T Nation

31 Y/O Male - Can I / Should I get TRT?


#1

Hi everyone,

I’m a 31 year old male. Been suffering with low libido and poor erection quality for the past decade. Have tried Cialis, Viagara, various herbs, etc. At times they have helped, but more than often disappointing. Wondering if I should seek out TRT under the supervision of a doctor. My bloodtests are below - would appreciate any insight you might have.

Bioavailable testosterone: 4.2 (1.6 - 13.2)
Prolactin: 13 (<18)
LH: 4 (2 - 9)
FSH: 3 (2 - 12)
TSH: 1.25 (0.35 - 5)
Free T4: 17 (12 - 22)
Free T3: 4 (2.6 - 5.7)
DHEA: 9.1 (4.3 - 12.2)
Estradiol: 88 (<159)
Vitamin D: 183 (76 - 250)
Ferritin: 151 (24 - 453)


#2

Please help anyone - would love to get some insight from the knowledgeable folks on this site.


#3

I think if you’re experiencing such symptoms you should go to the doctor. Do you have your total T value in ng/dl?


#4

Your T levels are in lower range . Plz post all values with standard units. You should get Free T also tested. But is sure your bioavailale T is in lower range. Thyroid seems to be okay.
@KSman


#5

Thanks. I did get my Free T levels as well.

Free T: 418 pmol/L (196 - 636)

It seems to be normal, but I guess it just seems strange that my bioavailable T is so much lower:

Bioavailable T: 4.2 nmol/L (1.6 - 13.2).

I have an appointment at an anti-aging clinic on Wednesday and I am hoping they have some suggestions. My primary focus is to really get my libido and erection quality back. I have done everything in my power to increase my test naturally including sleeping for 7-8 hours, diet high in healthy saturated fats, heavy compound lifting. Have even bought underwear that helps to keep my testicles cool. Unfortunately, the low libido and poor erections persist and I don’t understand why.


#6

Total testosterone needs to be tested as well. That can indicate if SHBG is elevated, normal or low.

Your location would be useful as your diagnostic and treatment options will be specific to that.

At your age, low-T is the symptom, not the disease. E2 and prolactin are not the cause. Blows to the head can damage the pituitary.

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

  • advice for new guys
  • 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.


#7

@KSman…do you happen to know of any good docs in Ontario by chance?


#8

The question might be better stated “Are there any good [TRT] docs in Ontario?”

Can’t help you, I left Ontario 20 years ago.


#9

Thanks KSman.

Just a quick update - I ended up seeing an anti-aging doc who agreed my bioavailable test levels were extremely low for a 31 year old. He is running a few additional tests but said he will likely start me off on HCG to initially test out. If there is no response, then we will proceed to TRT.


#10

Hi everyone,

Today is my 15th day on TRT.

I have been prescribed 100 mg testosterone cypionate weekly. My doc advised me to inject ~14 mg daily. I’m also on 250 IUs of HCG 2x a week (Monday and Thursday).

The main things I’ve been experiencing so far are:

  • Lessened anxiety
  • Subtle energy uptick
  • More aggression in the gym
  • Very very subtle improvement in libido and erection quality

The category I’m most concerned about improving is libido. Have been struggling with this for years so really hoping this is a turning point. I guess my question is when do you think I can really start to feel a significant impact from the treatment? My doctor said I should give it at least 6 weeks. I’ve heard from other it took 2 to 3 months. Others have said they felt it within days. Should I be concerned that I don’t feel significant improvement 15 days in?

Thanks.


#11

Everyone responds different which is why you’ll hear a bit of everything. Personally I felt great for the first couples weeks and for the last couple months I’ve been back to my pre-trt condition. That’s not entirely true, it’s better than it was but still far from normal. I wouldn’t be concerned if you’re not feeling a significant difference after a couple weeks, as long as you’re seeing slight improvements keep with the protocol and re-test bloodwork every 6-8 weeks and adjust as necessary, these things take time and going overboard out of the gate can cause as more issues if you’re not careful.


