Episode Summary: E245 – What It’s Really Like to Start TRT: Xander’s Testosterone Journey

Podcast: Pillow Talks
Hosts: Vanessa & Xander Marin
Date: January 29, 2026

Overview

In this highly requested, deeply personal episode, Xander and Vanessa Marin dive into Xander’s journey with Testosterone Replacement Therapy (TRT). From investigating his nagging energy issues to the nitty-gritty realities of treatment, they candidly walk listeners through the physical, emotional, and relational impacts of testosterone replacement. Their trademark open, honest, and slightly nerdy style makes this both an informative and entertaining conversation, busting stigma around men’s health choices and giving practical insights for anyone curious about TRT.

Main Discussion Points & Insights

1. Why Xander Considered Testosterone Therapy

• Primary Symptom:
  • Xander noticed a persistent lack of energy and a sense of lethargy dating back possibly to post-college years.
  • “I remember kind of always just being tired a lot and taking a lot of extra motivation to, like, get myself to want to, you know, go out or be up late.” – Xander (04:39)
• Not About Libido:
  • Contrary to common assumptions, his main concern was NOT low sex drive.
• Trigger for Seeking Help:
  • After getting sober, he felt he had “no more excuses” for feeling less than his best.
• Role of Functional Medicine:
  • Xander turned to a functional medicine doctor known for a whole-person, root-cause-oriented approach with extensive blood work.

2. Testing, Diagnosis, and the Problem with “Normal” Ranges

• Getting Tested:
  • Functional medicine routinely checks hormone panels, unlike most primary care physicians who typically test testosterone only in cases of pronounced sexual symptoms.
• What’s “Normal” vs. Optimal:
  • Lab-reported US “normal” range for total testosterone: 250–1100.
  • “What we consider the normal range in the U.S., personally, I think is kind of bullshit… Within that there’s probably a more ideal range.” – Xander (12:04)
• Symptoms vs. Numbers:
  • Western medicine usually treats only clear-cut hypogonadism (total T <300 + symptoms), dismissing lower “mid-normal” levels that may still impact well-being.
• Xander’s Numbers:
  • His testosterone fluctuated 425–275 pre-treatment, not low enough to flag under most standards but far from “optimal” (800+ for his activity level).

3. Exploring Non-Pharmaceutical Options First

• Lifestyle Audit:
  • “How are your stress levels? What does your diet look like? Are you getting enough sleep?” (16:43)
• Efforts Tried:
  • Stress management, sleep hygiene, genetic-based supplements, consistent weight training with heavy weights, DHEA, Tongkat Ali. None provided substantial benefits.
• Insight:
  • “Medications aren’t a magic bullet… Especially a lot of stuff related to libido is really about us needing to examine our lifestyle.” – Vanessa (15:55)

4. TRT Treatment: Methods, Experiences & Adjustments

A. Cream ([21:20])

• Started with Topical Testosterone Cream:
  • Pros: No needles, easy to apply
  • Cons: Annoying timing, risk of accidental transfer to partner, didn’t ultimately increase levels—actually caused a decline (due to suppression of natural production).
• Memorable Moment:
  • “You had one blood work where you kind of had, like, spike… Women’s testosterone levels are supposed to be way, way lower than men.” – Xander (25:31)

B. Clomid Pills ([27:52])

• Mechanism:
  • Stimulates body’s own production, preserves fertility
  • “Another benefit to Clomid is that it supposedly does not decrease your fertility level. So that's a huge consideration with testosterone.” – Xander
• Challenges:
  • Difficult insurance, unpredictable cost, inconsistent supply, and led to an unhealthy spike in estrogen (cancelling out testosterone’s benefits).
• Key Epiphany:
  • “I had, like, two weeks where I felt, like, better than I had ever felt in my life up to that point.” – Xander, recalling a perfect T/E ratio in Chile ([31:50])

C. Injections ([32:36])

• Transitioning to Injections:
  • Initially daunting: “The first couple of times I needed to inject myself, all of a sudden I was like, oh my God, this is really real and kind of scary. It’s a trip, man.” – Xander
• Self-Injection Techniques:
  • Settled on thigh intramuscular injections, soon transitioning to daily subcutaneous injections (less painful, more stable levels) ([36:07])
• Practical Notes:
  • Testosterone cypionate is viscous, requiring a thick needle.

