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I use 1-1/2" needles personallylatviantower said:
Overweight TRT Considerations
- Thread starter msyntakz
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I use 23g on glutes. Used to use 22g for some stupid reason decades ago. I feel like 25g more common now in the glute but many of like the 23 garage for more study needle and easier injection of the oil (especially at over .5ml). Personal preference. That artery in that area would take a 2 inch needle probably to get there, so 1.5 inch 23 garage is just fine for me.Omxxl said:
If you are severely overweight, I advise to lose some pounds first . Test aromatize to estrogen and visceral fat contains aromatase which cause you to deal with estrogen issues.
After losing weight you might see your test levels rise as a consequence.
After losing weight you might see your test levels rise as a consequence.
I am 6'4" and 310lbs. I have decent muscle, but yeah, plenty of fat. That's plain and simple at that weight. I have a hormone panel in the works, blood drawn, just awaiting the testosterone portion to come back.sfkid said:
I did get the Estradiol back: 54 pg/ml. Higher than I wanted to see, but we shall see what the testosterone says.
For reference, that’s my e2 level running about 400mg of test weekly (with no AI). I’d probably want to take .25 of Armidex on pin days if my e2 were that high (I start to have symptoms at that level). Didn’t that flag high well out of range?msyntakz said:
Test levels will be instructive. The first step of all of this is what you are doing - caring about your own blood work. Been at this for 3 decades, and one thing I know for sure, caring yourself and taking the time to research all yourself really matters because I’ve ran into so many pathetic doctors that don’t care, are lazy, incompetent, or some combination thereof. Good luck with it all.msyntakz said:
Damn I'm jealous. I wish I could run that with out an AI. At 200 per week , I needed .5mg of AI.Gt3294a said:
Reread this and seen the bipolar part. All the love your way. I don’t personally have it but a couple close family members do and I have seen the struggles first hand. It’s a sinister disease I wish no one had to suffer. Breaks my heart. Stay fighting brother and never stop advocating for yourself. I saw it go two different ways. One sort of gave up trying 20 years ago after a breakdown, divorce, and took an early disability retirement. The other is a fighter who try’s their best to live a normal life. Both are type 1 with 5+ hospitalizationsmsyntakz said:
So, regardless of what my test comes back at, what can I do to deal with the high E2? Is it just time at this point waiting for the fat to come off? 22 pounds down in under a month, cholesterol, LDL, and triglycerides all down... so health is moving in the right direction. Is there anything else meaningful that I can do? Or just fat loss and other meds?
Forgive me if I missed it… aside from the lab results, what symptoms are you having?msyntakz said:
Insulin resistance and testosterone
1. The Direct Hit to the Testes
Research shows that insulin resistance directly impairs the Leydig cells in the testes. These are the cells responsible for churning out testosterone. When your body is resistant to insulin:
• The Leydig cells become less responsive to Luteinizing Hormone (LH)—the "start engine" signal from your brain.
• Even if your brain is screaming for more testosterone, the testes don't "hear" the signal as clearly, leading to lower output.
2. The "Belly Fat" Factor (Aromatization)
Insulin resistance is almost always tied to increased visceral (belly) fat. This fat isn't just storage; it’s metabolically active and contains an enzyme called aromatase.
• Aromatase takes the testosterone you do have and converts it into estrogen.
• Higher estrogen levels then tell your brain, "We have plenty of hormones," which causes the brain to slow down the signal to produce more testosterone.
3. SHBG Suppression
Insulin levels significantly influence Sex Hormone Binding Globulin (SHBG), a protein that carries testosterone through your blood.
• High insulin levels signal the liver to produce less SHBG.
• While this might sounds like it would leave more "free" testosterone, low SHBG is often a marker of metabolic dysfunction and is consistently linked to lower total testosterone levels over time.
4. Inflammation and the Brain
Chronic insulin resistance creates a low-grade inflammatory state. This inflammation can disrupt the Hypothalamic-Pituitary-Gonadal (HPG) axis. Essentially, the "command center" in your brain becomes less efficient at monitoring and regulating your hormone levels, leading to a drop in production.
The Silver Lining: Reversibility
The good news is that because this relationship is bidirectional, fixing one often helps the other. Improving insulin sensitivity—is one of the most effective "natural" ways to boost testosterone.
1. The Direct Hit to the Testes
Research shows that insulin resistance directly impairs the Leydig cells in the testes. These are the cells responsible for churning out testosterone. When your body is resistant to insulin:
• The Leydig cells become less responsive to Luteinizing Hormone (LH)—the "start engine" signal from your brain.
• Even if your brain is screaming for more testosterone, the testes don't "hear" the signal as clearly, leading to lower output.
