T Nation

Considering TRT

Typing from phone, will update this weekend with additional information.

I’m a 34 year old male, 5’11, 195lbs. I lift from 2-3 times a week and do BJJ 3-4 times a week. I have been feeling depressed and unmotivated for some time now. I had a consult for TRT, but want to do more research before taking the plunge.

Symptoms:
Cold hands, feet
Poor sleep
Low libido
No morning wood
Less strong erections
Mental fog
Low motivation
Really dry cracking skin on hands
Thinning hair in certain areas (widow’s peak)
Really bad recovery, struggling through workouts
Seem to be carrying more weight in stomach, love handles

I am contemplating conceiving a child within the next year. My life has been extremely stressful for the past two years. I also had T checked in 2017 (508 total, 11.1 Free, TSH 1.290) but he did not do a thyroid panel. I have a script for T3 based on the March bloodwork, but haven’t started taking it yet (worried about SHBG/catabolic state). Diet has been higher fat and protein, very low carbs. I do not use much salt and have not consistently taken a multivitamin. Morning temperatures below 97, around 96.1 to 96.4. I need to check afternoon. I track sleep with Oura ring, and hardly ever get deep sleep (1-15 minutes max most nights). REM is often under 1hr. March labs were after a week of vacation, so possibly inflated. I have taken time off from the gym, but still do not seem to recover (Feeling and HRV).

If I go on TRT, would be HCG and Testosterone shots twice a week. As of last week I am taking:

DHEA 25 mg by mouth every night
Vitamin D3 5000 iu daily
Fish oil 3-4 g by mouth every day for HDL support

Do you think my body has potential and this is just stress/diet? Is there any hope for reducing SHBG, or should I just start TRT? Additional things I should check? Should I add iodine?

I appreciate any input offered and advice. I haven’t felt like myself in a long time.

I would not rush to TRT in your case. Your reverse T3 is high, even though your other thyroid numbers look okay. Your SHBG is retarded, and you E2 is low. You have something going on, and you need to figure out what it is. The T3 will probably help, because you will overcome some of that reverse T3, but you need to look into taking something to lower your SHBG. I didn’t see a value for prolactin, has that been tested? Your stated symptoms sound more like thyroid.

How long have you been taking the D3?

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Yah and I bet lowering stress is going to help a ton. More quality sleep as well.

Take the thyroid it’ll make a huge dent in the fatigue. With all these issues why are you hesitating? Self inflicted misery. Do the best you can with the cards dealt. If thyroids fudged then fix it.

Trt can help but it’s a life long therapy. just make sure you try to fix life style diet and the mental game before jumping on t.

T3 should give you the kick needed to pursue a better life style. It helped me a ton.

Given your reverse T3 level, your free T3 needs to be at least 4.4.

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From what I have read, T3 increases metabolism of muscle as well as fat, and can increase SHBG. I was just prescribed the T3 a few days ago and didn’t want to start taking it before I researched.

If t3 is needdd take it. Trt won’t work without a healthy thyroid. Don’t worry about shbg. It’s jsut a value that helps a doc decide how much test you need. Get your hormones sorted out and everything will fall into place. Shbg being higher is actually better than lower.

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Do you want to read about LOW E2, HIGH SHBG, and acceptable level of T? You are going to find that MOST of the guys on this board are NOT going to have LOW E and MID to AVERAGE T.

I did. I had undetectable E and High T – before TRT. It is a long read though.

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I understand I’m just saying people focus on shbg like it’s the be all. He hasn’t even started yet and shbg is an issue. Like good ok @physioLojik says / there’s more to it then shbg levels.

I have seen guys with shbg in the 50z and 40s no issues. I can see higher causing issues but even then it’s not set in stone.

I have just started to consistently take D3 as of April 1. I have not had prolactin tested, but will look into it.

He is at 80 for SHBG. And his T levels are at the level that most doctors would shoot for. AND he has LOW E, which is a different case than most of what you read on these forums. Low E with normal T, plus high SHBG is an oddity …

Of course, that is just my opinion.

I get it bro. I am just saying don’t focus on it so much that one is always fudging with SHBG.

There are plenty of cases where guys with high shbg have zero issues and can take a normal dose.

@physioLojik has best it to death and makes allot of sense as to why.

Ironically now a lot of the research coming out is showing the higher the shbg consistently the better. There are actual shbg receptors in cardiac tissue FYI. More to follow. On vaca with family.

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Well that’s interesting to hear. I’ll remind you when you get back :!

Enjoy the vacay!

There are no studies associating high SHBG with any diseases, only low SHBG. The only thing that high SHBG that I know of is it can lower Free T if it gets too high, but TRT is the workaround for that problem.

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That is the reason TRT was recommended. My doctor felt the most reliable way to counteract the high SHBG would be TRT. He felt that once on TRT my free test would overcome the high SHBG and the high SHBG would be helpful in keeping my estradioI under control. I have started taking the T3.

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Ok good we are on the same page :slight_smile:
Let me know how the t3 goes.
Make sure you take it with an empty stomach in am and wait 30-45 mins before eating.

My doc and others have me Take another 8 hours later