T Nation

32, Just Being Prescribed TRT, "Low Everything"

hey guys,
I’ve been reading here through everything trying to get an understanding before I post my question. My values seem to be low for everything. The doctor I went to see here in NC said its the lowest shes seen.

A few years ago, after baby #2 I started to lose some hair. At the same time I started grad school, got a promotion, started not being able to sleep, anxious all the time, stressed as could be. (New job, school and two young kids, who wouldn’t be?) So I wrote everything off to stress, even my mood swings and general sense of exhaustion 24/7. I started to talk to a friend and he recommended seeing a doctor and getting tested for low T. My diet is pretty good, 40% Protein, 40% Carbs and 20% fat, I also work out 5-6 days a week heavy lifting and running and rowing.

I am 5’8", 175lbs, 12% body fat. I “experimented” with some bodybuilding pills years ago, maybe 7 or 8 years ago in the military- Anavar. I am hoping I didn’t do long term damage, but I had two kids afterwards.
Long story short, here are my numbers from my labs a couple weeks ago. I haven’t started anything yet.

Cholesterol HDL: 56
Cholesterol LDL: 93
Total Test: 37 (range 264-916)
Free Test: 2.3 (range 8.7-25.1)
T4: 1.46 (range .82- 1.77)
Morning Cortisol 10.0 (range 6.2-19.4)
Estradiol: <5.0 (Range 7.6-42.6)
Vitamin D 27.9 (range 30-100)
Progesterone: .2 (range 0.0-0.5)
Insulin: 3.7 (range 2.6- 24.9)
T3: 3.0 (Range 2.0-4.4)
SHBG: 11.0 ( Range 16.5- 55.9)
Lutropin: 1.3 (Range 1.7- 8.6)

My doctor has prescribed 160 mg Test Cyp/week, 50mg Progesterone/night pill and 600UI HCG per week (day 5 and 6 injections)
So, any advice? Should I follow this for a while, is this abnormal blood work?
I am a little bit freaked out.
Thank you

Anavar isn’t a bodybuilding pill, it’s an anabolic, androgenic steroid (c17AA compound derived from dihydrotestosterone), it’s on the milder terms in regards to the amount of muscle one will accrue on it, however it is on the harsher side in terms of how it can effect your cardiovascular system, anyhow considering you were able to concieve two children post usage I don’t think this would be what tanked your testosterone, it may have been a contributing factor however a testosterone level of 37ng/dl is around what some women produce. If you don’t mind pain and you think you have primary hypogonadism you can always get a testicular biopsy… or just a painless testicular ultrasound to screen for various testicular issues. Either way, it doesn’t really matter, just start the trt, you’ll feel so much better.

A total testosterone level of 37 is absolute trash, we need to see a test of your gonadotropin production in order to determine whether your hypogonadism is secondary or primary, if you have secondary hypogonadism, get a prolactin test as you may have a pituitary tumor. I would suggest starting the TRT asap, you seem to have found a good doctor

Your vitamin D is low, possible supplement with some vit D? Your E2 is tanked, this can result in thinning and weakening of the bones and eventually osteoporosis, your testosterone is very low, this over a long period of time will lead to cardiovascular disease and increase your risk of acquiring various medical conditions.

Do you take prescription medications (opiates, benzodiazepines, statins, 5-alpha reductase inhibitors etc)

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I will tell you this protocol is going to end up making you feel worse, your SHBG is low so your ability to hold on to testosterone is not good. Normally low SHBG guys inject EOD and guys with really low SHBG every day since your testosterone is excreted into the toilet within 1-2 days.

You should be injecting 5-10mg daily, injecting large doses will only drive estrogen production.

Thank you. I see slot of people talking about an AI and not much traffic about progesterone, should I try it and see how it works? When you don’t really agree with the Dr, do you argue it or just self medicate. If I were to do micro doses everyday, I’d need to find the insulin needles and do it myself, right?
Of all the tests mentioned, are they something my dr should be talking to me about yet, or something I need to push with her?
Also, I’ve read and understand this is a dumb question…I had a vasectomy a year ago, any chance it affected me in any way?

No I don’t take any meds

Depends on what country you are in, if in US then you don’t need to self medicate, good doctors are aplenty. I’m not so sure about Low SHBG causing excess aromatisation for everyone, you see more free T typically = more free E2, my SHBG is not quite as low as yours (15-25), however my albumin is very high, testosterone also binds to albumin (albeit not as strongly) therefore high albumin can reduce the high free T (slightly) associated with low SHBG. High free T usually = high E2, however this is individual for everyone. I don’t tend to aromatise much, and I require larger doses of testosterone to get to therapeutic levels (although I tend to cruise at high normal to mildly pharmacological), 110 mg/wk gets me to around 500ng/dl on average. my natural production prior to hypogonadism was 1052ng/dl, I tend to feel very good in the upper ranges, yet due to where I live I have to self medicate as doctors typically aren’t willing to push patients above 400-500ng/dl or outdated terrible protocals are used that leave the patient worse off, my hematocrit hasn’t increased since starting TRT either. it’s been consistently in the high normal range.

For micro dosing ED you can use insulin needles or regular needles designed for IM injections, it doesn’t matter, if the oil is thick you may be better off with a slightly lower gauge needle (say 26-27) for ed shots than an insulin needle, however one can still shoot with a slin pin, just takes longer and in my experience can create more irritation around the injection site.

Yeh, vasectomies can reduce testosterone production, especially if the procedure is botched, even if it isn’t vasectomies have been known to cause hypogonadism. I say CAN because it isn’t particularly likely, however you may be unlucky.

Thanks for the info. I just checked, my Albumin serum was tested and it’s 4.7 on a range of 3.5-5.5
I’m just trying to think through the best course of action right now. I’m stocked up with the cyp, hcg and progesterone with the needles. I am worried about one large weekly dose vs small frequent doses given low SHBG. I may call the doctor and give her my concerns and see what she says
Thank you

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Sorry too hear about your situation Kmac28, that TESTOSTERONE level is 37 out of 1000 is WALKING ZOMBIE level.

I am Surprised the Doctor that she didn’t fall out of her Chair onto the floor! You need T.R.T not tomorrow, not next week, you need it Immediately!!! with that level. you putting all your organs at risk.

Especially the Heart working over time without not enough Fuel for your other muscles, Testosterone plays a ROLE for the Heart to pump blood to all other muscles & organs.

I would definitely be injecting 4-5 times per week given your SHBG is only 11 out 16.5 to 55 range. Also if you cut out MEAT in your diet it raises SHBG too & eat some FISH instead.

Propionate i believe is water ester 24-48hr Half life, you could inject Propionate constantly. but then again i would just go with a Long half-life ester like you said you have some Cypionate.

if my SHBG was low as yours i would do 20mg per day everyday so that’s 7 x 20mg = 140mg per week. But first you need to find out how much 20mg on a syringe 1ML would be measured out.

I think it would be 0.1ml on a 1ML syringe or something anyways get that TESTOSTERONE back in you. and hopefully after 6 months you will be feeling like your 18 years old again :slight_smile:

Thanks man.
I can order additional syringes and start injecting 20ml/ day. On that protocol, how would I time it with the HCG I am also prescribed?

What about a topical to maintain more of a constant level? It’s expensive as hell, yet my insurance covers it. And I had to chuckle at unreals comment. My female dr. years back thought 300 was just fine. I beat my head against the wall. Been there.