Hi mmh0000 apologies for replying like this but not long ago we had a little conversation regarding TRT. I replied to your last message but it is from a while ago and as HN doesn't alert you if you get a reply I've no idea if you read back through your older replies to see it. I was wondering if you had a bit of time to talk with me in private about TRT? I would be extremely grateful if you can and if so just drop me an email, my username satsyin at gmail will get to me. Thanks :)
This is of interest to me as I saw an Endocrinologist last Monday as I had a blood test a few weeks ago and my testosterone level was "quite low" at 257 (bottom of the range being 249).
Anything under 300 along with symptoms (of which I have several hence the blood test in the first place) means further investigation so I am now waiting for the results of a whole host of blood tests that I did last Tuesday that the Endocrinologist ordered. 9 vials! Never had so much blood taken in one go.
I am 39 and never really gave any thought to my testosterone levels if I am honest. But I have been suffering from a whole host of weird issues the past ~3 years. However I am not sure if TRT is something I want to do if it comes back that they are indeed low and it wasn't just a one-off in the first test.
At least it isn't something I want to try first, I will see what other things I can do naturally such as diet changes before I head down the TRT injections, gels, etc. route.
For what it's worth I am in [redacted] not the US and I've never known anyone on TRT. Honestly I had never even heard of it outside of sports with people that [ab]use such things.
I am in nearly the same boat as you. I'm 38, and 1 year ago, I had my testosterone levels checked. The results came back at 273ng/dL, which is considered deficient. When I asked about TRT, My doctor refused to prescribe it, but, couldn't provide any valid reasons or research to backup his one justification that "it makes your blood thicker, and increases the risk of heart attack" (see below).
After doing tons of reading, I decided TRT is something I want. I went to a very questionable "doctor" who will prescribe effectively anything you ask for—(Just Google 'Mens Health Clinic <your area>').
Below, I've listed some of the more compelling videos and articles I went through [0]
The main reason I wanted to try TRT is that I've suffered from severe depression for a long-time; literally, suicide was a daily thought. I tried all the other things people say to do; I ate right, and I religiously tracked my diet. I got sleep-tracking apps and devices and fixed my sleep to get 8+ hours of sleep. After all that didn't help, I went to my normal family doctor, who prescribed escitalopram which "fixed" my depression by making me unable to feel anything, which was a terrible way to live. So I stopped taking that.
I started TRT back in July of 2022.
After being on TRT for about five months, the depression just disappeared. I've had other benefits, too, such as significantly improved musical tone (though this isn't why I started TRT, but it's a nice side-effect).
I tried all the other things people say to do; I ate right, and I religiously tracked my diet. I got sleep-tracking apps and devices and fixed my sleep to get 8+ hours of sleep.
Not trying to second guess your health situation, but I don't see anything about exercise on here. You don't have to go crazy with it (unless you want to), but istm everyone should do some exercise. Walking at leisurely pace helps but I don't really count that as exercise - by that I mean something that gets your heart pumping or significantly tires you out, eg a long walk at a really fast pace or with a loaded rucksack. Obviously this will be different for people who struggle with obesity or have joint issues, but you don't mention any physical handicaps so I'm assuming you have full mobility.
Thanks for sharing your experience. I have heard very similar stories from many people and it is certainly a pretty good sell for trying TRT.
Your initial experience is weirdly similar to mine. My doctor has given me a few different antidepressants over the past 2 and a bit years (Escitalopram, Amitriptyline, Sertraline to name three) but they just made me worse in that I put on weight (which now will not fucking leave!), awful sleep, my penis became useless, and I was just angry 95% of the time. I was a truly awful person to be around and I felt so sorry for my wife and son having to put up with me. So I told him they're not working and we need to look at other ways of treating this depression and anxiety.
He sent me for a testosterone check I think as a bit of a way to just shut me up as I kept asking him what else can we do. He was surprised when it came back at 257ng/dL but as it was above the 249 bottom end he was like "it's a bit low but in the normal range". Thankfully I have a friend that is a doctor and they put me in touch with an Endocrinologist who agreed under 300 at least deserves some further blood work and check I don't have a pituitary gland issue which can cause a lot of my symptoms.
My symptoms are:
* extreme fatigue (to the point of falling asleep in my office chair)
* easily exhausted when exercising
* much longer recovery times from exercising, when I used to have maybe a day or two of muscle aches from pushing myself a bit more to build muscle it would now take me 3 to 4 weeks to recover.
