My Unexpected Journey to Hormone Replacement (TRT)

As a man of Science, I’m supposed to hide my enthusiasm about this somewhat controversial subject, and instead direct you only to the peer-reviewed studies. 

But man, I feel like I’ve stumbled upon the fountain of youth here. And the more I dig into the details and the hype and controversy surrounding the field of Hormone Replacement therapy, the more I need to share the word about it to my fellow middle-aged people (both men and women). 

But first a quick backstory:

I’ve been interested in optimization and trying to get the most out of my body and mind since I was a little kid. I started vacuuming up all the training and nutrition books and magazines I could find while I was just a teenager, and that field still remains a favorite of mine over 30 years later. And if you’re a long-time reader here you’ve been reminded plenty of times of this interest, because health has always been the very heart of Mustachianism.

But a funny thing has been happening in the last ten years: even as I kept honing the healthy living habits and trying my best to improve, there seemed to be a force pulling me back almost as hard. So despite working a bit harder and smarter every year, I still felt myself riding a gradually declining tide of energy, motivation, and physical stamina. 

“Perhaps this is just what it means to grow old”, I thought to myself, 

“But I’m still gonna keep fighting it!”

Yet there was one thing that didn’t quite fit. Why was I having this decline in energy, when some of my older friends weren’t? And why was I still seeing people out there in their 50s, 60s and well beyond doing things that I felt too tired to do today?

Long story short: his ideas planted a seed in my head, which led to a bunch of research and a growing interest in trying TRT myself. I had of course heard about the process, but for some reason never considered doing it until I heard Kevin’s enthusiasm: he had been on it for several years, and according to him it is a “night and day difference” in all the things you want in life: energy, focus, thinking speed, and of course physical health.

Another convenient twist of fate is that I happen to be dating an REI doctor – a Reproductive Endocrinologist and Infertility specialist who has two board certifications in exactly the relevant bodily systems that are affected by these hormones. And while she was initially skeptical that I needed more Testosterone (and in her practice she regularly sees the downsides of men taking the stuff too early in life and thus compromising their own fertility), she has followed along and helped me learn at each step of this process, eventually becoming fully in support of the program.

So I signed up as a test customer for Kevin’s new company, which is called Bolt Health. I worked with their doctor to get a baseline blood test and review my numbers compared to all the past tests I’ve collected, and as it turned out, my levels had been dropping consistently over the years, and the latest test was by far the lowest ever. 

Even more telling, my age-related drop in Testosterone was correlating perfectly with my decline in energy and motivation:

The next step was a prescription for a tiny daily dose of supplemental T, which arrived at my house the next week along with instructions for how to use it. And so began the journey.

Now let’s jump forward seven months to the present day as I write this.

And wow, what a great year it has been! I only wish I had known and tried this a few years earlier, because I’m getting a lot more out of my life. 

It’s not a night-and-day difference for me, but more like a 50% boost in overall youthfulness and energy. The biggest subjective change is that I just don’t have sucky tired days anymore, which was the main problem with my life before: wasting too much of my precious freedom due to not having the energy to enjoy it.

This is why I’ve become somewhat of an evangelist for hormone replacement therapy for people from about age 45 onwards. It won’t work for everyone – if your levels are already pretty high, you don’t get the same boost. Two of my male friends tried TRT and quit because they didn’t notice any benefit. But these same two guys already had plenty of energy to begin with, which is usually a sign that the body has what it needs.

TRT’s Sketchy Reputation

It turns out I am very late to this party. Although Testosterone supplementation started out as a niche practice in the 1940s, from the 2010s onward it has been everywhere.

TRT is the reason you see every actor suddenly showing up buff overnight for their superhero roles and it’s also why so many of today’s CEOs don’t look anything like yesterday’s CEOs.

