T Nation

25 Too Young for TRT? And Some Other Concerns


#1

Hi all,

I’m a 25-year-old, 5’10” male, and am about ~180 lbs. with 20% (maybe even 25-30%) body fat. I’ve been dealing with symptoms of low testosterone for a long time, well over two years.

I’m currently taking 20mg Adderall XR almost daily, and have been taking Adderall for almost 5 years. I recently got my labs drawn again, and got them drawn a few times. The highest total testosterone I ever had was 350 ng/dL (ref. range 250-1100) and the lowest I ever had was 224 ng/dL (different lab, but ref. range 250-827 ng/dL). The last time I had my free T tested was in December 2016, a year and a half ago, where it was 65.1 pg/mL (ref range 35-155 pg/mL)

I moved in 2017 and began seeing a new doctor (endocrinologist) thankfully, and in 2015 and 2016 the endo. I had was pretty crappy. She basically said when I “lost fat” my testosterone levels would improve, but it made no sense to me that she didn’t realize that testosterone would actually allow me to lose fat when combined with exercise & proper diet, both of which I was doing at the time.

I think I’m relatively young for someone potentially getting on hormone therapy. That’s one concern. Another concern is the endocrinologist I see. He’s a nice guy, but even some of the tests he didn’t order told me he wasn’t very well versed in the field. For instance, he didn’t order free testosterone, SHBG, or estradiol on the first labs I did. It took me doing my research to even realize how important these tests are to get a better picture of what’s going on and actually calling and asking him to order them.

Symptoms of low testosterone I’ve been dealing with almost daily are depression, extremely low energy, sleep deprivation or oversleeping, stubborn body fat, low strength (At 5’10” 180+ I can’t bench 95 lbs. for more than 10 reps at a time…), and I’ve overall been a lot more negative and temperamental. On top of that I’m procrastinating like crazy and can’t focus. Just don’t have energy and am always tired. Feels like I’m in a constant mental fog. I feel like I’m balancing a ton of things right now, but can’t do any e feel like a sleep-deprived meth head at all times. I got on Prozac for over a year, got off, got back on again for a year, and got back off about two months ago. One of my hobbies used to be reading, but I can’t even read read as well as I used to and get frustrated when I do because my comprehension is a joke. The Prozac definitely helped with mood, but I wanted to get off of it to see if it impacted testosterone. Clearly it didn’t since 3.5 weeks after getting off of it, my numbers were worse.

I’m also isolating myself a lot more, ever since I got off the psych meds, which I’m hoping that TRT can help me with. For instance, I usually made time once a week to go out and grab dinner with friends on a Friday or Saturday night, but I’ve maybe hung out with friends twice in the past month and a half. And when I did, I just didn’t feel as “good” or “sharp.” Everything feels like it’s forced, and I feel like I’m pushing a rock up a mountain but actually going nowhere. Probably sound like a weak bitch right now, and I hate it.

I’m in a crazy rush, since my insurance runs out at the end of June. I’ll still b have insurance, but here in the U.S we’re allowed to stay on our parents plan until age 26, and I chose to stay on my father’s plan since it’s cheaper and I get more access than the alternative. I attached all the labs I’ve ever done as well.
I have a few concerns. And it’s probably a lot of anxiety that’s making me hesitant to start TRT stat. One of them is if I’m too young and if medication is the issue.

I’ve also been comparing the past to now, now that when I began lifting weights in 2011, I still was in crappy shape. For example, one of my friends was a stick and grew like a tree, we starting lifting at the same weights, but he progressed like mad. I got healthier of course through proper diet and exercise, but failed to really build much muscle. Posted some “physique” pics as well. Any advice would be appreciated.

TL;DR: I’m anxious as hell about TRT, depressed, and am not sure if 25 (almost 26) is too young to begin TRT. Also, my doctor doesn’t seem well-versed which is making me a bit hesitant.

Posted current “physique” and the labs my doctor ordered.



#2

Labs ordered are right on. Try writing in on bottom Estradiol, Ultrasensitive(test code 30289

Edit. Also check off a1c and lipid panel box.

Also u can calculate your own free testosterone with shbg, albumin (included in a panel that was ordered) and total t.


#3

You’re not too young to start TRT…thinking that way is akin to thinking someone is too young to start chemo if they have cancer. One thing that I’m sure you’re aware of is this: your TRT journey will be a lifelong commitment, you’ll have a much better chance of getting your doses dialed-in (and keep E under control) if you lost a bit of weight. TRT will help somewhat by hopefully allowing your gym sessions to be more productive. These results should be self feeding…the more results you see the more motivated you become…
Good luck. There are plenty of folks here who’ve been in your shoes who are willing to help.


