T Nation

24 Y/O, Dr. Recommending TRT(Update 12/23/17)

I have a history of depression and recently put on 50+ lbs, went in for a checkup with my PCP, he ordered some thyroid lab work(Will be posted below) and a test for Total testostorone, which came out at 216, which he said was fine but led me to look into it and get a second opinion, my new doctor suggested I start trt based on the labs he did.

My only real symptoms would be brain fog, fatigue, extremely moody/easily annoyed, high body fat, difficulty gaining muscle and (somewhat) low libido but no other sexual symptoms.

I’m hesitant to start any sort of HRT seeing as sexually everything works fine now, and I’ve seen people who end up having problems after starting HRT.

-age 24
-height 6’2
-waist 42”
-weight 262
-describe body and facial hair - Full beard, generally hairy
-describe where you carry fat and how changed - waist, love handles, chest.
-health conditions, symptoms [history] -depression, GERD, anxiety
-Rx and OTC drugs, any hair loss drugs or prostate drugs ever - After taking Prozac for 8 years I’ve switched to Wellbutrin the last month. Also Prilosec otc.
-lab results with ranges - will post below
-describe diet [some create substantial damage with starvation diets] -Decently balanced diet, count macros etc.
-describe training [some ruin their hormones by over training] -Heavy weight training about 5 Times a week, 45 minute sessions
-testes ache, ever, with a fever? No
-how have morning wood and nocturnal erections changed - Morning erections probably 5/7 days of the week

Body temps- 6:00 AM 96.7
3:50 PM 98.5

TSH - 1.75 (0.34-5.60)
Free T4 - .80 (.58-1.64)
Free T3 - 2.82 (2.3-4.2)

Your test is low by any standards and Prilosec can contribute to your symptoms. Your missing SHBG, FT and E2 labs. You have the test levels of 100 + year old man and that’s something to be concerned about. Being that low for long periods can cause all sorts of health problems, diabetes, cardiovascular disease and heart disease. You make it sound as if your symptoms aren’t that bad, who would want to go through life with brain fog which over time low test levels are showing a linked to alzheimer’s which your test levels are associated with. You’re only 24 years old and you already have the test level of someone who is ready to checkout of this world!

I wasn’t meaning to make my symptoms sound insignificant but I’m unable to edit my original post because I have more than one image. The labs posted are the only ones I’ve had, is that sufficient for a dr. to suggest trt or do I need to find a new dr who’s going to run a full panel including free t etc?

I do see the shbg test. Your t3 and t4 free are def on the low end. Should be in mid to upper normal range. Though you do not have the estradiol sensitive test I do see the regular estradiol test. You do have enough labs to get treated. I wonder if u r secondary hypogonadism with the low end LH.
Make sure thyroid is optimal before any trt

Edit. The medication you are taking I think certainly have an impact on thyroid and t

I can probably taper off the Wellbutrin, but the Prilosec would be more difficult with the severity of my GERD

Replied on my phone therefore I couldn’t see SHBG. Good point about checking thyroid, we have a lot of guys who come in here and TRT does little for them and later they find out their thyroid is lagging behind holding back most of their progress. A slow thyroid will hinder recovery no matter how good your T levels are and some even need more T to compensate for a lagging thyroid.

At the very least you need TSH, fT3, rT3 and fT4 labs done. Any doctor who only runs TSH doesn’t have a clue as it only checking the signing hormone and not actual thyroid hormones. It would be like checking TT (bound) and not FT (unbound) with FT being the active hormone.

I actually have had a poor history of iodized salt usage, so I started taking 50mg iodine tablets/day last week.

Based on the labs I have now is it best for me to see another physician and get a full thyroid panel & free T tested before starting any sort of trt?

Wellbutrin absolutely WRECKED my HPTA. My total T was 117ng/dL. I would not start TRT at 24 except as a last resort. There are a host of other avenues to explore and IMO you should out all other treatments with a knowledgeable doctor.

It can be harmful to take high dose iodine with a selenium deficiency. You need 200mcg selenium to be safe. Risk is thyroid inflammation that immune system interprets at foreign and then you have thyroid autoimmune disease.

E2 estradiol was tested but seems to have an incorrect range. Range should be <39 pg/ml and E2=22pg/ml seems ideal for guys on TRT from the point of mood, energy, libido and sexual function.

Your depression can easily be founded on low T and low thyroid function.

Your E2 and T levels are making you estrogen dominant. And these also lower your metabolic rate which promotes fat gain and blocks fat loss.

AM cortisol - done at 8AM or 1 hour after waking. No caffeine.

Training with low T and low thyroid function in young guys is often seen as adrenalin overcoming low energy levels which is over-training [stress] relative to your energy levels. Risk is adrenal fatigue with rT3 blocking fT3. See the thyroid basics sticky with reference to: cortisol, adrenal, stress, Wilson’s Book.

We do expect to see thinner blood with lower T levels. But yours is quite deep. Please get an occult blood test to rule out/in a GI blood loss.

GERD can be from a hiatal hernia which may resolve with fat loss. Youthful T levels and resolving thyroid issues will enable fat loss.

