T Nation

32 Yearrs Old, Need TRT Advice

I am a 32 yr old very athletic fit male. 5ft 11 inch, 207(gym fit-lifting weights for 15 yrs consistently-former college football athlete) I recently got full labs performed and was diagnosed with Low T. Was shocked to hear cause I am still muscular and still very athletic. My T levels were 114ng. The P.A. I am seeing has prescribed me only 30MG of axiron one time per day. This is half the standard accepted Axiron dose which is 60mg a day. I have been doing it for 4 weeks now. I felt an initial jump in my recovery time. But after 3 weeks i feel that went away pretty much. I suspect what little T i was producing is now gone since i am on the replacement T.

I am kind of shocked that the P.A. would not try to restart of my natural T first before trying a replacement T but I understand from a drug manufacturers perspective she has no incentive to do that. I have not been on any supplements since 2005. Which makes me think I have been living with extremely low T for 8 full years. I also think that I am still strong and muscular due to the muscle memory and acclimation of lifting weights for 15 yrs consistently. I am no expert just need some help. Below are my full labs i got done.

My goal is to get back to a reasonable long term and sustainable T level without the side affects. Even 300ng T level would be great for me since that’s like a 200% increase from where I was at. thanks

Report Result Ref. Range Units Status Lab
TESTOSTERONE, TOT.,S. 114.1 249.0-836.0 ng/dL Low Final
TESTOSTERONE, FREE, SERUM 2.85 8.80-27.00 pg/mL L

Report Result Ref. Range Units Status Lab
THYROXINE, FREE (FT4) 1.04 0.83-1.62 ng/dL Final
T3 (THYRONINE), TOTAL 116 80-200 ng/dL Final
THYROXINE(T4) 7.0 4.5-12.0 ug/dL Final
T3 UPTAKE (T3U) 29.9 24.3-39.0 % Final
TSH 4.940 0.270-4.200 uIU/mL High Final
T3, FREE (FT3) 3.2 2.5-4.3 pg/mL Final
ANTI-TPO AB <10 <35 IU/mL Normal Final
FREE T4 INDEX 2.1 1.5-3.8

TOTAL PROTEIN 7.8 5.9-8.4 g/dL Final
ALBUMIN 5.0 3.5-5.2 g/dL Final
GLOBULIN 2.8 1.7-3.7 g/dL Final
A/G RATIO 1.8 1.1-2.9 Final
SODIUM 140 133-145 mmol/L Final
POTASSIUM 4.1 3.3-5.3 mmol/L Final
CHLORIDE 99 96-108 mmol/L Final
CO2 27 22-29 mmol/L Final
BUN 16 6-20 mg/dL Final
CREATININE 1.30 0.90-1.30 mg/dL Final
E-GFR 64 >60 mL/min Final
E-GFR, AFRICAN 77 >60 mL/min Final
BUN/CREAT RATIO 12.3 10.0-28.0 Final
CALCIUM 10.2 8.6-10.2 mg/dL Final
BILIRUBIN, TOTAL 0.3 0.1-1.0 mg/dL Final
ALK PHOS 58 40-156 U/L Final
AST 26 <40 U/L Final
ALT 21 <41 U/L Final
GLUCOSE 90 70-99 mg/dL Final
INSULIN, RANDOM 9.7 6.0-27.0 uIU/mL
HEMOGLOBIN A1C 5.5 <5.7
HOMOCYSTEINE, SERUM 10.8 5.0-12.0

WBC 9.76 3.40-11.80 x10(3)/uL Final
RBC 5.12 4.20-5.90 x10(6)/uL Final
HGB 15.1 12.3-17.0 gm/dL Final
HCT 44.0 39.3-52.5 % Final
MCV 85.9 80.0-100.0 fL Final
MCH 29.5 25.0-34.1 pg Final
MCHC 34.3 29.0-35.0 gm/dL Final
RDW 13.3 10.9-16.9 % Final
POLYS 68.3 36.0-78.0 % Final
LYMPHS 26.1 12.0-48.0 % Final
MONOS 4.8 0.0-13.0 % Final
EOS 0.6 0.0-8.0 % Final
BASOS 0.1 0.0-2.0 % Final
IMMATURE GRANULOCYTES 0.1 0.0-1.6 % Final
PLATELET COUNT 257 144-400 x10(3)/uL Final
MPV 9.7 8.2-11.9

SPECIFIC GRAVITY URN 1.016 1.003 - 1.030 Final
PH URINE 6.5 5.0 - 8.0 Final
PROTEIN, URINE NEGATIVE NEGATIVE Normal Final
GLUCOSE, URINE NEGATIVE NEGATIVE Normal Final
KETONE, URINE NEGATIVE NEGATIVE Normal Final
UROBILINOGEN URINE 0.2 0.2 - 1.0 Units Final
BILIRUBIN, URINE NEGATIVE NEGATIVE Normal Final
BLOOD, URINE NEGATIVE NEGATIVE Normal Final
NITRITES URINE NEGATIVE NEGATIVE Normal Final
LEUKOCYTE ESTERASE NEGATIVE NEGATIVE Normal Final
CRYSTALS URINE NONE NONE Normal Final
CRYSTAL AMT. URINE NONE NONE Normal Final
WBC, URINE 0-4 0-4 PERHPF Normal Final
RBC, URINE NONE SEEN NONE SEEN PERHPF Normal Final
EPITHELIAL CELLS, UR NONE FEW Normal Final

