29 Low T, about to Start TRT

I have been reading here for some time now and first of all thanks for all of the great information. I just got my labs back and wanted to start a thread to get some feedback. Thanks in advance for your time.

In your case/thread opening post:
Age: 29
Height: 6’2"
Waist: 33
Weight: 205

Describe body and facial hair:

Decently hairy chest with some hair on the upper back. Facial hair is not very thick, I shave once a week and that is sufficient to maintain a “professional” look. I don’t think I could grow a mustache if my life depended on it.

Describe where you carry fat and how changed:

Carry fat mostly in lower abdomen and sides/lower back. These areas have been hard for me to loose fat in despite cardio/weight training 5 days a week for about 2 years now.

Health conditions, symptoms [history]:

Low libido, slow recovery from training and hard fat loss are what lead me to researching TRT in the first place. From reading here it seems that I may have a thyroid issue as well. Ive been recording my body temps and waking is averaging 195.2 and afternoon temp is never above 197.4. I have started (beginning this week) taking Iodine in the form of lugols 2% as well as 200mcg Selenium daily. So far no increase in body temperature, although I feel a bit better/ not as sluggish as I have been.

Rx and OTC drugs, any hair loss drugs or prostate drugs ever:

None

Describe diet [some create substantial damage with starvation diets]:

I do not eat meat or dairy products. My diet is high carb low fat for the most part. Possibly even extremely low fat by some standards. I have been cutting calories trying to loose fat in my problem areas. I have not been using salt, Iodionized or otherwise in my cooking for a few years now.

Describe training [some ruin there hormones by over training]:

I do Crossfit 2X a week and weight lifting 3 days per week with a good amount of cardio (swimming/treadmill) mixed in.

Testes ache, ever, with a fever?:

No

How have morning wood and nocturnal erections changed:

Much less frequent than they used to be.

Labs:

Glucose, Serum 82 mg/dL 65 - 99
BUN 15 mg/dL 6 - 20
Creatinine, Serum 1.47 High mg/dL 0.76 - 1.27
eGFR If NonAfricn Am 64 mL/min/1.73 >59
eGFR If Africn Am 73 mL/min/1.73 >59
BUN/Creatinine Ratio 10 8 - 19
Sodium, Serum 142 mmol/L 134 - 144
Potassium, Serum 4.2 mmol/L 3.5 - 5.2
Chloride, Serum 102 mmol/L 97 - 108
Carbon Dioxide, Total 24 mmol/L 18 - 29
Calcium, Serum 8.6 Low mg/dL 8.7 - 10.2
Protein, Total, Serum 6.2 g/dL 6.0 - 8.5
Albumin, Serum 4.2 g/dL 3.5 - 5.5
Globulin, Total 2.0 g/dL 1.5 - 4.5
A/G Ratio 2.1 1.1 - 2.5
Bilirubin, Total 0.5 mg/dL 0.0 - 1.2
Alkaline Phosphatase, S 87 IU/L 39 - 117
AST (SGOT) 27 IU/L 0 - 40
ALT (SGPT) 40 IU/L 0 - 44
Cholesterol, Total 117 mg/dL 100 - 199
Triglycerides 117 mg/dL 0 - 149
HDL Cholesterol 36 Low mg/dL >39
VLDL Cholesterol Cal 23 mg/dL 5 - 40
LDL Cholesterol Calc 58 mg/dL 0 - 99
Prostate Specific Ag, Serum 0.6 ng/mL 0.0 - 4.0
Testosterone, Serum 516 ng/dL 348 - 1197
Free Testosterone(Direct) 7.1 Low pg/mL 9.3 - 26.5
LH 4.8 mIU/mL 1.7 - 8.6
FSH 1.3 Low mIU/mL 1.5 - 12.4
CBC, Platelet Ct, and Diff
WBC 7.0 x10E3/uL 3.4 - 10.8
RBC 4.58 x10E6/uL 4.14 - 5.80
Hemoglobin 14.1 g/dL 12.6 - 17.7
Hematocrit 41.6 % 37.5 - 51.0
MCV 91 fL 79 - 97
MCH 30.8 pg 26.6 - 33.0
MCHC 33.9 g/dL 31.5 - 35.7
RDW 12.8 % 12.3 - 15.4
Platelets 209 x10E3/uL 150 - 379
Neutrophils 47 %
Lymphs 43 %
Monocytes 7 %
Eos 2 %
Basos 1 %
Neutrophils (Absolute) 3.3 x10E3/uL 1.4 - 7.0
Lymphs (Absolute) 3.0 x10E3/uL 0.7 - 3.1
Monocytes(Absolute) 0.5 x10E3/uL 0.1 - 0.9
Eos (Absolute) 0.2 x10E3/uL 0.0 - 0.4 01
Baso (Absolute) 0.0 x10E3/uL 0.0 - 0.2
Immature Granulocytes 0 % 01
Immature Grans (Abs) 0.0 x10E3/uL 0.0 - 0.1

I was surprised that my Dr. didn’t request thyroid or E2 to be tested. It appears that my total T isn’t that bad but that free T is low. What can you guys tell by what was tested and the results? Thanks again for any and all help.

Please get these labs: - you have some now
TSH
fT3
fT4
TT
FT
E2
prolactin

Your total cholesterol is pathologically low. You need fats in your diet, animal or dairy fats. Also need essential fatty acids, fish oil, nuts, flax seed meal/oil. Cholesterol is the chemical foundation for vit-D3, sex hormones, DHEA, cortisol etc. Your diet is probably the cause of your problem, but dietary changes probably not cannot resolve this. Total cholesterol below 160 is associated with increased all-cause mortality.

