Before & After Testosterone Replacement Therapy

Before and after TRT

Before & After Testosterone Replacement Therapy


After taking a routine blood test at the tender age of 28 I discovered I had the testosterone levels of an 80 year old man.

The result blindsided and distressed me for weeks.

I was supposedly in the prime of my life. And yet my testosterone levels were little better than a geriatric woman…

At first, I actually felt embarrassed by the result – as though I were less of a man because of it.

Men are supposed to have high testosterone levels, right?

Although in truth, for a long time before that I had felt like a shadow of a man.

Among many other things, I was depressed, anxious and had zero sex drive.

Though the test result initially shocked and disturbed me, it was truly a blessing in disguise. It proved to me that my symptoms were due to low testosterone.

It wasn’t a reflection of me as a person.

This served as a catalyst for dramatic change in my life, and ultimately led to me undergoing testosterone replacement therapy over three years ago.

In this article I’ll share my experience of before and after TRT with you – my journey from the diagnosis of low testosterone to undergoing testosterone replacement therapy.

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ADAM Questionnaire

Low Testosterone Test

The ADAM questionnaire has been shown to have 88% sensitivity in testing for low testosterone.

My Health, My Responsibility

First off, allow me to clarify one thing. I didn’t discover that I had low testosterone by accident. In fact, I had been taking yearly blood tests for a few years up until that point. This has allowed me to see the huge difference in blood results from before and after TRT.

I recognized early on that my health was my duty and sole responsibility. Too many people rely on others to be the guardians of their health.

Their doctor, families, spouse, etc.

When something goes wrong, they blame someone else for not ‘finding the problem.’ And they would only take action when disease strikes.

But by then it’s often too late.

This reactive mindset never made sense to me. I wanted to prevent things happening in the first place. I wanted to live the best quality of life possible and knew optimal health was integral to this.

And by this stage, I had identified testosterone as the centrepiece to optimal health.

I had been listening to podcasts and reading books. I remember reading my friend Jay Campbell’s magnum opus on testosterone therapy, the TRT MANual. I read it from cover to cover and absorbed every minute detail.

Originally, I thought blood tests were just for older guys. However, he made it clear that men of every age should take regular blood tests; regardless of your age.

As a result, I made sure I got a full hormone panel on every blood test I took. This included markers such as total testosterone, SHBG, oestradiol (oestrogen) and free testosterone.

Although in their paternalistic, ‘I know best manner,’ doctors would try to dissuade me and say things like, “You don’t need to worry about testosterone at your age!”

Nevertheless, I was adamant, and respectfully insisted they include it.

Before TRT – Low Testosterone: The Elephant in the Room

As mentioned, discovering I had low testosterone was a huge shock to me.

Though by the same token, it also served as a massive wake up call.

After getting the result it dawned on me how bad my life had become over the past year.

I felt depressed almost all the time; I was in a constant rut, and struggled to see the positive side of things.

Prior to this however, I was a happy go lucky kind of guy; always laughing and joking.

In addition to the depression, I had a gnawing, daily anxiety that ate away at me.

Trivial things I would normally pay no heed to suddenly became big ordeals. I would worry and overthink almost everything.

Not only did I suffer many sleepless nights, but I also felt drained of energy and confidence.

I also struggled badly with my sex drive. Looking back, more than anything I think this affected me most.

As a man, your sex drive is key to your identity. Once it’s taken away you feel like a shadow of your former self.

I would go weeks without feeling any sexual desire. And when sex did happen, it felt more like an ordeal that sapped my energy, instead of an enjoyable, intimate experience.

On top of this, I trained seriously in the gym; squats, deadlifts, bench, etc., but my progress completely stalled. I had tried everything, but nothing seemed to work, and I couldn’t explain it. I figured that my diet wasn’t up to scratch or that I had reached my ‘genetic potential.’

To be honest, I could talk all day about all the ways my life had taken a nosedive.

Until you have gone through it yourself, you can’t fully appreciate how hormonal imbalance can derail your life.

Indeed, some of the most understanding and competent doctors I have met that specialise in hormone therapy also went through low testosterone themselves.

Coincidence? I think not.

Although I knew what the symptoms of low testosterone were, it just didn’t occur to me that I might have them. At 28 years old, I didn’t think it was something I needed to worry about.

But like a thief in the night, the symptoms crept up on me over time – almost imperceptibly so.

As a result, I developed a strange kind of Stockholm syndrome, whereby these symptoms became a part of my identity.

Strange as it sounds, finding out that I had low testosterone was almost a good thing. Finally, everything in my life made sense. If you know what your problem is, that means you can do something about it.

Though at that time I wasn’t entirely sure what the next step might be…

Blood Test

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Undergoing Testosterone Replacement Therapy

After getting my low testosterone diagnosis, I took stock of my situation.

I didn’t smoke, take drugs or even drink alcohol. My diet was very clean. My life was generally low stress and I slept a fair amount.

Nutrition, sleep and stress levels are all key to testosterone production.

Therefore, I didn’t think there was much more I could do to improve my situation – at least naturally. It appeared as though undergoing testosterone replacement therapy (TRT) to optimise my testosterone levels was the only viable option.

Although at this point I want to make clear that TRT is not for everyone. Most men would do well to improve all aspects of their lifestyle first, i.e. improve sleep, nutrition, and mitigate stress levels, before considering TRT.