#4

OP needs to fully investigate the cause of low t. Do not jump in trt. Do the labs, post and we can give further comments.

You may have several issues going on and it may be wise to fix 1 thing at a time. That’s not always possible.
Btw Adderall can greatly affect your hormonal balance. Affect your prolactin levels. Is there a way to get off this drug? Maybe a trail.

Google Adderall affect testosterone.


#5

The real reason you’re doctor saying you’re too young for TRT is because he’s afraid of getting sued. You have got some feminine features, manboobs and all. You never to young for prescription drugs, quite silly if you ask me.

It’s okay to wreck a guys hormones using prescription drugs, but its not alright to replace those hormones using bioidentical one’s. How silly.

It’s going to be difficult to lose weight when you are a metabolic emergency do to low hormones. I’m delighted to see a comprehensive thyroid panel being done, we often see doctors cut corners.

Fixing your thyroid won’t likely cure your low testosterone, when the time comes you need to push for injections, T Gel is garbage and injectible testosterone is proven more effective at building lean muscle.


#6

Agreed that thyroid won’t necessarily fix T problem but losing the weight will go a long way to making what little T his body’s producing more effective if he decided to go TRT route or not. Right now he’s going to have adevil of a time getting T dosage right with all that extra fat trying to aromatize it all.


#7

Sweet, will do. Out of curiosity, how does A1C and lipid panel tie into testosterone?

Yeah, they’re only accurate because of all the research I had to do. Based on the research I’ve done, the original labs he ordered way back in October were someone who didn’t know a whole lot about TRT - or at least not as much as I would’ve liked. Found someone who did know a lot, but he didn’t accept MY insurance and a single consult cost $400… no thanks.

I’ve just been really, really depressed and my sleep has been horrible. I was on Prozac from Dec. 2016-this past March, and I don’t think I realized how much it helped me. Ever since I got off, things just became harder. I became more irritable on the outside, more tired, and stopped hanging out with friends because I didn’t feel like I could engage like I used to.

A friend from my hometown called two weeks ago to see if he could stop by and visit me and go on a roadtrip to Yosemite Nat’l Park, to which I said yes. We went to Reno together in February and I had a blast. I was on Prozac and definitely was low T, but had a good time regardless. Yosemite, which should’ve been fun, was exhausting. My brain was in a constant fog, and I had to use two prescription meds (.5 mg Xanax and 12.5mg Trazodone) to even put me down at night.

Even right now as I type this, I just feel like I’m in a total fog. It’s about 5:30 where I’m at, and whereas I’d normally be in the gym I feel like fucking crying or some shit. Beta af. Which is why I’m hoping this TRT will help alleviate some of those issues so long as I’m committed to the gym.


#8

I’ll say again The medication u are taking affects your hormones. Some need meds but it sounds like the meds in it case are masking other issues.

You may decide to get off all meds for a restart maybe stimulate LH production will clomid - before u go on trt. And maybe fix thyroid, loos some weight, after u analyze labs, before going on trt.

A1c for diabetes. Diabetes affects hormones.
Lipid. Cholesterol is the mother of hormones.

You should get also so you have pre trt levels. In case u go on trt or any other therapy. Getting iron level is good to. Iron also plays a role.

Next step for u I think is get all the labs.


#9

Thanks a lot, I appreciate it.

I guess I’m trying to learn as much as I can before going in, because I don’t want to make a major decision impulsively. Definitely need some fat loss as well, which is why I want to start doing HIIT on non-lifting days.

The self-feeding part is especially true. I notice that especially since I got off of the antidepressants, I have to go to the gym at least 5x a week, just to keep my mental state static. Whereas on it, I was ok if I took a day off, now I almost lose my mind if I don’t.

Tell me if I’m wrong here. My thought process is, that since I’ll be feeling better on TRT, I’ll also be able to push harder in the gym, and thus lose fat at a more consistent pace. I also have to be more consistent with my diet which I haven’t been recently. Again, another thing that improved with the Prozac since I think I was mentally ok I felt ok to at least go to the gym. Used MFP with proper macros and was losing good weight & fat, but fell off slightly.

Plus, I’m not getting on TRT strictly for gym gains. If I wanted to do that I might as well start a steroid cycle, just hoping that it’ll help give me a boost and feel alive again for once and regain a lust for life.


#10

Awesome. Sorry didn’t see your second post.