 In many cases, it has gone too far with young men using it just to gain muscle for the beach or the football field, and questionable online providers (aka “Prescription Mills”) handing out prescriptions to anyone with a valid credit card – with profit as their sole motive. It became overhyped in certain pockets of Bro Culture, where every Bro eventually receives the advice “Bro! You need to get on the T!” from another Bro, and therefore does it. And some of this reputation surely contributed to my own skepticism.

But there’s a lot of valid science behind TRT, if you’re the right candidate and you take the right dosage. And because of that, I feel it is probably under-hyped in my own demographic, the Nerdy Tech Worker Semi Retired Dad contingent. And that’s why I’m writing this blog post, because there are a lot of us out there. 

Many of us just tend to work with what we were given, and accept that aging means slowing down. And for those of us already enjoying an early retirement, we have the option of unlimited rest and recuperation time, so who really cares if we get tired a bit more often? After all, what better way to flex one’s wealth than with a decadent Tuesday Afternoon Nap while everyone else is stuck in the office?

While this seemingly healthy attitude has a lot of positive aspects, it can also mask a real problem which may be easily fixable. Because sometimes, the only thing that’s even better than an afternoon nap, is having the energy and motivation to go out for an afternoon hike, bike ride or adventure with friends. More energy is also pretty darned useful if you’re still raising kids or trying to do well in your career as a person over 45.

How it Actually Works (and What Happened to Me)

Distilling all of the fluffy discussion above into the simplest possible answer: TRT means using a tiny needle to inject a few drops of clear liquid just below the surface of your skin. And you do this by yourself at home, ideally once every morning.

Here’s one of the baby needles I use for my daily dose.
The typical serving is less than one tenth of a milliliter, which is only a few drops.

And while the term “needle” sounds scary to some, this is very different from the monstrosities they use to draw blood from your veins. This one is so miniature that you don’t need special training to use it, and you usually don’t even feel it.

So I began doing this to myself on May 1st of this year, while keeping a daily journal of my results along the way. The results seemed to be almost immediate in all the promised areas, but I know how powerful the Placebo Effect can be so I kept my skeptic’s hat on to see what would happen in the long run.

I was seeing increased energy and motivation as well as lean weight gain through the whole spring and summer, but I remember the first truly shocking observation happened during a mountain vacation in July. I was part of a multi-family trip with lively adults, chaotic kids, early mornings, late nights with a few drinks, very intense high altitude sunshine and nonstop physical activities. It was just the type of situation that would drain my energy pretty quickly in the past. 

But on day three I went out on a solo mountain bike ride to explore the area, and as I was climbing a long ascent with the blazing sun cooking me from every angle I just somehow kept having plenty of energy to keep climbing. Then I came down and joined the group for a few games of full-sun pickleball, biked back up the mountain to our cabin, and the story of unlimited energy went on from there.

“Hot Damn”, I thought to myself, “I don’t know whose youthful and tireless body I have inherited here but I’d sure like to keep it!”

In August, the Bolt Health program scheduled a follow-up blood test for me and sure enough, my Testosterone levels had been boosted from 415 to 730ng/dL, bringing me from the low side of normal to the higher side.

 Many labs define “normal” as anywhere between 300 and 1000, which seems strange to me given the huge effect this hormone has on your wellbeing. It’s a bit like saying “Most cars have between 90 and 300 horsepower, so it doesn’t really matter what engine you have” 

I mean yeah, either one will still get you down the road, but which one would you rather be driving?

Since then, it has just been more of the same good results. My improvements ramped up and then just stayed there – so I’m operating at a new, much higher and more enjoyable level of functioning. Energy and motivation are no longer a problem, and I even find myself willing to make longer-term plans again (before this everything beyond same-day planning felt overwhelming). And my body seems to just want to gain strength and size with any excuse. Heavy weights feel lighter and the hard manual labor I still like to spend my time on feels easier for longer. It’s nice to be young again!

So Why Doesn’t Everyone Do This?