Heart burn meds can lower absorption of Vit-D3 while also leading to possible multiple mineral deficiencies. Many are taking 5,000iu Vit-D3 capsules. If you get foot/leg cramps that is a sign of magnesium deficiency, Biotest ZMA is a good supplement.

TRT increases/restores metabolic demands and if the body cannot deliver one can feel worse. Thyroid function and cortisol status are important factors.

Please read the stickies found here: About the T Replacement Category

  • advice for new guys - need more info about you
  • things that damage your hormones
  • protocol for injections
  • finding a TRT doc

Evaluate your overall thyroid function by checking oral body temperatures as per the thyroid basics sticky. Thyroid hormone fT3 is what gets the job done and it regulates mitochondrial activity, the source of ATP which is the universal currency of cellular energy. This is part of the body’s temperature control loop. This can get messed up if you are iodine deficient. In many countries, you need to be using iodized salt. Other countries add iodine to dairy or bread.

KSman is simply a regular member on this site. Nothing more other than highly active.

I can be a bit abrupt in my replies and recommendations. I have a lot of ground to cover as this forum has become much more active in the last two years. I can’t follow threads that go deep over time. You need to respond to all of my points and requests as soon as possible before you fall off of my radar. The worse problems are guys who ignore issues re thyroid, body temperatures, history of iodized salt. Please do not piss people off saying that lab results are normal, we need lab number and ranges.

The value that you get out of this process and forum depends on your effort and performance. The bulk of your learning is reading/studying the suggested stickies.

Went and got full labs and asked my dr about trying hcg if my thyroid panel came back normal, he shot it down immediately. Is it normal for a dr to want to begin trt but be scared of hcg? If not… anyone know any knowledgeable drs in the central/north Texas area?

Scared do to inexperienced, if he shot it down quickly he’s unlikely to be open minded. These type of personality live a life long in ignorance because they are unable adapt.

Yeah bro no criticism but im going to venture your diet is fast food and fried processed foods and you dont work out regular. Before going on something that usually is for life and not to mention keeps doctors eating good, i would clen up my diet and start a exercise regimen.after you do this for a while maybe try a cycle but a proper one not 100mgs of cyp 2xs a week tjats weak and frankly will just sjut you down. I can recommend several 1st time cycles but mostly just test e 250 for 6 weeks to see jow you amf your body reapond.

Really? Please self-edit before you post.

“100mgs of cyp 2xs a week tjats weak and frankly will just sjut you down”

Many here do great injecting 50mg T twice a week.

Any form of effective TRT shuts down LH/FSH within hours. What are you believing?

"I can recommend several 1st time cycles"
You are in the wrong forum.

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Lol 50 mgs a week for a 24 year old man come on you have got to ne kidding.maybe for a 80 year old but this guy obviously doesn’t want to feel lethargic slow and depressed and any trt wich basically is a joke because most people on trt are dosing other aas at the same time they just want the script. A 24 uear old is not going to be happy taking a substance renowned for cutting fat and building muscle at such a low dose.you will hardly see any kind of results if you see any.I dont know what "journals "you read im speaking from experience .I don’t tell anyone to do anything i have not done. I think you should edit uourself sir talkin out thr side of your mouth lol.Such as anastrozole is the best AI.maybe 20 years ago.There is a thing called technology and that thing has proven anastozole is mid pack.So keep dishing out all this book knowledge and let the guy’s who actually lift tell the real story lmao


You’re not even comprehending what’s being typed and perhaps english isn’t your first language.

Nobody said anything about 50 mg weekly, but 50 mg TwICE WEEKLY, 2 or two times per week. The OP is interested in a replacement dose not an AAS dose, I don’t even think you realize you’re in the TRT forum section.

I’m on 80 mg per week injecting EOD and I land in the 700-800 range. You were saying…

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My brother is 30 and on trt he gets 2xcyp 250 a week. I also know several othets who do as well regardless of trt or no a 24 year old is not going to get what he wants wich most likely differs from what u want.you may be satisfied with avetage but if i pay for trt or anything else i want to be the best me not avg me. But to each their own ill keep gaining and you stagnate and teach others how to.

How do you know if 800 ng/dL is average for me or anyone for that matter? Naturally I could have been in the 500-600 ranges and now I’m in the 800 ranges, how is that average? When a guy goes beyond his natural limit it’s no longer a replacement dose.

I think you’re just speaking out of your *** and it’s ignorance at it’s worse. I don’t have time for nonsense!


Small update, found a new dr. Started me on Clomid 25mg EOD & arimidex .5mg twice a week, labs redone in 4-6 weeks.

My question is, if I end up coming off Clomid and arimidex after the 4-6 weeks, will my e2 and TT eventually return to what they were before starting it?

Clomid “rarely works” and most feel terrible on it, most once they stop clomid see their levels fall to previous levels. If I received 1$ dollar every time I hear clomid didn’t work I could quit my day job and retire.

that’s what I’m afraid of but doc wanted to exhaust more options before putting me on trt.

Do people take Clomid long term if it’s sucessful? Or is it something you use to try to bring your natural levels up and eventually Discontinue use of? Also, do your e2 levels baseline the same as your test levels do upon stopping?