TRT and Kidney Concerns: Seeking Guidance

RoyGBiv

RoyGBiv

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Hello, please excuse my typing—years of self-employment, I guess.

May I ask something I've wondered about for a while regarding TRT here?

I'm unsure where to post questions directly since I can't seem to message people one-on-one.

So here goes: I think I read on reddit that oral Testosterone avoids the same side effects as injections, especially hair loss and testicular shrinkage.

Hair loss worries me most. My T is in the very low 100's, and I've felt at my breaking point this past year.

For context, I'm about 150 lbs. overweight and 6' tall, and I've genuinely been trying to get healthier—it's just really hard with my life; I know everyone says the same.

I was born with a horseshoe kidney, so I have to be cautious with any pills and also with injections. So yes, I'm very worried, and when I try to talk to my doctor, it's instantly "get the stomach surgery." But I can't be away from work for a day, let alone a week or two. My kids and life depend on me every day at my business. I want to do GLP's, but every day it's like I'm doing it, then no—I can't trust it, what if this, what if that—I have my 3 boys to worry about. Then I tell myself, fuck, if I don't do something, they're gonna have to worry about me.

So I'm first checking if it's Testosterone, as I've tried before but had almost immediate side effects—hair loss and my testies shrunk only one month in. However, I did feel great, though in retrospect that may have been all in my head.

I guess I'm just looking for guidance—if anyone has been where I'm at, any insight would be wonderful.
 
Your post covers a lot of ground, so here goes;

Testosterone replacement — this isn't really what this community specializes in, though a handful of members do have firsthand knowledge and might respond. For solid guidance (and to get torn apart), look at MesoRX. Bring your TRT questions to your physician, not reddit. Different esters or delivery methods may shift timing a bit because of half-lives, but assuming that translates into fewer adverse effects is at best mistaken. And carrying a lot of excess weight while using testosterone is usually not wise — lab values really need to be fine-tuned, and at higher body fat, aromatization becomes a genuine concern.

GLP's — given where you are, I'd focus on getting your weight under control first. That will produce major downstream effects on nearly everything else, your hormones in particular. On the safety question, I don't follow the logic that exogenous hormones are the "safe start." That is a wild take.

TLDR- Discuss GLP-1 with your physician, specifically (in my opinion) Tirzepazide. If a prescription is out of reach or unaffordable, then come back — there's plenty of useful material here, on gray.guide, and on other forums about beginning in a DIY manner.
 
The people over at Meso appear to favor the following for supporting kidney and liver:

TUDCA (Tauroursodeoxycholic Acid), NAC (N-Acetylcysteine), CoQ10 (Coenzyme Q10), Omega-3, Fish Oil (high EPA/DHA), Citrus Bergamot and P5P (Pyridoxal-5-Phosphate, active B6).

Additionally, getting blood labs for Cystatin C and eGFR would help you gauge how much stress your kidneys are under.

I spent 3 years arguing with my doctor to get TRT. Eventually I gave up and went through a TRT telehealth service, sent in my blood work, and within a week I had vials of test in my hands. Just like with peptides, I fell down the rabbit hole. I dropped the telehealth, switched to UGL, and never went back. Was that a bit reckless? Yes, it was...

I wouldn't waste time on creams or pills. Pick up some Test C and pin M/W/F, which keeps levels steady and reduces E2 side effects. My suggestion would be to start a glp1 and shed some weight prior to beginning TRT, since the more body fat you carry, the more E2 you'll aromatize. I've witnessed this in my own blood work. On the other hand, if test motivates you to get off your butt and work the weight off, then go for it.
 
When testosterone is extremely low, blood sugar tends to rise, and the odds of developing type 2 diabetes increase if it isn't already present. The catch is that carrying excess weight means aromatization will occur, so an aromatase inhibitor (a pill) would be necessary. The side effects remain the same either way. For the kidney and liver, injections put less strain on them at the start. If your level is below 100, my honest take is to just use it. GLP-1 is something your body already produces, and I would definitely go for it.... what's the alternative? Diabetes along with insulin, heart disease, elevated blood pressure, glucose, inflammation, a1c, lipids, and so on.... check with your doctor ABOUT WHETHER YOU'RE A CANDIDATE, and if you are and insurance won't cover anything, go grey. Before injecting anything, learn all you can. GLP-1s exist precisely for this purpose, and fat loss is just a handy bonus. Testosterone supports glucose entering muscles and boosts insulin sensitivity, which assists in keeping blood sugar steady.
 
When testosterone is taken by mouth, it gets absorbed and passes through the liver. That means the liver ends up seeing very high testosterone concentrations, which leads to a greater number of adverse effects and worse metabolic outcomes than you would get from your body's own testosterone, from a topical product, or from an injection. This is essentially why doctors avoid prescribing it.

