T Nation

Is TRT Likely to Help?

I’m a 28 year old male with low testosterone symptoms over the last year or so: low libido, difficulty getting/sustaining erections, lack of energy & drive, loss of muscle mass, increased abdominal fat. Also weird bald patches at the bottom of both legs.

I’ve been referred to an endocrinologist, who has prescribed me testosterone. However, I’m not convinced that it will help since there are a few abnormalities in my lab results below and I don’t want to go down that route unless I’m confident it’s the right move. Everyday life is difficult at the moment so I’d appreciate any advice that you can offer if you have any idea what’s wrong with me and what I can do to improve. Thanks hugely for any help you can offer.

Age: 28
Height: 5’10"
Weight: 160lbs

Body & facial hair: Some, but less & slower to grow back than previously
Fat distribution: mainly abdomen, more than previously
Health history: had testosterone gel for a few months in 2004-5 due to extreme weight loss, but have been fine since (until a year or so ago). 2 surgeries for gynecomastia, first in 2005 and then in 2011.

Drugs: None
Supplements: Vit D, Vit C, Glucosamine, ZMA

Diet: When my issues started I was eating fairly clean, with lots of meat, fruit/veg and healthy fats like nuts. I took in about 2900 calories a day then (33% carbs, 20% fat, the rest protein). I’ve since tried adding in more carbs so it’s now more like 55% carbs, 15% fat and the rest protein, but that hasn’t solved the problem after a few months. I did try massively increasing calories with my normal diet plus 4 pints of whole milk a day and I saw some incredible improvement and felt completely back to normal again, but that only lasted a few days (and may or may not have been related to the diet in the first place).

Training: used to train fairly intensely 4-5 days a week with about half of those weights and half cardio, but never excessively: weight-training workouts were always under an hour and cardio was HIIT at no more than 30 mins. For the last few months I’ve trained 3 times a week: 40 min weight sessions twice a week and one 20 min cardio session a week.

Testes ache: never
Morning wood: occasional, not hard

Lab Results (abnormal results asterixed):

*SHBG: 57 nmol/L (14.50-48.40)
*Free androgen index: 21.6 (>30)
Serum testosterone: 12.3 NMOL/L (8.30-27.80)
Serum TSH level: 2.01 mU/L (0.30-5.50)

Serum total bilirubin level: 15 umol/L (0-21)
Serum alkaline phosphatase: 111 U/L (40-129)
*Serum ALT level: 59 U/L (0-41)
Serum albumin: 49 g/L (35-52)
Serum total protein: 69 g/L (66-87)
Serum globulin: 20 g/L (18-35)
Serum calcium: 2.34 mmol/L (2.15-2.56)

Serum sodium: 140 mmol/L (133-146)
Serum potassium: 4.2 mmol/L (3.5-5.3)
Serum chloride: 100 mmol/L (95-108)
*Serum urea level: 9 mmol/L (0-8.30)
Serum creatinine: 81 umol/L (50-110)

Haemoglobin estimation: 149 g/L (130-170)
Total white cell count: 4.7 109/L (4-10)
Platelet count: 116 109L (150-410)
Red blood cell count: 4.92 10
12/L (4.50-5.50)
Haematocrit: 0.429 L/L (0.40-0.50)
MCV: 87.2 fL (83-101)
MCH: 30.3 pg (27-32)
MCHC: 347 g/L (315-345)
Red blood cell distribution width: 12.6 (11-15)
Neutrophil count: 2.5 10
9/L (2-7)
Lymphoctye count: 1.9 109/L (1-3)
Monocyte count: 0.2 10
9/L (0.20-1.00)
Eosinophil count: 0.04 10*9/L (0.02-0.5)
Basophil count: 0.01 109/L (0.02-0.1)

*Plasma glucose level: 3.9 mmol/l (4.1-6)