Note – This is the third of a four-part series. Click here for Part 1 for a primer, here for Part 2 regarding my symptoms, and here for Part 4 on finding treatment.
After being diagnosed with low testosterone in Spring 2014, I finally understood the laundry list of problems that had baffled me for most of my adult life.
But more importantly, I was armed with the information I needed to seek out a solution.
For me, that solution was Testosterone Replacement Therapy (TRT) and it's changed my life for the better.
After celebrating my first anniversary of TRT in August 2015, I feel like I finally have the proper perspective to share with others.
I've been waiting to talk about this until now because I wanted to be able to tell you about the journey I've taken, not the journey I was beginning.
So here it is – the good, the bad, the awesome, and the timeline in which it all took place!
Effects of TRT – The Bad
I think it's best to get the bad news out of the way first. And there have only been three very minor negatives to this whole experience.
I’ve always had very clear, even skin, even as a teenager.
But now it's become a little oily and acne prone on my upper back, shoulders, and upper arms.
This is easily managed with a little extra scrubbing using a loofa and the occasional use of acne control body wash.
I still have occasional zits and more spots from the ones that are healing, but it's been a fairly minor annoyance.
Increased body hair
I’ve also become a bit more fuzzy on my upper body.
I used to have almost no visible hair on my upper arms, shoulders, and upper back.
It’s now become slightly darker and longer, though I'm still not what you would call a “hairy guy”.
It isn’t even enough for most people to notice, but I'm aware of it because I’ve spent the last 30 years in my body and I'm in tune to minor changes.
To put it in medical terms, I’ve experienced testicular atrophy of approximately 10%.
Essentially, my balls are a little bit smaller.
I’m talking a really insignificant amount and it doesn't bother me in the slightest.
But in case you're concerned with this side effect for yourself, my wife has noted (via girl talk) that women truly don’t care much about our balls as long as they aren’t “peanuts or grapefruits.”
Really, a 10% decrease is likely to go unnoticed.
In my case, they actually shrank by about 25% initially (this worried me, of course), but have returned to just below their original size.
However, I did experience quite a bit of aching in the early days after beginning TRT. Nothing sharp or unbearable, just a dull ache.
Fortunately, the aching and shrinkage were just the initial shutdown and lasted only a few weeks.
And that's it for the bad…really!
Effects of TRT – The Good
Now, for the positives!
Let me assure you that the benefits of TRT have far outweighed the very minor negatives of this whole experience.
A couple weeks after my first injection, I had an experience that indicated a significant improvement in this very important aspect of a man's life.
My wife and I were on our weekly grocery shopping trip at Trader Joe’s and I couldn’t help noticing that I seemed to be surrounded by supermodels.
I looked at my wife (we have a healthy relationship) and asked her “What is this, hottie day at Trader Joe’s?”
She looked at me like I was crazy and replied that this was the normal amount of attractive women for this particular store. It was like I was seeing the world through the eyes of a high school senior.
I felt like I could, and needed to, take on every woman in the entire grocery store.
This is a big shift coming from a guy who spent the last decade preferring sleep over sex.
In the last year, I went from thinking sex once a month would be more than enough to feeling like having sex multiple times per week.
Since starting testosterone, my mood has stabilized substantially.
Before testosterone, my mood was usually a little below average. But I would also have sudden dark, depressive spells lasting a few days to weeks when I didn’t feel like fighting against the world anymore.
These spells were really my biggest problem and a main reason I looked into treatment.
Little things would cause me to get extremely upset, and my mind would be flooded with every bad experience and negative thought I’d ever had.
There were days when I would wake up and I’d be in the kitchen slamming shit around for no apparent reason.
I just hated life.
Now, I feel good to great on a daily basis.
I still have the occasional day where I don’t feel so hot. But for the most part, a bad day for me is more in the middle or neutral.
I don't find myself “spiraling” without any control and I don't feel like I'm hitting rock bottom during a “down day” any more.