* My concentration is garbage
* Cannot lose the weight around my abdomen. I managed to lose around 13KG back in 2020 yet put it back on thanks to the SSRIs mentioned above and doing the same things I did the first time just does not shift the weight
* Depression but it feels different to my previous experiences with depression not to mention it seems treatment resistant this time whereas before I found Sertraline was at least somewhat effective.
* Heart palpitations that are extremely uncomfortable
* Terrible sleep. It often takes me 2 hours to finally get to sleep and my sleep quality as measured by my FitBit is awful compared to a few years ago (first time the sleep tracking came in helpful)
* Very irritable and easily frustrated
I don't know how that compares to your list of symptoms but they have absolutely wrecked me the past few years. I am just hoping to god there is something of value found in my blood results so I can start working on improving things.
As I said I don't know if I will jump on TRT as it does worry me a little bit. There is no such thing as side effect free HRT after all but my wife has said I should keep an open mind and listen to my Endocrinologist who has said she would recommend it if my blood work comes back with levels in line with ~250ng/dL. I will see what the results are though, if I'm under 250 I think I will have to seriously considering just trying it for a few months. If I am around 300 I think I would rather try some natural ways and retest in 2-3 months and see if it has helped at all. If not then I will give TRT a try.
> I don't know if I will jump on TRT as it does worry me a little bit. There is no such thing as side effect free HRT after all...
Brother, it sounds like your life is made of horrendous side effects. I am just a random internet commenter, not a doctor, but I am a fellow man. And if there were ever a time to ignore your fear and roll the dice, it's now.
You're not wrong and my wife certainly shares your opinion too!
I am naturally a bit of a worrier about "big" medication regimes like TRT and I over research and over think everything which is obviously not a great thing when it comes to medicine as everything has side effects.
I am slowly starting to adjust my mindset with regards to trying TRT but I need to see what my results are to help me make a decision.
It is a decision, but, I wouldn't say it's a "big" one. It is possible to come off TRT, though it's a long ramp-down period. The TRT itself isn't really a hassle, I just poke myself in the butt twice a week. I've worked it into my morning routine: shave, shower, teeth, poke.
I was like you before I started TRT, super hesitant, and worried I would just be poisoning myself. A good friend of mine kept pushing me to try, and I can't say I have any regrets.
For me personally, I wouldn't want to come off TRT, I feel so much better consistently. IMHO, there are no downsides, at least none yet that I've experienced.
That's still quite low. As I mentioned in a previous comment, my family doctor wouldn't persribe TRT even though I was outside of the "normal" range. I ended up having to go to a "mens health clinic", who are much more liberal with handing out prescriptions.
Not sure if you will see this but on the chance you do I was hoping you could get in touch with me directly as I would really like to talk to someone on TRT to ask some questions. If possible could you drop me an email? You can email my username [redacated] at gmail. Many thanks!
Do your own research on that. Even endocrinologists oversee obvious reasons for low testosterone.
Usually, low testosterone is more a symptom. Better fix the underlying issue. Get somebody with expertise to look at your tests (i.e. not a government-paid doctor).
Yes the recent blood work has all the diabetes, cortisol, thyroid and some other stuff being tested. Plus a brain/pituitary gland MRI in a few days.
Thankfully here I get all my results directly in accessible formats (so like a normal video for my MRI results) so I can easily research myself or go for a second opinion without the hassle of having to get my results like back in the UK.
Having said that the Endocrinologist I saw was highly recommended by a close Doctor friend so I have confidence in them.
I don't like to be notified about anything non-critical. I take time in my day to check the 'threads' link at the top of Hacker News and spend the 10 seconds or so it takes me to see if anyone has replied to anything I posted over the past few days and if I feel it warrants a response.
If it does I pop a note in my to-do list along with a link to the comment in question and get around to it later.
The last thing I want is yet another ping to tell me someone replied to me on a social news site. One of the reasons I comment on Hacker News is that it doesn't poke me in the eye for every reply I may get.
Honestly if Hacker News were to add this feature I would disable it instantly or maybe just not bother interacting with the community if they did it in an invasive way that I cannot disable, although that is quite unlikely.
Quick edit: I didn't mean for the above to sound hostile to what you have made. Apologies if it comes across that way. I just feel very strongly about over-notifications in todays world. For those that want it hopefully they find your extension helpful!
Nice to hear your perspective. Just asking, You wouldn't use it even if it's just a badge (or an indication), and nothing intrusive like a push, or a popup?
You know on reddit it has that little orangered envelope to notify you of when you have a reply? I use uBlock Origin to nuke even that tiny little envelope (I also remove a lot of other stuff from reddit to be fair).
A few years ago I totally removed all forms of notifications outside of actual critical things such as my sons school calling.
