T Nation

20 Y/O low Test Advice Needed

Hello guys,

I need your help in understanding my blood work. Doc says “everything is within range”. He did a bunch of other tests like screening for sarcoidosis(no worries, everything fine). To me thisT level isn’t accpetable and I’m kinda depressed about my gym/physique progress. Also sometimes feeling really lethargic and unmotivated. Also low libido and no real hard erections.

He’s redudant to prescribing TRT.

Spinning just wheels in the gym, although I do everything I can to increase T levels. Even got a coach who coaches me on macros and training.


  • 6’1’’
  • Growing a beard.
  • Carry most of my fat in the belly region
  • No health concers
  • Hair is already lost/ I cut it off. But this is genetic

-describe diet: Mostly whole foods eating rice, chicken, tuna, potatoes, veggies, eggs, olive oil etc. Should be sort of a balanced typical bodybuilding diet. Macros 205P, 400g Carbs, 100g Fat
-describe training:
Bench,Squat, Deadlift,OHP Rep range 6-8 Sets 3-4
accessories Rep range 8-12, Sets 2-3
Calves and Core reps 10-15 , Sets 2-3

Rest periods for compounds 3-5 minutes, accessories no longer then 1-2 minutes

Monday - Chest/Triceps

Bench Press
Incline Bench Press
Close Grip Bench Press
Incline DB Bench Press
Incline DB or Cable Fly
EZ Bar or DB Skull Crusher
Triceps Rope Push Down

Tuesday - Back/Biceps

Pull Ups
Bent Over Barbell Row
DB Row
Wide Grip Cable Pull Down
DB Pull over
Straight Bar Curl
EZ Bar Curl
DB Alternate Curl
DB Hammer Curl

Wednesday - Off

Thursday - Shoulders/Traps
Seated DB Press
Straight Bar Shrugs
DB Side Laterals
DB Shrugs
DB Rear Delt Flies or Cable Rope Facepulls

Friday - Legs/Core
Leg Extension
Leg Curl
Standing Calves Raises
Seated Calves Raises
Captains Chair Leg Raises

Saturday/Sunday - OFF/REST

-testes ache, ever, with a fever? No
-how have morning wood and nocturnal erections changed: Like I said often very lethargic in the morning.

Labs: I’m really sorry for the German language. Hope you can still read it. Most recent 21th July: Most recent blood work

8th July blood work:8th of July blood work

Planning to start self-prescribedTRT next week on Monday. Looking for some advice or interpretation of my bloof work.

Read the stickies and it will tell you everything you need to know about standard starting protocol. Get labs six weeks after you start to see whats happening for adjustment. Your T is definitely low so I don’t understand the hesitancy. So is your LH/FSH begging the question of secondary hypo. Age?

Sorry if I didn’t follow the rules in the stickie. I actually read them and thought you could give some knowledgeable feedback. I’m just 20, that is why I’m kinda afraid to start self-prescribed TRT. But will definitely start it on Monday next week.
Basically I was afraid that my low t could be due to “overtraining”( what ever that term might be), that is why I asked for feedback.

I wasn’t implying no help, just that the stickies have the protocol that I would just be retyping. You seem set on starting. IMO I wouldn’t at your age. I would try an HPTA restart first.

Okay thanks than for your help/suggestion. Appreciate it! I think you might be/are right, but …honestly what could a restart do? I would suspect that it will boost my natty levels into high 700-800s and I’m just fuckin’ tired of busting my ass SUPER low natty levels and just spinning wheels. It’s so frustrating. I will probably experiment with TRT for some months and observe how I react. Then I have to restart anyway, am I right?

Do you also recommend starting with an AI from the beginning of TRT like the stickie recommends? For example the Reddit forum doesn’t necessarily recommends it.

Personally, I think the smartest doctors hold the AI until 6 week labs. I started with an AI and it drove me E2 to zero. I had some sides from this. If you wait, get labs at 6 weeks and see how elevated your E2 is. If its not bad, you could not add an AI but most likely you will need some form. You could start with .5mg arimadex if its not bad and it it is, jump to the full 1mg a week.

TSH suggests an iodine deficiency. Low thyroid function might explain a lot of things. The thyroid lab ranges are mostly useless.

Have you been using iodized salt long term and/or vitamins that list iodine+selenium?
Sea salt and pink salts do not have iodine.

Check oral body temperatures as per the thyroid basics sticky.


