T Nation

Feedback on Levels?

39/M
I’ve been wanting to get tested for a while now so this year during my physical I asked my doc to test. (Internist) Results came back this week and I was shocked but also weirdly relieved to maybe have figured this out.

Total T was 174 - range is 250-1100 ng/dL
Free is 30.8 - range is 35-155 pg/ml

I’ve been having extreme fatigue for the last few years (getting worse) along with increased irritability (anxiety my whole life), unable to get lean like I could 8 years ago, feel weak a lot, joint and soreness in muscles, stiff and achey in the AM, sex drive has decreased. I sleep OK for a guy with a stressful job and two kids but I also eat healthy and work out like a madman including weights and martial arts (bjj) several times per week. I’m 5’10, 175 around 15-16%bf

Vitamin D is low and blood was taken at 3pm.

I’m going back in to discuss tomorrow, would appreciate any advice/thoughts/pitfalls/questions, etc.

I am not a doctor but you seem like a perfect TRT candidate. A more thorough list of blood work/results would help confirm that more but you sound like every other perfect candidate here.

Just be assertive and say “I want to start trt” dont ask if he thinks you should or that you want to discuss it. Just explain that you know you are very low and that as a parent it would be great if you could work with your gp instead of having another large expense at a clinic. Just be wary of poor treatment if he agrees. Read up on what will not work so you can move on immediately if he offers 200mg every 3 weeks or something.

IF you are truely interested in knowing your real T levels you need to take a break from the gym and any other body stressors like your martial arts for a couple days and have you blood drawn in the morning before 9am and be fasted from food and sex/masterbation. Only then will you know what your real T lvl is.

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These are disease state levels and you are at high risk for cardiovascular disease. Now that you’ve had your levels tested, the hardest part is finding a knowledgeable doctor who is up to speed on everything TRT. The odds are you won’t find one under insurance and the standard protocols most doctors use are outdated and only cause suffering.

You need a doctor that doesn’t ignore estrogen management, thing is the standard of care for TRT doesn’t even mention estrogen management, expect your doctors to be TRT ignorant.

My Vitamin D was low pre-TRT as well, not so after I started TRT even without supplementation. Testosterone affects so many other hormones, DHT and estrogen. We men on TRT use four main tests to balance out all our hormones, Total T, Free T, SHBG and estrogen.

SHBG is a big one, it regulates Free T, estrogen, thyroid hormones and insulin. Any sex hormone evaluation should include SHBG.

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.

I agree but wouldn’t my levels if they were lowest at that time still be an issue?

I haven’t trained since Friday and my appt. is at 9am tomorrow so I’m assuming he will pull more blood.

What were the actual numbers for Vit D? And Calcium too if they checked it.

Vitamin D 26.9 range is 31-100

Albumin and Calcium were both in upper part of range.

Thanks, I have some training partners who are very well educated on this so they will be helping advise me as well. My doc has experience with LGBT patients so we will see how well he knows hormones. Already seeing that weekly or eod doses can be ideal.

You’re levels should never be as low as there are regardless of working out or life stressors. Men scoring this low can’t fix things naturally, there’s a point of no return and you are past it. Your protocol will depend on the rate you metabolize and or excretion of testosterone, SHBG is a big factor in both these areas.

My SHBG is on the lower end and respond poorly to TRT when not at least injecting EOD. If doctors offers androgel or 200mg every 2 weeks, that would be enough for me to look elsewhere for treatment.

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Same type of levels as myself. Get started on trt don’t waste time. Also get your thyroid checked out. You might need both and won’t feel better if you do one and not the other. I started trt and didn’t feel any evenfit for almost 3 months. I started thyroid and it all started to come together and I feel better now.

Trust me and get both checked out. Some docs say if you do trt might as well optimize both thyroid and t.

Thyroid and testasterone are the only two feel good hormones a man has.

Usually insurance doesn’t cover low t symptoms. Your so low that most likely insurance would cover it. There’s no doubt that you should start. Don’t hang around with a doc who wants to think about it. He’s just making life suck and has no interest in ones well being.

Docs who care would respond with “I feel your pain; you are suffering and we need to get you help right away. Not tomorrow. Today. Here let’s give you a script start this dose today” perennial meet again in a month or whatever…::

That’s my doc.

Thanks for the advice. Can you tell me more about the thyroid meds?

Do you know the actual number for your Calcium? Low D is a flag for a couple of things and the actual number for Calcium would be enlightening. Reference ranges for Calcium are as stupid as reference ranges for test.

9.9 range is 8.5-10.5

No I have heard a natty can lose 1/2 his TT lvl in one day do to workload/ stress/ lack of sleep/ and an extra good night in the sack. Who knows.

Look man no reason to lie here no one knows anyone else. There a reason we all use fake names and in many cases we don’t even know what country each other is from.
If you want to go on TRT do it. We can’t help you do that you have to convince your doctor.

I was just saying if you really want to know your natty lvls that was what you needed to do. Don’t want your doc to know your real lvls go buy a set of bloods. Its pretty easy and not very expensive and no one but you and god will know.

How old are you, and was that fasting?

I’m going to say up front, that the suggestion I am about to make may be unnecessary and serve only to eliminate a possibility. You should have your Vit D, PTH, and IMO your Vit D 1,25 tested. All at the same time, that part is important, has to be from the same draw for all of those tests or they accomplish nothing.

39, and I had a banana and protein bar about 1.5 hours before.

PTH and Vit D 1.25 are what? I’ll ask my doc but I’d like to understand further.