CAST, HYALINE, URINE 0-4 0-4 PERLPF Normal Final
CAST, GRANULAR, URIN NONE SEEN 0-1 PERLPF Normal Final
CAST, RBC, URINE NONE SEEN 0-1 PERLPF Normal Final
BACTERIA, URINE NONE FEW
C-PEPTIDE 1.32 0.81-3.85

You need LH/FSH for diagnosis before starting TRT

Transdermals can be wrong for someone who trains and sweats

You thyroid is very FUBAR
Thyroid problems often show non-abortion of transdermals as a symptom

Please read the thyroid basics sticky

  • post your body temps
  • post your history of using iodized salt or vitamins listing iodine

Get off TRT

  • test LH/FSH after 4 weeks
  • test E2, prolactin
  • test rT3

read the advice for new guys sticky, carefully
your low T is a symptom and you need to find the cause
do not get T tunnel vision like your PA

how do you feel? sleep?
energy levels?

I got my levels restested after 30 of being on one pump of axiron my T levels only rose to 198ng from my pre trt levels of 114. My TSH levels are back to normal now 2.8. My AST rose to 43 but i suspect that only has to do with heavy working out. I was referred to an endo doc now hoping they get me on HCG to restore my natual test functions.

Went to the Endo doc. and he wants me to do more specific labs such as LH,etc. He is prescribing me 3 shots weekly of HCG? Is this stuff any good?

HCG can be good for boosting test if your balls still work, which is where the LH/FSH becomes important to diagnose primary or secondary hypogonadism. Follow KSMan’s advice and read the thyroid sticky and get the tests he mentioned. Your “normal” TSH of 2.8 is not normal at all and indicates an issue with the thyroid. Follow the temp taking instructions and iodine replenishment instructions in the sticky. The rT3 test would be very informative to see if you have adrenal fatigue. Again it’s in the thyroid sticky. Axiron did nothing for me, in fact my level only rose 2 points on that stuff. Either way unless you deal with your thyroid and adrenal systems you can throw all the test in the world at your problems and still feel like shit.

Hi Mike thanks for the advice will do all that. I was told though that my thyroid is working fine since it produces the right amount of T3 and T4 hormone. It is just the TSH which is only a messenger signal to the thryoid that is hypo and needs more stimulating hormone to give to the thyroid. All the advanced endo docs of the world are narrowing the for TSH from 0-3 so i am still within their expertise guidelines. My testes work fine and I am thinking once i get on the HCG it will get the LH working to send the signal to jumpstart my testis back into producing T for the rest of my life although it might take a year or so of HCG to do that.

You want your fT3 and fT4 numbers to be midrange, and they aren’t. Even if they were, if you have elevated rT3 then your fT3 is blocked from working. You can get elevated rT3 with adrenal fatigue, which can be brought on by stress, over training, and other such events. I got adrenal fatigue from having back surgery and horrible pain, followed by being his hospitalized for pneumonia then going through a divorce within less than two years.

My TSH never got as high as 2.8, but my rT3 was top of the range and I had all of the symptoms of hypothyroid (along with low T). Every doctor prior to my current integrative medicine doctor told me I had normal thyroid levels, my current doc goes for optimal. I feel much better with my numbers near optimal, let me tell you.

From personal experience I would urge you to look closely at your thyroid and iodine intake along with your test levels. Treating just your low T with a functional hypothyroid is setting you up for a crash.

The funny thing is which is odd cause my T levels are so low I feel great i am fast explosive and and great energy. The only symptom I get from Low T is that i cannot get a consistent rock hard erection it is very spotty. I hate having a semi rigid penis for sex its terrible.

I have gotten my third set of lab results in and the ENDO ordered me to get a Pituitary MRI and Testicular Ultra Sound before I start HCG injections. How likely is it that i have cancer or Tumor? I did a steroid cycle in 2005 with no clomid or anything to restore natural T levels 9 years ago…The endo said something might be wrong with my Pituitary since the levels of LH and FSH are low. he said they should be higher because of the negative Feedback Loop. Is he being extra cautious with the MRI?
Test component

Your result Standard range Result comments
FERRITIN 165 ng/mL 22-322
FSH 0.6 mIU/mL 1.5-12.4 Below Normal Low
PROLACTIN 15.1 ng/mL 4.0-15.2
LH 0.6 mIU/mL 1.7-8.6 Below Normal Low
TEST Total 109.9 ng/dL 249.0-836.0 Below Normal Low
TEST FREE 2.99 pg/mL 8.80-27.00 Below Normal Low