T Nation

Iowa, TRT, 52 Years Old

After years of feeling tired and my doctor saying my testosterone levels were in range (as low as 2.83ng/ml, range of 2.80-8.0, at age 44), I finally found an experienced hormonal doctor. I found this forum after meeting my new doctor three weeks ago. It appears that there is a lot to digest on this subject.

After spending 30 minutes reviewing my last ten years of lab results, the new doctor offered to start me on TRT immediately, but I asked to wait for the results of the lab tests that she prescribed.

The doctor said that my cholesterol was too low and was concerned about a high Free T3 test from November 2009 (5.08 pg/mL, range 1.5-4.1).

She told me to eat a Paleo diet, but I already eat eggs/bacon 6 days a week and meat daily. My cholesterol has ranged between 130 to 160 no matter what I eat. My blood pressure is almost always 118/68.

She was also concerned about potential adrenal fatigue, referred me to the Wilson book and added a cortisol test to the labs.

She normally prescribes gel from a compounded pharmacy, is open to the idea of HCG and will not use an AI unless E2 results show an increase. After reading the sticky, I will see if she will go for SC self-injection.

I use iodized salt on everything and crave salt constantly. There is no iodine in my multivitamin.

Oral temperatures (F): 0830:97.5, noon:98.0, 1400:98.1, 1900:97.6, 2100:97.7, 0530:97.5,1500: 98.4. I am cold a lot and typically have a heater running at my desk.

After reading some of the threads, I am now concerned about a couple of car accidents. I had one severe accident back when I was 23 (knocked unconscious). Within 3 months of the accident I started putting on weight going from 140lbs to 185lbs, mainly around my abdomen. It was like someone threw a switch on my metabolism, going from eating 4 meals/day to maintain 140lbs to having a hard time keeping my weight under 170lbs. Coincidental? I am able now to maintain a body weight of ~155lbs by cutting out all wheat products and sugar sweetened drinks.

-age: 52
-height: 5ft 8 inches
-waist: 39 inches
-weight: 154lbs
-describe body and facial hair: Thick, full head of hair. Fairly hairy body; can easily grow beard
-describe where you carry fat and how changed: Fat carried primarily in abdomen. Pot belly that just will not go away.
-health conditions, symptoms [history]: Vasectomy in 1997, fatigued and feeling somewhat blue for last 8 years. Lack of motivation, lethargic, loss of mental focus, just not feeling quite as sharp as I should be. My skin is very dry and has been for years.
-Rx and OTC drugs, any hair loss drugs or prostate drugs ever - No hair loss or prostate drugs ever. Took Concerta from December 2011 to June 2012. Although I ultimately decided that the Concerta was not necessary, I credit it with providing me with the energy to investigate and do something about my issues. Currently: Mens 1-a-day multivitamin (no iodine), D3 (2,000iu), Magnesium (200mg), fish oil (1,200mg), melatonin (3mg), Vitamin C (1,000mg) multi-year use of triamcinolone acetonide cream (.1%). I totally wrecked my sleep with 17 years of rotating shift-work (shift-work ending 1997) and the melatonin seems to be very helpful in maintaining good sleep patterns.
-lab results with ranges: See below
-describe diet [some create substantial damage with starvation diets]: vegetarian diet for 12 months in 2009, otherwise somewhat Paleo. Eat eggs and bacon 6 days per week. Have craved salt as far back as I can remember. Gave up bread and wheat in 2012 after being told I was at risk for diabetes.
-describe training [some ruin their hormones by over training]: bicycle and some weights. Did 6 months last year using the Starting Strength protocol, but hit a wall within 3 months and it did not impact my testosterone levels.
-testes ache, ever, with a fever? - No
-how have morning wood and nocturnal erections changed: Same

I have an appointment next week to discuss the new lab results and she will likely start my TRT then.

She sent me the lab results (included below) prior to my upcoming appointment and I noticed that she had circled total/free testosterone and also DHEA-S.

Are there any other lab tests that I should have done prior to starting TRT or am I good to go? My medical is out of pocket, no insurance, so am not interested in getting the ultimate set of lab tests if not necessary; only those required to structuring a treatment plan.

Does anyone see any underlying causes or other contributing factors that I should be concerned about or address prior to starting TRT? I would hate to start a lifelong TRT program when there was something else that I could have fixed.

Thanks to everyone on this forum. I feel fortune to find this resource