D. Estrogen Blockers ([38:02])

• Need for Balance:
  • Increasing T can elevate estrogen (“aromatization”), so he supplements with anastrozole (aromatase inhibitor).
  • “It’s a little bit tricky to take… I have to cut this pill into quarters… but that’s what I do and it works.”—Xander

5. Fine-Tuning TRT: What Works for Xander

• Ideal Numbers:
  • “For me, it’s being around like, 900, 950… the best balance of both testosterone level and that ratio of testosterone to estrogen.” – Xander (41:10)
• Insurance & Cost:
  • Injections covered due to diagnosis, $15/month with insurance, syringes about $5. Wide variability is possible ([43:16]).

Side Effects & Frequently Asked Questions (Rapid Fire: [43:25] onward)

• Libido

  • Strongly positively impacted—when balanced.
  • Too high or too much estrogen led to swings (from excessive desire to tamped-down libido).
  • “If your libido is feeling out of control high, we need to talk about that because that's… not beneficial for you.” – Xander (44:15)
  • “At first, it was fun… and then it was like, oh my God, I can't even look at him, and he's just going to want to have sex again.” – Vanessa (45:18)

• Ball Size

  • Minor shrinkage possible (“maybe 10%”), not noticeable or bothersome to Xander ([48:11]).

• Fertility

  • Injections and cream will reduce fertility; Clomid may preserve it.
  • “You want to wait to do this until you're done having kids.” ([49:10])

• Sleep

  • Improved, but Xander credits this to other health changes too ([50:35]).

• Energy

  • Capability and stamina meaningfully increased: "I don't ever have the question in my mind of, like, 'Oh, am I going to be too tired for this?'" – Xander ([51:06])

• Mood (Anger, Aggression, Grumpiness)

  • Mild irritability/aggression for a couple of days, only when levels were unbalanced, quickly resolved with dosing correction.
  • “If you are not, like, if your libido is feeling out of control high, we need to talk about that because that’s… not beneficial for you.”—Vanessa ([44:10])

• Muscle and Body Changes

  • “It seemed like a switch got flipped for me in terms of my metabolism and in terms of my ability to add muscle.”
  • Body composition changed significantly; added muscle without increased gym time ([54:27], 55:23).

• Skin/Glow

  • "TRT glow" noticeable, especially in face/neck; some acne initially, later controlled with supplements ([55:29], 56:46).

• Hair Growth

  • Mild new body hair in small patches, but nothing major ([56:49]).

• Voice

  • No perceptible change ([57:25]).

Highlights & Notable Quotes

“When you feel really good, when you feel capable of a lot, I think you're able to show up as a better man.” – Xander (00:20)

“This isn’t a shameful topic. It doesn’t say anything about your masculinity, at least in my opinion.” – Xander (02:51)

“I think seeking tools, seeking help, looking for resources, like, to live your best life, to be a better person—that’s more masculine, not less.” – Vanessa (03:35)

“It’s all about T to E ratio—testosterone to estrogen. You want that ratio to be not, like, unlimited high, but you want it to be relatively high.” – Xander ([28:40])

“For me… energy wise, I feel better than I felt throughout my entire 30s and probably through most of my 20s.” – Xander (58:34)

"A lot of people might be burying their heads in the sand... I hear so many who are just scared to even find out what their levels are. What's it going to say about having data on yourself? It's not going to change anything. All it's going to do is give you what you need in order to decide, oh, do I want to make a change or not?" – Xander (60:54)

Timestamps for Key Segments

• [04:31] When Xander realized something was wrong (initial symptoms)
• [06:41] What is functional medicine?
• [10:40] Understanding "normal" testosterone levels
• [15:55] Non-pharmaceutical, lifestyle approaches
• [21:20] TRT methods: cream, pills, injections
• [27:52] Clomid and the "Chile energy epiphany"
• [32:36] Beginning injections
• [38:02] The role of estrogen blockers
• [41:10] Finding the right levels for his body
• [43:25] Cost and insurance
• [43:44] - [57:25] Rapid fire: Side effects & Q&A
• [58:34] - [60:54] Masculinity, stigma, and final reflections

Tone & Final Takeaways

True to Pillow Talks’ brand, this episode is candid and refreshingly unstuffy, balancing nerd-level detail with disarming humor and vulnerability. Xander’s journey demystifies TRT, showing it’s more than muscle and libido. It’s about personal agency, actively seeking to feel one’s best, and not letting social shame dictate health decisions. Vanessa enriches the discussion with thoughtful prompts, genuine curiosity, and expert context about how multifaceted issues like libido or energy truly are.

Listeners come away empowered: there’s no “one right way” and hormones aren’t the whole story, but informed curiosity and self-compassion are always worth pursuing.

Curious about TRT or men’s health? This is an honest, actionable, stigma-busting listen—from the doctor’s office to the bedroom and beyond.