T Nation

27 y/o with Low Testosterone. New Bloodwork


#1

What’s guys?

I am wondering if I should pursue TRT/HRT. I will give a bit of background on my me.

I cycled on and off SARMs and designer steroids several times between June 2016 and August 2018. I always did a PCT and waited 2-3 months after that to do another cycle.

Never got bloodwork done during that period because I was uneducated and an idiot. So I have no idea what my hormone levels were prior to going to on cycle.

In March 2017, my cholesterol was 250 mg/dL (100-199). LDL was 162 mg/DL (0-99). HDL was 62 mg/DL

I noticed that between cycles my cholesterol would always shoot up and during cycle it would get back down under control (under 200 mg/DL). I had no idea why and never though it was related to my hormone levels.

Anyway, I began to battle my cholesterol my hopping off all PEDS, losing fat, and changing diet to inflammatory over the course of 3-4 months. Nothing worked. My cholesterol stayed high.

This is when I began to think my cholesterol and hormone levels were related. I stumbled across this forum and read the stickies. And got some bloodwork done.

This is September 2018. These were my test results:

Total Testosterone: 375 nd/dL (264-916)
Free Testosterone: 13.1 pg/DL (9.3-26.5)
TSH: 1.060 uIU/mL (0.450-4.5)
E2: 10.2 pg/dL (7.6-42.6)
LH: 2.5 mIU/ML (1.7-8.6)
FSH: 6.3 mIU/ML (1.5-12.4)
Cholesterol: 248 mg/DL (100-199)
LDL:176 mg/DL (0-99)
HDL: 54 mg/DL
VLDL: 18 mg/DL (5-40)
Triglycerides: 92 mg/dL (0-150)

During this time, Everything else was in range. I just do not feel like typing it out. I was everything at this point for a month or so.

Given these levels, I decided to do a HPTA restart with Nolvadex. 20 mg/day for 4 weeks and then 10 mg/day for 4 weeks. 8 weeks total.

After those 8 weeks, these were my levels posted below. This is November 2018. Same reference ranges as above.
Total Testosterone: 682 Ng/DL
Free testosterone: 19.6
E2: 32.1
LH: 3.3
FSH: 6.9
Total Cholesterol: 188
LDL: 105
HDL: 55
Triglycerides: 127
Liver enzymes spiked a bit. Which I attributed to the oral Nolvadex. Everything else in the CBC and CMP was within range. I cruised on some Aromasin. 12.5 mg twice per week for 8 weeks after.

Now I waited another 8-9 weeks until the Nolvadex was completely out of my system. I got my bloods done again last week. My testosterone crashed and cholesterol is back up. Bloodwork posted below. Same reference ranges as above.
Total Testosterone: 285 Ng/dL
Free Testosterone: 14.7 pg/dL
E2: 14.4
LH: 2.8
FSH: 4.5
Total Cholesterol: 243 mg/DL
LDL: 155 mg/DL
HDL: 54 mg/DL
VLDL: 34 mg/DL
Triglycerides: 169 mg/DL

My triglycerides and VLDL are up. This is very concerning to me. I know now that it is directly tied to my hormone levels.

I am wondering if I should pursue TRT given that my levels went back to being like shit?

Any opinions and advice are welcome.

Thanks in advance guys.


#2

So what’s your question?

If it’s this,

Then your going to have to go and get full labs done and post the results before anyone can answer that.

Total T
FreeT
SHGB
LH
FSH
TSH
T3
RT3
Sensistive E2


#3

Sorry about that. I accidentally posted before I was finished writing. I edited the post with my labs and timeframes above.

I do not test my free t3 and t4. Or my SBHG. So I still need to have that done.

Much thanks for any advice you can give with the information I provided though.


#4

TRT and no aromatase inhibitor.


#5

It’s likely you will need TRT for life at this point and it will be difficult to find a doctor willing to prescribe TRT to a 27 year old. I would seek out an anti-aging clinic over a garden variety doctor/endocrinologists as they tend to be not very knowledgeable.

Based off your Total T and Free T numbers I would put your SHBG about midrange. I would then recommend two 50-60mg injections per week as once weekly isn’t always optimal. If you can do TRT without AI’s, this would be best for the long term.

I would freeze sperm now while you are producing, TRT can make you infertile without HCG or FSH injections added to your TRT protocol.

I have caught my liver enzymes spiking whenever I change my T dosage up or down on routine blood work, when you change your dosage, you leave a stable state and that always affects other systems.

As it stands now these levels are putting you at risk for cardiovascular disease (<440 ng/dL) among other nasty diseases. High triglycerides indicates your metabolism is crap do to low testosterone, your metabolic rates are low.


#6

Ya man. I believe my cholesterol is directly linked to my metabolism. My metabolism is directly linked to my testosterone, MEaning my HTPA is all fucked up.