Now, when I feel like replying to an Instagram comment seems like an insurmountable task, I just watch a couple episodes of Arrested Development (seasons 1-3, of course), and all is well within a few hours.
No more wallowing in a dark hole of self-pity for weeks at a time.
I still have moments where I feel “less than” or not good enough.
But it's only to a degree that I assume other people experience rather than the intense feeling of self-hatred and inadequacy that used to dominate my thoughts and feelings.
In general, I can see myself the way other people do.
I'm able to embrace and congratulate myself on the things I do well, acknowledge my successes, and accept my shortcomings (or at least not rake myself over the coals for them).
While testosterone may not affect how every person views themselves, given my lifestyle goals and chosen career, being able to make the gains for which I was working so hard was a game changer for me.
By allowing me to be successful in my chosen field and the things I'm passion about, I have a totally different outlook on life.
Dealing with Anger and Adversity
Things that used to send me into a rage are now easily handled. It’s an amazing feeling!
For the first time, I have the emotional control to use the techniques I’ve been studying for years in self-improvement books.
One day, some months after starting TRT, I went to my parking spot only to find that someone left a grapefruit-sized scrape on the front bumper of my pristine car, all the way through the paint.
Instead of being flooded with anger, I just thought to myself “It doesn’t look that bad. And if I ever want to sell it for top dollar, I'll have the bumper replaced. Problem solved.”
I was completely shocked that I had just thought my way through a stressful situation rather than simply reacting (with rage).
My wife stared at me in disbelief. She'd expected me to start yelling or kick a garbage can.
But I just reasoned that, “worse things have happened.”
This is the kind of rational reaction I’ve always wanted to have to life's little problems, but was always somehow unable to make it happen in practice.
My mind truly doesn’t spiral out of control anymore.
Little things happen constantly that are out of our control and it was debilitating to not be able to shrug them off.
I’m also better able to handle the bigger challenges in life.
I had my first child in February 2015. And while she’s a smart, spirited little girl full of smiles, she’s also the most temperamental, high maintenance baby my family and friends have ever witnessed or heard tale of.
My mother-in-law recently noted that my daughter alone is more difficult to care for than a newborn, an 18-month old, and a 3-year old all at the same time.
My daughter screamed at the top of her lungs to the point of choking, going hoarse, and becoming feverish for the first 4 months of her life. She also required being held nearly 24 hours a day, even overnight.
She screamed bloody murder in the car, the stroller, her bassinet, her crib. Still does a lot of the time.
I really don’t know how I would’ve gotten through that, how my marriage would’ve survived, if not for the emotional stability I’ve gained from correcting my testosterone deficiency.
Now that I’m on TRT, my mind is much quicker.
The mental math ability that was all but gone throughout my 20s has returned and I don’t stare blankly at my computer screen nearly as often.
The fog that I lived in for so many years has lifted.
I used to have to work in 20 minute blocks of time in college when researching or writing because I was completely unable to form cohesive thoughts after that point.
Now, if I get an idea for an article, I can write and edit for hours at a time. I may take a break to eat or make coffee every once in a while, but other than that, it’s laser-like focus.
I can see multiple solutions to daily problems that would’ve previously paralyzed my actions.
Self-motivation is much easier now or, I should say, it finally works.
Getting in the mood to work used to take a celestial event. Now I just make the decision to act and good things happen.
Another major change I’ve noticed on TRT is that I need less sleep.
My entire life, I’ve been a zombie on anything less than 10 hours of solid sleep.
Remember when you were a teenager and could sleep for 12 to 14 hours a night? I never grew out of that.
I’ve basically been unconscious for half of my life, and merely existing for the other half.
On testosterone, I’m absolutely fine on 7 hours. I go to sleep at 10 pm with an alarm set for 5 am, 7 days per week.
Many mornings, I’m lying in bed waiting for my alarm to go off and thinking about how I’m going to dominate the day ahead.
Muscle and Strength Gains
The photo on the left was taken in May 2014 and the one on the right in June 2015.
