New to the community · Dr. Ty Vincent

New to the community

Hey everyone, my name is Jason. I’m new to the community, and I have several detailed questions I’d really appreciate Dr. Vincent’s perspective on.

1. Is TRT aging, and does it damage your skin long term?

I’ve seen people claim that TRT makes your skin age faster, causes wrinkles and destroys collagen. I feel like this could largely be fearmongering because, based on what I’ve researched, properly managed TRT may actually make the skin look better.

Can TRT improve skin thickness, firmness, color or overall appearance? What determines whether someone’s skin improves or worsens?

2. In general, does TRT speed up aging, slow down aging or have little to no effect?

When testosterone and its metabolites are properly managed, does TRT generally accelerate aging, slow certain aspects of aging or have little meaningful impact either way?

Does the answer change when comparing properly managed TRT with excessive anabolic-steroid use?

3. What is the simplest protocol for preserving my hair and fertility?

I’m 25 and want to preserve my hair and remain capable of having children later, but I also don’t want to end up taking four or five different medications or injections unless they’re genuinely necessary.

My priorities are:

Maintaining high testosterone
Keeping estrogen controlled
Preserving my hair
Preserving my fertility
Using as few medications as possible

Realistically, how many different medications or injections would someone with these priorities typically need?

Would I likely need testosterone, HCG, an estrogen-control medication and a hair-loss medication—or could some of those be avoided depending on my bloodwork and response?

Does HCG need to be used continuously to preserve fertility, or can fertility generally be restored later when I’m ready to have children?

4. Are there legitimate health problems associated with properly managed TRT, or is most of the concern fearmongering?

The more I research TRT, the more it seems that chronically low testosterone may carry more health risks than properly managed high testosterone.

One specific concern I have is hemoglobin and hematocrit. I understand that TRT can raise red-blood-cell levels, and I’m worried that my regular doctor may see an elevated result, become alarmed and immediately tell me to stop TRT—even if the increase is expected and not genuinely dangerous.

How should hemoglobin and hematocrit be interpreted in men using TRT? At what levels would you personally become concerned, and how do you distinguish an expected TRT-related increase from something that actually requires intervention?

If my regular doctor “flips out” over the result, what information should I discuss with them so the situation is evaluated in the proper context?

More broadly, which health concerns surrounding TRT are legitimate, and which are primarily based on outdated information, poor monitoring, inappropriate dosing or comparisons with anabolic-steroid abuse?

5. Could correcting my hormones significantly improve my anxiety and depersonalization?

This is probably the most important question for me.

I’ve experienced severe depersonalization, dissociation, anxiety and social anxiety for years. There were periods when my anxiety was so intense that I could barely leave my house. I feel dissociated virtually 24/7 and have lived in a chronic fight-or-flight or freeze state for a long time.

I’ve read numerous testimonials from men who experienced similar problems and said TRT dramatically reduced or completely eliminated their anxiety and depersonalization. Those stories have given me considerable hope.

If hormonal dysfunction has been contributing to these symptoms, is it possible that getting my hormones back where they should be could allow the anxiety and dissociation to dissolve? What have you personally observed in patients with similar symptoms?

6. How much muscle and physical improvement could I realistically experience?

I’m 6’1” and approximately 185 pounds. I can train six days per week, eat extremely clean, maintain a strong sleep schedule, avoid processed foods and abstain from alcohol and recreational drugs.

Despite doing everything correctly, I still feel exhausted and struggle with basic tasks, training and recovery regardless of how hard I push myself.

I realize the answer depends on dosage, genetics, training and nutrition, but what would be a realistic expectation for changes in: