T Nation

Considering TRT in 6 Months, Need to Use Online Clinic

Hi everybody. Since two years I was feeling horrible compared to before and found out my Total T and especially free T are quite low. Cortisol is relatively high, prolactine is on the high end, SHBG is relatevely high. I’ll post some of my lab tests by dates:

30.03.2017 - I was feeling well and I was rocking

Testosterone S 18.14 nmol/l 9,90 - 27,80 ECLIA

Free Testosteron S 22 ng/l 8,30 - 40,10 RIA - the last time this shit was in good range for me

Cortisol (morning) S 461.3 nmol/l 133 - 537 ECLIA

Общ холестерол (Chol.) S 4.76 mmol/l 3,5 - 5,20 PHOT

HDL- Холестерол (HDL-C) S 1.58 mmol/l >1.5 PHOT

LDL - Холестерол (LDL-C) S 3.07 mmol/l 0 - 3,35 PHOT

Estradiol S 40.58 pg/ml 7,63 - 42,60 ECLIA

From here on I was feeling like shit, low energy, low constant depression, inability to focus on my work, problems at my love life, not feeling manly, feeling emotionally week.

18.06.2018

Estradiol S 32.49 ng/L 7.63 - 42.60 ECLIA

Testosterone S 12.91 nmol/l 9.90 - 27.80 ECLIA

Cortisol (morning) S 651.6 nmol/l 133 - 537 ECLIA

Free Testosteron S 9.5 ng/l 8.30 - 40.10 RIA

07.07.2018

LH S 3.43 IU/L 1.70 - 8.60 ECLIA

FSH S 1.28 IU/L 1.5 - 12.40 ECLIA

Prolactin S 367 mIU/L 84.80 - 318 ECLIA

Estradiol S 28.76 ng/L 7.63 - 42.60 ECLIA

Testosterone S 14.11 nmol/l 9.90 - 27.80 ECLIA

Free Testosteron S 11 ng/l 8.30 - 40.10 RIA

SHBG S 30.25 nmol/l 18.30 - 54.10 ECLIA

Желязо S 17.48 µmol/l 7.20 - 27.70

Ferritin S 231.4 µg/L 30 - 400 ECLIA

25-OH-Vitamin D S 25.35 ng/ml ECLIA - now is above 60!

19.11.2018

LH S 4.06 IU/L 1.70 - 8.60 ECLIA

Estradiol S 27.79 ng/L 7.63 - 42.60 ECLIA

Testosterone S 13.68 nmol/l 9.90 - 27.80 ECLIA

Free Testosteron S 13 ng/l 8.30 - 40.10 RIA - Not so bad, still low

Магнезий (Mg) S 0.77 mmol/l 0.66 - 1.07 PHOT

25-OH-Vitamin D S 21.48 ng/ml

Zinc in Serum S 14.2 µmol/L 9 - 18 AAS

31.12.2018

25-OH-Vitamin D S 54.44 ng/ml ECLIA

Free Testosteron S 6.7 ng/l 8.30 - 40.10 RIA - Horrible, but I slept bad for one week and had a lot of sex previous night. Can be because of that?

My libido is still fine, I can do it 3-4 times a night, but still less good than before. I wanna get back my energy, my vigor and energy for life. I’m taking now Tongat Ali. I do everything natural to increase my T - good food, enough water, sleep, strength training etc. I feel slightly better from taking the Tongkat Ali but, still not enough. My libido got much better, but this is not enough for me. A friend of mine increased his free T by 25 percent for one month after taking the same Tongkat I take now. I’ll do myself a new test after two months on Tongkat Ali and I have ordered for six more months.

IF AFTER this six months my free T doesn’t have a significant improvement, I need to go to TRT in my oppinion. What do you think? The problem is I live in a country with fucked up health care - Bulgaria. There are no doctors here that are willing to put me on TRT and that can make it correctly(I’ve been to ALL). They see my total T is within range and say you are fine, that’s it. But because TRT is complicated stuff, I guess I need to take something to lower estradioll, to get my dosages precised and so on I need an online clinic I can count on, especially if something FUCKS UP!

Do you think I’ll need TRT and which online clinic you can recommed?

You don’t need me to tell you that you need TRT, that part is obvious. Defy Medical is a popular telemedicine clinic, finding a knowledgeable hormone doctor under insurance is almost impossible.

I do not live in USA. Are you sure I need TRT? I’m still only considering it

I don’t think you need TRT have you looked at your thyroid?
Some more details would help how old are you, how tall and how much do you weigh?
Are you active or lay around more?
You really should mention where you live. I do not believe there are any international TRT clinics.

His total testosterone is at 371 and free testosterone is below range on one test, we see guys in here higher and symptomatic, the levels seen in 80 years olds. President Trump at 72 years old has higher levels than his and he’s heavily symptomatic.

He’s at risk for cardiovascular disease.

Testosterone Threshold for Increased Cardiovascular Risk in Middle-Aged and Elderly Men:

These data showed that a testosterone threshold of 440 ng/dL was associated with increased Framingham 10-year CVD risk in middle-aged and elderly men. Poor sexual performance, decreased morning erection, and loss of libido had an impact on the testosterone threshold for CVD risk. The threshold level was higher in men with sexual dysfunction.

There are many options before jumping on the needle.
Test for primary or secondary
HCG with an AI to stimulate natural T production
Clomid to stimulate natural T production

I’m willing to bet on the second test his SHBG increase therefore decreasing his free testosterone giving him the 6.7 score.

Testosterone in range doesn’t guarantee no symptoms, doctors don’t seem to understand this because all doctors outside the US follow idiocy that’s practiced here in the US.

In range doesn’t automatically mean you’re normal, if you were normal you would feel like shit.

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Can you give me more info about it? I know only Clomid from what you said, the doctors I’ve been told me not to touch it(I do not think they are good, but no better around)

Thank you for your answers. Obviously I feel shitty, and there is something wrong with my body. I spend a lot of time to find the cause, but none exists.

I’ve checked my thyroid. All levels are at range. Although they found a small gland in it, but it is good, it is not a cancer, a biopsy was taken and six months later it has not increased(even they say it decreased a bit). According to all doctors and literature this small gland should not affect my T production.

So the issue is - I have symptoms of low T, but my T even on the bottom part is within range and doctors here do not want to do a shit. They want me to get really bad first. I on the other hand would not do anything alone without a doctor. Too many things can go wrong.

I need to find some online remote assistance by qualified persons. All I tried to contact want me to be in USA on sight

Defy Medical can offer advice only consults for those abroad, at least your protocol will be directed in the right direction.

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GRRRRRRR…

I wouldn’t mess with a thing.

You will get way better info on Clomid from google also look into HCG it simulates LH which is the signal for your balls to make more T. It will raise your E2 so you have to watch that as well.

How old is he. If he’s 25 or 35 those levels are very low. If he’s 80 there’s good…

Sorry, forgot about that. I’m 30. All doctors here say my levels are fine because in range. I feel frustrated at the face of the health system.

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Well it used to be better :smiley: Also tongkat ali now helps a lot here. At least it did this job.

That what I expect a sick care doctor to say, they only care about reference ranges and ignore symptoms. This is how insurance companies save money on healthcare costs, by denying treatment and doctors flapping their gums by saying you’re within range.

There’s no profit in preventing disease, sick isn’t in the business of preventing disease, but waiting for disease to strike before taking action. The latter is more profitable.

Sick care definition

A sick care system instead of a health care system. We have a medical (that is, sick) care system a system that waits until we become ill before it kicks into action instead of a health
care system focused on helping us stay healthy.

Yournlow for 30. That’s my personal opinion. But not so low or old enough to take the plunge. Find a good doc who is tuned in on hormones. Find other alternatives to fix your system.

Look at diet, environment, any new chemicals being introduced, sleeep, everything… a combination of fixing everything could get u back on track. Especially if your taking some medicines.

If you start TRT you need to be somewhere you can get it consistently. You don’t want to start and then cannot buy it. That would be misery. You need to look into permanent solutions as suggested below. Supplements are temporary. They can cause more harm then good. Do not take boosters for T. Once you stop it drops again and sometimes worsens the issue.

I have access to medications, I need someone to guide the treatment. Whatherver it will be TRT or some other medicals to stimulate the T production like Clomid or Triptorelin. I need the person to make that decisions, to decide what is best in my case considering my results and to make me exact program. I’ll find all necessary medicals, testosterone and etc.

What do you mean by T -boosters? I do not think they work at all.

You can always consult a trt doc in the states and they can guide your treatment. They will not be prescribing but guiding like you said. You will spend money on an hour consult, send them your labs and medicines and medical history pre call.

Honestly that’s what I’d do if I were you :slight_smile: