[Aurornis]

TRT is great for people who have true hypogonadism that can’t be fixed by other means. I had a friend growing up whose testosterone was under 100ng/dL no matter what he tried with his doctor. Finally got TRT and felt normal again.

However, after the honeymoon period the experience made him realize that not everything is explained and fixed by testosterone. He still had some mental health issues, he still had to work for gains at the gym, wasn’t suddenly full of boundless motivation. All this despite being put toward the upper end of the range for a long time.

This seems to be playing out with a lot of young people going to TRT clinics: The TRT clinics are prescription writing factories that will find an excuse to give almost anyone TRT. They make claims that the normal ranges are wrong and the only correct result is to be at the top of, or above, the reference range. They start people on insane beginning doses like 250mg/week because it gives them a rush to feel like it’s “working”, especially before their natural production shuts down.

The clinics also try to lock people into getting their prescriptions from the clinic in a subscription model. They basically get people hooked, literally dependent on testosterone because their endogenous production has shut down, and then require them to order the testosterone through their pharmacy to continue receiving the prescriptions. If they go to a family doctor, the family doctor will probably decline to continue writing such high dose prescriptions because high doses generate significant side effects, so the person returns to the TRT clinic.

It’s really bad out there. I think we’re headed for tighter regulation of these clinics soon, or at least I hope so. Every time I listen to the radio I get several ads for different clinics every hour promising men they will lose weight, be better in bed, have more energy, conquer the world.

[Auracle]

I had low testosterone due to a brain injury, and going on TRT was absolutely life changing. I do wonder if it could be largely beneficial for older men in the same way hormone replacement therapy for post menopausal women is.

That said, permanently messing with your hormones as a younger person for no good reason is insane and I would try to talk anyone I knew out of it.

Fun fact: I had an endocrinologist at the University of Minnesota medical clinic tell me that going on TRT wouldn’t affect my fertility. Cue IVF 8 years later…

[Jcampuzano2]

I'm only 30 and no plans on going on TRT soon, but I definitely plan to if my levels start to get below the normal range for a substantial period of time just based on all the positive effects being in the normal range brings.

I am highly into fitness myself, but I know plenty of either friends or people I've met who are already getting TRT mostly because they want it to help them, but many of them have so many other issues that its just masking when it comes to things like diet, training, consistency, etc.

Additionally in the fitness world many go on TRT even when they already have normal test levels partly because they don't see it quite as "cheating" as other performance enhancing drugs are seen.

[Pigalowda]

Did you have hypogonadotropic hypogonadism from the brain injury? If you did the endocrinologist is right about the TRT. Without TRT you would have been infertile because you lacked GNRH/FSH/LH from disruption of your hypothalamic pituitary axis due to injury. Your Leydig cells would not be able to produce local testosterone in your testes for your Sartoli cells to utilize in spermatogenesis.

With TRT you would have systemic androgen but not high enough in your testes locally for spermatogenesis. So with or without TRT you would be infertile (if you have hypogonadotropic hypogonadism)

[Auracle]

It was never ruled one way or the other and the brain injury is just a theory based on the start of my symptoms (along with losing height after), but to quote him "if TRT worked to reduce sperm counts enough we'd be using it as birth control." He wasn't talking specifically about me.

From what I remember my FSH and LH were normal. I don't recall GNRH being tested.

[Pigalowda]

Usually with pituitary axis injuries the other hormones are affected as well and not just FSH/LH.

The FSH and LH being normal with low testosterone means there’s some kind of dysfunction. There’s an inverse relationship and if T is low LH should be higher to induce synthesis.

Sort of like in women’s menopause - when the ovaries run out of oocytes the ability to produce estrogen is gone and FSH/LH increase.

Anyways, obesity could be another issue. Adipose cells produce estrin and estrin has promiscuity with the estrogen receptor which reduces testosterone production. Another is elevated prolactin which has multiple causes and can reduce T production.

Anyways, my caffeine ranting is at an end. Good luck