#12

6 Week Update: 100mg test cypionate weekly (14 mg daily); 250 I/u HCG Monday and Thursdays

Hey everyone…went for a couple labs yesterday for estrogen and bioavailable testosterone.

Estrogen:
Reference Range: <159
March 11, 2017: 88 pmol/L (normal)
May 25, 2017: 248 pmol/L (high)

Still waiting on the bioavailable test results, but I’m guessing the above explains why I haven’t felt the rockstar benefits of TRT yet?

Do you guys think I’ll have to get on arimidex at these levels? I have been taking zinc 50mg daily but no other anti-estrogens.

Will be hearing back from my doc next week but just wanted get your thoughts as well. Will also post bioavailable test results when I get them.

Thanks


#13

Hi everyone,

Need some guidance on what I should do next:

April 10

  • Started 1st injection
    Test: 14mg / day
    HCG: 250 units twice a week

Labs on May 25:
Estradiol: 248 pmol / L (range <159)
Bioavailable Test: 16.4 nmol/L (range 1.6 – 13.2)

On May 29:

  • Reduced the test dosage to 12mg / day
  • Started the Super Miraforte (2 caps in the am; 2 before bed)

June 15
Estradiol: 225 pmol / L (range <159)
Bioavailable Test: 22.6 nmol/L (range 1.6 – 13.2)

My doc prescribed Arimidex and told me to take 0.25mg 2x / week. I asked him if I should also be reducing my test dosage but he is away on vacation for a week. In the meantime, do you guys think I should drop it down to like 10 mg / day.

Not feeling any benefits whatsoever right now…I’m guessing because of the high estrogen levels.


#14

Please help guys…would love to get your thoughts on this one.


#15

Dont drop the dose at all. 100 mg a week is fine from all the reading I’ve done on this site and others.

You feel like shit because a high amount of that testosterone is aromatizing into e2.

The right thing to do would be to stay on 100 mg cyp weekly and figure out your arimidex sweet spot.

Also you dont need to inject daily its a hassle. Just follow Ksmans protocol and split into 2 x 50 mg doses 3.5 days apart. For example monday morn, thurs night. Take 0.5 mg arimidex at time of injections. And see how you go from there.

Maybe even listen to doc and take 0.25 mg twice so the next labs will show him that it isnt enough and he will bump your dose up


#16

Thanks tj.

I will definitely use the arimidex starting today.

But isn’t my free test way too high (even at 12 mg a day). It’s 22.6 and the range is 1.6 - 13.2?


#17

@KSman will have to answer that one. The only thing I can think of is that your SHBG is superlow so your bio T is very high…

It would help if doctor tested shbg and total test.

Also how do you dose 14 mg per day. That would be less than 0.1 ml from a standard 200 mg/1 ml cyp vial… are you sure you havent been injecting too much


#18

I’ve got a syringe which draws up 1.0mL.

The test cyp I am taking is 100MG/mL.

I inject 12 units of that 7 days a week for a total of 84 mg’s / week.


#19

I was definitely surprised to see my free test skyrocket this much in such a short period of time

Especially after the doc told me to lower the dosage from 14 mg / day to 12 mg / day


#20

Its strange, so someone with more knowledge will have to put their two cents in.

From all the numbers Ive read on here most guys get to 800-1000 ng/dl total test from 100 mg cyp per week and then get top of the range free test once e2 is adjusted. So I dont know why yours is so far out of range.

Also your e2 is extremely high which generally takes away from bio t/free t…

Just wait for Ksman to throw his 2 cents in.

There are some TRT clinics in the states who prescribe 200 mg cyp per week under the notion that the spike doesnt matter aslong as the low days by the end of the week are still high in test before the next shot.

Dr rand mclain does this. 200 mg cyp once per week with 1 mg arimidex eod but I know this protocol is frowned upon here.