TRT journey content: what week 95 probably gets right and wrong

What did @bigpuncustoms actually say?

The core claim here is actually pretty reasonable. After nearly two years on TRT, the creator is dealing with a laundry list of orthopedic problems: two grade-one shoulder tears, bone spurs, bilateral carpal tunnel, and a pinched sciatic nerve. His position is clear: "none of the injuries that I had had to do with TRT. It was just different shit." He's also documenting weight fluctuations he attributes to holiday eating and inflammation, landing at 280.2 lbs this week. No dramatic testosterone claims. No miracle body composition promises. Just a guy cataloguing a rough week with a banged-up body.

He also mentions receiving an injection, likely his regular testosterone shot, and skipping sauna on injection days. The surgical planning he describes, back surgery in winter, shoulder PT, and carpal tunnel releases simultaneously, is medically ambitious but not inherently reckless to discuss publicly.

Does the science back this up?

On the central claim, that TRT itself didn't cause his orthopedic injuries, the evidence is mostly on his side. But it's more complicated than a clean yes or no.

Testosterone replacement at therapeutic doses does not directly cause tendon tears, herniated discs, or carpal tunnel syndrome in the way that, say, anabolic steroid abuse can. The mechanism that causes problems in supraphysiologic androgen use, where muscle strength rapidly outpaces tendon adaptation, is less relevant at standard TRT doses targeting normal physiologic ranges (typically 400-700 ng/dL). A 2021 review by Coward et al. in Translational Andrology and Urology found no significant increase in musculoskeletal injury rates in men on therapeutic-dose TRT compared to untreated hypogonadal men.

However, one wrinkle worth flagging: carpal tunnel syndrome has a documented association with fluid retention, which can be a side effect of testosterone therapy. Testosterone can raise hematocrit and influence water retention. If he's also on HCG, which he mentions, that adds another hormonal variable. A 2019 paper by Trost et al. in Sexual Medicine Reviews noted edema and fluid shifts as real, if underreported, side effects of combined TRT and HCG protocols. So while TRT probably didn't cause his carpal tunnel, dismissing it as entirely unrelated might be slightly too confident.

What did they get wrong (or right)?

He got the big thing right. Orthopedic injuries from car accidents, heavy lifting with pre-existing structural issues, and repetitive strain do not suddenly become TRT's fault just because someone is on testosterone. That's a common and unfair conflation online, and he's correct to push back on it.

Where he's slightly off is the carpal tunnel dismissal. Saying the numbness "is not related to the TRT or the HCG" with that level of confidence isn't fully supported. Fluid retention from both testosterone and HCG can compress the median nerve. It may not be the primary cause, but writing it off entirely is premature without bloodwork and nerve conduction studies ruling it out.

The decision to ignore the medical advice to take three to four months off from training is, frankly, his own business, but worth naming. Grade-one tears can progress. Bone spurs in a joint that keeps getting loaded don't typically improve on their own. He's aware of the risk and choosing to accept it. That's a choice, not a medical recommendation.

What should you actually know?

If you're on TRT and dealing with mystery symptoms, the relationship between testosterone, HCG, and fluid balance is real and worth discussing with your prescriber. Carpal tunnel symptoms, joint swelling, and even nerve-related tingling can be downstream effects of hormonal shifts, not just mechanical injury.

The bigger picture here is that TRT is not a recovery drug. It optimizes hormone levels in men with diagnosed hypogonadism. It does not repair torn tendons, decompress nerves, or fix bone spurs. Men sometimes come into TRT expecting it to make them bulletproof. It doesn't. What it can do, when appropriately prescribed and monitored, is support energy, libido, mood, and lean mass in men with genuinely low testosterone. The surgical plan he describes, back surgery followed by concurrent shoulder PT and carpal tunnel releases, is a serious undertaking regardless of what his testosterone levels are doing.

One practical note: if you're considering TRT and also have carpal tunnel symptoms, tell your prescriber before starting. Baseline nerve conduction studies are a reasonable precaution that most TRT clinics skip.