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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 regular guy in good athletic shape for my age at 62. I’ve been resistance training for over 45 years following a bodybuilding-fitness 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 could not have known, as I was unaware of it and, therefore, not considering it—is what my natural testosterone levels were when I had two testicles before July 2009 and one testicle before July 2019, before having 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 my YouTube Channel @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 performance-enhancing drugs (PEDs).
I’m steroid-free and natural, but testosterone is a steroid. However, I have NEVER used PEDs. In other words, 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 PEDs. PCPs prescribe TRT to males who have low or no testosterone. My body cannot produce testosterone naturally because I have no testicles. My PCP manages the amount and frequency of my TRT injections.
I use a 10 mL (200mg/mL) bottle to inject 0.5 mL every other week or 1 mL monthly, which is enough for a low testosterone value of 250 nanograms per deciliter (ng/dL). A 10 mL bottle for me lasts 10 months, whereas for a competitive bodybuilder can last only 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.
In January 2022 I had an elevated prostate value. For this reason, my PCP took me off TRT. There’s a widespread belief among oncologists that intramuscular testosterone can fuel prostate cancer, potentially enlarging the prostate and raising PSA levels. Although this claim has largely been debunked, it was the basis for my physician’s decision to halt treatment.
A study by the University of Washington School of Medicine, which analyzed nearly 150,000 patient cases, found that intramuscular testosterone injections or TRT treatment does not increase the risk of prostate cancer. You can access the study here: Brain Donohue, “Study: Testosterone therapy does not raise prostate cancer risk” (June 21, 2018)—UW Medicine. Retrieved: https://newsroom.uw.edu/news-releases/study-testosterone-therapy-does-not-raise-prostate-cancer-risk.
Intramuscular testosterone injections or TRT treatment does not increase the risk of prostate cancer
After just three weeks without TRT, I experienced 20 to 30 hot and cold flashes every day and night. My doctor prescribed a low-dose antidepressant to help mitigate the symptoms. My sex drive disappeared. My physiological drive to train intensely dropped. Recovery became slower. I felt more pain throughout my body. My skin became soft, smooth, and slippery. And I gained fat around my midsection. To fight back against these changes, I modified my training approach, adjusted my variables, and trained as intensely as I could.
On March 11, 2022, my testosterone level measured just 39 ng/dL, derived solely from my adrenal glands. At that time, I was 60 days into post-chemotherapy recovery. Just over two weeks later, on March 27, 2022, I hiked up a mountain in Montana—without TRT.
Frustrated and angry at my doctor’s decision, I took matters into my own hands. Using the remaining testosterone from a 10 mL bottle, I resumed TRT without medical supervision in mid-May 2022, injecting 1 mL weekly for four weeks. The hot and cold flashes stopped after three weeks, and my workouts became energizing once again.
At a follow-up in mid-June, my bloodwork showed a testosterone level of 1500 ng/dL. My doctor was nearly ready to drop me as a patient. Fortunately, my prostate was still within the normal range, so he resumed TRT at a lower dose of 0.5 mL every other week. I promised to follow his guidance moving forward.
In mid-September 2022, however, my prostate values spiked again, and my doctor discontinued TRT for a third time—this time for 10 months. During that period, my testosterone level hovered around 74 ng/dL. Still, I continued to train and exercise. On June 25, 2023, I even ran my first half-marathon in Montana—again, without TRT. In mid-July 2023, my doctor resumed TRT at 0.5 mL every other week, or 1 mL 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—such as squats, deadlifts, bench press, rows, and clean and jerks (i.e., the tough exercises most people tend to avoid)—can significantly boost testosterone levels when you push yourself and train with serious effort.
From mid-May to mid-July, thanks to muscle memory, I saw major gains:
Deadlifts increased from 135 to 315 pounds for 10 reps.
Squats went from 135 to 245 pounds for 10 reps.
T-bar and dumbbell row weights also rose dramatically in just two months.
Check out the progress in my videos on Instagram: @randymherring.
On August 2, 2024, during a follow-up with my primary care physician, I received confirmation that my testosterone levels had increased—without any change to my prescribed 0.5 mL dose of TRT every other week.
Since my last testosterone reading on January 25, 2024, and after returning to intense compound training between May and July following shoulder surgery, I successfully increased my testosterone from 253 to 347 ng/dL—a 94-point rise—driven by my adrenal glands, not the TRT itself.
This increase was achieved solely through hard, intense training—by me, and me alone. See the comparison results below.
Do You Need TRT Treatment?
If you think you might need TRT (testosterone replacement therapy), consider one of the following three steps:
Get blood work done to check your testosterone levels. If your total testosterone is below 300 ng/dL—or especially under 200 ng/dL—talk to your doctor about whether TRT is appropriate for you.
If your levels are low, try boosting your testosterone naturally by training hard. But don’t just go through the motions—evaluate your workouts to understand what truly intense, consistent training looks like.
If you don’t have testicles, like me, then TRT is essential to function normally. In this case, you’ll need TRT to support your body’s hormone balance—and with hard training, you can still help your body optimize testosterone production from other sources like your adrenal glands.
Are You Natural or Unnatural?
If you’ve chosen to take TRT, consider these three points to help determine whether you are natural or unnatural in the context of training and performance:
If your body already produces a sufficient amount of testosterone naturally within the standard reference range, but you take TRT to raise your levels beyond your natural capability in order to perform at a higher level, then you are using TRT as a performance-enhancing drug (PED). This means your training results are not solely the product of your natural effort—you are being assisted by synthetic hormones, and therefore, you are unnatural.
Large quantities of synthetic testosterone—i.e., PEDs—replace your body’s natural testosterone in excessive, unnatural amounts, often resulting in a fake or enhanced physique that doesn’t reflect your natural limits.
If your body produces a low amount of testosterone (below the standard value range), and you use TRT only to restore levels within the normal physiological range, allowing you to function at your natural capacity, then you are not taking steroids in the performance-enhancing sense. Your training results are based on your own effort and consistency, and therefore, you are natural.
If your body produces no testosterone at all—such as in cases where you no longer have testes—but you take TRT within the standard reference range to maintain normal function, you are also not using TRT as a performance enhancer. Your training outcomes reflect your personal effort, and thus, you are natural.