T Nation

40 Y/O Male Trying to Decide on TRT


#1

Hello...

I've been watching my T levels for a while trying to decide if I should start TRT since I have always been low-normal. Well, I finally got a result back yesterday that shows me as Low instead of low normal. The thing that really concerns me about this one is that 90 days ago I started lifting heavy compound lifts(squats, dead lifts) to try and increase my T naturally and it doesn't seem to have helped.

Hoping someone here can look over my labs and advise whether I am missing any ways to naturally increase my T or if I should just go ahead and try to get an Rx.

My biggest concern is being tied to a pharmacy and taking "medicine" for the rest of my life. But with that said... having the symptoms of Low T isn't all that great either. Just trying to get as many opinions as I can before I make the leap.

Another concern is the low HDL cholesterol even though I have been following a decent diet and working out.

Here are my numbers -

Free Testosterone results from over the years -

2006 : 383 NG/DL
2-2012 : 304 NG/DL (started working out heavy and supplementing Vitamin D)
4-2012 : 395 NG/DL Total & 8.0 pg/mL Free Test(Good Vitamin D @59.5 ng/mL)
5-2013 : 440 ng/dL
Current : 275 ng/dL (after going on a heavy lifting program for the past 90 days, bummer)

Info from the stickies -

-age - 40

-height - 5' 8"

-waist - 36

-weight - 182

-describe body and facial hair - facial hair patchy, light body hair

-describe where you carry fat and how changed - love handle / waist area

-health conditions, symptoms [history] - nothing major.... allergies

-Rx and OTC drugs, any hair loss drugs or prostate drugs ever - None

-lab results with ranges - Posted below

-describe diet - For the last 90 days or so I've been on 1660 calories plus exercise calories measured with a heart rate monitor. So if I measure 500 calories burned I'll add that to my 1660 for the day.

-describe training - Weights for about an hour every other day (5setsx5reps protocol with warmups, squats every workout and other compound power-lifting style lifting) Every other day I walk for 30 - 45 minutes instead of lifting. No regular intense cardio right now.

-testes ache, ever, with a fever? Not really... they did ache some before I had a vasectomy about 3 months ago but not now. Never a fever that I noticed.

-how have morning wood and nocturnal erections changed - Fewer than before.

Labs -

Tests: (1) CBC W/AUTO DIFF WITH PLATELETS (1000)

WBC 5.7 K/UL Range 4.0-11.0
RBC 4.82 M/UL Range 4.10-5.70
HEMOGLOBIN 14.8 G/DL Range 13.0-17.0
HEMATOCRIT 43.8 % Range 37.0-49.0
MCV 90.9 fL Range 80.0-100.0
MCH 30.7 PG Range 27.0-34.0
MCHC 33.8 G/DL Range 32.0-35.5
RDW 13.1 % Range 11.0-15.0
NEUTROPHILS 61 % Range 40-74
LYMPHOCYTES 27 % Range 19-48
MONOCYTES 9 % Range 4-13
EOSINOPHILS 4 % Range 0-7
BASOPHILS 0 % Range 0-2
PLATELET COUNT 175 K/UL Range 130-400

Tests: (2) LIPID PANEL (173)

CHOLESTEROL 158 MG/DL Range <200
TRIGLYCERIDES 88 MG/DL Range <150
HDL CHOLESTEROL [L] 34 MG/DL Range >39
CALCULATED LDL CHOL [H] 106 MG/DL Range <100
RISK RATIO LDL/HDL 3.13 RATIO Range <3.55

Tests: (3) TSH (2835)

TSH 1.5 UIU/ML Range 0.5-4.7

Tests: (4) BASIC METABOLIC PROFILE + e-GFR (145)

GLUCOSE 92 MG/DL Range 65-100
BUN 19 MG/DL Range 8-25
CREATININE 1.0 MG/DL Range 0.8-1.4
eGFR AFRICAN AMER. 100 ML/MIN/1.73 Range >60
eGFR NON-AFRICAN AMER.
83 ML/MIN/1.73 Range >60
SODIUM 138 MEQ/L Range 133-146
POTASSIUM 4.3 MEQ/L Range 3.5-5.3
CHLORIDE 106 MEQ/L Range 97-110
CARBON DIOXIDE 25 MEQ/L Range 18-30
CALCIUM 9.6 MG/DL Range 8.5-10.5

Tests: (5) LIVER (HEPATIC) FUNCTION PANEL (9175)

PROTEIN, TOTAL 7.2 G/DL Range 6.0-8.4
ALBUMIN 4.6 G/DL Range 2.9-5.0
BILIRUBIN, TOTAL 0.9 MG/DL Range 0.1-1.3
BILIRUBIN, DIRECT 0.2 MG/DL Range 0.0-0.3
ALKALINE PHOSPHATASE 68 U/L Range 30-132
SGOT (AST) 21 U/L Range 5-35
SGPT (ALT) 14 U/L Range 7-56

Tests: (6) PSA, TOTAL (2606)

PSA, TOTAL 0.4 NG/ML Range <4.0

Tests: (7) VITAMIN D, 25 OH (4958)

VITAMIN D, 25 OH 62 NG/ML

Tests: (8) TESTOSTERONE, FREE/TOTAL WITH SHBG (4937)

TESTOSTERONE [L] 275 NG/DL Range 292-867
! TESTOSTERONE REF RANGE

SEX HORM BIND GLOBULIN
35 NMOL/L Range 17-66
CALC FREE TESTOSTERONE
5.2 NG/DL Range 4.8-25.0


#2

I am not going to give you medical advice and I have not reviewed your labs in detail. But, I went through the same thought processes as you are going through now. First, TRT is not a miracle medicine. In and of itself it will not transform you overnight. All people react differently to different levels of T.

