T Nation

49 Year Old; Do I need TRT


A friend and I were discussing life as "older gentlemen". We discussed some of the impacts of aging (lower libido, no recovery from training, lower zest for life, etc.). Long story short is on TRT and suggested it to me. I was able to get a fairly complete blood panel and am wondering what you all think - Is it worth it for me to pursue TRT based on the results? I'd love to feel "young" again, I have definitely felt older in the last few years.

My bio info:


Here are my test results:


It would be difficult to get TRT prescribed with your TT number. There are some doctors who might do so based on your free T or your low estradiol (assuming that standard estradiol test is good, which is a subject of some controversy). However, as a general rule guys who post on forums whose TT was already as good as yours before TRT don’t tend to feel much different on TRT, except for a usually temporary initial dopamine spike. That doesn’t mean there aren’t exceptions. Maybe only the ones who have problems post on forums. But still, there is some research showing that it is guys with frankly low TT who derive most benefit from TRT.

Still, a short trial might show if it is worthwhile. If you do that, be aware that while most men would recover fine after having been on TRT for, say, three months, and then stopping it, some might not.


At your age, one can assume age related issues and not get too carried away in trying to ID and fix a cause.

The best overall measure of your thyroid function is to check your oral body temperature when you first wake up AND mid-afternoon. Best to be around 97.7 when you wake up, 97.3 and lower a a problem. You need to hit 98.6 in the afternoon. If temps low, read the thyroid basics sticky.

You need to be using iodized salt and should have a long history of that. Ditto for your wife/GF.

Have you read the advice for new guys sticky?

TT looks OK, but we are really interested in FT. FT lab work [low] looks not so horrible, but FT levels change a lot and we thus do not know your overall FT status. E2 is low, suggesting that FT is lower. TT can be exaggerated in older guys as increasing SHBG levels lead to more SHBG+T that exaggerates TT which can easily mis-lead most doctors. LH is also released in pulses and has a short half life. FSH is a better measure of LH than LH itself. With lower E2 we do not expect that SHBG is high. But if the liver is not functioning well, the clearance rate for SHBG+T can be reduced, and again TT levels are exaggerated. AST/ALT seem elevated, but sore muscles from the gym can easily do that.

You will not find an ethical main-stream doctor who will do anything with your current TT. Need LH/FSH.


You both told me what I wanted to hear. I spoke with my friend’s doctor who ordered the test. I read and re-read the stickies and several posts and my levels do not seem so bad. On the phone, before the tests, he seemed to be pushing TRT. After reading about the potential side effects of treatment, it does not seem like something to jump into without a true need. I’ll meet with the doctor but based on what I have read and your input, I won’t do the treatment.

Thanks so much for your input and expertise. It is appreciated and valued.