TRT for Bodybuilding (The Ultimate Guide)

James Cunningham, BSc, CPT
Published by James Cunningham, BSc, CPT | Staff Writer & Senior Coach
Last updated: May 20, 2024
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Men of all ages could end up in a situation where low testosterone levels are causing issues with athletic performance.

As a certified personal trainer, I work with many amateur and professional bodybuilders.

And they regularly ask me about whether they should try to get access to testosterone replacement therapy (TRT).

To help our readers better understand whether they can or should use TRT for physical gains, I spent a few weeks doing a deep dive into research, and I also went over scientific literature and medical guidelines with a doctor to verify my findings.

Quick Summary

  • Testosterone replacement therapy is often used to help men counteract muscle wasting, and bodybuilders like the idea that it can help with their physique.
  • Many bodybuilders resort to steroids through illegal channels to boost their muscle growth and performance, but that is a very risky and not recommended option.
  • Bodybuilders who have specific symptoms of low testosterone levels could be suitable for medical treatment using reputable online TRT clinics.
  • Legitimate medical TRT is available via reputable online clinics for those with medically verified low testosterone levels, distinguishing it from the illegal and risky use of steroids.

Can TRT Be Used for Bodybuilding?

A person on TRT working out for bodybuilding

While TRT can be used for bodybuilding, it’s important to understand the difference between using it as a medical treatment and what competitive bodybuilders often do.

Testosterone replacement therapy (TRT), also sometimes called androgen replacement therapy, is a medical treatment used to bring T-levels back up to the normal range [1].

And when you start with quite low testosterone levels, one of the benefits will be increased muscle development.

But this is where it gets tricky.

Men with testosterone deficiency syndrome will likely have also experienced some muscle wasting [2].

Counteracting that with TRT and resistance training will increase muscle mass, but it’s not like they will turn you into a huge bodybuilder pumped full of anabolic steroids.

There seem to be two reasons why some bodybuilders tend to turn to exogenous testosterone treatment: 

  • Some may be legitimately dealing with low T-levels that they have verified through a blood test. And if they are also dealing with other physical or mental health issues that could be related, then TRT could be a good option.
  • The other reason is purely for the purpose of gaining more muscle. I’ve heard of a few people who tried to register for medical testosterone administration even though they didn’t have low T-levels.

Any reputable doctor would turn them away, and that’s why bodybuilders often turn to dodgy and illegal sources.

Clinics have different thresholds for considering that someone is eligible, so it’s worth checking that during your research.

How Fast Do You Gain Muscle Mass on Testosterone Therapy?

A person on TRT doing bodybuilding workout

You can start gaining muscle mass after about 12 weeks of testosterone therapy. This all depends on multiple additional factors, including diet and exercise.

Studies have concluded that men going through testosterone replacement therapy (TRT) typically notice results between 12–20 weeks.

It's important to note that peak muscle gain will likely take 6–12 months [3].

So, does that mean that a bodybuilder going through TRT will see huge gains after a few months?

That all depends on the dosage administered to treat the low testosterone levels.

Typically, treatments will aim to bring your T-levels back into the normal range. And what bodybuilders would need for huge muscle mass gains are much higher T-levels.

However, doctors will rarely prescribe higher doses just because you want to change your aesthetics.

“Testosterone plays a role in the development of muscle mass, and reduced levels of the hormone can result in a significant loss of muscle mass.”

- Joseph Brito III, MD

Can All Bodybuilders Get Access?

A doctor holding a syringe in front of a bodybuilder

No, not all bodybuilders can get access to testosterone replacement therapy.

This type of medical treatment is not simply available for the purpose of bulking up.

Doctors should only prescribe it to people with verified low testosterone levels.

While that can happen to bodybuilders of all ages due to underlying health conditions like hypogonadism or prostate cancer, the intention is not to raise T-levels to extremely high ranges.

The idea behind treating free testosterone deficiency is to raise levels into the normal range.

And those ranges won’t provide bodybuilders with the massive gains you often associate with professional bodybuilders who rely on huge doses of anabolic steroids.

But there is a positive way that it can be used.

I have worked with a few amateurs who hit plateaus in their bulking a lot sooner than could be explained by their training and diet routine.

After they got tested at a TRT clinic, doctors determined that they had significantly reduced total testosterone levels. 

Before they started treatment, they also went for a DEXA scan to get details of their BMI, bone density, and muscle mass [4].

They repeated this after six months of treatment, and the results were great.

In these cases, bringing free testosterone back to normal levels was enough to break through that plateau and achieve some great results for muscles and bone mineral density.

What Treatment Types Are Suitable for Bodybuilders?

A gym doctor looking at a bodybuilder's TRT

Both injections and topical testosterone replacement therapy are suitable for bodybuilders.

Both types can provide performance enhancement for muscle strength and growth, but it’s typically injections that can bring on faster results.

But you have to be careful with anabolic steroid use.

When it comes to bodybuilding, TRT can often be this temptation to increase dosages. But you have to be aware that there is an increased risk of health issues ranging from acne and fluid retention to serious liver damage.