I made a deal with myself: first I would get my diet in order and consistently go the gym for a period of two months. After this, I started TRT. I am older than you (54) and was not concerned about having more children. This may be a concern for you. I only use T, no other meds. I have my blood work done every six months and donate blood every few months.

I have been very happy with my decision and gleaned a lot of information here. Injection twice a week. Start with a dose of 100 mg a week and see where you are. This may be enough. I would have labs done after about a month of starting TRT just to see where I am. Check you E levels and if needed add a medicine to deal with this. In the end, I wasted a fair amount of time thinking and worrying about it.

It is a natural substance in the body and after you try it and see how it works for you, you can stop if your not happy about it. Don’t worry about others and what they may think about your usage. F…k’em, it’s your life. I would rather be able to live it well, rather then crawl around with a walker. Best of Luck.


#3

Thanks Gulfcoast… I appreciate the perspective. I agree that diet and workout should be good before going on it. One of the reasons why I’m leaning heavily towards trying it is that I have gotten my diet and workout locked in and it hasn’t helped my T levels. I was really surprised by that actually.


#4

I tried diet, sleep, exercise, etc and none of it worked. Before I started, I was at 191 TT and 4.9 FT and I was miserable. 44 years old btw. I have been on TRT for 2.5 months and I’m hear to tell you it is a miracle drug for me. Honestly, I mainly started looking at TRT for mood (always have struggled with depression). And this has totally turned things around for me in many ways. And no, it’s no placebo effect. It’s well worth it. I’m never looking back.


#5

[quote]Flyingknee wrote:
One of the reasons why I’m leaning heavily towards trying it is that I have gotten my diet and workout locked in and it hasn’t helped my T levels. I was really surprised by that actually.

[/quote]

It’s possible you may have been over-trained and needed to take a day or 2 off before the blood test considering it was a 90-day heavy lifting program. Also you’re not eating enough. On that regimen you need to be eating eating at least 2000+ cal


#6

[quote]Slasher917 wrote:
It’s possible you may have been over-trained and needed to take a day or 2 off before the blood test considering it was a 90-day heavy lifting program. Also bro you’re not eating enough. On that regimen you need to be eating eating at least 2000+ cal[/quote]

Thanks. I have thought about the fact I might have been overtrained but it’s not too intense of a workout since weights are only every other day.

Oh yeah I forgot to mention I did take a few days off before the blood test. Part of the reason I was going in was a slight groin injury. Another thing that was making me think my test may have fallen off is that I get injured real easily now (well relatively easily in my opinion).

I may not have been clear in how I was eating in my original post. I actually do eat over 2kcal on my training days. 1660 cals is my baseline if I did no workout. I use a heart rate monitor to measure the amount I burn during my workout and I normally burn around 600 cals on weight days. So on those days I would take in around 2260 cals total.


#7

[quote]1sickdude wrote:
I tried diet, sleep, exercise, etc and none of it worked. Before I started, I was at 191 TT and 4.9 FT and I was miserable. 44 years old btw. I have been on TRT for 2.5 months and I’m hear to tell you it is a miracle drug for me. Honestly, I mainly started looking at TRT for mood (always have struggled with depression). And this has totally turned things around for me in many ways. And no, it’s no placebo effect. It’s well worth it. I’m never looking back.[/quote]

Thanks, I’m mainly looking at mood and libido too. I’m not a beast or anything but I do ok in the gym. I workout first thing in the morning so I am able to get motivated for it pretty easily with a cup of coffee in me. But it’s not long after my workout that I just crash out… tired no motivation etc.

I made an appointment to see my regular doc next Wednesday and find out options.

Are you taking an AI? Armidex? or any Hcg?

Trying to decide if I need to use that immediately or not. I know gulfcoast said he is only taking test.

I haven’t had E2 tested since 2006 but it was 39 then.


#8

Dude I’d really like to tell you to just hop on TRT and stick to a good protocol and monitor bloodwork, but we need to see more bloodwork before you hop on TRT. How is your LH and FSH? Adrenals? Thyroid? These are all contributors…

But if you don’t wanna go through all of that, then…

Take EOD injections of Test Prop (Best option - most consistent levels with least aromatization into estrogen) or twice weekly injections of Test Cyp (you can do EOD Test Cyp as well).

If you want to maintain fertility, use HCG. Usage of AI’s are variable from person to person, some need it some don’t. In any case, monitor bloodwork to see if it’s needed and refer to KSMan’s stickies for guidance in that area. Ditto for the HCG usage.