The last time I testested my test levels was in April, and I had been off of Prozac for 3.5 weeks and with the exception of maybe 2 days had been off of Adderall as well. I was incredibly tired due to the lack of stimulation and hadn’t worked out, and my total test was the lowest it had ever been at 224 ng/dL. Prior to taking off the meds, I wa working out 3-5x/ week. However, I notice that with just the Adderall very “ADD” in the sense that I can’t focus at all. My mind shifts all over the place and I still have the attention span of a cricket, which makes me think that maybe I’m not truly ADHD anyway. The only time it helped with focus was a few times when I first began taking it. Also, my comprehension used to be good, but now it’s horendous.

The only reason I got back on was because the lack of energy from not being on it was killing me, and so I figured I’d rather take it and go to the gym than not at all. All I found outside of anecdotal evidence through Google searches of forums was one scientific study showing that amphetamine lowered testosterone in rats. See,

I will post the labs I’ve done, along with the most recent labs. I’m doing my labs tomorrow morning, so this has definitely been a help.


#11

Yeah I agree fully. The doctor who wouldn’t prescribe was actually a different one who I saw back in 2016 in a different state (moved from East Coast to West Coast), and her reasoning seemed off, for a few reasons but I won’t get into that here.

The endocrinologist I currently see is quite better. He’s not great, but so long as I do some of the leg work and with the help of some people on here I can at least get a good idea of what’s going on. I had to do some due diligence to ask him to write this lab, but he did do it. He suggested gels but ultimately said that the choice is completely mine.

Definitely have feminine features, and feeling like this isn’t healthy at all.

Like charlie12 said, I think it would be wise to get off of all psychiatric meds (Adderall) before starting TRT, and I’m only on one now, but I’m not sure how practical that is.


#12

I have ADHD and Tourette syndrome and TRT makes it seem like I have neither, no medications of any kind. If you met me you would not suspect either, most people who find out I have Tourette syndrome are stunned when they find out.

Been on meds since 12 yesrs old and the meds are what damage my testosterone production when I withdraw off of them 2 years ago. It was as if withdraw never ended, it continue to drag on for more than a year.

Lots of guys are able to come off their meds once they are on TRT for at least 6 months to a year. Some find it easier to deal with their problems once there TRT is dialed in.

Most insurance doctors do not know how to do TRT properly and issue protocols designed to fail, you must educate yourself because these doctors are not going to educate themselves as they don’t have time.

Once you get all your labs in post them up and include lab ranges and I can make some recommendations.


#13

Wait, really? That’s seriously awesome.

I mean in all manliness, I want to hug you after hearing that. Makes me extremely hopeful.

I’m figuring out how to post prior labs, and will post the labs I get tomorrow when they come in.

If you don’t mind me asking, did you start TRT before or after getting off of the medications?

I mean even to sleep tonight to make it to my labs I may have to take a sleeping pill, which hopefully won’t mess with results, but still. Sucks that I have to depend on this stuff just to function, when there is something natural out there that can potentially help.


#14

I was off all medications for a year before starting TRT, at that point after what all the medication did to me I would rather have died than gone back on them. I spent 10 grueling months withdrawing off of them which damaged my pituitary gland, so going back on was not an option.

Some find that they need to go back on their meds when they are first going on TRT, then months later start slowly tapering off as TRT starts working.

It will be miserable for you if you do not find a doctor that knows what he’s doing, if the doctor looks hesitant or hesitates when you ask him a question, it’s time to find another doctor.

Most of us pay out of pocket for proper care, insurance is useless for TRT. You’re more than likely going to be converting a lot of your testosterone into estrogen and you will need an estrogen blocker as part of your protocol.

Insurance doctors do not prescribe estrogen blockers so you see your problem right there, that’s my problem too and I’m looking to pay out of pocket for my TRT in about a month or two with Defy Medical which offers and online Skype type of service.


#15

Wow, good stuff. I took that advice and have been off of Adderall for 8 days now. Hoping it helps. The only TRT doctor that seemed to know what he was doing 100% is out-of-network and charges $400 for an initial consult…

I heard Empower Pharmacy is good, not sure if I’m wrong, but sounds like a vial of cypionate is $60 or something like that. Sounds reasonable.

I’m gonna post some before pics from when I was probably in the best shape I’ve ever been in and see if anyone here can give any tips. Really feeling like an 80-year-old man and it sucks.


#16

One last question, I’m getting my bloodwork again tomorrow morning but my local lab (Quest) has its earliest opening at 11 AM which I took. My lab order says to do the bloodwork between 7-9 AM, and I read that for young men it’s better to do it in the morning.

If I make the effort to sleep in and wake up at like 10:15 and do the bloodwork at 11 AM, should I still consider those results valid, or would it be better to wait it off?


