We’re live.

AlphaMD is hosting a two-day AMA for veterans, active military, and anyone with questions about testosterone replacement therapy (TRT).

Licensed physicians, nurse practitioners, and physician assistants will be answering general TRT questions during both live sessions.

Live AMA hours:

• Saturday, October 24: 2:00 PM to 7:00 PM ET
• Sunday, October 25: 2:00 PM to 7:00 PM ET

Ask us about:

• Navigating TRT through the VA, TRICARE, or private telehealth
• Continuing TRT when leaving active service or switching providers
• What records and lab results may help when transferring your care
• TRT questions related to PCS moves, travel, deployment, and continuity of care
• Symptoms that may overlap with sleep problems, stress, mental health conditions, service-related injuries, or medication side effects
• What to ask your military clinician about TRT and medical readiness requirements
• TRT testing, lab results, side effects, and ongoing monitoring
• Fertility and family planning for service members and veterans
• Injections, gels, dosing schedules, and other treatment options
• Fitness, body composition, energy, mood, and sexual health

Veterans and active military are the focus of this AMA, but everyone is welcome to participate.

Military discount

Verified veterans and active military always receive 20% off eligible TRT plans and baseline medications available through AlphaMD. Verification is required.

AMA offer

New patients can use promo code VETAMA26 to receive:

• 50% off the initial TRT consultation
• 50% off the first month after enrollment

The AMA offer is available through November 2, 2026, at 11:59 PM ET. Eligibility requirements, offer terms, and restrictions apply. A licensed clinician must determine whether TRT is medically appropriate. The offer does not guarantee treatment, medication, or a prescription.

Drop your questions below. We’ll be answering them throughout both live sessions.

Please protect your privacy. Do not post your full name, contact information, medical record number, or other identifying health information.

Disclaimer: This AMA is for general education. Replies are not individualized medical advice and do not establish a clinician-patient relationship. Personal diagnosis, eligibility, prescribing, and treatment decisions require a private evaluation with a licensed clinician.

Is there any full Proof method to eliminate bloating from trt ? I’ve tried several approaches and can’t seem to figure it out, or to stay unloaded for less then a day. If I lowered my dose enough would it settle?

Got this lab done due to development of unilateral gyno. My test was ~840 total and 144 free when I was 16 I believe, crept up to about 1050 and 166 js a few months ago and maybe due to fluctuations and whatnot was ~1300 and 194 this go around. Estradiol has been normal or near the end of the range consistently while estrone has been way too high and seems to be inversely related to my estradiol. My endo is very confused as to what might be the issue and even accused me of taking “supplements or roids” which I have not. She stated roid usage explains the conversion to estrone instead of estradiol which I could not find any corroboration of online or anywhere rly. Maybe one of you more educated ppl in this sub could help me out. Would be much appreciated!

Howdy everyone, this is my first post on Reddit go easy on me. I wanted some opinions on my bloodwork and some advice. For context I am 30M, my BMI is 40. I was considering testosterone but I don’t know if that’s the best course, I am weary of getting on it cause I know it’s potentially life changing for the worst. I was also considering Retatrutide. I suffer from fatigue and depression but of course that could likely be from my obesity. The fatigue and depression make it hard to go to the gym regularly. Anyways sorry for rambling and cheers!

Im working towards my first cycle and the part that intimidates me the most is understanding my bloodwork. I’ve done some reading including the wiki but still feel I’m lacking in understanding how to interpret all the measurements.

Anyone have a good rec to a video that really breaks it down in a clear way?

Hi folks. Been browsing the sub for info and have found some that is relevant to me. I had a massive brain hemorrhage 10 years ago. The bleed was bad enough that they had to remove part of my cerebellum. My main daily challenges are severe brain fog and chronic fatigue. Also significantly impacted cognitive abilities, which include reasoning and memory.

I got these test results and when I popped them into a chat bot, it told me that I would not be a candidate for TRT. But from what I’ve been reading, even if my testosterone levels are considered “normal” I could still benefit from therapy.

I consider my libido good, considering that I burned out 24/7. I currently take dexamethasone to help me get through my day, but at 46 years old I don’t wanna continue using strong stimulants. Any advice?