Honestly, I am just going to keep going to different Endo and Uros until I find one willing to prescribe. I was just shocked how much my cholesterol went down when my testosterone was near 700.

I want to get this handled as soon as possible. I have walking about with fluctuating cholesterol and hormones for over 2 years.

Although I did get a echocardiogram and calcium score done in September 2018 and it indicted that my heart doing just fine. Nothing popped up out of the ordinary at all. So nothing life threatening right now.

But this is a slow burn that will affect me as I get older. So I want to get it handled now.

I need a doctor that takes insurance. I cannot afford a anti aging clinic. I live in Washington DC and most charge $1500 just for a consultation and then few hundred dollars per month as a membership.

Then I checked out the ones that do online consultations in Florida and you have to pay for the drugs out of pocket which come out to like $1000+/month. Can’t afford that either.

I am going to need to get a doctor’s prescription in order to afford and that might take some time. I am going to keep calling pharmacies in the area to get some names of more doctors.

If anyone has any recommendations in the Washington DC area, please let me know.

My buddy has a prescription for Test cypionate, HCG, and AI. He only pays $130/month on average. He is 35 y/o and used to compete. He Got a prescription a year ago.

So that is my game plan. I will keep calling pharmacies and getting doctor names willing to prescribe.

Any other suggestions, opinions, or pieces of advice are would be most appreciated.

Thanks!


#7

Defy Medical is a telemedicine anti-aging clinic and at the most it would only cost $100-$150 monthly.


#8

Is that before or including the costs of drugs. Do they write prescriptions? Do you have any recommendations on clinics?

Thanks!


#9

It includes everything, consults, medicine and labs. It all average out to $100-$150 monthly, pay as you go.

I paid $250 for initial consultant and $250 initial labs, it’s cheaper after the first year do to only $120 for Dr. Saya (medical director), $75 mid levels doctors and physician $50 for consults. Their mid level doctors are far better than most doctors.

I’m not on HCG so it’s cheaper for me.


#10

Got it. That is a solid option. Did not think it would be that cheap. That’s great.

I would definitely want HGC though. I do not want any testicular dystrophy. I am sure that costs a bunch of money out of pocket.

I will definitely pursue this as an option if I do not find a doctor willing prescribe and do lab tests through my insurance.

Do you have any other suggestions? I really appreciate you taking the time to provide your feedback man.

Thanks!


#11

Hi,

I apologize for the length of my post, however, I think what I have to share should help you navigate your questions a little better. Before I rant, my HPA axis is messed up too - rX’d Metformin & T4 (levothyroxine) - and I was feeling better in two days. My metabolic issues were compounded by a concussion/mTBI.

First Imagine having to write down every metabolic process your body has to complete. If we have a health imbalance, get sick or train our muscles to exhaustion then that ‘to-do’ list grows longer and out of control. If we stub our toe or hit our head, it get’s more complicated because we stand on our feet and think with our heads. They don’t get much of a break. Time for some housekeeping with this list while your body heals. Don’t add to the list. Nutrient-dense foods are critical because even digestion taxes our bodies energy expenditure.

Next, read about metabolic syndrome. It’s tied in with the HPA axis… as well as high triglycerides, heart disease, stroke, diabetes, weight gain. Modify your life to avoid these things at any and all costs, they’re all inner-connected in a strange way. A concussion can cause metabolic syndrome; they’re also very common injuries - and if you haven’t had one, now is the time to avoid them at all costs. Your metabolism needs to heal. Think of a rock tossed into a pond. The ripples need to settle.

Read up about Metformin. Some people take it for metabolic syndrome. It’ll help high triglycerides. Metformin is used by diabetics, in addition to bodybuilders, life extension and longevity enthusiasts also. It’s safe and studies have shown that T-2 diabetics who take Metformin often live longer than non-diabetics who do not take Metformin. At the end of the day, it’ll buffer and heal the fallout caused by metabolic insults. It’ll also improve insulin sensitivity.

Sildenafil (Viagra) is also shown to help with T… and can be purchased generically with a discount card for around $30 bucks a month. If it’s taken at a low dose three times a day, alongside T, it’s been shown to aid soft tissues repair. Also good for the brain, digestive track and “elsewhere” - all fact checkable on pubmed.gov. I wouldn’t say it’s necessarily safe - but it can offer some substantial health benefits for some people.

While I’m on the topic of price - I think you also mentioned cost of T being a concern. Shop the discount rX cards - a 10ml vile of Testosterone should cost around $42 a vile at a major pharmacy. This is a one or two month supply for most people.

