So you’re “Low T”? Guide Part 2

So now you kinda understand why guys may need testosterone replacement therapy and you have learned the various ways you can replenish you levels. You have since been given a prescription for one of the three applications mentioned in Part 1. So whats the deal now, you’re asking. Why can’t you just take your prescribed weekly dose and move along? Well, there is more to do to ensure you stay healthy, and we are here to get healthier, are we not?

The two things to watch are listed below. This really needs to be done. The reason to take these necessary steps is to observe the body’s natural way of checks and balances.  Again, be your own advocate! Once you start your prescription of testosterone, your’re going to have to keep track of the time, in weeks. Get a notebook or use your notes on your phone, but keep track. Tracking the weeks will enable you to keep an eye on the following:

Estrogen (aka E2)

In the beginning, every 12-16 weeks, you need to have your E2 checked. Not total estrogen (there are E1,E2, and E3 levels). The most important one in this situation is your E2. Your body will notice the extra testosterone and it will go into checks and balances mode, in which some of the testosterone will be converted to estrogen. Testosterone doesn’t lower estrogen, it actually raises it. If you have high amounts of estrogen you can get a prescription for an estrogen blocker. The blocker will lower your estrogen levels fairly quickly.

Estrogen is a must in men, but too low and or too high can be a huge negative. On the low side are body and bone aches, feeling pretty terrible, and a general feeling of weakness or fatigue. When levels are on the high side, there are erection problems and low libido. There are other symptoms worth looking into, but to me these were enough to get my attention and make me monitor my general health.  Make sure to keep track of any unusual symptoms and discuss them with your doctor.

Estrogen range should be kept between 20-50. I aim for 30. I have had mine at zero and 100. At zero was the worst thing ever. I ached so much and felt so tired and weak, despite my stable testosterone levels.  At 100 I was so passive nothing bothered me. After some time and effort, you will get your E2 in check and that’s when you can push back the blood work to every six months. It takes time to understand the variables you are putting your body through, and if you’re like most, you will need a prescription for a E2 blocker. I take Letrozole once a month. Insurance will not cover it so out of pocket for me, so it’s $48 for 12 pills. The Estrogen test and doctor visit out of pocket will be $100-$150 initially for most.


After you have been on TRT for 16-20 weeks, go to the Oklahoma Blood Institute (or you nearest local donation center) and donate blood. Testosterone increases red blood count which is good, but in doing so it thickens it also. Giving blood keeps your blood thinned out and at normal thickness. Not giving blood while on TRT is irresponsible to yourself and your family. Not keeping your hematocrit level in check will put a strain on your heart. After your initial donation, keep track of the thickness and donate every 60 days until your hematocrit hangs out in the low 40’s. Then you can push back the blood donations to, say 90 days. In addition to giving blood, they also check your heart rate, cholesterol and blood pressure. This entire step will take about 30 minutes of your time. Its all free and you receive a free t-shirt. Also you get some cookies and a drink, my favorite part.

In addition, even if you decide not to workout while on TRT, you still need keep your hormones in check. These steps still need to be taken.

Being on TRT is not difficult. These necessary steps are all part of the process. We cant help it that our bodies don’t produce testosterone like they once did, but what we can help is the way we feel going forward.