T Nation

Are My Levels Low Enough to Be on TRT?

Hello, I just got my blood work done and wanted to know what you lads here think of these numbers. I’m 33 and all my other blood work is in the normal range. I live in Canada and getting any doctor to take me seriously has been almost impossible. My doctor said I’m completely normal and no doctor would ever prescribe someone like me testosterone. I feel lethargic with little to no drive. And little to no libido. And trying to keep an intimate relationship with my wife has bee a struggle. Thanks for all the great advice on this site.

TSH: 1.22 ref range 0.32-5.00
FSH: 2.6 ref range <9.5
LH: 2.2 ref range 1.1-8.8
Prolactin: 15.7 ref range 3.8-20.6
Estrodiol: 107 ref range <157
Testosterone: 8.4 ref range 8.4-28.8
Testosterone Free: 216 ref range 115-577
Testosterone bioavailable: 5.1 ref range 2.7-13.5
SHBG: 18.7 ref range 10.0-70.0

In my opinion, yes especially with your symptoms.

It’s certainly low enough to not be out of line to want to talk to a doc about it.

Where are you located in canada? @dbossa Dan is in Canada and has a pretty decent doc he works with. Probably pays out of pocket, but you get what you pay for.

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I’m in Montreal though my doc is currently on a leave of absence.

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Where in Canada? Canada is a REALLY big place lol

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You mean Canada doesn’t just look big on a map? Mind Blown.

:slight_smile:

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Your LH is low so it’s no wonder your testosterone is low. Your symptoms are classic low testosterone, it’s not even a close call, your levels are very low given your age. The problem is there aren’t a lot of doctors that are properly educated in sex hormones, steroids has been demonized in western medicine for so long and the 1941 reports hinting that exogenous testosterone causes prostate cancer.

The newer studies and Dr. Abraham Morgentaler has pretty much shown exogenous testosterone doesn’t cause prostate cancer, this is why most doctors has stayed the hell away from sex hormones in the last 70 years and therefore hardly anyone knows about normal testosterone.

Mosty doctors misinterpret the reference ranges, whether you’re a 20 or 80 year old man, they are unconcerned with levels at the bottom of the range. A low hormone state is of low priority to doctors. You’re actually low enough to qualify for TRT, the problem is your doctor is not well versed in testosterone and don’t even read their own guidelines.

You’re profoundly estrogen dominant, T is very low and estrogen is near the top of the ranges. You are going to have a lot of problems on TRT unless you inject your doses daily using insulin syringes, otherwise I expect a lot of symptoms.

Dr. Lawrence D. Komer is in Burlington, Ontario and is private and cash only and is probably where you should get treatment anyway because it’s difficult to find a doctor that is up to speed on TRT.

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Thank you for the response. These low numbers are a tough place to be. Just high enough for my doctor to not really care but low enough for me to feel all the symptoms.

He’s not estrogen dominant. He is testosterone deficient. Estrogen is irrelevent… Again. Bring up his T levels, leave E2 where it is, and suddenly everything is wonderful. Funny how that works?

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Your doctor doesn’t care because he/she doesn’t know enough to make the diagnosis. They see normal numbers and are like get out of here, if you keep coming back they think you want to get ripped and look like a bodybuilder.

Go private and find someone who is not only willing to prescribe TRT, but is properly educated and isn’t fooled by all the bad studies painting a bad picture of steroids. A knowledgeable doctor is going to have you fill out a questionnaire, he is going to compare those symptoms with your numbers.

A doctor who has critical thinking and analytical thought processes is going see levels are at the bottom of the ranges across the board and compare these numbers to other men in your age group, he is going to consider the symptoms and come to the conclusion that you’ll more than likely feel better at the top of the ranges.

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I always take out the popcorn when the match between you two begins…

Why I continue to think that the truth is somewhere in between?

@vonko1988 Because you haven’t read any of the medical literature nor dealt with somewhere approaching 2000 men at this point? I’m guessing it may be that.

Yes, thats true but you’ve seen examples as well for people doing everything right and yet having issues with estrogen. So you cannot say this as absolute as a mathematical theorem

I have never seen issues with estrogen. Ever. The issues have zero do with estrogen and everything to do with other things.

How many people do I need to interview that also confirm estrogen is of no consequence until you stop doubting this? Ten? A hundred? At what point does it become enough? How many studies do we need to provide? I could show you the sky is blue and you’ll still debate that I haven’t demonstrated it. This is why it is pointless conversing with you.

Two more… With more on the way… All confirming the same thing:

Almost non of the people interviewed by you have not expressed this statement as absolute and universal as you do it. I truly believe you are right for the vast majority of population, but there are people like @systemlord out there and @bigmistake2 for example

I personally have no issues with estrogen and your statements most probably apply for me but I see it is too much of a sensitive topic for you :wink:

@vonko1988 find one person I’ve had on that blocks estrogen. Just one. It isn’t a sensitive issue. I can drown you in literature and get you to speak with a 100 docs and it still won’t make a difference to you. That’s my point. You waste people’s time. Systemlord is a totally different case, takes 5mg a day, riddled with health issues, and it still isn’t an estrogen problem for him. Don’t know big mistake either. I bet I could get him figured out.

What I AM sensitive about is people spreading misinformation. You do that often. It angers me to know that men will read the advice you dish out and ruin their protocols. I want people to have the correct information. I’m doing my best to rid people’s brains of this bro science nonsense. You’re not exactly helping and you watch all our videos!

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@vonko1988 I’m yet to figure things out, but my erectile function does seem to decline around the time my TT hits 1000 (which usually puts E2 around 40).

I recently found a paper about estrogen increasing prolactin, and as I already have elevated prolactin, I suspect that’s more the issue. I linked to it in another post but I’m on my phone right now.

I did try taking .125mg anastrozole recently and absolutely nothing changed. My E2 was last tested at 40.

I don’t buy into the whole E2 management thing, but when I’m out of ideas, I am open to ones I previously shut out. Hence the trial above. That’s my stance.

At least for men which are not on TRT this is not correct. Men with high aromatase activity have lower T levels due to the feedback loop of estrogen. This is for example causing the hyperestrogenic state men with Klinefelter syndrome live in which causes a bunch of negative consequences.

For men on TRT it’s a completely different situation. It appears as if the T/E ratio is best correlated with the symptoms of androgen deficiency. Interestingly a nice study demonstrated that the T/E ratio is better on increasing doses of T because the aromatase enzyme is saturated at higher T levels. This could be an explanation why some men here do better on higher doses of T.

A too high T/E ratio on the other hand has been linked to an increased risk for cerebrovascular disease in the elderly.

In summary the balance between T and E may be more important than their absolute quantities.

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@bigmistake2 if it is of any consequence, my prolactin has always been over the range, both before and during TRT. Once free T was optimized, prolactin was no longer a concern. Not to hijack the OP’s thread or anything but could you quickly share what your protocol is as well as labs (most importantly, free testosterone).

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Completely agree here. Yes, I should have been more specific that I’m referring to guys on TRT (since that is the topic in question).

Raising T and then lowering E2 increases that ratio and causes issues. People believe that raising T means that E2 will continue to rise along with it which isn’t the case as E2 eventually hits a plateau. Being a paracrine hormone, you are only getting a small picture of the overall situation as you are only measuring serum levels and having no clue what is happening in the tissue. In the vast majority of cases, as you said, it is insufficient levels of androgens and zero to do with E2 for men on TRT which is usually the result of doctors being content on getting their patients into the normal clinical range, completely disregarding symptoms.