Do You Need TRT Treatment?

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Testosterone Replacement Therapy (TRT) is the most popular Google search word for a man or woman looking for that extra boost, that extra edge to either enhance their performance and get faster results or just to feel better. I am familiar with TRT because I take it, but not by choice. And I am 100% natural.

Do you need TRT treatment? Consider the following reflective questions to answer this for yourself. Why might I want TRT? Why might I consider TRT? Why might I need TRT? How might I increase my testosterone naturally without TRT?

I consider myself a normal guy in good athletic shape for my age. I’ve been weight training for over 45 years following a bodybuilding regimen. Since February 2022 I’ve survived testicular cancer three times. The first occurrence appeared in July 2009 (discovered by me), which resulted in the removal of my left testicle. The second recurrence appeared in July 2019 (discovered by me), which resulted in the removal of my right testicle. Since I had no balls and, therefore, could no longer produce testosterone naturally, it was then that my primary care physician (PCP) treated my condition with testosterone replacement therapy (TRT). The third recurrence appeared in November 2021 in the middle of my chest (discovered by CT scan), which resulted in 10 weeks of 40 bags of chemotherapy.

The only thing that I regret, but not have known because I was unaware of it and, therefore, not thinking it, is what my natural testosterone value was with two testicles prior to July 2009 and one testicle prior to July 2019 before I had none. But it was obvious. Even when I had one testicle, I didn’t need TRT to enhance my performance to build muscle. Building muscle is and always has been simultaneously mental activity and hard physical work along with eating well and recovering sufficiently.

The pictures below are screenshots from a YouTube video (@TheFitnessMindset) while I was making cauliflower casserole on January 12, 2020.

Guys who have balls or at least one and produce testosterone naturally, be thankful. USE your natural testosterone to maximize your physical potential and congratulate YOURSELF for it because it derives from your own effort and not foreign-directed derived from PEDs!

I am steroid-free and natural. Testosterone is a steroid. I have never “chosen” to take testosterone to “enhance” my physique and have never used testosterone “beyond” the normal value range to enhance my physique. I have built my physique from my own effort self-directed and not foreign-directed by taking performance enhancing drugs (PEDs). PCPs prescribe TRT to males with no or low testosterone. My PCP manages the amount and frequency of my TRT injections.

I use a 10mL (200mg/mL) bottle to inject 0.5cc every other week or 1cc monthly, which is enough for a low testosterone value of 250 nanograms per deciliter (ng/dL). A 10mL bottle for me lasts 10 months, whereas for a competitive bodybuilder it lasts 3 days. According to a Google search “testosterone value range,” a normal male testosterone value for adult males 19 years and older is between 300 to 1,000 ng/dL. For adult males 50 years and older the value range is between 200 to 750 ng/dL.

According to medical research, testosterone fuels the growth of prostate cancer cells, which enlarges the prostate. In January 2022 I had an elevated prostate value. For this reason, my PCP took me of TRT. After three weeks with no TRT and no testosterone, I experienced twenty to thirty hot and cold flashes every day and night (my PCP put me on a low dose of antidepressant to mitigate the hot and cold flashes), my sex drive was nonexistent, my physiological drive to train intensely was lower, my recovery time was slower, I felt more “pain” throughout my body, I had soft smooth slippery skin, and I got fatter around the mid-section. On March 11, 2022, my testosterone value was 39 derived from my adrenals. I still went to the gym and trained intensely as I could. I also hiked up my favorite mountain in Montana on March 27, 2022.

But I was frustrated and angry at my PCP for taking me off TRT. For this reason, and with what amount of testosterone I still had left in the 10mL bottle, I put myself back on TRT without his permission in mid-May. The hot and cold flashes stopped after three weeks.

This is the period when I “experimented” taking more testosterone than what my PCP had prescribed me. I injected 1cc or 1mL once a week for 4 weeks from May to June 2022. My mood became elevated with a sense of well-being and vitality. And the depression I was feeling without TRT, or testosterone subsided. My workouts were quick and energizing. I felt like “superman” and “alive with testosterone” compared to having none for four months.

I did not make any significant strength gains, except for a dramatic increase in physiological drive, speed, and endurance as described in my training journal. After a follow-up with my PCP, my blood work came back in mid-June with a testosterone value of 1500 ng/dL. My PCP almost dropped me as a patient. By then my prostate was within the high normal range. My PCP started me back on 0.5cc of TRT every other week. I promised that I would listen to him and do what he prescribes.

In September 2022 my prostate value shot up again. My PCP took me off TRT, but this time it was for 10 months. My PCP put me on a low dose of antidepressant to mitigate the hot and cold flashes again. With a testosterone value of about 40 ng/dl deriving from my adrenals alone for nearly a year, I still continued to train and exercise. I even ran my first half-marathon in Missoula, Montana on June 25, 2023. In July 2023, my PCP started me back up on TRT at 0.5cc every other week or 1cc monthly.

