T Nation

37 and Low T... Help


#1

Hi,

I have been in a funk for a while (around 6-8 months) so my wife told me to get my testosterone checked out. I told my PCP about it so she had me do some blood work and these are the results (there’s more info, but wasn’t sure if it’s necessary):

Testosterone, Serum: 321 (348 - 1197)
TSH: 0.988 (0.450 - 4.5)
Hematocrit: 50.4 (37.5 - 51)
Cholesterol, Total: 187 (100 - 199)
Triglycerides: 135 (0 - 149)
HDL Cholesterol: 53 (>39)
VLDL Cholesterol Cal: 27 (5 - 40)
LDL Cholesterol Calc: 107 (0 - 99)
Prolactin: 7.5 (4.0 - 15.2)
Estradiol: 17.1 (7.6 - 42.6)
Lh: 8.5 (1.7 - 8.6)
Fsh: 7.7 (1.5 - 12.4)

I’m 37 years old, about 5’6", and around 183 lbs. I recently had a discectomy so I was on percocet (no longer), meloxicam (no longer), and gabapentin (in weaning process).

I went to a urologist and he gave me a prescription for Axiron which I’ve been on for about three months. 60 mg (30 per underarm) in the morning. Then I took another blood test that he prescribed and the result is:

After Axiron:
Testosterone, Serum: 466 (348 - 1197)

I saw the urologist yesterday and told him that I was still in a funk. My libido was low, energy still isn’t quite the same, sexual dysfunction, etc. The urologist said that he could bump me up to 90 mg (60 mg for one underarm and 30 mg for the other) and said that he doesn’t want me going too much higher than 500 testosterone (isn’t that still too low for someone my age?). He said that if it doesn’t help, then there could be an issue elsewhere, but didn’t go into detail what that could be. He said to take the increased dosage in the Axiron and take another blood test in a couple of months.

Any insight is GREATLY appreciated!!

Edit: Added ranges


#2

I believe I’m in the same situation as you. Your LH and FSH are good and according to ksman the problem is with your testes. I’m no expert as I am new to this as well. Ksman will straighten you out.


#3

You have primary hypogonadism. Sometimes this is caused by correctable vascular problems with the testes.

Please follow these links here: About the T Replacement Category

  • advice for new guys
  • things that damage your hormones
  • protocol for injections
  • finding a TRT doc

Suggest that you do self-injections with insulin syringes

  • 50mg T cypionate or ethanate twice a week, 100 total
  • use 0.5ml[50iu] 1/2" #29 insulin syringes, ~$14 per 100 at USA Walmart, ReLion house brand
  • 250iu hCG SC EOD injections to preserve your testes [can use #31 5/16" or above]
  • 1.0mg anastrozole per week, 1/2mg at time of injections

Hematocrit=50.4, this is very high for your pre-TRT T levels.
With TRT you probably need to have blood removed routinely.
Do not eat any iron fortified food or supplements. Comercially prepaired breads/cereals often have added iron.


#4

Thank you! I will read those threads. I need to do a lot more research on the information you have provided.

I forgot to mention that he also suggested going the pellet route if I didn’t want Axiron.

Should I suggest this to my doctor? (They have a website where I can message them) What should I say would be my reasoning on axing the Axiron and going the injection route?


#5

Pellets provide steady T levels day to day, but the levels vary by the week. This creates a problem where anastrozole dosing cannot be right very often.

Pellets are not popular here and some of the guys who have done that have stopped because of various reasons.

Pellet insertion is minor surgery and a money maker for the docs.
If you need hCG to preserver your testes, what is the point of not self injecting T?


#6

Thank you!

I kind of figured that the doctor I’ve been seeing is making go this route for his benefit like the reason you stated for pellets.

How do you think I should approach my doctor about your recommendations? If he’s not onboard, then I should go elsewhere?


#7

Write out your proposed protocol, labs and E2 management and present it.


#8

I emailed him with the proposal.

The pharmacy called and told me that Axiron will now run me over $400 which will last maybe a month. Wow… Definitely need to look for cheaper options. I’m curious how much the meds you proposed will run me.