On my phone I have no notification badges on the icons and all app notifications disabled. I don't care to know about anything without it being my choice.
Do I waste a few seconds now and then? Sure but it's time I can control. If I don't want to waste those few seconds I just don't check for any updates. With a notification I have no choice, that second or two is sucked away from me no matter what.
Perhaps it seems extreme but using a phone, tablet or computer is so much better when it doesn't keep poking you in the eye with "look at me!!" badges or notification shades popping or sliding in the corner or edge of the screen.
That's nice :) In my case, notification (or an indicator atleast) help me save a lot of time. This is especially when I'm serious about knowing the latest updates on something. If it's something less critical, I'd simply snooze them!
Indeed. I have an M2 Max MacBook Pro with 64GB and holy shit this thing just doesn't break a sweat for even heavy workload and is still small enough to be my every day laptop I can take with me to do basic work on when I travel about.
I used to need a big desktop/workstation for "real work" and had an ultrabook for all the related admin stuff that I like to do out of the office for sanity. Two machines isn't difficult to manage but it can be a bit annoying. Having one machine that can do everything without compromise is a dream.
Not to mention this one MacBook Pro, while expensive, is still cheaper than what I used to spend on a desktop+ultrabook setup. It is so close to perfect I pretty much have nothing to complain about which as my wife will attest to is unheard of for me when it come to computer :)
I had toyed with the idea of getting an Air and a Mac Studio and continuing to work in my old two machine way but with how good the MacBook Pro's are I realised I no longer needed to do that and I am very happy I made the decision to just go all in with a good MacBook Pro and not think about it anymore.
I have an M1 Max MBP w/ 64gb and I'm like you. Short of this thing breaking, I'm not sure what Apple can do to make me want to upgrade. It's very fast, does everything I need it to easily, has great battery life, etc...
Maybe if they add something like cellular to the MBP I might be tempted, but even then wifi is ubiquitous now.
Would you also say it is non-sensical to claim more work gets done in 40 hours compared to 48? Or perhaps 56 hours?
Why is 40 some magical number to productivity? What if 40 hours leads people to padding out their day with extra bullshit like meetings or needless admin that ends up sucking away more of the time they could spend on their actual work than if they never had to pad things out by only working 32 hours?
For transparency I live in [redacted] where the standard work week is 35 hours. Also I've never found the [redacted] with their 35 hour work week are less productive than our friends in Asia with 45+ hour work weeks. Regardless of time worked the productivity output is roughly the same for any given week.
> Would you also say it is non-sensical to claim more work gets done in 40 hours compared to 48? Or perhaps 56 hours?
Absolutely. Because all you have to do is not produce negative work beyond 40 hours. You can literally do nothing.
As I said, there is a balance to be struck and diminishing returns are a real thing. But in order for a 4 day work week to be more productive than a 5 day work week then that means your work output on the 5th day is negative.
> But in order for a 4 day work week to be more productive than a 5 day work week then that means your work output on the 5th day is negative.
You are assuming equal productivity (per working hour) in both scenarios. However, it just might be that the worker who just came off a 3-day weekend, and knows they only have to work for 4 days before their next break, will be more productive per hour than someone who just came off a 2-day weekend, and who knows they will need to work for five days before their next break.
Basically, you are assuming that people are robots and get a certain amount of work done per hour regardless of circumstances.
As metabagel said you seem to be basing this on every hour in a persons working week being equal which is obviously not how things really work out.
Do you not find yourself more mentally and physically fatigued at ~35 hours compared to ~25 into the work week?
When do you do your best work? At the start of the work week? Middle? End? Do you feel you do better work after you've had more down time to let your brain "decompress" or whatever you want to call it?
As far as I can tell we stumbled into the ~40 hour work week a long time ago due to physical exhaustion and that exhaustion led to more mistakes and productivity impact due to assembly lines being held up to correct those mistakes, etc.
This makes sense to me and seems like a pretty understandable and reasonable upper limit when it comes to physical jobs such as assembly lines and such.
Why do we just assume that ~40 hours transfers over to knowledge worker jobs? We all know how mentally fatiguing it is after several hours of debugging a tricky issue or trying to design a modern scalable architecture.
Whereas a mistake on an assembly line from a fatigued worker at 40+ hours into the week may put the assembly line out of action for a few hours it that is usually it for the negative impact.
Mistakes in a platform design or a silly bug can easily lead to constant productivity impact and huge costs down the road if that mistake makes it into production. We see it all the time with technical debt.
In your opinion how many hours per working week strikes your balance? How did you get to this number and do you think it is specific to you or more of a general figure that should be the standard?
Damn.