When you dig into the details, hormone replacement is mired in a soup of both real and incorrect information about both its benefits and its risks. And then our well-meaning medical establishment locks this whole container of soup deep in the cabinet with a label that says, “Needs Further Study”. But if you summarize the findings on both sides of the issue, you’ll see this:

Stuff you should do BEFORE trying TRT:

The modern American Lifestyle is a Testosterone and Health Crusher. It’s a miracle that anybody feels good ever with the crap that people do to their bodies. So if you’re not already doing all the simple, natural, outdoor things that naturally boost your health, energy, and hormone levels, you’ll want to start with these first. You can find a pretty complete list on my oft-cited Badassity Tracker page.

Since I was already doing all of these things pretty consistently, I felt ready to take the next step and at least consider hormone supplementation. But wait, there’s more!

Risks of TRT:

• Decreased fertility for men hoping to conceive
• Increased production of red blood cells, which may increase the risk of blood clots for people with certain risk factors (a good provider should screen you for these risks before prescribing)
• Potential worsening of certain prostate conditions if you already have them
• Mood fluctuations and acne, especially if the dosing is way off.

The Importance of Dosing:

Many of the problems above are more likely to appear when the body is flooded with too much testosterone. In the bad old days, TRT was administered by sticking a pellet beneath your skin or injecting a large amount into the butt which then gets used up over the next several weeks. One friend recounted a story of extreme moodiness when the pellet was first implanted, ramping down to tiredness by the time the hormone was all gone.

More modern providers like Bolt have fixed this problem by breaking the dose into much smaller servings which you administer each day. The idea is that your levels remain stable, and you need a lot less overall which reduces side effects.

For my part, I have not had any of the negative side effects because I was a pretty ideal candidate in the first place: 50 years old with depressed Testosterone levels but an otherwise healthy lifestyle and no risk factors.

The Internet TRT Police

My hope in sharing this article is to be transparent and hopefully take some of the stigma out of this subject of other people who might benefit. Because in our modern over-connected world, everybody has an opinion on your life, even when you didn’t ask them.

And it’s not just men – many women in this same age group benefit from Estrogen replacement (and there are even interesting stories about female testosterone supplementation in certain situations as this author shares). The point is that aging is normal, but in some cases there’s a pretty easy way to make it slower

How Much Does this Cost?

The great news is that Testosterone itself is a cheap and widely available substance, typically under $50 per month even for people like me without conventional insurance or drug coverage. The expensive part (here in the US) is just the doctor stuff – consultations, blood tests, ongoing analysis and prescription renewals and so on. 

The company that I used is positioned as a premium provider, bundling these services along with a bunch of other men’s health perks and deliveries for a few hundred dollars, which is expensive relative to most other parts of my budget, but still cheap if I consider the life and financial benefits of being 20-50% more energetic and productive. 

If you want to be on this program, your final decision will hinge on your income, insurance coverage if applicable, whether your existing doctor can already help you, and how much service and advice you’re willing to pay for. 

Note: I decided not to become a Bolt health affiliate because I wanted to write this article without conflict of interest. And I can honestly say, Bolt’s product and service seem great to me because I know and trust the people who run it. But  it’s also the only one I’ve tried. So I don’t know much about the competition and there may be other good options out there. At the very minimum, you can always try one service and switch to another if you don’t like the first one.

The Bottom Line

I’ve got lots more to say on money and early retirement, and lots of interesting projects in the works now too. So I’m thankful to have stumbled upon this booster for all aspects of life, so I can do more of everything else, for even more decades than I had expected. 

I wish this same type of good fortune for you, however you create it.

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In the Comments: Do you have questions about hormone replacement or anything else in this article? I’ll try to invite Kevin, Dr. Sean Bender and other knowledgeable people to contribute and answer questions as well.

Further Reading:

Is testosterone therapy safe- Take a breath before you take the plunge – Harvard Health (2024)
Cardiovascular Safety of Testosterone Therapy (aka the TRAVERSE Study) (2023)
TRT – Association with Mortality in High Risk Subgroups (2023)
Bolt Health website – if you do decide to go with this company, be sure to ask for their best discount even though it’s not related to me.