#17

Now you’re catching on, they know how the TRT game is played and can charge whatever they like because they have a skill most doctors do not, that makes them special. Most of the really good doctors have left the sick care model, they leaves only the D- doctors to fill in the vacancies.

Defy only charges $250 for a consult, another $250 for labs and yearly is $1300-$2000 depending on dosages and whether you’re using HCG.

These private practice doctors are the only ones who can get custom orders from Empower Pharmacy, compounded doses of Arimidex, even .010- .125mg. Just try cutting up an 1mg tablet into that many pieces. There are AI over-responders who require this service unless they are happy dissolving Arimidex in vodka and dosing it that way.


#18

I had the opportunity to start at 25 as well. Not too young. I’m all for people on TRT, but I always think you should try to fix yourself naturally before going the exogenous route. Fix your lifestyle, diet, sleep, micronutrients, lean down to an acceptable BF % and your testosterone will triple in itself along with diminishing symptoms. I understand reading something like this you’re most likely going to push it out the window, but I’ve been there. I’ve had every symptom you’ve had. Doctors told me the same thing and I got mad at them. Just know that You can can fix yourself without the drugs.

If you have excess body fat, especially around the abdomen, when you lose that fat, your testosterone levels do improve. It’s not a question of will they improve, because they will. Your endo was not wrong. Excess body fat is highly estrogenic. It is harder for your body to produce testosterone when you are above 15% body fat. Testosterone doesn’t just burn fat away like a magic pill. However it does allow your body to burn it quicker through proper diet and exercise.


#19

Yeah, it kind of sucks because he wrote a research paper on testosterone, but so be it. I’m actually still seeing a doctor for my testosterone replacement therapy (an endocrinologist), but he just wasn’t very competent in my opinion. For instance, he suggested doing injections with test cypionate every 2 weeks, when I read that the half life is 3.5 days. On top of that, I was left to do a lot of the legwork in terms of research.

I have one more round of bloodwork to do, and then I’m going to decide on whether to start it or not. Pretty sure I am, because I’m incredibly depressed and my mood has tanked. At least on the Prozac I was more competent and patient, feel like I’ve lost my mind without it. On the other hand, not taking Adderall for nearly two weeks is a bit of an accomplishment.

Maybe I’ll see if my doc can get a custom order from Empower. Do you know what a normal dose of Arimidex is, is there a standard system of dosing that most doctors do?

Lastly, my understanding of HCG is very minimal. Is HCG mainly for people who have their testes shut down or are concerned about fertility, or is it considered a first-line option for people who want to consider having their testes produce testosterone as opposed to getting it from an exogenous source as is the case with TRT?

Also read that sexual activity (sex, masturbation, anything) is not advised for 48 hours prior to the testing due to a potential negative impact on prolactin levels. This is easy for me since I have no interest in sex which is depressing. I could see the most beautiful woman in the world and feel nothing. ED also is still a major factor impacting sex life that’s basically nonexistent and is concerning. Most of the time I achieve partial erections at best. I’ve had a few concussions (maybe that explains this), but I remember waking up with erections fairly regularly as a teenager.


#20

I totally agree. I actually was 226 pounds in 2010 and one point, and dropped it down to 160 pounds in about a year and a half. It’s actually interesting, because the summer after I had lost a ton of weight (was about 175 lbs), one of my friends from high school and I decided to start hitting the gym seriously.

We began lifting the same amount of weight, I started tracking my macros, eating clean, and basically became obsessed. While we both started lifting the same amount of weight, he went from a stick to a tree (lean & jacked), while I trimmed down and became healthier but was nowhere near where he was in terms of our physiques.

I couldn’t progress at all, and almost gave up on lifting weights altogether for cardio. My physique looked like a smaller version of my fat self, while he looked huge. Then six years later, I learned about testosterone, got it tested, and boom, hit me like a ton of bricks.

here’s a picture of me at what was probably my best in 2012 (gut prob sucked in)

and again sucked in around that same time. In the picture in my first post, it is not sucked in as I wanted a full analysis of what might be going on. I certainly gained weight in that time between the two photos. However, in that time, my body comp hasn’t seem to change no matter how hard I worked, which leads me to believe that it’s simply difficult if not impossible for most men to be men without the proper hormonal levels and may be near impossible to bring them up naturally if for whatever reason the body chooses to not produce them.

Bottom line for the TL;DR: It’s more than just the physique for men dealing with low testosterone. The lethargy, and in my case inability to sleep. I’ll get in bed and toss and turn for 45 minutes-an hour most nights with incredible anxiety. The need for coffee and just managing life. I feel like it’s hard to be a man, let alone a productive one without it.