T Nation

Is TRT a Possibility for Me?

Hello everyone! I am a 18 year old male. I weigh 158 pounds and my body fat percentage is 10%. I used to be pretty overweight at 200 pounds with little to no muscle mass, but I’ve fixed that since last year. I lift 5x5 3 times a week and I also get a lot of walking done per day on campus.

Recently I’ve been concerned that I’m experiencing symptoms of low T. I’ve had little to no libido this past year, my skin is very dry, it’s difficult to get and maintain an erection with my girlfriend, no morning wood, trouble sleeping, irritability, lack of focus.

I eat about 2700 calories a day with more than sufficient protein, at least 150+ carbs, and healthy fats from nuts and avocados.

Here’s my recent bloodwork: https://imgur.com/a/F3dvLh3

Total T in the absence of Free T doesn’t really dig deep enough to be able to advise you, Total T is bound to SHBG and isn’t bioavailable, free T is the bioavailable portion of testosterone. If SHBG is high enough, it can grab onto enough testosterone and decrease your Free T making you experience low T.

My SHBG is on the lower end at 22, a Total T of 500 would see my Free T at the very top of the reference ranges, if my SHBG increase to high normal, it can decrease Free T by as much as 50 percent and my Total T would be higher which to an untrained doctor wouldn’t raise any alarm bells.

Your dry skin comment may point to a thyroid problem, testosterone (DHT) can affect skin as well. Again most thyroid doctors have been taught wrong for the last 30 years, the most important and most ignored thyroid hormone Free T3 is the only active thyroid hormone.

GP’s, endocrinologists and urologists most likely will not be able to help, these types of doctors are typically ignorant in anything related to sex hormones.

If SHBG is higher than 30 which would mean Free T is sub-optimal. My SHBG is 22 and Total T 496 and my Free T is 20.8, at the top of the reference ranges, so if your SHBG is 30 or higher, there’s no way your Free T is optimal.

You need to test Total T, Free T, SHBG and estrogen.

Thanks for your reply. In my next test, I’ll try and get these values taken as well.

UPDATE: He ordered labs for Total T, Free T, SHBG, and TSH.
Results were taken at 9 A.M

Total T: 378 ng/dL
Reference Range - 276-941 ng/dL
Testosterone Free Calculated: 7.7 ng/dL
Reference Range - 7.0-36.7 ng/dL
SHBG: 32 nmol/L
Reference Range - 11-78 nmol/dL

TSH: 2.27 mcIU/mL
Reference Range - 0.35 - 4.00 mcIU/mL

Any doctor only checking TSH is a warning sign you doctor isn’t up to speed on thyroid, TSH isn’t always a reliable biomarker for thyroid disease.

The endocrinology guidelines state a Total T value above 300 ng/dL isn’t eligible for TRT and doesn’t even consider Free T values or SHBG levels. SHBG is responsible for androgen metabolism, a lower value means you will metabolize/excrete testosterone more quickly, the higher SHBG, the more Total T value you require.

A man with an SHBG of 12 can easily get away with a total T of 450 because his Free T is affected by the lower SHBG, his free hormones are much higher than a guys with the same Total T score that has an SHBG levels of 30.

Free T needs to be well above midrange to relieve symptoms of low testosterone. A lot of doctors are operating in the dark and will latch on to the reference ranges for Free T and see your Free T is .7 higher than the bottom of the ranges and say you’re within range. This would mean your doctor is incompetent and doesn’t specialize in this area of medicine.