2. The "Belly Fat" Factor (Aromatization)
Insulin resistance is almost always tied to increased visceral (belly) fat. This fat isn't just storage; it’s metabolically active and contains an enzyme called aromatase.
• Aromatase takes the testosterone you do have and converts it into estrogen.
• Higher estrogen levels then tell your brain, "We have plenty of hormones," which causes the brain to slow down the signal to produce more testosterone.
3. SHBG Suppression
Insulin levels significantly influence Sex Hormone Binding Globulin (SHBG), a protein that carries testosterone through your blood.
• High insulin levels signal the liver to produce less SHBG.
• While this might sounds like it would leave more "free" testosterone, low SHBG is often a marker of metabolic dysfunction and is consistently linked to lower total testosterone levels over time.
4. Inflammation and the Brain
Chronic insulin resistance creates a low-grade inflammatory state. This inflammation can disrupt the Hypothalamic-Pituitary-Gonadal (HPG) axis. Essentially, the "command center" in your brain becomes less efficient at monitoring and regulating your hormone levels, leading to a drop in production.
The Silver Lining: Reversibility
The good news is that because this relationship is bidirectional, fixing one often helps the other. Improving insulin sensitivity—is one of the most effective "natural" ways to boost testosterone.
So, I've been over 300 lbs since '09 and got my biggest (390) in '22. So, I've been dealing with this stuff for a while, but general depressive issues, irritability, on top of the bipolar, low motivation, low libido/ED issues, hair loss on and off when I was at my heaviest, sleep... holy hell, the elusive sleep. Been consistent 7.5-8.5 hours since getting some weight off and being on GLP, so that's better. That's the gist of it, though.woundcarping said:
I mean, I definitely am the walking definition of insulin-resistant. I have belly fat, but my fat is very evenly distributed all over. Not a giant gut, but I'm sure I have plenty of visceral fat to deal with. My HbA1c has never been bad, though, 5.1 for the past six years, and it just came back at 5 even on Sunday. So, not sure how much that (A1c) reflects insulin resistance, but it's never been high. So, it sounds like it's in the right direction.Turbo-Farmer said:
Most of those sound like low T symptoms too.msyntakz said:
In theory the main sides I look for with elevated E2 while on TRT is fluid retention/puffy and sensitive nips.
I have been back and forth on so many TRT forums/sites, and what I consistently am seeing for overweight guys is pin often at low dose and subQ, all to keep spikes low and mimic natural production for the least aromatization. It seems to be a polarizing subject, to say the least.woundcarping said:
It’s not the sugar that’s the problem, it’s the insulin required to keep the sugar low. Insulin is a powerful hormone and it effects other hormones.msyntakz said:
You can calculate your
HOMA-IR (Homeostatic Model Assessment for Insulin Resistance)
By testing your fasting insulin and fasting glucose
I am currently using the ss31 /mots-c / NAD+ protocol for mitochondrial function, because at my last physical my fasting blood sugar was low, however my insulin levels were high.
My personal advice would be to wait until you lose some fat. I haven't noticed anyone mention it, but your blood pressure is also a factor. Test can dramatically raise your hematocrit and increase the chance of a heart attack or stroke. And as with all the other side effects of TRT, it increases with your bodyfat %.
I was 300lbs at over 40%BF. I decided to wait to start TRT due to high e2, insulin resistance, and high blood pressure. Spent a year working hard to drop the fat. Good diet and weight training 5 days a week. I started Reta, and tesa/ipa for the fat loss. Then cycled NAD+, SS31, and Mots-c to increase my insulin sensitivity. After I got under 20%BF I felt safe to start TRT. Now I'm on 150mg test-c a week, total T is 1200, e2 is 50, and hematocrit is 47. Never felt better in my life! It wasn't the fastest way to get here, but I felt it was the right way. But my way was just that, my way. You'll have to make your own risk analysis and choose the path that's right for you
I was 300lbs at over 40%BF. I decided to wait to start TRT due to high e2, insulin resistance, and high blood pressure. Spent a year working hard to drop the fat. Good diet and weight training 5 days a week. I started Reta, and tesa/ipa for the fat loss. Then cycled NAD+, SS31, and Mots-c to increase my insulin sensitivity. After I got under 20%BF I felt safe to start TRT. Now I'm on 150mg test-c a week, total T is 1200, e2 is 50, and hematocrit is 47. Never felt better in my life! It wasn't the fastest way to get here, but I felt it was the right way. But my way was just that, my way. You'll have to make your own risk analysis and choose the path that's right for you
I appreciate the breakdown from a similar side of the coin. That is all very much necessary to consider. I’m on a good track for weight loss, so patience may be needed. I know I’ll get there physically, the thing I’m really impatient about is feeling better mentally. All of the success stories of night and day improvements mentally is so hard to ignore. It will be interesting to see what the rest of the tests come back as.Tbagger said:
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