I’ve made more progress with my physique in the past year than I made in the previous 6 years combined!
I haven't transformed into Mr. Olympia (and I've never expected to), just a much better version of myself.
To get from the first photo to the second, I gained 25 lbs over the winter and then cut about 15 lbs to get to a leaner state than I was at before I started.
The previous 6 years of training resulted in what most guys with healthy hormones can accomplish in 6 months. I lost a bunch of fat and gained a minuscule amount of muscle.
On the bright side, having low T forced me to learn everything I could about bodybuilding just to make very minor progress.
Now, I’m like a newbie in that I’m primed for my initial gains. Only I have more than a decade of experience and wisdom to actually put my body’s readiness to grow to good use!
Imagine what an ancient boxing coach from the movies could accomplish if he was suddenly transferred into a young, able body.
As I said before, when bulking pre-testosterone, I would gain much more fat than muscle. My strength on core lifts would often increase at a slower rate than my body weight.
One bulk in particular, I gained an honest 30 lbs of body weight, but my bench press only went up 20 lbs. That’s some scary math for a guy with eyes toward big core lifts.
At that rate, I would've had to weigh over 500 lbs just to squat, deadlift, and bench a respectable amount.
On TRT, I’m able to add significant strength and muscle mass while gaining a proportionally smaller amount of fat.
Bulking and Cutting
I just finished my first bulk on testosterone (probably the 10th bulk in my lifetime).
I went from 175 lbs to 200 lbs and still had visible abs! I wasn’t ripped in any way, but the abs were there in the right overhead lighting.
Gains like that aren't going continue and have already started to tapered off.
That was just me finally being able to make the newbie gains I never experienced when I was a newbie.
My first cut on testosterone has also been nothing short of amazing!
I’m used to losing absolutely every measly ounce of muscle mass I’d gained while bulking in order to lose that stubborn body fat, and ending up in the exact same place as I started before the bulk.
With testosterone, I’m able to maintain most of my muscle mass, while dropping into vascular ab territory.
I even continued to increase my strength for a while, despite running at a caloric deficit and losing 15 lbs of body weight.
Finally, everything is working like it’s supposed to!
Nothing is coming easy and I’m not superman by any means. It isn't like I've gained 40 lbs of muscle while simultaneously loosing body fat in a single year.
Right now, I’m monitoring everything I eat down to the gram, hitting the gym with ferocity almost daily, and using every strategy I've learned over the past 15 years to make the best of my body.
I still have to eat a caloric surplus and train hard to gain muscle. I still have to nail my target macros everyday to lose body fat.
I’m just so fucking pumped that I’m able to make progress that I actually went to the gym for 90 days in a row recently!
It’s like I’ve been running with a parachute strapped to my back for my entire life and now the rope has been cut.
I feel like the fastest man alive!
My Friends Weigh In
After seeing some results in the gym, I was talking about my treatment with one of my closest friends and I asked him what his thoughts were about my previous inability to gain muscle.
He replied that all of my friends just thought that I was scared to eat enough to gain weight.
He was referring to the same group of friends who’d seen me pack on 30 lbs of bodyweight multiple times over the years.
Before going out to the bars, they would be drinking beer while I was shoveling down turkey sandwiches and cottage cheese (and beer).
These are the guys who start lifting, add a protein shake to their normal diets, and make consistent progress.
I wasn’t building muscle, therefore I wasn’t eating enough – it was the only conclusion they could make.
I think a lot of young men struggling with low testosterone will encounter opinions like this.
People are incapable of recognizing effort and methodology in the absence of results.
Young men with low T are likely to be dismissed or heavily critiqued no matter what others see them doing or how hard they're working because they aren't getting results.
Everyone wants to know when things happen and at what dose (I know I did), so I’ve laid my treatment in blocks of time corresponding with my dosage and blood work results at the beginning of the time period.
The effects on hormone levels can be seen at the beginning of the following time period.
