T Nation

Help with My Situation?


this is going to be a bit long winded and i apologise but im hoping some fresh eyes and knowledge can help with my situation

im a 32 year old male 5ft11 17st, i live with a partner, have 2 young children and work full time

over the past few years ive noticed less semen amount and force of which it came out, i also noticed errections not as good or frequent as before, i just put this down to getting a bit older a bit over weight and not just as fit as i used to be but overall i felt healthy enough. i would be fond of pre workout supps and would use them quite alot i found they helped my with training and also with busy work life. fast forward to sept 2017, and i had an unexplained blackout after using a automated blood pressure cuff (i have never fainted in my life) since that day i have constantly felt like complete crap, low energy, feelings of doom, severe nausea, occasional light heads, times i seriously feel like im gona die, this in turn has led to 20 months of hell and quite a list of tests as follows

mri head scan
exercise ecg
echo cardiogram
heart moniter 24h and 7 day
all came back clear

ive also had numerous blood tests and something that kept comming back was low testosterone, my doctor seemed to think it was anxiety and put me on sertraline which i was on from aug-oct 2018 when i decided to stop taking it

medichecks blood tests test levels

dec2017 6.88 nmol/l
feb2018 10 nmol/l
july2018 11.3 nmol/l
oct2018 8.62 nmol/l
jan2019 6.37 nmol/l

range 8.64-29

i knew the sertraline was affecting this which was one of the reasons i stopped.

feb i went privatly to an endo and had more in depth tests done and my results were as follows

free test 207 pmol/l (198-619)
test 9.4 nmol/l (8.6-29)
albumin 51 g/l (35-50)
fsh 2.8 iu/l (1.5-12.4)
lh 3.4 iu/l (1.7-8.6)
oestradiol-17b 87 pmol/l (41-159)
shbg 21 nmol/l (16.5-55.9)
prolactin 221 miu/l (86-324)

free thyroxine 18.8 pmol/l (12-22)
tsh 1.40 miu/l (0.27-4.2)

im also having alot of calf cramps and sometimes cramps into arm pits thought i was possibly low on sodium or potassium but levels are

potassium 4.4 mmol/l (3.5-5.3)
sodium 144 mmol/l (136-145)

any input greatly appriciated thanks


You need to post reference ranges to all labs or else we cannot make sense of your labs because there are no standards between countries or lab testing companies when it comes to testing for testosterone.

Even without the ranges testosterone is very low, lower than my 86 year old father and you are only 32 years old and should not have these low levels at this age. Doctors often prescribe SSRIs when the problem is more than likely low hormone levels, the reason is most doctors having absolutely no knowledge in hormones and prefer to stick to the medicine they know best rather than dabble in something that they have no training or education.

Sure anxiety can lower testosterone, but more often than not, low testosterone and/or low thyroid hormones is almost always a cause for anxiety/mental instability. TRT can crush anxiety if done right by a knowledgeable TRT doctor, endo’s usually are terrible at TRT. You should consider multiple smaller injections per week do to lower SHBG.

TSH is a poor indicator of thyroid status, free thyroid hormone provides more information.


I have shared those symptoms in the past and they have been linked to anxiety attacks. Since starting TRT, anxiety has not been much of an issue so it has either helped cure it, or possibly the extra aggression just helps me push it to one side (if that makes sense?).


updated guys


free t3 6pmol/l (3.1-6.8)


Thyroid looks strong.


should i look into some form of trt systemlord?


Those are indeed suboptimal levels, you need to get Free T to the high normal ranges. No doctor can truly tell you that your levels are normal, normal is whatever your levels were when you had no symptoms.

You need TRT, just expect to have to pay out of pocket for your TRT.


what would you recommend?


I would start with testosterone, 150mg, once a week.

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how long would it take to notice a difference do you think?


Most notice a difference within a coupe of weeks. Some take a little longer. Given your levels, I would expect you’ll be sooner than later.


Onset of effects of testosterone treatment and time span until maximum effects are achieved

Effects on sexual interest appear after 3 weeks plateauing at 6 weeks, with no further increments expected beyond. Changes in erections/ejaculations may require up to 6 months. Effects on quality of life manifest within 3–4 weeks, but maximum benefits take longer. Effects on depressive mood become detectable after 3–6 weeks with a maximum after 18–30 weeks. Effects on erythropoiesis are evident at 3 months, peaking at 9–12 months.

Prostate-specific antigen and volume rise, marginally, plateauing at 12 months; further increase should be related to aging rather than therapy. Effects on lipids appear after 4 weeks, maximal after 6–12 months. Insulin sensitivity may improve within few days, but effects on glycemic control become evident only after 3–12 months. Changes in fat mass, lean body mass, and muscle strength occur within 12–16 weeks, stabilize at 6–12 months, but can marginally continue over years. Effects on inflammation occur within 3–12 weeks. Effects on bone are detectable already after 6 months while continuing at least for 3 years.

The time-course of the spectrum of effects of testosterone shows considerable variation, probably related to pharmacodynamics of the testosterone preparation. Genomic and non-genomic effects, androgen receptor polymorphism and intracellular steroid metabolism further contribute to such diversity.


guys would it be possible to feel extreme nausea from low test?


i get frequent bouts of nausea and have to lie down quite alot, sometimes i need to take a travel sickness tab to help with the symptoms, could all this be caused by low t?


Trt is needed it will help you . I would do 2 x 75 weekly or 100 twice a week. Once a week is not used by many of the Trt docs out there. Frequency helps with more than you know.

Make sure you are living a healthy lifestyle as well. TRT is not effective otherwise.


I have had nausea from being hypercalcemic, theoretically. It could be Vit D poisoning too (not the 25 OH that they typically test for - the D 1,25 which is the activated form) They couldn’t happen independently so I cannot know for sure which one caused it. Most likely you have some other levels off other than test that are causing that.


Can’t be vitamin D as I am always higher than lab range dr mercola have a long article about vitamin d you can safely reach 100 with no side affect. Forgot the units but they’ve international I think m

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how could i check this if the 25 oh isnt used to check?


last calcium test i had was 31st july 2018, calcium 2.47nmol/l and corrected calcium 2.36nmol/l

vitamin d oh was 51nmol/l but that was jan of this year