T Nation

43, Low Libido, Went for Testing at HRT Clinic

Hey guys. I am new here and found my way here because I am experiencing a reduction in sex drive. Here is some information about me. I am 43 yrs old, 6’2", 200 lbs. I have worked out my whole life. I had a vasectomy about 2-2.5 years ago. My sex drive has decreased noticeably since then. My wife says that the vasectomy was like getting neutered with regards to my sex drive. It seems like just 5 years ago that I wanted sex about 3 times a week and would still rub one off usually once a week as well. Now we have sex only once every 1-3 weeks, and I vary rarely rub one off. I even occasionally have mild difficulty obtaining an erection when trying to rub one off. I went to a local HRT clinic and had blood work taken. My total T was 543. I was expecting it to be lower considering how I feel. She said they find that their clients feel best in the range of 700-1,200. She gave me three options. Clomid pills, weekly test injections, or pellets. She recommended Clomid if there is ever a chance of us having more kids, but my wife and I are done with kids. I am thinking either injections or pellets. I am not sure what I am going to do. I never make important decision quickly, so will likely think on it for at least a couple of months.

My work checks my cholesterol every year, and it has always been low. I eat a very healthy diet, and do not drink alcohol. This past year it was 108 with my HDL coming in at 53. My wife is a nurse and thinks it might be too low, so I started eating more healthy fats, but have not noticed any difference in how I feel.

My blood pressure was 98/58 during the health check.

Here is the list of things that they tested:
F TSH 1.180 0.450-4.500 (uIU/mL) BN
F Triiodothyronine,Free,Serum 3.0 2.0-4.4 (pg/mL) BN
F Reverse T3, Serum 17.3 9.2-24.1 (ng/dL) BN
F T4,Free(Direct) 1.25 0.82-1.77 (ng/dL) BN
F Prostate Specific Ag, Serum 0.4 0.0-4.0 (ng/mL) BN

  • Roche ECLIA methodology.
  • .
  • According to the American Urological Association, Serum PSA should
  • decrease and remain at undetectable levels after radical
  • prostatectomy. The AUA defines biochemical recurrence as an initial
  • PSA value 0.2 ng/mL or greater followed by a subsequent confirmatory
  • PSA value 0.2 ng/mL or greater.
  • Values obtained with different assay methods or kits cannot be used
  • interchangeably. Results cannot be interpreted as absolute evidence
  • of the presence or absence of malignant disease.
    F Testosterone, Serum 543 264-916 (ng/dL) BN
  • Adult male reference interval is based on a population of
  • healthy nonobese males (BMI <30) between 19 and 39 years old.
  • Travison, et.al. JCEM 2017,102;1161-1173. PMID: 28324103.
    F Estradiol 21.4 7.6-42.6 (pg/mL) BN
  • Roche ECLIA methodology
    F WBC 3.9 3.4-10.8 (x10E3/uL) BN
    F RBC 5.18 4.14-5.80 (x10E6/uL) BN
    F Hemoglobin 15.4 12.6-17.7 (g/dL) BN
    F Hematocrit 46.0 37.5-51.0 (%) BN
    F MCV 89 79-97 (fL) BN
    F MCH 29.7 26.6-33.0 (pg) BN
    F MCHC 33.5 31.5-35.7 (g/dL) BN
    F RDW 13.2 12.3-15.4 (%) BN
    F Platelets 184 150-379 (x10E3/uL) BN
    F Neutrophils 47 (%) BN
    F Lymphs 41 (%) BN
    F Monocytes 8 (%) BN
    F Eos 3 (%) BN
    F Basos 1 (%) BN
    Immature Cells BN
    F Neutrophils (Absolute) 1.9 1.4-7.0 (x10E3/uL) BN
    F Lymphs (Absolute) 1.6 0.7-3.1 (x10E3/uL) BN
    F Monocytes(Absolute) 0.3 0.1-0.9 (x10E3/uL) BN
    F Eos (Absolute) 0.1 0.0-0.4 (x10E3/uL) BN
    F Baso (Absolute) 0.0 0.0-0.2 (x10E3/uL) BN
    F Immature Granulocytes 0 (%) BN
    F Immature Grans (Abs) 0.0 0.0-0.1 (x10E3/uL) BN