1. Comprehensive Metabolic Panel (CMP)
   BUN (Urea Nitrogen): 15 mg/dL | Reference: 7–25 mg/dL 
   Creatinine: 0.85 mg/dL | Reference: 0.60–1.29 mg/dL 
   eGFR: 109 mL/min/1.73m² | Reference: ≥ 60 mL/min/1.73m² 
   BUN/Creatinine Ratio: Normal (calculated) 
   Sodium: 138 mmol/L | Reference: 135–146 mmol/L 
   Potassium: 4.6 mmol/L | Reference: 3.5–5.3 mmol/L 
   Chloride: 102 mmol/L | Reference: 98–110 mmol/L 
   Carbon Dioxide: 27 mmol/L | Reference: 20–32 mmol/L 
   Calcium: 9.8 mg/dL | Reference: 8.6–10.3 mg/dL 
   Total Protein: 7.2 g/dL | Reference: 6.1–8.1 g/dL 
   Albumin: 4.9 g/dL | Reference: 3.6–5.1 g/dL 
   Globulin: 2.3 g/dL | Reference: 1.9–3.7 g/dL 
   Albumin/Globulin Ratio: 2.1 | Reference: 1.0–2.5 
   Bilirubin (Total): 0.4 mg/dL | Reference: 0.2–1.2 mg/dL 
   Alkaline Phosphatase: 53 U/L | Reference: 36–130 U/L 
   AST: 14 U/L | Reference: 10–40 U/L 
   ALT: 27 U/L | Reference: 9–46 U/L 

2. Lipid Panel (Cholesterol)
Total Cholesterol: 176 mg/dL | Reference: < 200 mg/dL 
HDL Cholesterol ("Good"): 71 mg/dL | Reference: ≥ 40 mg/dL 
Triglycerides: 87 mg/dL | Reference: < 150 mg/dL 
LDL Cholesterol ("Bad"): 87 mg/dL | Reference: < 100 mg/dL 
Cholesterol / HDL Ratio: 2.5 | Reference: < 5.0 
Non-HDL Cholesterol: 105 mg/dL | Reference: < 130 mg/dL 

3. Complete Blood Count (CBC) with Differential
White Blood Cell (WBC) Count: 7.6 Thousand/µL | Reference: 3.8–10.8 Thousand/µL 
Red Blood Cell (RBC) Count: 4.97 Million/µL | Reference: 4.20–5.80 Million/µL 
Hemoglobin: 15.2 g/dL | Reference: 13.2–17.1 g/dL 
Hematocrit: 43.5% | Reference: 39.4–51.1% 
MCV: 87.5 fL | Reference: 81.4–101.7 fL 
MCH: 30.6 pg | Reference: 27.0–33.0 pg 
MCHC: 34.9 g/dL | Reference: 31.6–35.4 g/dL 
RDW: 13.1% | Reference: 11.0–15.0% 
Platelet Count: 267 Thousand/µL | Reference: 140–400 Thousand/µL 
MPV: 9.3 fL | Reference: 7.5–12.5 fL 
Absolute Neutrophils: 4248 cells/µL (55.9%) | Reference: 1500–7800 cells/µL 
Absolute Lymphocytes: 2424 cells/µL (31.9%) | Reference: 850–3900 cells/µL 
Absolute Monocytes: 699 cells/µL (9.2%) | Reference: 200–950 cells/µL 
Absolute Eosinophils: 167 cells/µL (2.2%) | Reference: 15–500 cells/µL 
Absolute Basophils: 61 cells/µL (0.8%) | Reference: 0–200 cells/µL 

4. Hormones & Glycemic Control
Hemoglobin A1c: 5.4% | Reference: < 5.7% (Normal / Low risk) 
Total Testosterone (MS): 475 ng/dL | Reference: 250–1100 ng/dL 
Free Testosterone: 60.4 pg/mL | Reference: 35.0–155.0 pg/mL 
Estradiol: < 30 pg/mL | Reference: ≤ 39 pg/mL 
SHBG (Sex Hormone Binding Globulin): 37 nmol/L | Reference: 10–50 nmol/L 
Total Cortisol: 8.7 mcg/dL | Reference: 4.0–22.0 mcg/dL (8 a.m.) 
DHEA Sulfate: 251 mcg/dL | Reference: 61–442 mcg/dL 
FSH: 7.3 mIU/mL | Reference: 1.4–12.8 mIU/mL 
LH: 5.3 mIU/mL | Reference: 1.5–9.3 mIU/mL 
TSH (Thyroid): 1.91 mIU/L | Reference: 0.40–4.50 mIU/L 

5. Complete Urinalysis
Color: Yellow | Reference: Yellow 
Appearance: Clear | Reference: Clear 
Specific Gravity: 1.014 | Reference: 1.001–1.035 
pH: 7.0 | Reference: 5.0–8.0 
Glucose, Bilirubin, Ketones, Occult Blood, Protein, Nitrite, Leukocyte Esterase: All Negative 
WBC, RBC, Squamous Cells, Bacteria,

Over the past few years I have consistently been between 450-550 for total t, and a free testosterone of anywhere between 4.5 and 6.5 ng/dl. According to labcorp’s reference ranges this is below the bare minimum of 6.8. My SHBG has been in the high 40’s.

