The TRT Starter Guide

The TRT Starter Guide

Everything you need to know before, during, and after starting testosterone replacement therapy — without the 20 minutes of clinic upsell.

1. Know Your Numbers First

Before anything, get bloodwork. Don't start TRT based on symptoms alone — start based on data.

Minimum markers to request:

  • Total Testosterone — the baseline number. Normal range: 300-1000 ng/dL, but most men feel off below 500.
  • Free Testosterone — the bioavailable portion. Often more telling than total.
  • SHBG — binds testosterone. High SHBG means less free T.
  • Estradiol (E2, sensitive assay) — critical for dialling in dose.
  • LH / FSH — shows whether your pituitary is signalling properly.
  • Prolactin — elevated levels mimic low T symptoms.
  • TSH, Free T3, Free T4 — thyroid mimics T-deficiency symptoms.
  • CBC, CMP, Lipid Panel — baseline health markers.
Private lab tip Most GPs won't run the full panel. Private labs in the UK/US charge £80-£150 for the complete hormone workup. It's worth it.

2. Understanding Your Options

Ester Half-life Injection freq. Best for
Enanthate 8-10 days 1-2x/week Most users. Stable, proven.
Cypionate 10-12 days 1-2x/week Slightly longer ester, very similar to enanthate.
Propionate 2-3 days EOD (every other day) Fine-tuned control, but frequent pinning.
Sustanon / Blend Mixed 1-2x/week Smooths peaks and troughs.

For 95% of men starting TRT, Testosterone Enanthate or Cypionate is the right call. Long ester, stable levels, easy dosing.

3. Starting Protocol

Conservative, evidence-backed starting point for most men:

  • Dose: 120-160 mg/week (split into 2 injections)
  • Frequency: Monday + Thursday subcutaneous or IM
  • Needle: 27-30g 1/2 inch for subq, 23-25g 1 inch for IM
  • Ancillaries (maybe): AI only if estrogen goes high — don't crash it preemptively
  • HCG (optional): 250-500 IU 2x/week if fertility matters to you
Important Retest bloodwork at week 6-8 after starting. Dose adjustments are based on data, not how you feel. Most men over-dose because they feel good at first.

4. What to Expect

Weeks 1-2

  • Placebo bump — many men feel better instantly
  • Possible slight water retention
  • Mental clarity may start returning

Weeks 3-6

  • Real effects begin — libido, mood, energy
  • Some men report deeper sleep
  • Gym performance noticeably improves

Weeks 6-12

  • Body composition shifts — less fat, more muscle at same training
  • Steady-state levels reached
  • Bloodwork retest window — adjust dose if needed

Months 3-6

  • Full benefits realised
  • Consistent mood and energy
  • Testicular shrinkage (if no HCG) — normal, reversible

5. The #1 Mistake: Bad Sources

An estimated 40% of underground lab (UGL) gear is underdosed or contaminated. You can do everything else right and get nowhere because the product is fake or weak.

What to look for in a source:

  • Certificate of Analysis (COA) — third-party lab report showing actual potency and purity. Not optional.
  • Pharma-grade manufacturing — GMP certified facility, not a kitchen lab
  • Consistent batch testing — not just one old COA
  • Reputable shipping — tracked, discreet, no customs issues

Ready to start properly?

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Frequently Asked Questions

Is TRT safe long-term?

Clinical studies going back decades show properly monitored TRT is as safe as any long-term medication. The risks come from running high doses without bloodwork monitoring.

Will I need to be on TRT forever?

If you have clinically low T and choose TRT, yes — stopping shuts down your natural production. Some men prefer this trade-off over feeling awful on natural levels. Others use SERMs or cycle protocols instead.

What about fertility?

TRT suppresses natural testosterone and sperm production. Adding HCG at 250-500 IU 2x/week maintains testicular function and fertility in most men. If fertility is a priority, start HCG from day one.

How much does this cost?

Clinic TRT runs $150-400/month in the US. Private pharmacy through a telehealth service: $99-180/month. Pharma-grade self-sourced: ~$30/month for the product itself. Bloodwork adds $80-150 every 3-6 months.

What's the difference between pharma-grade and UGL?

Pharma-grade = GMP-certified facility, consistent dosing, third-party tested. UGL = underground lab, variable quality, often underdosed or contaminated. The price difference is usually small — don't compromise on this.

Still have questions?

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