Side effects that come from male hormones acting throughout the body, such as thinning hair, are largely dose-dependent. How you administer it probably doesn't change that much. Still, because of your weight, the oral route is probably not a good choice. If you're thinking about treating yourself, you need to pull your information from trustworthy scientific and medical sources rather than reddit. Otherwise, it might be worth asking for a referral to an endocrinologist for TRT. From what I know, in Australia you won't be given a TRT prescription if you're obese and nothing else is going on, since the advised approach is to lose weight. I'm not sure how US doctors view this. If you plan to self-treat without medical supervision, you have to completely grasp what you're doing, including the risks, the benefits, and the side effects, which means doing a great deal of research.

Are you on GLP's? I can hardly think of any reason you shouldn't be at 150kg, unless you're aiming for surgery, and even in that case it's still probably wise. They would make far more of a difference than TRT and could even resolve the low testosterone through weight loss. Again, if your doctor isn't willing to prescribe them, an endocrinologist is who you need, provided you can pay for them, or else there's the grey option, but once more you'd need to research heavily first, much more than a little.
 
yrrdead said:

Your post covers a lot of ground, so here goes;

Testosterone replacement — this isn't really what this community specializes in, though a handful of members do have firsthand knowledge and might respond. For solid guidance (and to get torn apart), look at MesoRX. Bring your TRT questions to your physician, not reddit. Different esters or delivery methods may shift timing a bit because of half-lives, but assuming that translates into fewer adverse effects is at best mistaken. And carrying a lot of excess weight while using testosterone is usually not wise — lab values really need to be fine-tuned, and at higher body fat, aromatization becomes a genuine concern.

GLP's — given where you are, I'd focus on getting your weight under control first. That will produce major downstream effects on nearly everything else, your hormones in particular. On the safety question, I don't follow the logic that exogenous hormones are the "safe start." That is a wild take.

TLDR- Discuss GLP-1 with your physician, specifically (in my opinion) Tirzepazide. If a prescription is out of reach or unaffordable, then come back — there's plenty of useful material here, on gray.guide, and on other forums about beginning in a DIY manner.
Click to expand...
Hey Yrrdead,

Thanks for taking the time to reply, and sorry for being so scattered. Most of the time my head is just overloaded.

Putting my thoughts into words isn't a strength of mine. My brain has been absolute garbage for about a year and a half now, to put it mildly. If I sat here for an hour typing the whole thing out, I'm pretty sure you'd tell me to just end it... put myself out of the misery, ha, just kidding of course — I've got 3 boys who need me sticking around, and that's exactly why I'm looking for help.

Like I said, I was headed down the Doc path when they up and canceled my health care for no reason back in August. It's only gotten worse since. I haven't even had a second to sit in front of this pc since my last post. Finding time to even read here is a struggle. Wish there was something like an

ELI5 section.

Anywhooo, appreciate your time, I'll check into gray.guide hopefully. I'd like to learn more about Reta but have no clue where to begin and honestly need guidance. From what I've read, hundreds of stories about how amazing and life-changing it is. I want that so badly — more than anything, I want to be able to do things with my boys. My youngest is into dirt biking and wants me to come along, but physically I can't anymore. And plenty more. I'm trying to carve out time for research but wish there was some kind of definitive guide on the dos and don'ts. Guess I'll stumble on it eventually, just feels like there's no time to waste. Problem is, I don't have time. I read about them cracking down and shutting sellers down, and that by the time I get to a point of trusting a source or finally getting it...

Again, truly thank you for your help.
 
Such1943 said:

The people over at Meso appear to favor the following for supporting kidney and liver:

TUDCA (Tauroursodeoxycholic Acid), NAC (N-Acetylcysteine), CoQ10 (Coenzyme Q10), Omega-3, Fish Oil (high EPA/DHA), Citrus Bergamot and P5P (Pyridoxal-5-Phosphate, active B6).

Additionally, getting blood labs for Cystatin C and eGFR would help you gauge how much stress your kidneys are under.

I spent 3 years arguing with my doctor to get TRT. Eventually I gave up and went through a TRT telehealth service, sent in my blood work, and within a week I had vials of test in my hands. Just like with peptides, I fell down the rabbit hole. I dropped the telehealth, switched to UGL, and never went back. Was that a bit reckless? Yes, it was...

I wouldn't waste time on creams or pills. Pick up some Test C and pin M/W/F, which keeps levels steady and reduces E2 side effects. My suggestion would be to start a glp1 and shed some weight prior to beginning TRT, since the more body fat you carry, the more E2 you'll aromatize. I've witnessed this in my own blood work. On the other hand, if test motivates you to get off your butt and work the weight off, then go for it.
Click to expand...
Such1943, thanks for taking the time to reply,

Could you explain what UGL means?