The picture I’m trying to illustrate is that there are many angles of attack that can help put your body back on track. Once your body begins to heal a little, you’ll experience relief. When you experience relief, you’ll be more active and prone to engage in activities that contribute to good health. Just as health problems can work synergistically against us, we can also establish protocols that work FOR our health.


#12

Hi - I don’t want to double post. I’m new on the forums, and I’m not sure if I accidentally hit ‘reply’ while editing - or cancel.

Regardless, I apologize for any confusion. Just wanted to share that if your HPA axis is messed up, then your brain is not regulating your hormones properly.

T4 & metformin may help. If you read up about metabolic syndrome, that’s the long-term stuff you want to avoid - I mention this because of your triglycerides.

TRT… If I were in your shoes, I would elect for TRT. You’ve recognized a HPA axis problem. Secondary hypogonadism is essentially a signaling problem between the hypothalamus or pituitary and the testicles. If we begin producing less T around age 30 anyway, I would want TRT because it makes no sense to suffer a decline in health or quality of life at age 27 that will simply snowball later in life.

I think it’s important to recognize that you may very well have a health concern that requires medical treatment. There’s no need to suffer.

As for cost concerns, discount Rx cards at major pharmacies make T treatment affordable if that’s a concern. I’ve paid around $40 for a 10ml vile at major pharmacies.

I would definitely focus on the goal being obtaining proper care from your Dr. If your body can not regulate hormonal function, then you will (unfortunately) suffer if this isn’t addressed. Once your doctor is on the same page, they should have the ability to navigate authorizations from your health insurance company. Your concerns sound entirely valid and once a Dr. sees the whole picture, I doubt they would want to see you suffering – and it’s a difficult situation for a Dr. to recognize because the HPA is in the brain, and bloodwork may not accurately diagnose the brain.

I sincerely hope this helps.


#13

I appreciate it. Thanks a lot. I have a an appointment with an Endo on Wednesday. We will see how it goes.

I will definitely read into the metabolic syndrome because that is definitely what is causing my high cholesterol and triglycerides.

I will also look for big pharmacy discounts. IS there anywhere you suggest that I go find those coupons?

Thanks!


#14

A little update on thyroid labs for those who care.

So I got my free T4 and TSH tested a week ago. In the past, my TSH has always been between 0.9-1.1 uIU/mL (0.5-4.5) and free T4 has been 1-1.2 ng/dl (0.82-1.77) in the past.

A week ago, my TSH came back as 1.94 and free T4 at 1.1 ng/dL (0.82 - 1.77).

My THYROID PEROXIDASE (TPO) AB was 19 IU/mL (0-34).

I am still waiting on my free T3 levels. I should know those at the end of the week. Anyway, the Endo tells me this is normal because I fall within the medical range on everything. So she says there is nothing wrong with my thyroid. But I beg to differ given my low testosterone and the fact my TSH is higher then normal with no increase in T4.

Whatever. Let’s see what happens. I think I am going to start taking body temperatures throughout the day to get a better gage of my metabolism.

What do you guys think?

Thanks in advance!


#15

not to scare op or anything. but at 27 have you guys seen young people trt and manage to go live 50 years on it without problems?


#16

That’s a good question. I don’t see why not, especially considering potential negative conditions caused my low T. But I don’t even know how long TRT has been around.


#17

Well, with low T your life threatening conditions you leave your body too drastically increases (cardiovascular diseases, metabolisms problems, etc). So I would rather face issues trying to get healthy and solve the problem than sit around, do nothing, and wait for things to get worse.


#18

true. hardest part is finding the right doctor who is willing to listen to you. you with a good endo?


#19

So my full lab results came back and my cardiovascular situation has gotten worse in a little over 2 weeks. Kind of frightening.

But I’m moving forward with Defy Medical to find a solution. Let know what you guys think. Postingvthe blood work below.

My diet is bad. Only snack a few times a week and have been eating mostly chicken and rice. But my VLDL went up! So did my triglycerides.

My prolactin is high too. My T3 and T4 do not seem be improving either.

What do you guys think?

Thanks in advance!


#20

The worst thing you could do starting out is once or twice weekly injections, it’s more than just because of low SHBG, but there are other factors. You won’t bind much of the testosterone you inject, but you will hold onto the estrogen far longer.

Would like to know where Reverse T3 sits, if high could negate some of that Free T3. If adequate amounts of thyroid hormone are not supplied, the liver’s ability to remove cholesterol out of the plasma is compromised do to your terrible diet!

One thing I have notice in myself is when my T levels are low, I crave junk food, but when my T levels are optimal, I crave healthy foods. Your diet is likely to blame for your low T and possible low thyroid function.

You will not recover naturally at these levels, it’s too late as things have been allowed to go on for too long. There are very few who can turn things around, those men who can are generally in the 400 ranges as things aren’t so bad that it’s too late.

Prolactin is barely elevated, not a problem.