What kind of feedback are you looking for? You didn’t test FSH/LH, SHBG, or Free T. Your total T is absolutely fine. You could have very high SHBG and thereby feeling the effects of low T. We wouldn’t know without you testing. Based on your Total T only I wouldn’t start a TRT regimen.

I’m curious why the HRT place that I went to didn’t test those things.

I was just looking for any general opinions based on my situation.

Body weight suggests a problem.

Agree that total cholesterol is too low. <160 is associated with increased all-cause mortality. Cholesterol is base for all steroid hormones and Vit-D3.

Thyroid not bad, but do check oral body temps as per below to confirm OK. Looks like you do use iodize salt, but perhaps not enough.

Vit-D is very important. Many need 5,000iu per day.

While labs look good, missed:
FT - free testosterone or SHBG or both
E2 - estradiol
AM cortisol - at 8AM please or 1 hour after waking up
fasting glucose, perhaps A1C
DHEA-S - not DHEA - if really low, could be related to low cholesterol
LH/FSH - must be before starting T treatments!

  • HRT clinics can have tunnel vision, you can order labs on line in USA in most States if your docs do not cooperate.

Please read the stickies found here: About the T Replacement Category

  • advice for new guys - need more info about you
  • things that damage your hormones
  • protocol for injections
  • finding a TRT doc

Evaluate your overall thyroid function by checking oral body temperatures as per the thyroid basics sticky. Thyroid hormone fT3 is what gets the job done and it regulates mitochondrial activity, the source of ATP which is the universal currency of cellular energy. This is part of the body’s temperature control loop. This can get messed up if you are iodine deficient. In many countries, you need to be using iodized salt. Other countries add iodine to dairy or bread.

KSman is simply a regular member on this site. Nothing more other than highly active.

I can be a bit abrupt in my replies and recommendations. I have a lot of ground to cover as this forum has become much more active in the last two years. I can’t follow threads that go deep over time. You need to respond to all of my points and requests as soon as possible before you fall off of my radar. The worse problems are guys who ignore issues re thyroid, body temperatures, history of iodized salt. Please do not piss people off saying that lab results are normal, we need lab number and ranges.

The value that you get out of this process and forum depends on your effort and performance. The bulk of your learning is reading/studying the suggested stickies.

My height is 6’2", so the body weight is proportional (32-33" waist). My body fat was 18% on one of those electronic scales. I have had it measured 3 times over the past 5 years and it has varied between 15% and 18.7%

Glucose was 82 fasting, and this is normal for the past 10 year of records that I have.

I drink about 2 gallons of milk per week, plus take a multi vitamin daily, so would think I am getting enough Vit-D, but perhaps not?

Thanks for all the help and responses.

The amount of Vit-D3 in vitamins and milk is typically enough to prevent bone deformities in children [rickets]. Now it is known that optimal amounts for good health are way more than that.

Please take time to get trough the stickies. You need the info there and may find things that apply to your situation that will not otherwise come up in this format.

Do your healthy fats now include EFA’s from fish oil, nuts, flax seed meal/oil …?

Regarding fats, I recently added the following to my diet: Avocados, mixed nuts, olive oil to put on bread, cheese on my sandwiches.

My body temp first thing this morning was 96.0, 96.6, and 96.2 with three successive tests with the same thermometer. I frequently feel ‘hot’ when everyone else around me is cold, or at a minimum, I will feel comfortable when others are putting on a sweater or light jacket while I am only wearing a shirt. This happens at work, at home, and family gatherings etc. This has been constant though for my entire adult life.