Advice wanted for TRT (not seeking medical advice)

[TruffleGnocchi]

An older person I know has non-functioning testosterone production, zero production from balls. I got him some testosterone, different esters, will recommend using shorter esters daily but bought longer esters if he will insist on not doing daily injections. Also got him exemestene.

My question if anyone has experience or thoughts on this: would it be better for him to take a low dose exemestene right away with the first dose of testosterone he takes, or would it be better to try testosterone first, get it up to 700-1000ng/dl, then only if he feels off or has side-effects, take exemestene?
Since he is an older gentleman, I am worried he will have a significant risk of cancer from conversion to estrogen, and maybe will not recognise the effects of estrogen since he never took testosterone and now has been for some years with no production at all. Also he is a bit overweight and a bit bloated, judging from appearance.
It has been a challenge convincing him that taking testosterone is good for him and will give him at least some of his life back, if he gets side-effects from estrogen I worry he will never want to try testosterone again. In my country there is no such thing as replacement. There are a few new clinics only in the capital city, but that is like a whole new thing here, compared to USA. Doctors will probably advice against it or say it is not needed from my experience with the medical system in this country. At the same time I dont want to unnecessarily give him exemestene and maybe give him unkown side-effects or reduce the benefits of testosterone injections/replacement.
I know shorter esters and higher injection frequency produces more stable levels, and injecting it subcutaneously makes it absorb more gradually. Also is it more likely for testosterone to aromatise when injected into the fat? Bodybuilders say it reduces conversion since it doesnt produce spikes compared to injecting into a muscle, but I'm thinking since aromatase enzyme is produced in the fat, and he is slightly but visibly overweight (not morbidly obese), would IM injections actually result in less conversion.
Also still havent been able to source DHT in Europe. So that is not an option, at least at this time unfortunately.

Any thoughts or experiences are appreciated. Not looking for medical advice.

 

[Pedigree]

Your assessment of TRT as a path forwards seems logical to me. I would opt for testosterone base over injections though. There is a lengthy thread on this forum with people detailing their experiences. It would allow for progest-e style usage or you could make a dmso topical. You wouldn't have to mess around with needles, no toxic oils and dosing could be done more astutely. I think Ray took testosterone (as a unesterified base) here and there.

Exemestane could be positive too but my concern is him being reliant on estrogen, and then when the estrogen gets nuked, what takes it's place as a stress hormone? Unless it just starts a positive feedback loop of increased testosterone/dht to sustain the system?

The basic dietary interventions - milk, carrots, sugar, regular eating - should be foundations too, before embarking on drugs.

 

[TruffleGnocchi]

Is it hard to get testosterone base and what form is it? I imagine the topical administration would take care of the small halflife of no esters? And the dosage would therefore need to be larger?
Luckily I got him those esterified testosterones dissolved in MCT + some other things that are not oils but probably not a big problem compared to if it was soy oil or something.
I'm also worried about too-low estrogen. I actually take exemestene myself from time to time and I dont even take any androgens, but I dont want to expose him to some risk that I dont know of, from too low estrogen, just because I believe that low estrogen is most likely not a problem. Maybe still better than high estrogen I dont know, just dont want him to die instantly from a heart attack or something, and later I find out some amount of estrogen is needed for that or something terrible.

I'm not gonna attempt to change his diet, but apart from grains and a few oils other than olive oil his diet is.. ok.. I think. They grow a lot of their food at home, and mostly use olive oil, he probably avoids too much fat since he thinks cholesterol is bad. Afaik he eats dairy, eggs, meat, fish, grains, veggies,.. Omnivore but without junk food

 

[tasfarelel]

Aromasin right away - as you describe him, he will not be able to feel high estrogen.

Other option is low testosterone say 50-75mg/week with a DHT (dose you decide). Then no aromasin unless blood tests show high estrogen.

 

[ChemHead]

An older person I know has non-functioning testosterone production, zero production from balls. I got him some testosterone, different esters, will recommend using shorter esters daily but bought longer esters if he will insist on not doing daily injections. Also got him exemestene.

My question if anyone has experience or thoughts on this: would it be better for him to take a low dose exemestene right away with the first dose of testosterone he takes, or would it be better to try testosterone first, get it up to 700-1000ng/dl, then only if he feels off or has side-effects, take exemestene?
Since he is an older gentleman, I am worried he will have a significant risk of cancer from conversion to estrogen, and maybe will not recognise the effects of estrogen since he never took testosterone and now has been for some years with no production at all. Also he is a bit overweight and a bit bloated, judging from appearance.
It has been a challenge convincing him that taking testosterone is good for him and will give him at least some of his life back, if he gets side-effects from estrogen I worry he will never want to try testosterone again. In my country there is no such thing as replacement. There are a few new clinics only in the capital city, but that is like a whole new thing here, compared to USA. Doctors will probably advice against it or say it is not needed from my experience with the medical system in this country. At the same time I dont want to unnecessarily give him exemestene and maybe give him unkown side-effects or reduce the benefits of testosterone injections/replacement.
I know shorter esters and higher injection frequency produces more stable levels, and injecting it subcutaneously makes it absorb more gradually. Also is it more likely for testosterone to aromatise when injected into the fat? Bodybuilders say it reduces conversion since it doesnt produce spikes compared to injecting into a muscle, but I'm thinking since aromatase enzyme is produced in the fat, and he is slightly but visibly overweight (not morbidly obese), would IM injections actually result in less conversion.
Also still havent been able to source DHT in Europe. So that is not an option, at least at this time unfortunately.

