthanhalf said:

When someone already has cardiovascular disease, using testosterone replacement tends to be a debated topic. Still, most of the evidence suggests it likely lowers risk instead of raising it — provided the dose stays in the replacement range. That said, you will find a variety of medical views here. Large doses are an entirely different matter. My suggestion is simply to keep testosterone at sensible levels, letting testing guide you rather than pushing above normal, so cardiac risk stays as low as possible. (For what it's worth, I'm 58, use testosterone gel every day — applying it daily is a bit of a hassle, but it gives me fairly steady, reasonable levels. I also have coronary artery disease that was found before the heart attack, though luckily I didn't need bypasses.) Is this self prescribed or through a doctor?
Click to expand...
A private TRT clinic/doctor is the one prescribing it. Right now in the UK, unless your symptoms are urgent (whatever the issue), getting in front of our own doctors can be quite a drawn-out and tedious process. On top of that, at this stage low testosterone in men isn't really treated as a serious matter in the UK either.
 
Diddif said:

I'm a 54-year-old man from the UK, and I'm overweight. I've been using GLP-1's, and over the past 6 months I've dropped 42lbs. Losing that much again would be helpful. My height is 5ft2", and I weigh 13.2 stone.

I got a blood test to look at my Testosterone levels along with other biomarkers. It revealed, among other results, that my total test was low-ish at 240.83ng/dl. Free Testosterone came back at 4.27ng/dl.

So I've begun TRT with HCG. For TRT I'm using Sust 250 @ 125mg total weekly, split into 2 injections. The HCG 5k is @ 250iu three times per week. Fertility isn't really the reason; I just wanted to keep things as natural as possible (well, I wanted my body to keep making what it did before TRT).

Finally, I take 2.5mg of cialis daily.

I don't go to the gym. I don't lift weights. But I do walk 5km every day, and my job as an Electrician can be physical, so I'm not sedentary.

I got my TRT checked because I'd started noticing loss of libido (2-3 years). Loss of get up and go (energy/lethargy). I've had low mood for 20 years and have been on SSRI's for it.

Also, nearly 3 years ago I had a quadruple heart bypass. It came from checks at the doctors, not from a heart attack, so it was lucky it was found before it became a problem.

Thanks for reading, everyone. I'm hoping to learn a bit here. Hopefully get a bit fitter along the way.

Any help/pointers or advice would be much appreciated.
Click to expand...
Hey, a few weeks back when I began my TRT journey, I was on a sustaplex containing the same 4 esters of T taken subQ, but it left me with really big lumps. Switching to cypionate made a massive difference — these days I can even do an IM shot without any pain using a 29G 1/2 needle 3 times per week, since my cypio is in mygliol 840, which is less viscous. Worth giving it a go, and with your glp1 you really ought to add some gym work too, provided your heart allows it.

Hoping everything keeps going well for you!!
 
unclebuff702 said:

Since you're talking in stone rather than pounds, my guess is you're located in the UK or Ireland, which means test cypionate probably isn't available to you. Sustanon has a reputation for sides that are tougher to control.

Given your level of body fat, moving over to test enanthate and pinning SubQ every day would serve you really well, because that keeps your E2 from spiking. It also cuts down on thick blood, as this approach comes closer to copying how your body makes testosterone on its own.

Drink plenty of water — really push the fluids — to help keep your blood from thickening further. And like Shittersfull mentioned, don't slack on your blood work.

Do everything you can to avoid needing an AI. Crashing your estrogen is awful, man. Best of luck and God speed, brother!
Click to expand...
The reasoning behind sustanon makes sense to me, yet I wonder whether it truly produces steadier testosterone levels.
 
Diddif said:

A private TRT clinic/doctor is the one prescribing it. Right now in the UK, unless your symptoms are urgent (whatever the issue), getting in front of our own doctors can be quite a drawn-out and tedious process. On top of that, at this stage low testosterone in men isn't really treated as a serious matter in the UK either.
Click to expand...
Which private clinic are you going through, if you don't mind me asking — and is it one you'd suggest to others? What does it run you, as well?

I've had 2 testosterone tests via the NHS, and they keep brushing me off over them. According to the endocrinologist, my levels sit in the normal range, but I filed a subject access request to get the actual results, and AI says they're low. Just not low enough for the NHS to step in. So private is the route I'm taking. My thinking is that the cash I'm not spending on grey Reta can go toward private care instead. All I'm after is some clinic recommendations.
 
Same age range here. I've been using enclomiphene, tesamoreline & reta for 10 weeks now, and the outcomes I've gotten have been excellent.
 
Fostradamus said:

Which private clinic are you going through, if you don't mind me asking — and is it one you'd suggest to others? What does it run you, as well?

I've had 2 testosterone tests via the NHS, and they keep brushing me off over them. According to the endocrinologist, my levels sit in the normal range, but I filed a subject access request to get the actual results, and AI says they're low. Just not low enough for the NHS to step in. So private is the route I'm taking. My thinking is that the cash I'm not spending on grey Reta can go toward private care instead. All I'm after is some clinic recommendations.
Click to expand...
Apologies, I've only spotted this now. The first time round I went with Voy because a 60% off code was available back then, bringing it to roughly £35. After 8 weeks on Test I've just done another test, this time through Manual. Hunt around and you'll find a half price code for them, which brings it to about £39.90.

In reality they're the same company. These were clinic blood tests, listed on their site as Advanced TRT Blood tests. Do NOT go for the basic finger prick test, since it gives you nothing that you actually need to know and merely steers you toward the advanced test regardless. Pay no attention to the (only suitable for those who have took the basic test) note and simply order the advanced one.

Once your bloods are done you can obtain your Testosterone from another source. Just use them for the bloods.

You might even show your test results to your GP if you are low and see whether he'll accept them and refer you to the clinic that handles low test in males. But plenty won't even glance at a private test result, and at best they'll just add you to a waiting list to have the test repeated on the NHS....and then they wonder why there are bottlenecks.
 
As long as you aren't experiencing any problems and you feel well, Sustanon works just fine. Should problems come up, bring them to your clinic so they can recommend what adjustments, if any, are needed. With TRT, frequent switching back and forth isn't an option; it needs time to take effect, and you have to watch for any negative sides. That said, you should definetely begin lifting weights, because even at 125mg the test will make a huge difference to your results and it will help you shed that last fat.
 
Sounds like you're on the right track. TRT can feel pretty confusing when you first start out. Because Sustanon contains several different esters, your levels will be less steady, and those peaks may cause you to aromatize more.

With testosterone cypionate and enanthate, levels stay more stable, and since these 2 esters have half lives that are nearly identical, you can swap one for the other.

Injection frequency follows the same logic; that is, splitting the same total into more shots each week means smaller peaks and troughs. At TRT doses, it makes little difference to absorption whether you go subcutaneous or intramuscular (particularly when you pin often). I take 20mg every day, and whether that ends up shallow intramuscular or subcutaneous just depends on which pen tips we have on hand; I can't tell any difference.

At 140mg per week I ran into 'sides', so my advice is to keep an aromatase inhibitor on hand. For me, dropping my daily dose by 5mg was enough, and the symptoms went away right away.

Plenty of people hold plenty of opinions. My suggestion is to let your blood work be the thing that guides you. There are people who know their stuff here, on Meso, on Anabolic Atlas (TG), and so on.

Welcome to the gang, and I hope your treatment helps you find your best!
 
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