T Nation

35 Y/O with Labs, Help


#1

ISaw my doctor today and my test results are trickling in I figure I will start with what I have, he said he didn’t normally test for estrogen but he might depending on my T level. Been lifting heavy for 1.5 years after no previous weight training.

I do take Creatine and BCAA

Age: 35
Weight: 231
Height: 6’0"
1 Rep Max
Bench: 175
Squat: 235
DL: 320

Testosterone Total - 179.3
Free Androgen Index - 44.44
SHBG - 14.00
TSH - 1.305
GLUCOSE - 111
Urea Nitrogen - 19
Creatinine - 1.09
Sodium - 141
Potassium - 3.8
Chloride - 104
Total C02 - 26
Total Protein 7.8
Albumin - 4.2
Bilirubin - 17
SGOT/AST - 17
SGPT/ALT - 27
ALK PHO - 91
gfr NON - 87


#2

I was about your age with that level. However I’m assuming the reference ranges were the same as mine. Can you post those as well.

Get retested to verify low levels. Get LH tested as well as estradiol.

Your shbg is very low. Any test you introduce exogenously will be excreted fast. Gels May be a good
Solution if you cannot find root of your low t issue and want to go on trt.


#3

Thanks for the quick reply I’ve already got a notice on my app that says doctor requesting second blood draw, I’ll ask to be tested for estrogen as well. I’ve been having this suspicion that I’ve had low T. I’ve cleaned up my diet eat mostly raw foods, with the occasional pizza, and I’ve lost 50 pounds since I started to take my health serious 2 years ago


#4

As low shbg myself I would state that the gel has been worst even if applied both morning and night. Hits fast and then it is gone --> rollercoaster of hell.


#5

Low SHBG men have great difficulty controlling estrogen on TRT so the comment about your doctor not normally checking estrogen is a big problem for you.

Your doctor’s comment about not usually checking estrogen is like a car mechanic saying when I work on cars I don’t use tools, it’s blasphemy in the world of TRT to say something like that and tells me he has no idea what he’s doing.

Low SHBG men who have high body fat will convert a ton of testosterone into estrogen, so I recommend you inject 10-12mg everyday or I see you quitting TRT inside of 6 months.

It’s more than likely your doctor isn’t up to speed on TRT and he can’t help you, most aren’t and those that do do not exist within insurance networks.

I was forced to go private and pay out of pocket because all my endocrinologists are brain dead when it comes to sex hormones and TRT.


#6

Get LH tested too. It will give you an indication of pituitary function.

If pituitary isn’t functioning correctly, prolactin then should be tested.

I’d test both along w e2


#7

You should keep an eye on your blood glucose as well. You are reading at pre diabetic levels.

What does your diet look like? Percentage of fat? Drink alcohol? Recreational or prescribed drug use? Sleep habits?

All these things things play a part. YES, your SHBG is low right now, but that may or may not be the case once you start TRT. Levels fluctuate pretty often and you will need to see where YOUR levels land once you start a protocol and have stabilized.

Depending on the answers to the questions above, you may be able to make improvements without starting TRT just yet. Even if you do, you will want to make sure that everything else (diet, lifestyle, workout routines, etc) are on point and pretty dialed in before you start TRT.

You can’t fix bad habits by throwing medications at your body. You have to give the body the best chance that you can to make sure it has everything it needs to heal itself, and THEN, you can supplement the parts where it comes up short on you.


#8

Thank you for the reply I have really clean up my diet the last year 5-6 days a week I wear pretty good
Breakfast: 3 eggs with milk
Snack: apple
Lunch: chicken with rice and mix veggies
Dinner: same as lunch or whatever the wife made

Marcos I try to stay within

Carbs: 100-120g
Protein: 200g
Fat: 100g
I’ve lost 50 pounds since starting 1.6 years ago.

I don’t smoke and only a social a drinker (1-2 drinks a month, sometimes I go a few months without drinking) this past weekend we had out of state family over which did involve eating like shot all weekend. Not sure if that played a role.

I take zero drugs prescription or recreational.

My sleep habits sucks, I have 15 month old who is teething 3 mollers right now… I should note we had to do ivf to have a child because of issue with my wife

Workout routine is pretty consistent I’m doing a PHUL routine, with today’s cardio. However I’m going into my busy season at work and might have to switch to a 5x5


#9

@systemlord on my app I do see he wants to test estrogen levels, I’m greatlfulbthat I work for one of the top insurance companies in the US, and know our plan in and out and trt is paid.


#10

It’s great you have excellent insurance, but that doesn’t guarantee a doctor will be up to speed on TRT. Medical school doesn’t teach doctors about sex hormones and it isn’t even covered in residency or medical school, so right out of medical school doctors know virtually nothing about how to design a protocol TRT protocol because it isn’t taught.

Guideline are decades outdated and everything learned is through clinical experience, so unless your doctor has been doing this for more than 10-20 years, then I doubt your doctor is experienced enough.

I come here everyday for the past two years and have noticed a trend of comments from doctors and suffering always proceeds comments such as the ones your doctor has made.

Those comments are, “men don’t have estrogen”, “I don’t normally check estrogen”, “estrogen will balance out on its own”, 200mg every 2 weeks is the standard protocol written in the guidelines and works for only 2% of men on planet earth.

I’ve come to the conclusion insurance is useless for hormone therapies such as TRT the majority of the time. It’s rare you will find a competent TRT doctor within your insurance network.

Visit stupid things doctors say.


#11

Doctor office said it was within normal range… don’t see how time to find a doctor.


#12

Do you have time to take days off of work because you feel like you’re going to die if your protocol makes your E2 skyrocket, or better yet E2 crashes? No disrespect meant but these are very real possibilities without a properly designed protocol that takes ALL aspects into account.

You came here looking for advice right? I’d say that was a wise choice. Don’t cancel that wise choice out with a possible stupid one if indeed you do have an incompetent doctor.

Believe, you’ll want to find the time.


#13

Thanks for the reply, I wish I could go somewhere like numale but their cost is a little to high for me to go that route right away.


#14

I get it man. I definitely know what’s it’s like to be tight in the financial department. I also know what it’s like to have no choice but to be stuck in an insurance network, but I guarantee you that there are more docs in the insurance game, and there is one out there that would be willing to listen to you. Don’t let them bully you into a protocol that will leave you worse off than you were before man.

You will need to educate yourself and plead your case intelligently to them. In your situation, it’s going to be up to you to know more about this than your doc. It’s your health on the line brother not theirs. They get paid whether it works for you or not. You just have to make sure that they won’t get paid by you or your premiums if they aren’t willing to let you have a say in your treatment. It may take a while man but they will listen, IF they want to keep getting paid by you trusting your health care to them.

Good luck man and use this forum and others like it to learn as much as you can before you speak with the docs again.


#15

Update I got a second opinion, and he agreed the T is very low and wanted. Draw completed that and the levels came back slightly higher then the first result, but this was also because of bition, he want me to dose 50ml twice a week perfably Sunday and Wednesday.

He did test for e2 and pituitary which came back in range, but concern how trt will impact them so wants to redraw those after 2 months on the program.

I don’t have the results since they are not on Epic yet.

Let me know your thoughts, also he was concerned with Shbg being low but says if I drop my body fat more this might stabilized