Your temperatures are well done.- have a look. You seem to be indicating that you have deep hypothyroidism. Are your outer eyebrows sparse? That would indicate a long term problem.

You are over training given your diet. If you are training muscles without proteins in your diet you are burning up what proteins are in your muscles and may well have multiple essential amino acid deficiencies.

With low T and suspected hypothyroidism, loosing weight with a carb based diet seems impossible and starvation mode and training seems like a good way to elevate rT3.

Have you studied the advice for new guys sticky. I think that there are many things there that may apply to you.

Sorry if I seem abusive, just not in a very good mood right now. My best advice is to become a carnivore.

Thanks for your response, I will look into getting those labs done as well. Eating dairy is not an option for me due to allergies. Do you think I can get my cholesterol up by including more non animal fats in my diet? I have just started taking a flax supplement as well.

As far as the eyebrows, I guess you could say they are sparse at the ends. I doubt that is diet induced because I have only cut meat and dairy out of my diet in the past year. My mom is hyper (medicated) and my brother(older) was diagnosed hypo when I was younger. Do you think I’ve had long term thyroid issues? I’ve always been easy to gain and hard to loose weight.

Was your free T in pg/ml or ng/dl.
Also your total looks descent.

pg/ml

Bro don’t jump into TRT get your values tested as told by KSMAN.I am also suffered like you and waiting for some other solution.

Most cholesterol is made by your liver and cholesterol in food is a small component. But some fats promote higher cholesterol levels.

You can bypass this issue with DHEA which might be helpful. Could also get DHEA-S tested.

Hypo from low iodine can progress to hyper then a risk of cancer too.

Started TRT @ 200mg per week Test Cyp/ 100mg Mon and 100mg Thurs., .5mg Ananstrozole EOD and 250ui HCG MWF. Here are the 6 week labs.

T Serum 1400 ng/dl 348-1197
Free T 22.6 pg/ml 9.3-26.5
E2 3.0 pg/ml 8.0-35

Obviously the .5mg Anastrozole dose was too high so I did like KSman suggests and took 6 days off and resumed .25mg on Mon and Thurs with my injections. I inject with .5ml 5/16th slin pins SC btw.

I retested E2 after a few weeks on this new dosing protocol. As well as thyroid labs as requested before. Results were:

E2 35.7 pg/ml 7.6-42.6
TSH 5.32 pg/ml 0.45-4.5
Free T3 3.5 pg/ml 2.0-4.4
Free T4 1.09 ng/dl 0.82-1.77

According to the math my new Anastrozole dose should be around .79mg per week. What do you sugest I do? Should I inject .66mg E3D and take .25mg with each injection? Should I lower the Test dose? As far as thyroid, body temps never above 97.4. Hypothetically speaking if I were to take T3 from a research company, what would be the starting dose? 100mcg split daily? Any help would be great. Thanks in advance.

Lower your Tdose your total T is 1400 on trt it should be only 800-1000 range.your free t levels are not in proportion to Total T.
Try 100 mg cypionate per week and i dont think you need anastrozle seeing your e2 which is way low it should be around 20-25.

[quote]sonudv8 wrote:
Lower your Tdose your total T is 1400 on trt it should be only 800-1000 range.your free t levels are not in proportion to Total T.
Try 100 mg cypionate per week and i dont think you need anastrozle seeing your e2 which is way low it should be around 20-25.
[/quote]

I agree. Way too much medicine being used here! He could probably get along just fine with 100 mg T cyp per week and 500 IU HCG twice per week, likely with no AI.

New anastrozole dose should be 0.25 * 35.7/22 = .41 mg twice a week.

Good midrange fT3 and low body temps suggest that rT3 is blocking fT3 at T3 receptors.
This is typically adrenal fatigue. See thyroid basics stick and ^F search for these terms:
iodine
iodized
rT3
adrenal fatigue
97.3
Wilson’s book

fT4 also suggests that you could [still] be iodine deficient.
Sometimes a good idea to run thyroid antibody tests.

Why not get Rx thyroid meds? You are over range.

TT was high. Not worried about T+SHBG that is not bio-available.

FT was low [to therapeutic target] and E2 was low. An odd combination. It is implied that SHBG was high.

100mg T per week would be under medicated in this case.

With E2 getting dialed in, we can watch and see what happens to TT, FT and E2.
When E2 is good, it can take a while for the rest of the hormone profile to adjust.

yes, AST/ALT can be a factor, see the labs

There appears to be some hyper t metabolization going on. Then we can make more changes as needed. If T dose need to be reduced, then if AI dose is reduced by the same factor, E2 levels should be much the same. So the effort of getting E2 dialed in is not lost.

What do you think of me splitting the 200mg int 3 doses MWF and taking .25 anastrozole at time of injection. I have .25 RX and .50 Reserch chem caps. I would rather not have to deal with trying to dissolve the powder and all that stuff. Thanks

  1. It is controversial whether you actually have low T. Total T is fine. Free testosterone is not a reliable test.
  2. 200 mg/ml is not TRT, it is a steroid cycle (except forever). Are you being treated by one of those fly by night Florida clinics? That is typical of them.

[quote]Trueskill wrote:
What do you think of me splitting the 200mg int 3 doses MWF and taking .25 anastrozole at time of injection. I have .25 RX and .50 Reserch chem caps. I would rather not have to deal with trying to dissolve the powder and all that stuff. Thanks[/quote]

I don’t think highly of the idea.

I am NOT a doctor, just a patient with thirteen years of experience receiving TRT.

As stated before, you might not even need an AI if you reduce your T medicine down to 100 mg per week, and contrary to what many say, 100 mg of cyp doesn’t have to be divided into several doses over the week, but if you must, say do two shots of 50 mg per week.

HCG for 500 IU twice per week is a good add-on.