It has sunk in that dropping a lot of weight has to happen before I start test again. I keep going back and forth in my head about whether I can trust Reta. One minute I tell myself screw it, I'll track down a supplier, start reta, and sort out the details later. Then I pull back and think maybe I should hold off until it's mainstream, so I feel safer given all my health problems and how much my family and my workers' families rely on me. Ending up in the hospital or getting sick is not something I can gamble on. I won't even begin checking out vendors until I can actually question people about every detail. I suppose I'm naturally very skeptical, but I also know I need help and can't keep doing this alone.

Most of the supplements you listed are already part of my routine, but CoQ makes me feel odd. Saljit is something I began taking not long ago, and it has helped my inflammation and clarity. I think the antioxidants in it are beneficial as well.

I appreciate the ideas and the direction. TUDCA is something I'll give a try, nobody had ever mentioned it to me before.

Thanks again for your help,
 
RoyGBiv said:

Such1943 said:

The people over at Meso appear to favor the following for supporting kidney and liver:

TUDCA (Tauroursodeoxycholic Acid), NAC (N-Acetylcysteine), CoQ10 (Coenzyme Q10), Omega-3, Fish Oil (high EPA/DHA), Citrus Bergamot and P5P (Pyridoxal-5-Phosphate, active B6).

Additionally, getting blood labs for Cystatin C and eGFR would help you gauge how much stress your kidneys are under.

I spent 3 years arguing with my doctor to get TRT. Eventually I gave up and went through a TRT telehealth service, sent in my blood work, and within a week I had vials of test in my hands. Just like with peptides, I fell down the rabbit hole. I dropped the telehealth, switched to UGL, and never went back. Was that a bit reckless? Yes, it was...

I wouldn't waste time on creams or pills. Pick up some Test C and pin M/W/F, which keeps levels steady and reduces E2 side effects. My suggestion would be to start a glp1 and shed some weight prior to beginning TRT, since the more body fat you carry, the more E2 you'll aromatize. I've witnessed this in my own blood work. On the other hand, if test motivates you to get off your butt and work the weight off, then go for it.
Click to expand...
Such1943, thanks for taking the time to reply,

Could you explain what UGL means?

It has sunk in that dropping a lot of weight has to happen before I start test again. I keep going back and forth in my head about whether I can trust Reta. One minute I tell myself screw it, I'll track down a supplier, start reta, and sort out the details later. Then I pull back and think maybe I should hold off until it's mainstream, so I feel safer given all my health problems and how much my family and my workers' families rely on me. Ending up in the hospital or getting sick is not something I can gamble on. I won't even begin checking out vendors until I can actually question people about every detail. I suppose I'm naturally very skeptical, but I also know I need help and can't keep doing this alone.

Most of the supplements you listed are already part of my routine, but CoQ makes me feel odd. Saljit is something I began taking not long ago, and it has helped my inflammation and clarity. I think the antioxidants in it are beneficial as well.

I appreciate the ideas and the direction. TUDCA is something I'll give a try, nobody had ever mentioned it to me before.

Thanks again for your help,
Click to expand...
Stands for underground laboratories
 
I should have brought this up when I replied before, but you mentioned kidney problems. Is this an early stage of renal failure, or not early, or is it a different kidney condition altogether? It can be tough to figure out because people in the US often appear to go without even basic medical care, given how expensive it is there. I don't know whether that applies to your situation, but it sounds like it might, so I'm mentioning it just in case. I hope I'm simply wasting my time and you've already got all of this handled.

If we assume there's some level of kidney failure, are you taking anything to keep it from progressing?

Typically you'd also be on drugs for cardiovascular prevention, since even quite mild kidney failure raises cardiovascular risk substantially.

So if blood pressure is high it needs to stay in the normal range; urine protein, lipids and diabetes should at minimum be checked; and treatment would include ace inhibitors or ace blockers, statins, low dose aspirin, slgt2i therapy (and glp therapy if overweight). The older GLP's have been shown to significantly slow kidney failure progression, and that probably holds for reta though it isn't proven yet. Everything else is proven to stop kidney failure from worsening, and usually all or most of them are used even in very early mild kidney failure.

Even without insurance, you'll need to see a doctor unless all of this is already taken care of. I'm sure others in the US can suggest ways to get lower cost health care there. The original question, plus your comment that health care had been cancelled for no reason, makes me think this hasn't been properly sorted out yet and you don't have ongoing medical care.

If none of this is sorted out yet, tirzepatide might suit you better than reta, simply because you can tell doctors about it without them freaking out as much.

