Did Bloodwork. TRT or Not TRT?

I’m 39 y.o.
Weight: 93 kg
Height: 183 cm
BodyFat: ~18
Waist: 34-35 inches
Lift weights 3-4 times a week (primary-strength)
Protein and fat sources: kefir, eggs, meat, cheese, nuts, lentils etc.
Carbo sorces: various vegetables, oats, buckwheet etc.
Always tired, some depression, little motivation, mind fog, low sleep quality. No problems with libido.

Visited 2 urologists, 1st wants to put me on Sustanon 250ml/ 3 weeks, no AI, no Anti-Es, told me, body will balance everything by itself, 2nd- wanted me to try tribulus, I disagreed, so he told me to inject sustanon like 1st said and see how will I feel, if it feels great then he would prescribe Clomid, no AI. I’m meeting endocrinologist next month.

My blood stats:
RBC 5.58 10^12/l ref. 4.57 - 5.98
HGB 160 g/l ref.139 - 177
HCT 47.2 % ref. 39.6 - 51.8

PRL 141.0 μIU/ml ref. 45 - 375
SHBG 15.68 nmol/l ref. 14.55 - 94.64
FSH 4.02 U/l ref. 1.4 - 18.1
LH 2.30 U/l ref. 0 - 6
TTE 7.81 nmol/l ref. 5.72 - 26.14
E2 89.54 pmol/l ref. 0 - 146.1
PSA 0.55 ng/ml ref. 0 - 146.1

Thyroid profile:
T3 1.54 nmol/l ref. 0.92 - 2.79
T4 7.6 ug/dl ref. 4.5 - 10.90
FT3 4.87 pmol/l ref. 0.92 - 6.50
FT4 16.56 pmol/l ref.11.50 - 22.70

Lipid profile:
CHOL 4.5 mmol/l
HDL (DTL) 1.04 mmol/l
LDL (MTL) 2.93 mmol/l
TG 2.10 mmol/l

Liver stats:
ALT 38 U/l (x0.0167=μkat/l) ref. 16 - 63
AST 19 U/l (x0.0167=μkat/l) ref. 15 - 37
BIL-T 8 mol/l ref.< 17
BIL-D 2 mol/l ref. < 9
BIL-I 6 mol/l ref. < 14

CRB C mg/l 0.58 ref. <5.00

Insulin non-fasted: mU/l 15.7 ref. 3.00 - 25.00
Insulin fasted: mU/l 9.10 ref. 3.00 - 25.00

HbA1c % 5.14 ref. 4.80-6.00 non-diabetes;
6.10-8.00 controlled diabetes;
8.10-20.00 uncontrolled diabetes
HbA1c mmol/mol 32.50 ref. 20.00-42.00

CORT(morning) nmol/l 514.6 ref. 118.6-618.0

Thyroid numbers are great, LH is low so it’s a no brainer testosterone is low. SHBG is low enough that if you were on a shorter ester like ethanate or cypionate I would tell you to inject testosterone EOD or every day. You will clear out testosterone quicker (excreted into urine) than a guy with SHBG midrange and so on.

Most of what’s injected will never make it to your cells, it will end up right in the toilet. SHBG overrides the half life, so as soon as it’s released, it’s in the toilet. Sustanon is better than Nebido, stay clear of Nebido if you can help it.

If everyone balance out there wouldn’t be guys suffering on TRT do to high estrogen.

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Thank you for the reply, Systemlord. What would be the best option for me at this moment: Clomid? HCG? AI? or straight to Testosterone injections?

I think you should investigate further why your low. I see you are going to Endocrinologist next month. That is good because they should investigate further. Like checking adrenals. Even if you end up needing trt it’s good to see an endo.
Check prolactin, cortisol.
Testicular ultra sound.
Maybe pituitary MRI.

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I’m not a fan of Clomid, half the pill is an estrogen and is why men typically don’t feel well on it, successfully restarting your HPTA happens rarely. HCG mono has slightly better success rate but still low chance.

TRT will work when done right, so if you follow my advice on Test ethanate injections EOD or ED, or Sustanon 2-3 times weekly you just may be in a better place in a year from now.

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I’ve been feeling the same lately… also on clomid at 50mg a day. Test and Estrogen both jumped into the high range and I’ve gone back to feeling like shit. Libido and drive still have never come back. I got set up with Defy and are just awaiting the extra blood tests they wanted above the large amount I just did and I can do my first consult. If it’s one thing I’ve learned without our health we have nothing. I’ll let you know what I figure out with Dr. Saya and share the experience.

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50mg a day tells me your doctors is a bit behind, it’s been known for some time that 12.5 to 25mg EOD is a better Clomid protocol.

I’ve updated my blood stats, please see above(first post).