  • feeling cold
  • outer eyebrows sparse
  • low physical and metal energy
  • mood problems or depression
  • dry skin
  • low body temperatures
  • many symptoms identical to low-T, so one can have double effects

Take 5,000iu Vit-D3 every day, take 25,000iu for first 5 days.

See the protocol for injections sticky for advice re E2, anastrozole etc. E2 management is mission critical.

FT not tested. With low TT and relatively high SHBG we can assume that FT is very low. I did not see E2 lab tested. Elevated E2 can be from liver problems which can be from Rx or OTC drugs or gear. AST/ALT lab results may be useful. Please post labs in future that are not rotated to vertical.

Thanks for that really useful and knowledgable answer KSman. I’m just using sea salt and therefore you might be right with the iodine defiency. Will follow your suggestions.
Sorry for the vertical picture.

Also: You recommend “1.0mg Arimidex/anastrozole per week in divided doses” from the beginning of TRT, right?

Yes. Most guys need anastrozole to get near E2=22pg/ml.
Then next E2 lab provides data for calculated dose refinement.

Some are anastrozole over-responders, not rare. They need 1/4th the expected dose and E2 will go unpleasantly low. No way to know in advance. See stickies for more info.

Most docs will do nothing and many others do a wait and see to see how bad it gets before Rx.

Pre TRT E2 lab data can be useful. If high before TRT, it can only go up. Did not see E2 in your labs.

Okay, will definitely start with 1mg/adex/wk then.

I got more blood work (with pre TRT E2), but did not post it, because it dates back to 14th of March ( so 5 months+) and it was done after I did a 3.5month cut (with mistakes, did drop too much weight too fast, did too much training & cutted too long). So please, observe it with caution (but I’m sure you can). Very thankful for your help KSman!

Blood Work

Just made my first pin today. Wow. And took 1/4mg Adex. It’s funny how such a small dosage/pill can alter your hormon profile quite drastic. Crazy.

Went into glutes like a charm.

Already feeling the super human powers haha /jk

There is no need at all to inject into the glutes. Bad idea for a number of reasons. Stick a needle into your sciatic nerve https://en.wikipedia.org/wiki/Sciatic_nerve and see if you can walk after that.

If you inject into upper leg, not inner leg, you can see what you are doing. Mark selected site pressing with syringe end cap, clean that location with prep pad, then inject there. You can inject SC or IM as you find more what is to your liking. Use #29 0.5ml 1/2" insulin syringes. If IM, use vastus lateralis.

Okay KSman, thanks for the info. I wanted to go for SubQ injections anyway. Just hadn’t the needles at hand.

One question: Can adex cause headache? Had some on the pin day and sucked kinda.

But could also be other reasons.

Not the adex directly. But there can be problems with low E2. Adex can reduce supply of E2 via fT–>E2, but then E2 levels drop slowly as liver clears E2 and a new balance point is slowly reached. So I cannot see a mechanism for a sudden onset effect.

Okay, could be whatever reason thanks.

Could you please explain a bit more for you would split adex dose? I’m pinning E3.5D on Monday and Thursday’s. So 0.5mg on each day? Or 1/4 on those days and 2x 1/4 on other days?

Inject T twice a week.
Take 0.5mg anastrozole at time of injection, only then. Half-life takes care of things from there.

Both T and anastrozole levels will peak and drop a bit, but will both move the same direction and the balance of anastrozole:T will be reasonable and E2 should be well maintained.

Great, exactly what the answer I need. Definitely will follow this protocol and check-in in 6 weeks with blood work.

Got my first blood work done !

Now on TRT: TT is 9.52 ng/ml and E2 47.6 pq/m.

Pre-TRT: TT was 2.0 nq/ml and E2 was 29.5 pq/ml

Need advice - would be awesome.

I started with 200mg Test E/wk subQ E3.5D and 0.5mg Adex on each pin day. Isn’t pharma gear, but reputable UGL. Blood work taken on Thrusday before my usual the pin in the evening.

The day before blood work draw, I drunk some beers. Maybe that is the high E2?? But don’t think that those beers could have raised E2 drastically. No beer drinker normally.

Unfortunately, I got just get Total test(TT) and no more tests about TSH or something.

Could you explain what to do next?

My goal is to get at least the maximum “normal testosterone range”. Which would be around 15.9 ng/ml.

Anything else to worry about?

First step would be to increase adex to get my E2 into the 22 range - right? How much and when? Also on pin day?

And then increase test e dose? Or do both?

And havent’t yet added HCG to my TRT protocoll. Plan to do this next week or something.