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.

Drs wanting me to do 50mg weekly. I was hoping to do 3 times a week instead of weekly but was wondering since dose is low would that even do anything being roughly 17mg every other day?

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

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?

I am at the second week of testosteron ,

Until now 3 injections of 125mg, tomorrow the 4th .

(I do wed and sunday injections of 125mg).

I'm in light surplus, First week I loose 0,5kg, and in the last 4 days I gained 3kg) . I feel ok at the mirror , a bit fuller.

In Gym I start to push a bit stronger gaining some reps in some exercises.

But now the problem: I Have Low libido and I feel already my balls "off" ..

Whats your opinions? I was thinking tondo the bloodwork at 5th week but maybe I Need them before.

Thanks guys

Is taking trt with 6000iu/week of HCG + 450iu/week of FSH going to work for fertility?

Partner has been taking testosterone for about 3 years (history of steroid use starting very young). 2 years ago had 0 sperm count.

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

Hi all,

On my first cycle of testosterone and want to know the best approach for cycling. I am 15 weeks in at 350mg/week split in 2 doses. Was planning to come off after 16 weeks. I want to try maintain fertility to try for another kid in 1-2 years. I was planning to do 16 week on/8 week off cycles.

Do i need PCT in those 8 week off periods ? I have purchased 20mg nolvadex pills, and i have been taking 500iu hcg on the days i pin test.

Just want to know best approach. Should i go to a cruise dose? Come off completely? My main concerns are future fertility.

Noting at my last blood work (5 weeks ago) my FSH and LH were completely suppressed.

Appreciate the advice here!

If I was to run a 400-500mg test Cyp cycle for 16-20 weeks. And say bloodwork was good. How long should use enclomiphene to PCT ?

I have some Hcg that’s expired on 8-22-26. Is it still good to use?

Been on test for 10 months. Gain about 14lbs in muscle while leaning out. Mood is better too. Work out 4-5x a week and my diet is better than what it was. Not perfect dialed in but a def improvement. But over that past almost year I can say my interest in sec has gone way down to where I really don’t care too much anymore if it happens or not. I do take tadalafil too as needed. But even then I just don’t really have a care for it. When the wife and I do have sex it’s fun but a quickly lose interest and lose my erection to half stiff. But it doesn’t bother me if I don’t finish and if I do then cool. Anyone else have this experience?

I wouldn’t call it an issue cause again it’s getting to the point where it doesn’t bother me. It did used to yea. Married 13 years and wife and I typically do have an active sex lifestyle.

Yes I find my wife attractive. No am not gay or bi. No I don’t take interest in men. No I don’t watch porn.

I've had three separate tests now all have come back low. One was done by the NHS, but I was just in range so they won't treat me.

Should I consider going private? And has anyone tried Voy or numen trt?

Just curious to hear people’s experiences. I’m about to start my first cycle and would love to hear how much strength people put on in their first cycle.

Right now I’m 170lb and can bench press 200lb (I hit 225 once but that was years ago). I plan to do a baby cycle first (250-300mg) for 16 weeks

My total T has been testing around 250-350 since I was 18 and now Im 32 with similar levels. I've never been super manly looking and puberty was slow. I have a sex drive but I wouldnt say it's amazing and I also have loads of social anxiety. Morning wood isn't consistent.

Ive seen a few docs over the years and they all say Im fine because free test is normal which seems to be the consensus from docs online as well. I saw a new endo who said she would be willing to give me trt based off the total but I feel conflicted if it's just a waste of time and effort and if it will even change anything.

January 1st-today
Added Reta and down 30 pounds while holding muscle.
150mg split twice a week
Honestly played around with higher doses through the year but back to TRT dose and happy with the progress and my over all sense of well being.
More isn’t always better in my opinion.

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,

Like the title says, I’m kind of confused about how urgent it is to take an AI when your estrogen goes up. I get the basic idea. If your E2 is high you take an AI to bring it down and avoid the sides, mainly gyno. What I don’t get is how you’re actually supposed to go about it.

Let’s say I start getting symptoms. Do I go get blood work first, wait the few days for results, and then decide? Or is it urgent enough that if the symptoms are pretty clear I should just take it? And honestly, how do you even know for sure it’s high E and not something else?

Also, is this a one and done thing where you take it once after bloods and then just wait until it happens again? Or do you have to run it for multiple days or even weeks? If it’s ongoing, how often are you taking it and when do you know to stop?

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.

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.

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?

Mid-40s andI have all the classic symptoms of low T (fatugue, muscle loss, weight gain, sleep issues, etc., but no loss of libido). So I paid out of pocket through Justlabs to get a testosterone test done through Quest. My results are back. Definitely low. I'm trying to figure out how low this is and options. I sent this to my doctor and asked for an appointment. I'm sure I'll have to do another confirmational blood test. Looking for opinions and thoughts.

TESTOSTERONE, TOTAL, MS: 124

TESTOSTERONE, FREE: 26.4

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!

I’m on prescribed TRT at 100 mg/week, with testosterone around 1,000. I’ve been lifting for 4 months and am currently cutting while making good progress, likely from newbie gains and TRT.

When I start bulking, I’m considering doing my first blast to add serious muscle. For those who have experience, what should I know about the risks and monitoring? I also want to understand how that could affect my bloodwork and prescribed TRT management.