The Truth About TRT: Who Actually Needs It (And Who Doesn’t)

Testosterone Replacement Therapy (TRT) has been growing in popularity, and for good reason. As men age, testosterone levels naturally decline, which can lead to lower energy, decreased muscle mass, and even a dip in libido. But is TRT the magic bullet that some claim, or is it a one-way ticket to lifelong needle dependency?

To break this down, we’re leaning on insights from two guys who know their stuff—Derek from More Plates More Dates and Dr. Mike Israetel from Renaissance Periodization. These guys aren’t here to sell you on TRT, but rather to give a no-BS take on what it actually is, who it might help, and the potential downsides. Let’s dive in.

What Exactly is TRT?

Dr. Mike lays it out simply: TRT is testosterone replacement therapy, meaning it’s used to replace testosterone that your body isn’t producing enough of. It’s not meant to turn you into a shredded Greek god. If you’re clinically low on testosterone (hypogonadal), TRT can bring you back up to a normal, healthy level, improving energy, mood, and muscle retention.

But if you already produce normal amounts of testosterone, injecting more isn’t “replacement therapy” anymore—it’s enhancement therapy, or in Derek’s words, “being on that good s***.” And that comes with some trade-offs.

Who Might Actually Benefit from TRT?

If you’re truly hypogonadal—meaning your testosterone levels are below 300 ng/dL—then TRT can be a game-changer. Dr. Mike points out that guys in this category often experience:

• Increased libido (yes, that means better “performance”)

• Better mood and sleep

• More muscle, less fat

• Improved energy levels and cognitive function

For these guys, bringing testosterone levels back up can restore quality of life and even improve health markers like blood work. Derek also notes that being deficient in testosterone can actually put you at higher risk for cardiovascular disease and neurodegeneration, so in some cases, TRT isn’t just about feeling better—it’s about long-term health.

But here’s the thing: If you’re not hypogonadal and you jump on TRT thinking it’ll turn you into a superhero, you’re actually making yourself less healthy by shutting down your natural testosterone production for no good reason.

What Happens When Normal Guys Take TRT?

Dr. Mike doesn’t sugarcoat this: If you already have normal testosterone levels (somewhere between 300-1,000 ng/dL), nothing significant happens when you take TRT. Your testosterone levels just stay about the same, except now you’re dependent on injections instead of your body producing it naturally.

But here’s where things get sketchy. Some “doctors” will prescribe TRT at the high end of normal or even above it (800-1,200 ng/dL+), which starts moving into enhancement territory. This is when guys start seeing real benefits—increased muscle mass, fat loss, more energy, higher libido—but also more risks.

Derek points out that being in a super-physiological state isn’t good for long-term health. The bigger you are, the more stress you put on your organs. He even jokes that a small Asian grandma is probably going to outlive a massive bodybuilder every time—because longevity isn’t about being the most jacked guy in the room.

The Downsides of TRT (It’s Not Just the Needle)

Both Derek and Dr. Mike agree: TRT isn’t a free ride. Even if it helps with energy and muscle, it comes with some serious baggage:

• Lifelong Commitment – Once you start TRT, your natural testosterone production shuts down. If you ever decide to stop, you could be dealing with months (or even longer) of low testosterone symptoms before your body recovers—if it ever does.

• Frequent Injections – You’re either stabbing yourself once or twice a week or dealing with daily micro-doses using insulin needles. Oh, and if you’re traveling? You better pack your meds and deal with airport security side-eye.

• Potential Side Effects – Depending on genetics, you might get:

  • Acne and oily skin

  • Hair loss (on your head) but hair growth everywhere else

  • Increased aggression and mood swings

  • Possible cardiovascular risks if taken in high doses

• Mood Swings & Fluctuations – Unlike natural testosterone, which stays stable, TRT comes in peaks and valleys, meaning you might feel superhuman right after an injection and meh when it starts wearing off.

Dr. Mike also emphasizes that if you don’t have symptoms of low T, there’s zero reason to start TRT. It’s like bringing sand to the beach—totally unnecessary and a waste of money.

Should You Do It? (A Reality Check)

Here’s the big takeaway from both Derek and Dr. Mike: TRT is not something to take lightly. If your testosterone is actually low and it’s affecting your life in major ways, talk to a doctor who isn’t just trying to sell you a prescription. But if you’re in a normal range and just chasing better gym gains or a libido boost? It’s probably not worth the long-term trade-offs.

In fact, Derek warns that many guys assume that slightly low testosterone = TRT is necessary, but in reality, Androgen sensitivity matters way more than your raw numbers. Some guys can function great at 350 ng/dL, while others might feel awful at 600 ng/dL. Symptoms matter more than numbers.

TRT can be life-changing for men who truly need it, but it’s not a casual decision. If you start, you’re likely on it for life. It comes with benefits, but also side effects, costs, and risks.

If you think you might have low T, get tested, look at symptoms, and talk to a legit doctor. Don’t just hop on TRT because some influencer or clinic tells you it’s the key to eternal youth. And if your levels are normal and you’re just looking for a boost? There are far better ways to optimize your testosterone naturally—sleep, diet, resistance training, and stress management all play a huge role.

Make smart choices, and don’t let the hype suck you in.

I’m here to support you on your journey to a healthier, fitter life. As always, I appreciate your feedback and suggestions. Let me know what topics you’d like me to cover in future issues by replying to this email.

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Be well,

Dave

Please note: This newsletter is designed for informational purposes only and should not be taken as professional medical advice. Always consult with a healthcare provider for advice tailored to your health and fitness needs.