I immersed myself in research and read endless books and studies. I reasoned that if I was going to do this, I wanted to understand the subject as best I could.

Eventually, I reached a stage where I felt like I knew more on TRT than my GP. And to be honest, I felt forced to this.

At the time, and still today, most doctors simply do not know enough about hormone replacement therapy.

Many have preconceived notions about who qualifies for treatment and who doesn’t. This is especially true if you are a young man.

So even if you have low testosterone and the symptoms to go with it, they dismiss you out of hand and say things like, “You’re too young to worry about testosterone!”

Though my local GP was quite progressive and open-minded. To my surprise, I actually qualified for treatment on the NHS because of my low free testosterone level. The GP told me he would refer to an endocrinologist – but the wait time was six months.

I declined the offer for a few reasons.

First, I didn’t want to carry on living like this for another six months. Even if I did wait, I had heard mixed reviews about endocrinologists who were unsympathetic to men with low testosterone.

Plus, the NHS was stuck in the dark ages when it comes to testosterone replacement therapy. They cling dogmatically to outdated practices that say an injection every two-three weeks is OK.

Treatment protocols like this raise your testosterone levels for the first few days. Then they drop off and you have to wait until the next injection.

This period can be very unpleasant and for me it defeats the whole purpose of undergoing hormonal therapy:


Many people in the UK have some sort of hang-up about paying out of their own pocket for their health. However, the way I see it, if the NHS wasn’t willing to help me then I had to help myself.

I didn’t want to carry on living such a miserable existence. Yet so many men will avoid going on private treatment because they don’t want to pay for it. I don’t understand this mentality.

Fortunately, I managed to find a progressive doctor who was willing to treat me. And initially, we agreed that I would go on Clomid (i.e. clomiphene citrate).

However, based on my research and speaking to other TRT patients, I felt like injectable testosterone was the right choice for me.

Before and After TRT

Results after 10 months on TRT for another Optimale patient – Mathew S


After TRT – A New Man Again

Within weeks of going on treatment I felt incredible. The difference between before and after TRT was astonishing. Though I don’t just mean in my body; words can’t express how good it felt to feel NORMAL again…

’So this is how it means to feel like a man! I’m not supposed to feel like I live in my own shadow all the time.’

I felt more positive and much calmer. The depression and anxiety that had been a persistent thorn in my side now vanished almost overnight.

I felt much more driven to go after what I wanted in life. Where before, my self-belief and confidence had vanished along with my testosterone levels.

Within a few months of undergoing I decided to move to quit my job and move to Spain. Although this was no spur of the moment, impulsive decision brought on my testosterone.

Far from it – in fact, I had wanted to do this for a long time. I simply didn’t have the courage to do it. Testosterone and hormonal balance simply gave me the will to carry through with my decisions.

In short, I felt like a MAN again.

In addition to the above, my results in the gym were finally commensurate with my efforts. I had trained hard for over a year, but with nothing to show for it. I felt discouraged and was beginning to question my sanity.

But now as a result of my training, I began to see results. Within a year, I had gained over 10 lbs of lean muscle mass. My before and after TRT pictures are testament to this.


The picture of me on the left is the day I started testosterone replacement therapy. They say the eyes are the window to the soul, and you can see it written all over my face.

I was a scared, anxious and unsure of myself. While I didn’t look bad at all, my physique simply reflect my efforts.

The picture on the right is me six months later. I am far more confident and self-assured. But not only that, my physique has changed dramatically. This is the power of hormonal balance.

Final Thoughts on Before and After TRT

Words cannot accurately express how grateful I am for undergoing testosterone replacement therapy. It completely turned my life around.

Prior to that I was in a dark place and didn’t think there was a way out.

Truth be told, there were times where I didn’t care whether I lived or died. No matter how hard I tried, I felt no enjoyment for life. I was so lost and desperate.

Testosterone gave me my life back. And at 32 years old, I feel better than ever.

As a result of my experience, I wrote a book, Optimized Under 35, to educate men on how to raise their testosterone naturally and safely, and if necessary, how to seek treatment.

Nevertheless, I want to take this opportunity to emphasise that my experience is not completely typical.

Many men see testosterone replacement therapy as some kind of panacea that will fix all their problems. Just by virtue of taking testosterone doesn’t mean my problems vanished overnight.

I am not superman and still go through the ups and downs of life.

I still had to put in a massive amount of work into my diet, lifestyle and training. I didn’t drink alcohol, take drugs and my nutrition was excellent.

And lest I am misunderstood, allow me to make it crystal clear:

If you don’t have these foundations in place, testosterone will do very little for you.

Testosterone replacement therapy is not something you simply take for a few months as a ‘top up’ as some men erroneously believe.

This is a lifelong medication and so requires a lifelong commitment, and in some cases, a reality check. You must decide whether this is something you truly need.

You must satisfy two requirements for TRT to work for you.

First, you must have a clinical need, i.e. low testosterone as verified by blood tests and the symptoms to go with it. Second, the desire and commitment to do what it takes to improve your lifestyle as described above.

If that describes you, testosterone replacement therapy could be life-changing for you.

If you want to find out more about TRT and see whether it might be right for you, contact Optimale today.

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