T Nation

Is TRT The Right Option?


#1

Hello… I am 34 years old, weigh around 185lbs and height 6 feet. I workout few days a week and play volleyball frequently. I would consider myself somewhat fit. I have been having ED problem for many weeks now. It has been sort of gradual. It has been hard for me to say if its recent or not. We had a baby in December and sort of getting back into things only now. Sex drive has been low but still there (has been declining over years). Other than that I have high triglycerides. I came to know about this during physical earlier this year. Primary Care doctor suggested to check testosterone levels. I have no other troubles with sleeping, concentration or just being happy! Diet is pretty much normal. No major fatigue issues and still able to manage household work with 3 kids! Based on the testosterone levels, doctor is putting me on Androgel and want to see after 4 weeks. He did not want to give any medicines for ED since he thinks testosterone levels should fix the problems. And he thinks other symptoms might be so subtle that I have not even realized them. I do feel little tired after a workday. But always thought it to be normal due to the work and drive since I can perform all the work without issues. Here are the numbers. Is TRT the right option? I am worried about being on this for life! Or should I go for second opinion? Appreciate your feedback in advance

Testosterone, Free (calc) - 5 ng/dL
Testosterone % - 2.24%
Testosterone, Total - 227 (subsequent test showed 192)
SHBG - 22.5 nmol/L
Albumin - 4.7 g/dL
Bioavailable Testosterone - 130 ng/dL
Bioavailable Testosterone % - 57.3%


#2

Transdermal, creams or gels are not appropriate where you can transferring T by contact to breasts, children and babies. You need to self-inject T and read stickies for more info.

You absolutely need to fix your hormone levels. TRT or fix a repairable testicular vascular problem, or resolve a cause of low LH/FSH. You have low T, but do not have a root cause.

TRT or resolution will make a huge difference in you life. So take action.

Please test LH/FSH before starting TRT, cannot do after that.

Also test prolactin if the problem has been gradually happening.

Labs:
TT
FT
E2
LH/FSH
prolactin
TSH
CBC
fasting cholesterol
fasting glucose

Note that hugging babies or recent orgasm can increase prolactin above base levels.

If a sudden change, possible from a blow to the head that damaged pituitary. - not recoverable.

Your T levels are low enough to explain ED and libido.

You can also be down if you stopped using iodized salt, critical for thyroid function. Iodine is vital during pregnancy, nursing and for child development. See below for evaluation of overall thyroid function via oral body temperatures. Check you and mom.

You should post all labs with ranges. Not just what hormones you think are important. If “normal” we still need to see.


Please read the stickies found here: About the T Replacement Category

  • advice for new guys - need more info about you
  • things that damage your hormones
  • protocol for injections
  • finding a TRT doc

Evaluate your overall thyroid function by checking oral body temperatures as per the thyroid basics sticky. Thyroid hormone fT3 is what gets the job done and it regulates mitochondrial activity, the source of ATP which is the universal currency of cellular energy. This is part of the body’s temperature control loop. This can get messed up if you are iodine deficient. In many countries, you need to be using iodized salt. Other countries add iodine to dairy or bread.

KSman is simply a regular member on this site. Nothing more other than highly active.

I can be a bit abrupt in my replies and recommendations. I have a lot of ground to cover as this forum has become much more active in the last two years. I can’t follow threads that go deep over time. You need to respond to all of my points and requests as soon as possible before you fall off of my radar. The worse problems are guys who ignore issues re thyroid, body temperatures, history of iodized salt. Please do not piss people off saying that lab results are normal, we need lab number and ranges.

The value that you get out of this process and forum depends on your effort and performance. The bulk of your learning is reading/studying the suggested stickies.


#3

Gels are generally poorly absorbed and after a while absorption rates decline for the majority of guys. Doctors make a ton prescribing gels when injectables are the most effective least cost, remember their running a business.

Most here inject testosterone, those that are on gels sooner or later end up on injectables.


#4

Thank you! I will post the complete lab results soon. Just need to access that. I eat iodized salt always. Never changed that. I will get the other lab works done as well. Appreciate your feedback on this


#5

Thank you! Are patches any better than gels? My main concern has been on transmitting it to kids and wife.


#6

You probably should just forget any kind of transdermal application. Injections (either subcutaneous or intramuscular) are the proper way


#7

If you choose to go the TRT route, you need to be prepared to educate yourself, its a long road but the result is that you return to your old self.


#8

Patches are worse than gels.


#9

When you work out and sweat, the flux thought the skin is reversed and the patch may not adhere with the wetness. Patches are probably the most costly. I can’t think of any posts here where guys have been on or stayed on patches.