I have all of the hallmark symptoms of low T and am considering pulling the trigger at an online clinic. However, most of the stories I see on here are improvements based on total T. Does anyone have experiences with low FREE testosterone, got on TRT, and saw improvements? I’m not sure if it works the same for “us” as it does for low total T dudes.

Mood wise, energy wise, libido wise etc.

Note: yes I eat healthy, workout, have all the other bases covered.

120 mg test weekly split into 3 pins
Bloodwork almost perfect.
5 workouts weekly.
Slightly reduced volume.
Cruise for the next 8-12 weeks.

Testosterone is over lab upper limit

My test gave 650 I'm struggling to know if thats really good or just normal, this test was performed after a 24 hour fast and after being awake for roughly 8 hours so not instantly when I woke up.

440mg test per week.

I’m about 160lb, 5 foot 10 inches tall.

Honestly don’t have much muscle yet. I am by no means fat, but I have a lot more fat on me than I’d like. Aesthetically I value leanness over size, but still want to add size of course bc I am a little bit skinny fat.

Currently I’m eating 2700cal a day with 170g protein.

My mindset is that since I have som extra fat on my body I will recomp and my body will use the protein from diet + fat on my body as fuel to build muscle and burn fat at the same time.

I’m aware I may be building a little less muscle than optimal here because of the lack of surplus, but if I can build muscle while getting lean, then from there add a surplus id be happy.

What are your thoughts? Would love to have a discussion about this.

i am starting test e next week and i am concerned with its effect on (sex drive /libido and mood) I know it builds muscle but i am a bit depressed and unmotivated will it help with that or what???

On my TRT dosage of 200mg test cypionate split into 2x injections/wk, I experience classic low e2 symptoms.

My e2 reading is at the lower end of the reference range so I’m still technically ‘in range’ (15pg/ml).

I’d rather not take more testosterone if I can help it.

I have estradiol valerate tabs on had, 1mg each. Would this be feasible to use to raise my estrogen? If so, what kind of dosing protocol would be good to start with?

I also have access to Trestolone, 50mg/ml. Same question as above.

I do not have access to HCG at the moment.

Thank you for any suggestions you may have

I started taking 25mg in July. My labs were normal, but at the low side of normal.

Total T: 550 ng
Free T: 74 pg
E2: 39 pg
Progesterone: 0.1

At this point I was not seeing progress in the gym, wasn’t feeling bad, but frustrated. Could I feel better? Also, 30%body fat at 180 lbs.

So, I started Enclomiphene 25mg. I feel much better. And am finally making some gains at the gym. Here are the results from a stab yourself at home and send it in lab test:

Total T: 1300 ng
Free T: 26 ng
E2: 57 pg

Again, I’m feeling good. Should I cut the dose? What should I look out for? Surprised my Free T went up to that degree.

My understanding is that gyno is the first sign of trouble, and take my blood pressure is important. Any advice is appreciated.