NOTE: The reference range for total testosterone for all tables below is 348 – 1,197 nano grams per deciliter (ng/dL) and the free testosterone reference range is 9.3 – 26.5 picograms per milliliter (pg/mL).
hCG Mono-therapy (April – July 2014)
|Treatment||Total T (ng/dL)||Free T (pg/mL)|
Originally, I was put on hCG only (hCG mono-therapy) by my previous doctor, a urologist, in the hope that my body would make its own testosterone.
My doctor was really encouraging in noting that this treatment was frequently very effective. I even came across quite a few accounts of guys who'd experienced great results from hCG mono-therapy.
So I was really hopeful…
but I noticed absolutely nothing.
After six weeks on hCG, my total testosterone increased from 290 ng/dL to 451 ng/dL. Not bad!
But I'd requested that my doctor also check my free testosterone at that time as I didn’t have a value before hCG.
Unfortunately, after 6 weeks on hCG, my free testosterone was at 7.2 with a reference range of 9.3 – 26.5 pg/mL.
That explained a lot of problems!
My total testosterone had gone up 160 ng/dL but my free T was still basically nonexistent.
I continued with hCG mono-therapy for a while because my doctor wasn't well-educated on current TRT and I didn't have any other readily available options at the time.
And so I started searching for another provider.
Weeks 0-6 of TRT
|Testosterone Dose||Total T (ng/dL)||Free T (pg/mL)|
|100 mg per week||497||7.2|
After finding my current provider, I began a weekly dose of 100 mg of testosterone cypionate.
I didn’t notice anything dramatic during the first week.
Well, I thought I could feel a warm sensation throughout my whole body as I was lying in bed after my first injection, but that could very well have been a placebo effect.
The morning of my second injection, I went to the gym for a chest workout.
My normal bench press routine was 45×5, 95×5, 135×5, and then I would lift a pathetic 155×5 for my “heavy” sets.
This was at a bodyweight of about 175 lbs with 6 years of consistent lifting under my belt.
When I got to my set with 135, it felt so damn light I had to jump up and read the numbers on the plate. I honestly thought I still had the Olympic-sized 25’s on the bar.
I couldn't believe it!
Now, testosterone obviously didn’t allow me to build muscle in a single week.
But its mere presence in my bloodstream made me the strongest I’d ever been, at a dose of only 100 mg per week.
For reference, sports performance and bodybuilding cycles of testosterone usually start at 400 to 500 mg per week and go up from there.
I maxed out that day at 195×1. I probably could’ve done a little more, but considering that was a 10 lb jump over my previous max, I decided to savor the victory and save some for next time.
I continued to add 5 lbs to my max, almost weekly, until getting up to 225×1.
Any under-muscled guy starting out in the iron game has ambitions of working up to benching “two plates.” When I first started lifting in high school, I reckoned I’d be there before Senior year.
But as it turned out, I wouldn't even come close. Unlike all my buddies, I never made much progress during that time.
After that initial defeat, I remember thinking how far away 2 plates was for me.
So to finally hit that number at age 29 was the single best lifting day of my life!
What seemed like an insurmountable task before, was now achieved because of a tiny little injection (and a shit load of hard work, but I was already doing that part).
However, as far as mental and emotional well being goes, I didn’t really notice much in the first 6 weeks.
For me, testosterone wasn’t like a “punch to the face” or “like turning on a light switch” as some guys report.
I started feeling better gradually.
When the doctor asked how I was feeling, I told him “if someone was dosing me in my sleep, I wouldn’t be able to tell I was on TRT, mentally at least.”
I kept waiting for a sudden rush of “I’m feeling great!” but it just wasn’t that abrupt for me.
Weeks 6-12 of TRT
|Testosterone Dose||Total T (ng/dL)||Free T (pg/mL)|
|160 mg per week||651||9.6|
I went in for my follow-up blood work after 6 weeks at 100 mg per week and the results showed my total testosterone at 651 ng/dL which isn't too bad, but my free T had only just crept into the very bottom of the range.
At this point, my dose was increased to 160 mg per week.