You can still benefit from TRT by sticking to the prescribed dosage.

You should never go against your doctor’s recommendations and start experimenting with different timing and doses just to maximize muscle strength.

It’s probably a lot more difficult to get a huge boost in T-levels from a gel. So, if you want to avoid the temptation of taking a large injection dose, then maybe discuss a topical option during your initial treatment consultation.

Who Should Consider Hormone Treatment?

A doctor talking to a patient about hormone treatment

Men who have verified that they have abnormally low testosterone levels with a blood test should consider hormone treatment.

The blood test will provide a doctor with information about free and total testosterone, which will ultimately inform the dosage and timing of your treatment.

Many men end up waiting too long for treatment, and that can ultimately lead to many issues, from low bone density to muscle wasting and erectile dysfunction. When that happens, it can take a lot longer to reverse the problems with treatment.

Even in bodybuilding, TRT can help men overcome plateaus where they struggle to gain more than they would expect from a dedicated training plan.

After a month or two of even moderate TRT, men who have been struggling with muscle gains should be able to start seeing improvements again.

But that shouldn’t then become an excuse to increase testosterone use for purely muscle-building benefits.

What I’m essentially saying is that you shouldn’t expect to sign up with a TRT clinic and receive legal access to way more testosterone than you need to bring your levels back to normal.

You May Also Like: TRT Before & After

Who Shouldn’t Consider Hormone Treatment?

A doctor looking at test results

People with significant underlying medical conditions like prostate cancer or cardiac health issues shouldn’t consider taking hormone treatment.

Also, men with normal testosterone levels shouldn’t consider this type of medical treatment.

Let’s start with some medical considerations.

Because testosterone plays such a major role in regulating many different body functions, it’s vital that a doctor look at your full medical history and current health issues before considering TRT.

While the potential benefits for chronic fatigue and muscle wasting might be important, they could be counterproductive if they make other health conditions worse.

Another medical consideration is the underlying reason for the lack of testosterone production. One reason could be related to the pituitary gland.

If it doesn’t produce enough luteinizing hormone, then the testicles will become less productive. Addressing that issue with long-term TRT might not be the best option.

This is also precisely why you should never consider taking testosterone medication without consulting a doctor. There are so many things that can go wrong, from testicular atrophy to a damaged cardiovascular system.

And once you factor in organ damage from abnormally high exogenous testosterone, it's really not a direction that any bodybuilder should go [5].

Related Articles:

Where Can You Go for Testosterone Replacement Therapy?

A doctor looking at paperwork

You can either go to your family doctor or a dedicated online clinic for testosterone replacement therapy.

The good news is that, with men's health becoming more acknowledged by the public, there is a shift in accessibility to such treatments.

What people would have always done in the past was discuss testosterone-related issues with their doctor during a routine check-up, and that would typically lead to a blood sample and lab testing for testosterone levels.

The doctor would then get you to come into the clinic once a week or something similar for an injection.

As you can imagine, this would be quite an expensive treatment, one that many insurance providers didn’t fully cover or that many men couldn't afford.

But things have changed.

Today, there are online TRT clinics, and as with everything that’s offered online, that has resulted in huge changes to the overall TRT cost.

You still have to go through the process of testing your free and total testosterone, followed by a detailed consultation with a doctor.

And depending on the medical assessment, you then receive your treatment through the mail.

You then have follow-up consultations to assess your progress and whether there is any need to adjust the dosage. And all this costs a lot less per month than what traditional medical services would charge.

It’s just as safe, and you get access to licensed doctors and FDA-approved medication.

“Low testosterone results from a problem in the testicles or the brain and can cause low libido, muscle loss, and/or depressed mood.”

- Nick Milazzo, MSc, MPH


How Much Does TRT Cost for Bodybuilding?

TRT for bodybuilding can cost anywhere from $50 per month if your insurance covers some of it, up to $400. It’s possible to reduce costs by choosing a licensed online TRT clinic. And you also have to keep in mind that it’s only legally available as a prescription for a medical issue.

Can You Get Ripped on TRT?

Yes, you can get ripped on TRT. However, it requires the right combination of diet and exercise on top of increased T-levels. Also, keep in mind that raising testosterone to normal levels will only provide a certain amount of muscle gain.

Does TRT Build Muscle Like Steroids?

Yes, TRT can build muscle like steroids. However, medically provided TRT will only aim to bring your testosterone up to normal levels. Many bodybuilders who resort to steroids tend to take excessive doses, and those come with severe health risks.

How Long Is a TRT Cycle?

There is no generally recommended TRT cycle length. Doctors fully assess the overall health condition and underlying issues of patients before deciding on the right dose, timing, and cycle length. In most cases, that will range from 3–6 months.


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About The Author

James Cunningham, BSc, CPT
Staff Writer & Senior Coach
James Cunningham, BSc, CPT holds a BSc degree in Sport & Exercise Science from University of Hertfordshire. He's a Health & Performance Coach from London that brings a unique blend of academic knowledge of health supplements and practical exercise experience to the table for his readers.
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