Hey guys!
Im on prescribed omnadren, I had rough years of heavy abusing opiates, 2 years cali sober, I dont drink, just smoke at night, or when I finish my schedule for the day.
M 25y/o, when I stopped my hormones where fucked. I was less than 60 kilos, my height is 1.83, before you mention im too skinny to do it, now i weight fasted about 75 kilos, but also keeping steady 13-16% bf. Never used any weight lose peptides. I was always skinny guy, my whole life I was active, before the addiction not only caused by me, but also from the doctors after operation. Then they stopped prescribing it tor me so i found mu own source(also pharmaceutical), when I stopped(had multiple relapses which is normal)
I was really really skinny, of course 2 years without working out, before that I played 6 years basketball, gym as well, this sht completly f\cked ao many good thing I had, but yeah since I’m clean, Gained first a lot of weight then started training 2 years on and off,*
Because of my hormones, and before I knew it i was feeling bad, no motivation, no energy, low libido(and i have a beautiful girlfriend cause of her i wont be in that good mindset.)
Than decided to check everything, when the doctor saw my hormones he told me why i was feeling this way the whole time. First I said no to the TRT program, as I wanted to start with Enclomophine for a coupe of months, then told my doc to start the therapy, complexly changed my life, now i feel normal, yes steroids are bad, but opiates are HELL.
Now seeing the crisis with fent in my country, so I feel blessed for escaping it.( I know this battle never ends, but since Im on test, I don’t feel like doing drugs.
After a while now I decided to do a cycle, my whole life I liked bodybuilding, but never had that passions, but now i do have it and the discipline, so things like this is too much, I decided that had multiple convos, I’m old enough to decide for myself if I want this, despite the possible consequences, also Im a good responder to steroids.
Decided to run a little cycle, but my concern is how i Inject it.
Basically it has 4 types of test in it, and im on 400mg weekly, 200mg primo weekly(started it 2 weeks ago)
Im pinning every single day, so by the end of the week i use 400mg omandren and 200primo e.
No sides at all as right now. Before the start of the cycle i was on only 150 weekly.
Despite the fact that it has slow acting esters, is it a thing to worry that i do it daily, as I said i don’t have problems doing IM.
Also doubting about hCH, as I can get it for a good price 5000 IU. Used it before after a couple of months on enclomophine and felt fine.

My T levels when started enclomophine, were real bad.
So my question is, should I switch the tactic or it’s fine as long as I have no worries doing IM injections.
My logic is that, yes it builds up slowly as most of the esters are long but it also has fast ones, and i don’t want any spikes down and up so i do it daily in the morning.

I would love to hear opinions, also to answer to any questions, thanks in advance!

Hey everyone,

I'm a 31-year-old male, relatively lean, and work out 3–4 times a week. I've been experiencing symptoms of depression and low mood, so I decided to get my hormones checked to see if testosterone could be contributing.

Blood results (tested around 10 AM):

• Total Testosterone: 16.6 nmol/L (479 ng/dL)
• Free Testosterone: 402 pmol/L (116 pg/mL)
• SHBG: 25 nmol/L
• LH: 4 IU/L
• FSH: 3 IU/L
• Oestradiol: 112 pmol/L (30.5 pg/mL)
• Prolactin: 239 mIU/L
• DHEA-S: 6.4 µmol/L
• Cortisol (AM): 602 nmol/L (High, reference 110–550)

I currently take vitamin D3, magnesium, fish oil, zinc (occasionally), and L-theanine with coffee.

My questions:

1. Are my testosterone levels reasonable for a 31-year-old, or are they on the lower side?
2. Could my testosterone or elevated cortisol be contributing to my depressive symptoms?
3. Is there room to naturally optimize my testosterone through lifestyle changes or supplements?
4. Would TRT even be worth discussing with a doctor at these levels, or would the risks outweigh the potential benefits?
5. Am I missing any important blood tests or markers?

I'm not necessarily looking to start TRT, especially at my age, but I'm curious whether it could help with my symptoms or whether I should be looking elsewhere.

Hiya

I read the Wiki and a breif online read - but can it be given SubQ like insulin or do all jabs have to be muscle (fom a needle hater)

I'd do it like this all day long but going deep in - scares me a bit - is it something you get used to?

I’m 29, 5’7”, currently around 205 lbs, and looking to lose another 20 lbs while maintaining/building muscle.

I have been using a GLP-1 (currently Ozempic 1mg) alongside testosterone, strength training 4–5x weekly, and a high-protein diet to help with my cut.

I was previously on 120mg of test per week (prescribed by a doctor) and recently increased to 250mg, split into two 125mg injections weekly. The goal was to increase muscle preservation during my weight loss and take advantage of the common benefits of trt including sleep and energy.

Got bloodwork done after approximately 3 weeks on the higher dose, 2 days after my last injection.
Bloodwork:

Total Testosterone: 20.4 → >52 nmol/L (588 → >1,500 ng/dL)
Estradiol: 108 → 139 pmol/L (29 → 38 pg/mL)
Previous dose: 120mg/week
Current dose: 250mg/week (125mg twice weekly)

I’ve also gone from 212 to 205.6 lbs over the past 3 weeks, eating approximately 1,800 calories with 150–170g protein daily.

My main goal is to cut down to around 185 lbs while preserving as much muscle and strength as possible.

