T Nation

Is HRT Right for Me?


-age 29

-height 6'3"

-waist 33.5

-weight 195

-describe body and facial hair - hairy legs, moderately hairy arms and chest, full beard if I don't shave

-describe where you carry fat and how changed - carry fat on my lower stomach and back and to some extent my chest

-health conditions, symptoms [history] - Nothing. family history of heart disease. mom has hypothyroid issues. also I had asthma as a kid

-Rx and OTC drugs, any hair loss drugs or prostate drugs ever - None. just multivitamin and various supplements like D3, DIM, fish oil

-lab results with ranges (I was in ketosis fwiw):
Total test 752ng/ml 348-1197
Free test 13.4pg/ml 9.3-26.5
Test% free and weakly bound 7.8% 9% - 46% (WTF?)
LH 5.1mIU/mL 1.7-8.6
Prolactin 7.0 ng/ML 4.0-15.2
SHBG 59.5nmol/L 16.5-55.9 (WTF?)
I was in ketosis when this was taken

-describe diet - High protein, moderate fat, low carb. sort of like the anabolic diet but i steal a lot from john meadow's mountain dog diet too

-describe training - lift 3-4 days a week hitting every body part at list once. focus is on incline db press, dip, pullups, barbell rows, hack squats, deadlifts, curls, extensions, etc. i also do HIIT 3-4 days a week postworkout

-testes ache, ever, with a fever? No.

-how have morning wood and nocturnal erections changed: BIG CHANGE1 I hardly ever get them whereas 10 years I use to get them like clockwork

So, I will be getting a prescription for 1/2c test cyp weekly, 25iu HCG weekly, 1 cap of ANASTROZOLE wekly. The question is do I want to go down this road?

It started with sexual dysfunction. It's been getting better which makes me think it's due to stage fright or something but I still don't get morning wood hardly ever. I also have been more tired and depressed in the past few years. That may be due to a hard professional life which has certainly taken its toll (out of work, hard job search, etc). A year ago my total test was measured at 421 ng/dl. No idea how it shot up so much. I think it's because I uped the fats and lowered the carbs in my diet.

Basically I just want to feel better! More energy, better erections, better frame of mind, etc. But I want to be safe and I'm afraid HRT won't necessarily help with that or give me what I need and might might cause irreversible damage. This is a big deal to me.

I think I might also have a thyroid problem:
RT3 441 pg/ml 90-350 (again wtf?)
TSH 2.620 uIU/ml 0.45-4.5
That was taken from the same blood draw as the test stuff above.

Any insight here? I'd really appreciate it.


What idiot doctor agreed to put you on TRT with your T levels in the mid 700's?

Did you check E2? If not, get that done.

If it is optimal (20-30), then look at ways to lower up SHBG to free up more T. You do not have a T issue, but rather a Free T issue. This is most likely due to high E2.

You are experiencing some thyroid issues as well, with high RT3. What were your FT3 and FT4 numbers to go along with that?


E2 is estradiol correct? My estradiol levels:
13.3 pg/ml 7.6 - 42.6

The bloodwork did not test t3 or t4.

Two questions: How do I begin to address the issue of lowering SHBG? How do I resolve the thyroid issue? For the later, I'm going to start supplementing with selenium and cooper. I'd love to hear ideas or read research on either. Thanks.


PLEASE read thyroid-rt3.com and/or stopthethyroidmadness.com/things-we-have-learned/

please consider postponing HRT until you get your thyroid issues addressed.


Thanks for those links.

Definitley NOT going down the HRT road as it's clear I have a thyroid issue. I'll update my thread when I get some clarification on those. Already made an appointment to see a highly-regarded endo in my area.


don't hold your breath with the endo. I saw the Top Endo in Dallas/Ft. Worth at least according to D Magazine... and got diddly squat... most stories here involving endos don't end well.

your doc could be the exception, but it is highly unlikely.... I would also call around to some compounding pharmacies and see if you can't get a referral that way.


So your doc tested Rt3 but not t3/4? I find that hard to believe. Are you sure there's nothing called thyroxine or triidothyronine?


Sorry! I didn't realize "triiodthyronine, free, serum" is freeT3:

2.0 pg/ml (2.0 - 4.4)

I think the ratio between RT3 and free t3 should be 10 or greater. Mine is 4 as per the sttm website. i think I found the root of my problems.


Your FT3 level is terrible...the lowest I actually remember seeing on this site. You are experiencing some terrible hypothyroidism which will explain your issues. You need to take a few important steps:

1) Get your 8 AM cortisol levels tested. If it is severly low, you will address this first. If it is normal, then you should address thyroid by:
2) Get thyroid antibodies tested (there are two of them, cant recall the name off the top, thats your homework) to make sure you do not have a thyroid disease such as Hashi's or Graves.
3) Get your T4 and fT4 tested. These will probably be fairly high due to your high RT3, but may be on the low side and you are just "pooled" with T3.

At any rate, the recommendation for clearing this and getting thyroid in order is to take T3 only meds (google is your friend to find this out...STTM is a good resource). This will clear your RT3 and get your T4 -> T3 conversion happening again, hopefully (if cortisol is controlled).

For high SHBG, there are supplements. Nettle root comes to mind, but dont quote me. Use google to figure it out and post your plan here for critique.


Thanks super helpful.

For the high SHBG I ordered NOW! brand stinging nettle root. I'm going to try 4 caps a day (two in the AM and two in the PM) and see if that helps. I'll follow up with bloodwork at some point.


Good start. But def need to prioritize the thyroid issues. This could be the reason for your high SUNG tho I'm not sure by what mechanism


check out thyroid-rt3.com

it is a good site with some great details.

be careful of trying to fix too many things at once or relying too heavily on herbal supplements as everyone can react differently to them, and they make it hard to pin down what is really happening to your system.