Everything continued in more or less the same fashion though my mood was a little better overall.
I would take a stressful situation in stride and be genuinely impressed with how well I handled it.
Gains in the gym were steady. I wasn’t setting PRs everyday, but every few workouts, I would break a record on one lift or another.
My body composition was starting to change a little. I wasn’t morphing into a completely different person, but I could tell I was gaining a little muscle.
My muscles had always been extremely soft and flat, even more so than guys who don’t lift.
But at this point, they were starting to have a little more firmness and look more full.
Weeks 12-26 of TRT
|Testosterone Dose||Total T (ng/dL)||Free T (pg/mL)|
|200 mg per week||643||11.5|
With my free T levels still less than optimal, my dose was increased to 200 mg per week (highest commonly prescribed dose) and I was told to come back in for blood work in at the 6 month mark.
I started feeling even better on a daily basis.
I truly felt strong, confident, and stable and my mood was “up” most days of the week.
In the gym, I was still continually making progress and had started carrying around a noticeably greater amount of muscle mass (and a little more fat).
I grew out of the majority of my wardrobe.
It wasn’t the testosterone alone. I was lifting like a beast and also systematically increasing my calories by just a few hundred per day every time the scale didn’t budge for a week or so.
It’s funny – people who’ve know me for years and years and are aware that bodybuilding is my life, began asking me questions like “have you been lifting weights?” or “what have you been eating?”
It was gratifying to finally have people acknowledge that they could tell I had dedicated my life to building my body.
Weeks 26-52 of TRT
|Testosterone Dose||Total T (ng/dL)||Free T (pg/mL)|
|200 mg per week||1090||23|
After 3 months at 200 mg per week, my total testosterone came in at 1,090 ng/dL and my free testosterone was at 23 pg/mL.
Both of these numbers have me at the top of the physiological range and I feel great right here!
Mentally and emotionally things aren't really on the upswing anymore.
But then again, I'm a right where I want to be in that department so a plateau is just fine with me.
It's hard to tell if I would've been able to keep adding size and strength as I've been on a caloric deficit for several months. But I think this fall/winter will be very productive when I decide to bump my calories up again.
I'm also happy to report that I haven't had an injury since starting TRT.
I'm finally able to recover from my workouts so I'm not digging deeper and deeper into overtraining.
Is testosterone really a miracle drug?
Yes and no.
I'm not for a second naive enough to believe that testosterone directly targets all of these individual problems.
But it can absolutely help some of the major ones, resulting in a synergistic effect that can be life changing.
The most important thing to know about TRT is that it can help guys in need who are willing to help themselves.
Note – If you're having symptoms and want get your levels checked, call the company I use, Primebody.com and get a free consultation, $25 off your monthly fee, and an additional 10% off your first month and when you use the code Lewis27.
It’ll most likely be useless if you expect such a small dose to move mountains for you while you put in no effort toward a healthier body and mind.
Though I have experienced so many benefits of TRT, in my opinion, here's what TRT is not:
- It's not a magic bullet
- It's not the “easy out”
- It's not a passive treatment
- It's not a short-term solution
For me, testosterone was simply the catalyst I needed to overcome certain shortcomings. It helped me break the vicious cycle of being stagnant, feeling depressed, and failing to improve my physical, mental, and financial situation.
And I likely wouldn’t have seen nearly the same intensity of benefits if I didn't put in obsessive amounts of effort to bettering my life.
But I do know that Iron & Tweed likely wouldn’t exist if not for testosterone. Untreated, I didn’t have the grit to overcome the struggles of starting a business from scratch.
Yes, there have been a lot of sleepless nights in the first year.
But with my new, much more resilient mental state, I was able to rationalize and remind myself that success will come.
I’m not sure the old me would’ve had the balls to do that.
So for that and so many other reasons, I find myself grateful to TRT and eager to see what the future holds for me because of TRT.
For the final installment of the low T series, I will be discussing the details of finding adequate treatment.
More to come!