If kidney function is normal, there's no proteinuria, and it's a different kind of kidney issue, then this may not apply.

But Reta or Tirz is still a very good idea, and will help more than the others in improving quality of life through weight loss, but tests and possible treatment, if they haven't already been done, might be needed to prevent kidney failure and heart disease. Good luck going the grey route with reta or tirz, do lots of reading.
 
LTH, I truly appreciate the time you've taken — thank you so much.

Kidney failure isn't where I'm at yet, because I've spent my entire life taking care of the single kidney I was born with. My condition is a horseshoe kidney — essentially one is fused to the other, and the second one is inactive, contributing nothing. Weight and glandular problems have followed me for as long as I can remember. Things like ibuprofen or any NSAIDs are off the table for me since they could harm the kidney. Being big but otherwise healthy was my normal — then covid hit, and after turning 45 everything has spiraled in what honestly feels like a nightmare. My decline has been rapid, and my C'est la Vie has taken the biggest hit. It's no longer just my problem — my family is affected too. My marriage suffers because I'm constantly drained, and with my kids I can't do what I once did. Things like fishing, camping, dirt biking ... ect..

Triz was my plan, but my health care was suddenly taken away and now I'm stuck dealing with the government. Applying for new coverage isn't possible until the old situation is resolved, and that won't happen since nobody is available to process it. Add the government shutdowns to that — as ridiculous as it sounds — and I'm powerless. Beyond that, I've heard about a lot of nightmare side effects with triz. With reta, I haven't come across those. I've gone through hundreds of accounts so far. What I need is direction on how to approach this — whether to source it from a known supplier or hold off until it leaves the grey market. I have many more questions too.

Deciding to want to go on reta has been really difficult for me — it's a constant back-and-forth in my mind. What I want is to feel normal again, to stop thinking about food every 5 minutes, and to not have that be the only thing that still gives me pleasure.

I suppose I'm on the path to learning.

Thank you for every bit of concern and advice. I don't take it lightly.

Thanks once more, LTH — maybe someday I'll be less then half as well.. Cheers!
 
I don't have expertise in this field, but I came across a guide that could be of use to you. Should you begin a GLP1, it seems that staying hydrated and keeping electrolytes in check would be especially important in your case compared to the average person. I'm not endorsing this company at all—it's simply an article that might prove helpful.



12817ab12a316a03d66df44d17973c2dc3705b8ba05db9ba3d12a8e433653470.png




Mounjaro with One Kidney: Safety and Monitoring Guidance – Bolt Pharmacy



Can you use Mounjaro with one kidney? Discover the safety, monitoring requirements, and prescribing considerations for tirzepatide in patients with a single functioning kidney, based on UK clinical guidance.

Image unavailable


www.boltpharmacy.co.uk
 
What was written above is worth your attention, and I am relieved it is not early renal failure.

As far as side effects go, the science remains murky. One thing is now settled: tirzepatide carries fewer side effects than semaglutide. When it comes to reta versus tirz, there is still too little research to paint a clear picture of the side effect profile; early studies put semaglutide and tirz on roughly equal footing, and that ended up being incorrect. Based mostly on what I have read on this forum, tirzepatide and reta have comparable side effects, though tirzepatide is likely marginally superior: somewhat fewer gastrointestinal issues, with nausea being by far the most frequent complaint across all the GLP's, a smaller rise in heart rate, and fewer skin sensory symptoms. That said, reta may deliver greater weight loss, an additional 5% over tirz, which, considering your starting weight, is likely reason enough to pick it despite the slightly worse side effects.
 
yrrdead said:

Your post covers a lot of ground, so here goes;

Testosterone replacement — this isn't really what this community specializes in, though a handful of members do have firsthand knowledge and might respond. For solid guidance (and to get torn apart), look at MesoRX. Bring your TRT questions to your physician, not reddit. Different esters or delivery methods may shift timing a bit because of half-lives, but assuming that translates into fewer adverse effects is at best mistaken. And carrying a lot of excess weight while using testosterone is usually not wise — lab values really need to be fine-tuned, and at higher body fat, aromatization becomes a genuine concern.

GLP's — given where you are, I'd focus on getting your weight under control first. That will produce major downstream effects on nearly everything else, your hormones in particular. On the safety question, I don't follow the logic that exogenous hormones are the "safe start." That is a wild take.

TLDR- Discuss GLP-1 with your physician, specifically (in my opinion) Tirzepazide. If a prescription is out of reach or unaffordable, then come back — there's plenty of useful material here, on gray.guide, and on other forums about beginning in a DIY manner.
Click to expand...
Start with a GLP1 and work toward getting nearer to the weight you want. Bring up your low testosterone with your doctor; if the tests show it is low, he will write you a prescription.
 
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