T Nation

Different Schools of Thought on TRT

I am 29, 215 ibs, 6’1, in pretty good shape. Pretty much have all the symptoms of low T. I started TRT about a month ago with a T clinic because I couldn’t get in to see an endocrinologist until today. My numbers upon testing go as follows:

Total test: 291 (264-916) Not low by labcorp but low by endocrine society under 300
LH: 2.2 (1.7-8.6) on the low side
Prolactin: 5.1 (4.0-15.2)
Estradiol: 6.4 (7.6- 42.6) low
SHBG: 32 (16.5-55.9)
free test: 5.8 (9-30) very low
TSH: .472 (.450- 4.500)
Bioavailable Test: 137 ng/DL

I had a variety of lipids, CBC, CMP…everything else came back pretty well within range.

Besides this, I had taken multiple other tests where my testosterone came back at 379, 421 and 282. She claimed that since these scores were “within range,” They were normal and that the low scores were barely under the minimal amount needed. She also said taking arimidex and HCG were completely wrong and that if you are on TRT, you should ONLY be taking testosterone. I am kind of at a loss right now because the T clinic doctor who is apparently trying to take money from me, seems way more knowledgeable and forthright about everything, whereas someone that went to medical school seems like a quack.

I just don’t know who to trust? She wouldn’t even test me for estradiol and so on because she didn’t want to be responsible for interpreting the test results…I am seeing a urologist in a week to see what he thinks but I’m just so confused about everything. I definitely have definite signs of low T, my scores are low but someone who is supposedly a specialist on the matter thinks things look good and that I never should have started therapy…

Other scores if needed:
Glucose: 81 (65-99)
Urea Nitrogen: 12 (6-20)
Creatinine: 1.09 (.76-1.27)
EGFR (non black)- 92 (>59ml/min/1.73)
EGFR (black)- 106 (>59ml/min/1.73)
BUN/Creatinine Ratio- 11 (9-20)
Sodium- 141 (134-144)
Potassium 4.0 (3.5-5.2)
Chloride- 102 (96-106)
Total CO2- 25 (18-29 mmol/L)
Anion GAP 14 (10-18)
Calcium- 9.0 (8.7- 10.2)
Protein, TOTAL- 6.2 (6.0-8.5)
Albumin, S 4.3 (3.5-5.5)
Globulin 1.9 (1.5-4.5)
A/G 2.3 (1.2-2.2) High
Bilirubin 0.5 (0.0-1.2)
Alkptase 38 (39-117)
AST (GOT) 19 (0-40 IU/L)
ALT (GPT) 23 (0-44 IU/L)

WBC:5.8 (3.4-10.8)
RBC: 4.77 (4.14-5.80)
HGB: 14.9 (12.6-17.7)

HCT: 42.3 (37.5-51%)
MCV: 89 (79-97)
MCH: 31.2 (26.6-33)
MCHC: 35.2 (31.5-35.7)
RDW: 13.4 (12.3-15.4)
Placelet CT: 216 (150-379)

MY Lipid profile is skewed because I accidently ate before this particular test. My doctor said my values were normal considering how soon after I took it
Cholesterol: 193 (100-199)
Triglyceride 164 (H) (0-149)
HDL Cholesterol:37 (L) (>39mg/dl)
VLDL: 33 (5-40)
LDL Cholesterol : 123 (H) (0-99)
CHOL/HDL Ratio 5.2 (H) (0.0-5.0 units)

If you havent already done so (and it seems like you havent based on your post) you need to read all the TRT forum stickies located here:

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Hopefully both DOCTORS went to medical school.

You didn’t test your FSH which is a better indicator and should be tested at the same time as your LH. Your TSH is low did your endo not order more thyroid labs? I would try to sort out the thyroid first and retest with FSH/LH and check prolactin levels. If your T levels remain low after fixing / checking your thyroid you are probably a candidate for TRT.

Where are you located?

That means little. Can we see the numbers?

TSH=.472 might be indicating a developing hyperthyroid situation. Is your thyroid enlarged or lumpy with nodules?

What is your history of using iodized salt.

“Normal” is not a statement of health aspect been normal. It simply indicates a range which captures 95% of the sample population. Doctors are almost universally mislead by this. A few ranges have been changed to be health based recommendations such as glucose, A1C, cholesterol and BP. Others are a problem.

Most doctors are idiots and do not understand male hormone issues at all and make shit up defining there ignorance.

Blood looks a bit thinner than we expect with low T levels.
Are you eating enough proteins?

Please provide oral body temperatures - see below.
Yes this matters!
Also discuss your history of using iodized salt.

Please read the finding a TRT doc sticky.

Please read the stickies found here: About the T Replacement Category

  • advice for new guys - need more info about you
  • things that damage your hormones
  • protocol for injections
  • finding a TRT doc

Evaluate your overall thyroid function by checking oral body temperatures as per the thyroid basics sticky. Thyroid hormone fT3 is what gets the job done and it regulates mitochondrial activity, the source of ATP which is the universal currency of cellular energy. This is part of the body’s temperature control loop. This can get messed up if you are iodine deficient. In many countries, you need to be using iodized salt. Other countries add iodine to dairy or bread.

KSman is simply a regular member on this site. Nothing more other than highly active.

I can be a bit abrupt in my replies and recommendations. I have a lot of ground to cover as this forum has become much more active in the last two years. I can’t follow threads that go deep over time. You need to respond to all of my points and requests as soon as possible before you fall off of my radar. The worse problems are guys who ignore issues re thyroid, body temperatures, history of iodized salt. Please do not piss people off saying that lab results are normal, we need lab number and ranges.

The value that you get out of this process and forum depends on your effort and performance. The bulk of your learning is reading/studying the suggested stickies.

I am located in seattle. My waist size 34 inches i am 6’1 215 pounds 29 years old…i dont have a history of focusing on iodized salt but will definitely look into that. My body temperature was 98.1 degrees last time i checked a few days ago in the morning. I eat quite a bit of protein. I was told my multiple doctors that the lower the tsh, the better as long as it is within the normal range, since it doesnt have to work as hard. Im not sure how much weight this holds if anyone else can elaborate…i want to definitely get more thyroid tests done and possibly a scan of my glands to rule out any possibility of a tumor. I had a pretty substantial head injury about 8 years ago along with recreational illicit drug use which i suspect contributed to less than optimal pituitary function.
With this being said, i definitely feel like a new man on trt, but i guess that is to be expected. Im still trying to investigate whether there is another piece to the puzzle so maybe i dont have to remain on it for life.

Please get both of the requested body temperatures.