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65 Year Old Trying to Stay in Shape. Help with Bloodwork and Protocol?

Gents, first please let me know where to post if this is the wrong area.

So I recently got lab results and need help on a protocol to get me to normal ranges. Any help would be amazing.
Currently, I am using 1 gram of topical 10% testosterone per day (100mg/G)

My labs:

  1. Sex hormone binding globulin: 20nmol/L

  2. Testosterone, total: 369 ng/dl

  3. Testosterone, free: 63.5 pg/ml

  4. LH: 3.7 miu/ml

  5. PSA, % free: 13

  6. TSH: 3.17 miu/L.

The doctor did not test my estrogen or IGF levels.

400ng/dl is typical with cream, in literature with the manufacturer stuff they had a hard time getting mens T levels over that mark.

Also I think some men need to rub the cream on twice per day, it is possible you caught the down curve and your TT levels do get higher than that.

There is 20% cream so I would consider moving to that and dosing multiple times per day, or you can rub it on the scrotum for better absorption but this will make your DHT levels skyrocket.

Or you can move to injections, which I prefer and they are typically easier to dial in. When you inject, whatever you put in the syringe you get. With cream you never know how well or if you can absorb it.

Hope this helps.

You might look into scrotal creams, which reportedly are ~70% absorbed. It is applied twice daily though. Personally, I take injections. The fact that your LH is not bottomed out means you can go higher and unless you are feeling great, I would want to see the test numbers at least doubled.

Do you know your total PSA level? Also, free T3 and free T4?

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Surprised to see Free T so low given your Total T and SHBG, definitely could hurt to optimise levels at this age, it’s not like you’re going to see increases in your near future. Improving testosterone would be extremely beneficial to a longer healthy life.

TSH is no good either, sadly most doctors are still tied to the old reference ranges, anything 2.5> is indicating a struggling thyroid. It doesn’t seem your doctor is actually testing thyroid hormones, very common and you will not be able to seek thyroid treatment in the sick care setting, the ranges are rigged and standards are low for getting treatment approved by insurance.

Free T3 (not TSH or Free T4) increases metabolism, drives your heart to beat, liver to function and metabolism to process and burn food for energy, when Free T3 is below mid-range, you slow down. You will not get approved for thyroid medicine in the sick care setting with these numbers.

Anti-aging clinics to the rescue. Your doctor will more than likely (clueless) only be good for the prescription, most are not trained in sex hormone therapies and operate on very narrow guidelines and do not know how to manage all your other hormones affected by T, like estrogen which is why it wasn’t tested.

TRT can sometimes increase IGF-1 and affect adrenal hormones, as it stands you would be better off seeking a doctor in anti-aging who specializes in hormones for a living. I can make some recommendations if I knew your location.

Reference ranges for TSH and thyroid hormones

Though TSH remains the most commonly used endocrine test in clinical practice, the issue of an appropriate TSH, and to a lesser extent, free T4 and free T3 reference ranges is still under debate. First of all the distribution of TSH reference range is not normal, with median values (also depending on population iodine intake) usually between 1-1.5 mU/L.

The evidence for a narrower thyrotropin reference range

It has become clear that previously accepted reference ranges are no longer valid as a result of both the development of more highly sensitive TSH assays and the appreciation that reference populations previously considered normal were contaminated with individuals with various degrees of thyroid dysfunction that served to increase mean TSH levels for the group. Recent laboratory guidelines from the National Academy of Clinical Biochemistry indicate that more than 95% of normal individuals have TSH levels below 2.5 mU/liter. The remainder with higher values are outliers, most of whom are likely to have underlying Hashimoto thyroiditis

Thanks. What is the issue with DHT levels being high if I start scrotum absorbtion?

The prostate regulates DHT, like a potted plant when over watered will overflow not allowing anymore water to penetrate. It was common belief prior that the prostate would explode when DHT was in excess, this was the imagination running wide without any data to back it up.

I can only imagine the DHT levels in AAS users, there have been zero increases in prostate cancer when all the AAS users are added to all the data which shows no increases in prostate cancer occurrences in the population.

All the studies are showing no adverse effects of excess DHT.

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Thanks, I’m going to get T3 and T4 checked if my doctor will do it.

Doctor didn’t do any other panels but I am going back in to request additional tests. Thank you

You’re welcome. Sometime Reverse T3 can be elevated and can block Free T3, I doubt it will be elevated, it’s probably just sub-optimal Free T3.

If your doctor resists more testing, there is always Discount Labs where you buy lab testing. You can always take these labs to any doctor and get the ball rolling sooner and actually have a productive conversation with your doctor instead of fighting the doctor for more testing.

There has to be a total PSA in order to determine the free PSA percentage. At 65, that number is good to know, and with a free PSA of 13%, especially so.