Any thoughts or experiences are appreciated. Not looking for medical advice.

Have an AI ready to use, but don't use it unless it's needed. Have him inject for a couple months, get labs and assess how he feels. If he starts noticing symptoms like numbness of genitals or uncomfortable bloating or any of the typical high E sides people complain of, then get him on the AI.

I inject esterless testosterone and testosterone propionate twice daily through an insulin syringe into quads. I have zero issues with estrogenic sides. I'm currently injecting 100 mg/week. If he notices any high E sides you could also just have him take a bit of DHT or masteron.. or proviron if he wanted to take an oral 5a-reduced androgen.

He may not need an AI and might end up feeling depressed if he's given one and doesn't need it.

 

[Hans]

An older person I know has non-functioning testosterone production, zero production from balls. I got him some testosterone, different esters, will recommend using shorter esters daily but bought longer esters if he will insist on not doing daily injections. Also got him exemestene.

My question if anyone has experience or thoughts on this: would it be better for him to take a low dose exemestene right away with the first dose of testosterone he takes, or would it be better to try testosterone first, get it up to 700-1000ng/dl, then only if he feels off or has side-effects, take exemestene?
Since he is an older gentleman, I am worried he will have a significant risk of cancer from conversion to estrogen, and maybe will not recognise the effects of estrogen since he never took testosterone and now has been for some years with no production at all. Also he is a bit overweight and a bit bloated, judging from appearance.
It has been a challenge convincing him that taking testosterone is good for him and will give him at least some of his life back, if he gets side-effects from estrogen I worry he will never want to try testosterone again. In my country there is no such thing as replacement. There are a few new clinics only in the capital city, but that is like a whole new thing here, compared to USA. Doctors will probably advice against it or say it is not needed from my experience with the medical system in this country. At the same time I dont want to unnecessarily give him exemestene and maybe give him unkown side-effects or reduce the benefits of testosterone injections/replacement.
I know shorter esters and higher injection frequency produces more stable levels, and injecting it subcutaneously makes it absorb more gradually. Also is it more likely for testosterone to aromatise when injected into the fat? Bodybuilders say it reduces conversion since it doesnt produce spikes compared to injecting into a muscle, but I'm thinking since aromatase enzyme is produced in the fat, and he is slightly but visibly overweight (not morbidly obese), would IM injections actually result in less conversion.
Also still havent been able to source DHT in Europe. So that is not an option, at least at this time unfortunately.

Any thoughts or experiences are appreciated. Not looking for medical advice.

Most of the high E symptoms can be dealt with by injecting more frequently. Like test cyp or enanthate 2-3x week.

 

[TruffleGnocchi]

Thanks for all the advice. I think I will try to explain to him that it is not uncommon to get estrogenic side-effects and if he experiences side-effects it is probably the estrogen. To take a very low dose of exemestene for the first few injections then slowly lower or take less frequently since tablet cannot be divided much more, then see how he feels, and if he feels any better or worse when not taking the micro exemestene dosage.
Lab tests would be the best, I dont know if he will go do them. I said to him and his wife multiple times he should go do a blood test to see where he is at but refused and got mad. I know he is at nothing because he doesnt produce anything, but I thought that might convince him if he gets the paper and it shows greatly below range, and for things other than testosterone of course that is good.

Do masteron or proviron or other DHT derivatives act similarly enough to DHT that it could be used instead of DHT if it's not available? It is easy to get those almost every steroid website has them.

I bought him propionate for daily injections, but if he will not want to do that he also has enanthate and some 3 ester mix that contains an ester with even longer half-life which I dont know how good that is but its cheap so he has it. I know research says longer ester more side-effects statistically. I think it is still better than no testosterone even if he doesnt end up injecting propionate daily.

I will see how up for it he is and adjust the amount of explaining and instructions based on that to not scare him away, he said I convinced him that he will try but he didnt call me yet lol, I imagine he wont inject without guidance. Even if he chooses to not try it now, I think it is good now that he knows this is an option and has it in the fridge, maybe he will even go do a blood test on his own someday

 

[tasfarelel]

Masteron, Primobolan, Proviron have all slightly different conversion rates and different anabolic to androgenic ratios, so I guess - but it's just a guess - that they do not act 100% as DHT. But I would still use them (or best a combination) instead of DHT as its rather unlikely that you can manage to get real DHT - unless you trust panda^^