T Nation

36 Years Old, Normal T Levels But Feel Terrible

Here is my story:

For the past couple years…my energy level, motivation, mental sharpness, and mood have plummetted.

I have had minor cases of depression on and off. It runs in my family (my mom has severe depression and so did my older sister). Nothing seems to work for my mom.

In my case, I would call it minor depression. And I have been seeing a psychiatrist for the past 5 years. I’ve done antidepressants a few times, with mixed results.

But recently it has gotten to the point where I’m barely functional. I don’t eat much or have a huge appetite. My libido feels significantly lower (though I still get morning wood just not as frequently as before).

So I got tested twice at different clinics. And both times I tested in the 600s, which is considered healthy.

Is there anyone here who has had normal T levels but started TRT anyway? And how were your results?

And if I try the TRT for 2 or 3 months to see how it feels…by then would it be too late for me to quit and go on clomid/HCG to kickstart my natural T production again?

One more question: What if I continue to feel awful 4 years from now when I hit the big 40…and I get tested at around 500, which is in the normal range. At that point would it be advisable to do the TRT if I feel awful?

At first glance Trt will not help your depression and will cause an entirely different set of problems that need solving once you begin. We really need at least free T to make that judgement, not total T though.

Finding a competent doctor can take years of suffering through awful protocols, getting your protocol dialed in, testicular atrophy etc. I’ve been on TRT for about 5 years now, so I’m speaking from experience.

Have you looked at food sensitivities potentially contributing to your depression? Improving your sleep? Meditating? Spending more time outside? Looked at any supplements that have clinically been shown to help with depression without side effects like saffron, high dose fish oil, vit d3, lithium orotate?

I believe many actually suffer with anxiety and the exhaustion manifests itself as depression. Do you think that applies to you?

A total testosterone in the absence of free testosterone and SHBG doesn’t tell the whole story, if SHBG is high than free testosterone would then be low. Free testosterone is the free hormone circulating in the blood and is more important than total testosterone which is bound to SHBG and not bioavailable.

Low thyroid hormones can cause symptoms of depression and there are a lot of people out there who actually have hypothyroidism and instead of treating it, people are put on depression medications that only mask the symptoms for awhile.

Those men who are naturally in the high normal ranges or above may be symptomatic in the middle ranges, there are men below the normal ranges and have no symptoms, everyone is biochemically unique.

When I got tested, my Total Test was in the 500 at first I think. Then it slowly crept into the 400’s. But I felt it way before that, because my SHBG was so high, my free test was in the dumps, even though my TT was decent.

If you can, post all of your lab results.

A bit busy now but I’ll respond that my free testosterone was 12 ng / dl. I don’t know what reference range the doc was using, but she said it fell under “normal”.

Got my thyroid checked as well and don’t remember the numbers but the doc said it was good.

The hormone experts state that you may benefit from TRT <15 pg/mL free t. The facts are if you compare your levels to your peers in the same age group, you’re lower than average.

You need to stop trusting your doctor because there’s medical decisions being made behind your back, this is what the insurance companies do.

I odds are if your doctor takes insurance he/she has no idea what normal is because they’re just going by a bunch of reference ranges taken from a population ripe with obesity, subclinical hypothyroidism and low testosterone that is only decreasing with every generation.

The ranges are tainted with sick people.

Okay here are my lab results: The first is from a TRT clinic, the other one from a general clinic.

So free test is 12 ng/dl: Reference range 5.7 to 17.8

I didn’t mention:

I did do HCG monotherapy for 2 months.

It didn’t give me the subjective benefits I hear about from exogenous testosterone…

Actually, it made me a bit anxious and moody. I was taking an AI with it so it may or may not have been because of estradiol levels.

While on HCG monotherapy:

-I was able to jump out of bed after sleeping for just 5 hours (normally I need at least 8 hours and still struggle to get out of bed)

-I found myself radomnly doing sets of push ups throughout the day.

-Morning wood more frequent, libido in general felt higher

-If I went out drinking, the next morning I’d have no hangover…or a minor one at most.

But mentally…I just didn’t feel the benefits of that people on TRT get. I’d say I felt a bit off on it. And the whole thing was a pain in the ass…having to keep the HCG refrigerated at all times limited my travel options…having so inject every other day.

So I quit the HCG Monotherapy. And I did feel a bit of a crash about 3 weeks after quitting, but eventually that subsided.

I think you would benefit from additional tests. Specifically: DHEA-S, E2, free T4, free T3, reverse T3, IGF-1 and VitD. You need to take a hard look at thyroid function.

Given your SHBG level, I’m surprised your free test is as high as it is. Everyone is different, and hormone optimization is based on how you feel. You could try TRT for a few months and see how it goes, however some take up to a year to get the full benefit of TRT. In my case, I felt much better in two weeks and at six months I had lost 15-20 lbs of fat and gained 10-15 lbs of muscle.

If I were you, I’d have those other items checked and go from there. I would try something, given your history and symptoms.

Regarding going on TRT with normal levels, I think “normal” should be discarded. For example, I have a friend who, at 62 y/o, had a total test of 800 ng/dL and a free test of 80 pg/mL, (I’m ballparking those numbers) . He went on TRT over a year ago and is now around upper 800s total and 180 free. He feels a lot better.

Thanks. I’m not that familiar with DHEA-S, T3 T$, IFG-1 but I’ll look into it.

What you said highlights what I have been wanting to know more about. There are professional athletes with a surprisingly low T levels who perform very well.

I wish I got a baseline test about 7 years ago to see what my levels were then. That way I could compare my levels when I was in my late 20s vs now.

My dad is 72…I remember he tested his hormone levels a few years ago…at the time I didn’t care about HRT much, but I recall him boasting about how incredibly high his T level was. He credited it to his lifestyle (he never drinks or smokes, he never eats junk food). I asked him about it just a month ago so I could compare our numbers…but he refused because he is against me even learning about these things(he’s very conservative).

That would be very interesting to see. Even better, get regular blood tests over the course of decades.

I’m not sure I understand your father’s position, but given his numbers, he may not relate well to low testosterone and therefore what TRT can do to improve quality of life. We know that over the last 30 years test levels are down 22% in men in the United States, sperm counts are down as well. We can suggest reasons, but it is likely an accumulation of many things.

My dad is very anti-medicine. He just believes in diet + exercise only. He even tries to tell us not to take aspirin.

He has a chronic back injury from 20 years ago and refuses to get any type of treatment for it. All he has to do is fly to Panama and get stem cell injections in his lower spine(he is rich)

I guess everyone is entitled to be as miserable as they want to be. Overall, that is not a bad philosophy when it comes to health care. Do the least invasive thing, avoid drugs if lifestyle changes will work, avoid surgery if medications will work, etc.

If you need to sell him, explain that testosterone is naturally produced in our bodies and you are just putting in what you are supposed to have.