In August 2023 I had left rotator cuff surgery. It took nearly a year to recover from rotator cuff surgery. For 10 months I could not perform compound exercises that work the large muscles of the lower back, legs, and lats (e.g., deadlifts, squats, rows) to train hard and intensely. From mid-August 2023 to mid-May 2024 my exercise training and energy expenditure was minimal and limited.

Compound exercises like squats, deadlifts, bench press, rows, and clean and jerks (i.e., the hard exercises that people tend to avoid) can boost your testosterone level if you are willing to challenge yourself and put forth a lot of effort. Due to muscle memory, from mid-May to mid-July, deadlifts increased from 135 to 315 for 10 reps in two months. Squats increased from 135 to 245 for 10 reps in two months. T-bar and dumbbell rows also increased dramatically in weight in two months. See my videos on Instagram @randymherring.

On August 2, 2024, I had a follow-up with my PCP. My testosterone value increased WITHOUT a change in the 0.5cc dosage every other week as prescribed. Since my last testosterone value on January 25, 2024, and my ability to start back training hard performing compound exercises from May to July after recovering from shoulder surgery, I boosted my testosterone value from 253 to 347 ng/dL (derived from my adrenals and not from TRT itself) in two months! This was achieved by me and me alone by exercising hard and intense. See the comparisons below.

Do I need TRT Treatment?

If you think you need TRT do one of three things. One, check your testosterone value from blood work. If it is below 300 or 200 ng/dL then ask your doctor if you need TRT. Two, if your testosterone value is below 300 or 200 ng/dL, then “train hard” to boost your testosterone naturally. Evaluate your training to understand what it means to train hard. Three, if you don’t have balls, like me, then you need TRT to function normally and boost your testosterone naturally.

Am I Natural or Unnatural?

If you have chosen to take TRT consider these three things to help you decide whether you will be natural or unnatural. One, using TRT even though your body produces a sufficient amount of testosterone naturally within the standard value range, but you desire more testosterone beyond your normal production and value range that enables you to function at an optimal level beyond your natural capability means that you take TRT as a performance enhancing drug (PED), which further means your training results are not from your own effort, and you are unnatural.

Large quantities of synthetic forms of testosterone, i.e., PEDs, replace a natural form of production of testosterone in unnatural amounts, which translates into an unnatural or fake physique.

Two, using TRT because your body produces a low amount of testosterone naturally below the standard value range but the amount of TRT is within the standard value range to function normal at your natural capability means that you do not take steroids, which further means your training results come from your own effort, and you are natural. Three, using TRT because your body produces no testosterone due to having no testes to produce testosterone naturally but the amount of TRT is within the standard value range means that you do not take steroids, which further means your training results come from your own effort, and you are natural.

Whether setting a personal record (PR) or winning a strength competition by demonstrating how much weight one can lift is an obsession with both men and women, young and old alike, because taking PEDs is less noticeable and less questionable as a foreign-directed assisted substance unlike winning a physique competition.

Train Hard, Not Long

What does it mean to train hard? Building muscle encompasses three basic facts. One, strength precedes muscle. That is, before a muscle can get bigger it first must get stronger. Two, training hard and long is impossible. You either train hard or long. You cannot do both. Training harder means training at a higher intensity and invariably shortens your workout time. It doesn’t necessarily mean using heavier weight, but rather making a set harder to complete. Three, the greater amount of force generated yields the most muscle fibers stimulated at one time. This is the “time under tension” principle. The amount of force generated in a muscle is directly proportional to the potential amount of muscle growth.

Training Harder with Reverse Pyramid Training (RPT)

The popular ascending pyramid training method is neither time nor energy efficient. Pyramiding up in weight while pyramiding down in reps wastes time, energy, and muscular effort. A pragmatic training approach that is time and energy efficient is the reverse pyramid. Reverse pyramid training turns the ascending pyramid method upside down and reverses the weight and repetition scheme. See the diagram below.

Rather than beginning with the lightest weight and completing 15 repetitions on the first set, the order is reversed, and the heaviest weight is used to complete 8 repetitions on the first set. For each succeeding set, the amount of weight is decreased (hence, the “reverse” pyramid) while the repetition range is increased. Since the first set is the heaviest weight, it is imperative to warm-up to the heaviest weight using the ascending pyramid method. Unlike the ascending pyramid, these first three sets (or more) serve only as warm-up sets to the first and real set of RPT.

Getting Optimal Results By Doing The SAME Exercises

If you want to increase your testosterone level after an intense workout, the muscles first must recover from the exercise stress or stimulus so they (the muscles) can adapt to a higher exercise stimulus (your next training session) to physiologically get stronger and bigger. This is how the body repairs itself and metamorphoses to function at a higher level at each training session and inevitably transform your physique.

In addition, and most important, performing the same exercises by mastering the movements go through several adaptation phases for dynamic growth. I call this “The Circle of Recovery.” See the diagram below.

Results are invariably linked to effort output and the amount of energy returned to effect changes to the body. To get energy, you must put out energy to get more in return.

Copyright Randy M. Herring and The Fitness Mindset: 7 Habits For Peak Performance