On Thursday, 5/28, I started TRT and am concerned I might have jumped the gun. I went to a hormone replacement clinic and they only did labs that would support their treatment options. Makes sense since they make their money off of treatment. Since my symptoms were so bad, I was ready to sign up for any option that would make me feel better. I do feel better since starting, but now I’m concerned that I don’t have enough baseline info.
My main question, is should I take a break and get labs before my HPTA shuts down or do I have enough information to continue treatment? I am grateful for your advice and look forward to becoming more involved with the forum.
I’m 39 years old, 6’5", 235 lbs, 40" waist. I have thin body hair and I can grow a so-so beard. Much of my fat is around my waist–I’ve put on 15 lbs in the last 2 years. My diet has been poor–not much fresh fruits/veggies. I don’t exercise much because I can’t get the motivation and I’m sore for days. Never had testes ache, sex drive has been lower, but usually have morning wood.
The last few years have been stressful. My wife had undiagnosed depression and it really wore on me, never knowing how she would react on any given day. She has started treatment and is improving, but still a difficult circumstance.
I have family history of enlarged prostate–no cancer, but enlarged enough to need surgery. No pre-existing conditions. I’ve never been very high energy and I’ve always had a hard time building muscle. My wife and I are still interested in having kids.
Tired all the time/fatigue
Lack of motivation
Decreased memory/brain fog
Inability to concentrate
The “Doc” ordered the following (test, result, ref range):
DHEA SO4, 75, 100-432 ug/dL
Free T, 3.8, 4.3-30.4 pg/mL
PSA, 0.67, 0.00-4.00 ng/mL
Ferritin, 104, 26-388 ng/mL
TSH, 1.40, 0.34-4.82 uIU/mL
fT3, 3.1, 1.8-4.2 pg/mL
Insulin, 14.80, 3.0-25.0 mcIU/mL
Glucose, 80, 70-110 mg/dL
Cortisol AM, 14.99, 4.3-22.4 mcg/dL
I found a walk-in lab and had a few other tests done before starting TRT. At this point I hadn’t done much research and was grasping at straws:
Total T, 430, 348-1197 ng/dL
Free T, 6.6, 8.7-25.1 pg/mL
LH, 3.1, 1.7-8.6 mIU/mL
FSH, 4.1, 1.5-12.4 mIU-mL
fT4, 1.41, 0.82-1.77 ng/dL
Prolactin, 7.4, 4.0-15.2 ng/mL
IGF-1, 175, 83-233 ng/mL
GH, <0.1, 0.0-10.0 ng/mL
I am still awaiting results on DHT, Lipid Panel, Vit D, and Total Estrogen (I know now I should have ordered E2, but didn’t know at the time and was very symptomatic). I will post once I receive them.
Here is what I’ve been prescribed. I started Thursday, but based on what I’ve learned this weekend I will talk with the Doc on Monday.
T cyp 160mg IM 1x week
hCG 1000IU SC 2x week
DHEA 50mg pill daily (for one month, then 25mg)
Nature-Throid 32.5mg daily
I also take fish oil and vit D3.
I have been feeling better since Thursday–not great, but better. I know the hCG is too high and plan on cutting back to 500IU 2x week. The T cyp also seems a bit high for starting. He didn’t start any AIs, but I don’t have an E2 baseline. I also want to talk to him about SC T instead of IM–at 39 years old, that’s over 2,000 holes I’ll be poking in my muscles if I live to 80.
I really wish I had CBC, SHBG, E2, and bioavailable T to get a more complete picture of my HPTA prior to starting treatment. Now is the opportunity to stop and get the labs if I need them. If I should get the labs, how long should I wait from my last injection?
I’m educating myself as rapidly as I can. Thank you again for your help!