T Nation

Considering TRT, Help with Labs

I’m 30 years old, and for at least 5 years now I’ve been suffering with low libido, tiredness as well as some depression/anxiety.
I had some basic hormone tests done and here are the results:

DHEAS: 8.0 (1.0 - 15.0) umol/L
Testosterone: 8.0 (5.7 - 26.1) umol/L
SHBG: 15 (15 - 95) umol/L
Bioava. Testo.: 5.2 (2.5 - 12)

I think that the total testosterone range is low, according to a few sources I have read, but the Dr says that it is fine.

I also have a few friends who have managed to get on TRT, one from a doctor and the other he runs by himself. They both say it has made a huge difference, so I’m considering getting another opinion, or just trying it for myself.

I was just hoping for some advice/feedback from some people, thanks.

Your testosterone may be normal, for an old man. Only a experienced doctor can properly diagnose you, most ordinary doctors are not very knowledgeable on the subject on normal testosterone.

They see in range without considering your age, truth is old men score near the bottom of the range. You’re gonna have a real rough time on TRT if you think you’re going to be able to inject large massive doses, you’ll need very small injections every day because of low SHBG.

You need a thyroid panel to investigate low SHBG, sometimes it can be low Free T3.

Thanks for the reply.

I have had my thyroid checked recently I believe, I will get those results sent to me in the next few days.

What do you mean by large, massive doses? I was under the impression of an average dose being around 100 - 200 mg a week.

The total dosage isn’t so much a factor, the size of the dose injected at one time is and large doses will cause excess testosterone and estrogen to flood your system. Low SHBG men need only about mid-range Total T to have sufficient Free T levels and we need to keep our Total T levels in a tight range to avoid excess and/or having levels drop too low. To do this we need frequent injections.

I’m like you, I have low SHBG (pre-TRT 14) and I didn’t really respond well to TRT injecting 1x, 2x weekly and Total T levels in the high normal ranges only caused symptoms. When I started injecting smaller doses (25mg) EOD I started showing benefits on TRT, but I would feel even better on daily dosing, way better.

Having low SHBG means you’ll have higher Free T in relation to Total T, Total T is bound to SHBG and is not bioavailable, Free T is the important stuff.

TRT will decrease your SHBG making daily injections all the more important, unless you’re one of the lucky few to see an increase in SHBG on TRT like myself which is not common.

Would this still be the case with one of the longer esters that are used in TRT?

Doctors are taught that the lab ranges are normal. If using insurance, a diagnosis of hypogonadism cannot be made without corresponding lab evidence, which for you and this lab, means 5.6 umol.L or lower.

Levels are not good for a 30y/o. The only thing saving you is your low SHBG, if it was mid-range, you’d have very little free test to work with.

Post any other labs if possible. Unlike systemlord, I do not believe low SHBG is an automatic indication for daily injections. Most guys do fine with weekly injections, even those with lower SHBG. Everyone responds differently. I would start with 150mg per week and adjust dose and frequency, if needed, from there.

It does. If possible, find someone who specializes in HRT, by that I mean all they do is hormone restoration. Almost always, that will be outside of insurance coverage.

It is true doctors are taught that the lab ranges are normal, if they are not educated on the subject of testosterone they will not consider your age when assessing your testosterone levels, young men typically land in the high normal ranges while older men on the bottom end.

The average 30 year old scores in the 600> ranges or 20> nmol/L), most doctors are not very knowledgeable about sex hormones or what constitutes normal levels at a given age. Most doctors do not care about TRT because it’s not really focus on in medical school and is a low cost, low profit treatment.

These long esters are not recommended, they just don’t work very well and takes forever to build up in your system and if you metabolize T quickly, you’ll never feel good on it because the half life is too long.

Thanks for all the replies.

Say I started with weekly injections, what signs would I be looking for to know that I need to adjust frequency?

You will notice, consistently, that you do not feel as well towards the end of the week compared to days 1-4 or 5 following your injection. Most report fatigue, they just feel unusually tired on day five or six.

I started out of TRT injecting weekly and after 15 weeks noticed 4 days after my injection I started feel really bad, this was a sign my levels were low 4 days after my injection, twice weekly was a little better, but still felt low in the middle of day 3, so I knew EOD would work because I always feel the same the first two days.

It would turn out I feel even better on daily dosing. You will however expect to feel as levels are high and low when first starting TRT, so if you feel these swing after 6 weeks, then you need to move injections closer together.

Would enanthate be the best for this schedule?

Cypionate is king.

One of the first things you’ll notice is that when you wake up your penis will be erect. The second thing you’ll notice is your girlfriend will be in a better mood. When you finally get out of bed and look in the mirror you’ll notice that you like what you see. That’s how it was for me when I started. If you need a doc that will prescribe you email me (in bio) but there are many docs out there that can help you if you are having trouble with the current doc.

I got my thyroid results from earlier in the year. The only results on it is
TSH: 0.97 (0.50 - 4.70)

TSH is a stimulating hormone, not an actual hormone produced by the thyroid gland, you want to see how the thyroid is performing, you need to check the free active thyroid hormones Free T3 and Reverse T3.

A lot of doctors fail miserably at testing thyroid and sex hormones.

Fair enough.

I’m seeing if I can get an appointment bulk billed with a men’s health practitioner, hopefully i can find out in the next few weeks.

Because of a the half life in a ED or EoD schedule?

When your inject this frequently it more about keep levels from fluctuating and decreasing T–>E2 conversion. If you can use less Test to achieve similar levels, estrogen will be lower. Whenever you have to compensate for drops in levels you will need more T to maintain a desired level and for some men this means more estrogen.

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Cypionate and enanthate are very similar. I’d use whichever you can get easier

I just spoke to my mum, it turns out that thyroid problems run in my family.
She had hers taken out, her dad had his taken out and his dad died from some complications with his, and my cousin was recently put on medication for it.
So I’ll try to see a Dr this week and get that checked out properly, and not just for the TSH like they did last time.