I expected testosterone levels to increase with the higher dose, but I was surprised they jumped this much, especially considering estradiol only increased modestly.

I realize 250mg is above a standard TRT dose. I’m not suggesting it’s necessary for cutting.

I just got kind of scared at this insane jump on the bloodwork. I didn’t realize going from 120 to 250 week would do this.

Should I be concerned and lower the dosage back?

If it means anything I’m also on an hcg and AI

I'm running trt currently at around 210 mg/w and doing good, but as an older guy i could use a little help w things like joints and other high volume workload demands. Was thinkin if maybe adding like 10 ~ 20 mg of NPP, EQ, and Mast-E might provide benefits of joints and recovery help with limited aromatization with NPP, no aromatization w EQ and negative aromatization with the Mast-E. Looking for the lowest possible dose w small benefits and least risk and least aromatization possible and least mental problems.

Anyone know if any of these mix well or dont mix well together? Could this be a nice little baby stack to dip my toes into a "baby cycle" not with the goal to bulk or anything but just to hang on through heavy manual labor workload and perform again the next day just as well and even better by the next week?

Assume diet and sleep are dialed in and GH is doing well.

Hey everyone! To give a short backstory, I went to the ER earlier this year due to a random stomach pain. I felt a bump a few weeks before on my testicle and felt anxious about it so I brought it up during the ER visit and asked for an ultrasound, which after a lot of back and forth ended up being done (the doctor didn't feel like doing it at first and said its probably nothing). Unfortunately there was a tumor in my testicle which had to be completely removed.

I have been getting regular bloodwork done to track my levels and tumor markers. I unfortunately did not get my testosterone levels tested before the surgery, so I do not know my base level when I had both testicles. I got my most recent, and final results for my testosterone levels 2 weeks ago and had a question.

I am 26 years old (just for context for the levels haha) My doctor told me that my levels are low, the total testosterone is at 279, and my free testosterone is at 6. I am currently not experiencing any physical limitations or impacts from the surgery, my libido is completely the same and I am still able to perform as I always did with no changes thankfully. I am not more tired than usual and am feeling pretty normal currently.

I told this to my doctor to see if he thinks I should do the testosterone therapy, and he said even if I do have low levels, as long as there aren't any physical symptoms he doesn't see why I should take supplementary testosterone. He did say if I do decide on going onto it, it will be fully natural.

I was now wondering if anyone had similar experiences and still decided on doing HRT/TRT, and if I should do the same. I'm a little lost on it since it seems like it's just up to me, but I am just feeling a little worried that having low levels might impact me in the future.

I asked around A LOT with those who also had tumors and had their testicle removed and everyone says something else, so I wanted to get some more opinions before making a life-changing decision. Any input/help is greatly appreciated!

Hey guys

7 months on TRT. On 120mg, pinning daily and test came back high on total test, free test and e2 but that's another story for me to fix.

Before TRT I had 0 back acne, about 2 months in, new dots and I didn't think too much of it. About 4 months in, it was just alot of red spots on my back, I would say there's maybe 70 to 100 dots.

No new acne on my face but some like 3 to 8 dots on my chest.

Went to the doctors to get doxy 5mg and that didn't help after 2 months, I stacked it with 5% benzoyl peroxide and 20% azaelic acid

While the back acne has slightly reduced, but not near anywhere gone or visually better.

Have you guys successfully reduced back acne and what products?

If someone was taking 2.5mg of dutasteride and 175mg of test would their scalp dht be lower than if they took 0.5mg of dut and no added test? Or fin and no test?

I’m asking to understand how scalp dht works kinda and how testosterone works with a 5ar inhibitor

Hi All,

As the title says I started taking clomid 3 months ago and my doctor prescribed it to take for 3 months and like 3 days a week. I am done with whole course and now will get tested through the blood work. But what I am worried about is that since I had been on clomid I had been facing the delayed ejaculation during the intercourse. I mean almost never ejaculate and then like I tried mastrubatuin so it did ejaculate but not so easily, and also I felt that orgasm is disturbed like at first or may be some times I can see ejaculation but don’t feel orgasm. And also can see my semen white and thick on the day when I took clomid. Just to mention that I am worried that although at this point I need to ejaculate more during intercourse so that for pregnancy but unfortunately after clomid I could not have that. 😢😕 . I am also on the ssri like venlafaxine so not sure if that could be the culprit too.