T Nation

Advice Regarding Possible TRT for My Father

Greetings. I came here to ask some advice/opinions on this certain situation. It is actually about my father who is 60 years old of age. He has been complaining about fatigue, some depression and host of other symptoms (that usually might pop up as your age goes up) and first his GP prescribed him antidepressant (SSRI). He took it for about 3 weeks and quit because of it worsened his sleep quality and generally didn’t really like the idea of taking that. So I have been dealing with my own (partially hormonal) issues in past so I have some knowledge on stuff like this. So I asked him to ask his doctor to test his testosterone levels. And turns out they came back quite low.

His LH levels were mid-range, total testosterone was 11 nmol/l (which converts to 317 ng/dl) with SHBG of 24 nmol/l so his free testosterone was quite low which would explain his symptoms, he also carries quite a bit of fat in his midsection (otherwise normal, fairly tall and skinny body). His other bloodwork like liver enzymes, kidney function, PSA levels etc. were normal. He also always has had his red blood cells at the very low end of reference ranges, still in range though. So I wrote him a list of commonly done bloodwork that is done pre-TRT to request from his doctor.

Now apparently his GP has agreed to a 3 month “trial” of TRT with Testosterone Gel because he agrees his T levels are low. Now I am no expert here but isn’t that a bit rushed, I dont know the full story yet but I guess his GP didn’t want to check anything else now pre-TRT but to do some labs in like month or two after this “trial”. Only thing he did agree to test BEFORE the teraphy was his estrogen, E2 levels. But there was several other blood work on the list. He has not started it yet but I think has the prescription. I have yet to have asked did his doctor mention possible estrogen control etc.

Other worth mentioning things are that he has had triple bypass surgery few years ago after suffering a minor heart attack. So he takes quite a few medications for blood pressure, blood thinner, cholesterol medication… One thing I also noticed that he takes as prescribed is spironolactone. Isn’t that medication some type of androgen receptor blocker/anti-androgen?

What do you think of this situation, he is very vary of questioning his doctor because he agreed to the TRT trial with gel so he don’t want to mess it up and so forth…

Any insight is appreciated!

Mainstream medicine is barbaric when it comes to hormone therapies, often men and women are prescribe SSRIs when the cause of the problems are hormonal and can be corrected by hormone therapy, these SSRIs only mask the symptoms or do nothing at all.

T gels generally are poorly absorbed by men, slim chance of success at best and indicates your doctors may not be up to speed on TRT. Compounded testosterone creams can work when applied to the scrotum once or twice daily, good luck getting it through state healthcare.

You may need to seek private care as the NHS or UK based state healthcare is generally terrible at hormone therapies and will only cause your father more suffering do to his high body percentage that may see estrogen skyrocket.

The majority of endo’s, urologists and GP’s will refuse estrogen management. TRT needs to be tailored to your fathers biomarkers few doctors know how to do well. Anastrozole and aromasin block estrogen conversion, increasing the injection frequencies can lower estrogen without the need for these drugs which should be used as a last resort.

An SHBG of 24 is good, but TRT will lower it a little which can change the protocol to include more frequent injection to mitigate estrogen sides. Injecting doses twice weekly, EOD and even everyday work great to lower estrogen without the need for these harmful drugs.

Getting on TRT and losing weight will lower estrogen.

“Balance My Hormones” is in Dorset, a private clinic that specializes in hormonal therapies.

Thanks for the feedback. Yeah, I am a bit worried how’ll this will go. I think his GP should’ve ran some more bloodwork which I probably will at a walk in lab If needed before he applies any testosterone from outside source. Also I live in EU and here the only injectables available are Sustanon and Nebido and the latter one is starting to fade out the first one or so I’ve heard… Just dont want him to have some nasty side effects (from e2 for example) and then his GP being clueless on what to do and just takes him off the T or some scenarios like that…

Greetings. Just providing with a bit of an update. So my father got his TSH and Free T4 levels tested by his doc (had a lot more tests written but he only wanted to do these) and results were

TSH 3.9 mU/l
FT4 13.5 pmol/l

Reference ranges varies a lot it seems but TSH upper limit I found to be 3.5-4 at lowest. Ft4 seems to be 9-19 to 11-22.

He is going to get blood drawn for ferritin, free T3, estradiol and prolactin. He has not started TRT as of yet.

What do you make of his thyroid numbers? He doesnt seem to have the common symptoms like cold hands or feet. Just the general fatigue but as you saw, his free test was low too.