T Nation

Before Going on TRT, . . .


I would like to rule out any possible causes of my low testosterone before I commit to TRT. What things should I check out?

  • I am making an appointment for an MRI
  • I am making an appointment to conduct a sleep study for sleep apnea

Lab Results: (Taken at noon)

Actual - Name - Reference Range

170 - Total Testosterone 250 - 1100
24.0 - Free Testosterone 46.0 - 224
50.4 - BioAvail. Testosterone 110.0-575.0
27 - SHBG 7 - 49
7.5 - Prolactin 2.0-18.0
3.1 - FSH 1.6 - 8.0

2.99 - TSH - 0.40 - 4.50

Age: 25
Height: 5'8"
Weight: 255
Waist: 42
Fat Distribution: Mostly on torso
Gyno: No, Nipples flat and asymptomatic

Mood: No Libido, Very Very Very slight low-grade depression - was slightly more prominent last year
Cold Easily: I would describe it as normal
Hair Growth: Average timeline at appropriate age (peach fuzz to sideburns & mustache to beard)
Body/Face Hair Description: Hairy legs, arms, back and chest, If I needed to appear clean-shaven, I would have to shave every 3 days or so)
Dry Skin: Jus' more so during the winter, other than that my face and hair gets pretty oily

Given this information, where would you go from here? My mom has hypothyroidism and wonder if I have it as well given the TSH value of 2.99. Previously, in April 2009, my TSH value was 1.932 (0.45 - 4.5).

Very much appreciated,


Oh, I forgot to mention that during April 2009, I had slightly elevated liver enzymes:

41 - AST 0 - 40
65 - ALT 0 - 55

In August 2010, they came back within range:

28 - AST 10 - 40
45 - ALT 9 - 60

An ultrasound revealed that my liver appeared normal and had no scarring. They attributed these high values to fatty liver disease and said if I lost some weight it would go back to normal. I'm not sure if this is worth mentioning but thought I would post it anyways.


good idea to check out everything else before jumping into HRT.

yes you seem to be hypothyroid.

you need more tests per the blood test sticky.
8am Cortisol