T Nation

Do I Qualify for TRT?

Hello all,

I recently saw an ad for low t and it reminded me that ive wanted to get mine checked for the past few years but never got around to it. Well i looked up how to get tested and ordered a test, went in yesterday and got the result i had sort of expected for a few years. for the past 5 years i have struggled with depression and anxiety my whole life. I came off of my depression meds 2 years ago and lost 20 lbs from 250 to 230 and maintained 230 for these past 2 years. still have moderate anxiety. 2 years ago my sex drive was high but has recently started to decline, and now i sometime shave trouble with keeping erections and orgasming.

age 27
-height 6’4"
-waist 36"
-weight 230lbs
-describe body and facial hair:
neck beard thicker and fuller than face, thin facial hair on jawline and cheeks and around mouth
-describe where you carry fat and how changed:
stomach!
-health conditions
general fatigue, tiredness, lack of energy to workout
-Rx and OTC drugs:
zyrtec, nothing else
-lab results with ranges:

-describe diet:
vegetables, sandwiches, daily fruits, chicken breasts, daily Huel meal replacement shakes, fast food two- three times per week, burritos, burgers, salads
-describe training:
i dont weight train (mostly from being lazy and tired from work and taking care of kids) I unload semi trucks 5 days a week. i am the guy inside the truck picking up every box and putting it onto the conveyor belt. typical truck takes 3-4 hours (no breaks) and has 700-900 boxes weighing from 2-220lbs after the truck is done i put 10-40 appliances on top rack shelfing using power equipment, usually lifting each appliance weighing between 60-250lbs each
-very minimal acne in teen years
-morning wood is hit or miss 50%

Unfortunately your testosterone panel doesn’t tell us much, like what portion of testosterone if free and bioavailable, total testosterone is bound to SHBG and not bioavailable, free testosterone and SHBG should have been tested.

Looking at only your total testosterone, it’s at a level you would expect to see in a health 70 year old like president Trump. The average guy in his 30’s typically see 600> with Free T in the high normal ranges, you are a lot younger and should be seeing 700-800 with Free T high normal or even higher if SHBG isn’t above midrange.

In other words your levels are underwhelming and if you think a managed health care doctor is going to prescribe you TRT, I’m sorry to disappoint you. You would then have to seek private care in order to have access to a doctor that specializes in this field of medicine as most managed healthcare doctors are living in the stone age when TRT is concerned.

You asked if you qualify for TRT, not under health insurance, your only recourse is a private TRT clinic which is where you should be looking for TRT in the first place. I feel sorry for the lad who looks to his managed healthcare doctor for TRT. He’s in for quite an experience, one that will only add more stress to your life.

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.

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I had similar symptoms and a higher testosterone level than you and starting TRT really helped me. If you don’t lift weights then you way want to try that first and see if it helps before using drugs (in addition to your job). Just lifting weights for 30-45 min a day can greatly enhance your overall wellbeing. This is all based on my own personal experience… TRT has been amazing for me but it’s no walk in the park. Getting dialed in takes a while and it’s a bit of a ride getting there. It’s not going to fix your problems but it may aid in your recovery process (fatigue, ED, weight loss, etc). Once you are on it for a while there is a chance that if you decide to quit you may not be able to go back to producing naturally the testosterone level you are currently at. Granted yours isn’t amazing to begin with but it’s worth noting. TRT has helped with my depression and has actually allowed me to get off wellbutrin with basically no withdrawal symptoms (it’s not really known for them though, SSRIs can be nasty to come off).

If you do decide to get on TRT one thing I wish I would have done was to start at 100mg/week instead of the 200mg/week I started at. Keep that in mind. If you have trouble getting a doc to prescribe you because your levels aren’t technically under the normal range and you’ve exhausted other options then email me (email in bio) and I can put you in touch with a doc that works via telemedicine for fairly cheap. At 27 you should really try everything before jumping on the TRT train because once you get on it doesn’t stop.

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You do not “qualify” for TRT in the sense that I think you are asking and that is within the insurance system with your insurance plan covering your treatment.

In that instance, your testosterone would need to be below 264ng/dL. Your doctor can not make a diagnosis of hypogonadism with your numbers, and if he or she did, and sent a claim to the insurance carrier, it is fraud. If they caught it, and they very likely would, coverage would be denied.

As mentioned above, it looks as though you may benefit from TRT. A more thorough work up would tell you for sure and provide some necessary details to determine what would be best for you. For that, you need to find a doctor that specializes in TRT/BHRT and by that, I mean the entire practice is hormone replacement/restoration. It will be an out of pocket/cash practice. Good luck.

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