Good luck! :smiley:


#9

Saw my uro doc and he ordered another early am total and free T levels test and also prolactin testing.

I got those results and while total is somewhat low at 330. Free is actually around average for my age at 10.2.

However, my prolactin levels are high at 21.4. Anyone ever dealt with prolactin levels with decent free T results?


#10

Doc wants me to get an MRI to rule out prolactinoma. Am I crazy or does an MRI seem like overkill at this level of prolactin?


#11

MRIs do not have the radiation danger of CT scans so I would just go if your doctor thinks it is justified. Just take very tight earplugs (wax ones are best) with you to avoid hearing damage - it is like a jackhammer next to your head, yet in my experience the techs who do them don’t care to warn patients about this and/or offer cotton earplugs that are about as effective as air.


#12

Thanks, I actually have zero concerns about getting the mri itself. It’s the $1200 it will cost me out of pocket due to my insurance deductible.

I don’t know that my prolactin levels are high enough to really warrant an MRI and I don’t want to waste a big chunk of money. All of the research I’ve done says prolactin levels lower than 40 or 50 you’re wasting your time getting an mri (paraphrasing obviously).

I might go get a second opinion from a different doc. I got a decent referral from someone that’s on TRT currently.

This is frustrating.


#13

Oh yeah, for $1200 I definitely wouldn’t go without very good reason. Could you change your insurance and wait until after? Can you ask your doctor for alternatives to MRI? E.g., CT is cheaper, though you have to weigh the radiation risk.


#14

I am not the most experienced person on this site, but I do have some experience with CT scans and MRIs …if you are gonna get a brain scan your best bet is the MRI its a lot better…you can look up the differences between them for what region you are getting scanned, The MRI will pick up things that the CT does not.
Could also retest prolactin to make sure it is really out of whack…make sure you don’t have sex/ejaculate,pet a dog, or hold a baby that’s from what I have read on the forums anyway.


#15

I call bullshit. Your diet and workouts are not “locked in”.

So you lift heavy but not too intense? How does that work? (Hint: It doesn’t). You also complain about low energy after working out on nothing but a cup of coffee? Then you are surprised that you are low energy?

Your eating and lifting suck. Being honest with you. I am not even commenting on the TRT thing, but if you think your lifting and eating are on point for increasing T you are wrong.

You can prove me wrong by posting your workouts and daily diet.


#16

[quote]KountKoma wrote:
I call bullshit. Your diet and workouts are not “locked in”.

So you lift heavy but not too intense? How does that work? (Hint: It doesn’t). You also complain about low energy after working out on nothing but a cup of coffee? Then you are surprised that you are low energy?

Your eating and lifting suck. Being honest with you. I am not even commenting on the TRT thing, but if you think your lifting and eating are on point for increasing T you are wrong.

You can prove me wrong by posting your workouts and daily diet.[/quote]

lol I don’t really care if you “call bullshit” to be honest and I have zero desire to “prove you wrong”. Be right all you want. Congratulations! You won the internets!

And I said my routine was not too intense because it’s weights every other day. I never said I didn’t lift intense during my weight routine. That’s about all I’m going to explain to you. (Hint: You’re a goofball.)


#17

[quote]Flyingknee wrote:

[quote]KountKoma wrote:
I call bullshit. Your diet and workouts are not “locked in”.

So you lift heavy but not too intense? How does that work? (Hint: It doesn’t). You also complain about low energy after working out on nothing but a cup of coffee? Then you are surprised that you are low energy?

Your eating and lifting suck. Being honest with you. I am not even commenting on the TRT thing, but if you think your lifting and eating are on point for increasing T you are wrong.

You can prove me wrong by posting your workouts and daily diet.[/quote]

lol I don’t really care if you “call bullshit” to be honest and I have zero desire to “prove you wrong”. Be right all you want. Congratulations! You won the internets!

And I said my routine was not too intense because it’s weights every other day. I never said I didn’t lift intense during my weight routine. That’s about all I’m going to explain to you. (Hint: You’re a goofball.)
[/quote]

You are asking for guidance on a medical issue on an anonymous weightlifting web site. Don’t be offended by the responses. Some of the folks on here are quite knowledgeable on TRT issues and I don’t mean to demean their advice in any way, but they aren’t your doctor. If you have a good doctor, listen to him. Did your doctor advise you that you should go on TRT?


#18

Well, I wasn’t so much offended as I was amused. I mean how can you not laugh at someone saying “your lifting and nutrition suck” and then following up with “Post your lifting and nutrition routine”. :))

My dr advised me to get an mri for a slightly elevated prolactin level. Going to get a second opinion before I do anything.


#19

[quote]Flyingknee wrote:
Well, I wasn’t so much offended as I was amused. I mean how can you not laugh at someone saying “your lifting and nutrition suck” and then following up with “Post your lifting and nutrition routine”. :))

My dr advised me to get an mri for a slightly elevated prolactin level. Going to get a second opinion before I do anything.[/quote]

I’m sure you thought your caloric deficit (probably low-fat) and mess of a lifting routine was really helping your T levels. Good luck with your issues.