T Nation

Ksman/Other Gurus: Considering TRT

First of All…Thanks so much to KSman and other gurus for the time and effort spent helping others. Im amazed

-age 45
-height 5’10"
-waist 32
-weight 168
-describe body and facial hair: muscular, athletic, in very good shape. facial hair maybe a little more than average

-describe where you carry fat and how changed: midsection…but not much fat at all…maybe a little bit more since turning 45
-health conditions, symptoms [history] depression and anxiety since i was about 16. significant stress at job. increasingly reclusive. premature ejaculation since 20’s. low energy/motivation. overall physical health very good. probably lower than average sex drive. achieve very hard erections which last very hard all the way through ejaculation using porn.

-Rx and OTC drugs, any hair loss drugs or prostate drugs ever: use ovc shampoo that says its supposed to reduce hair losss (never used any prescription hair loss drugs)
– real dangers! see this http://propeciahelp.com/overvi
-lab results with ranges
-describe diet [some create substantial damage with starvation diets]: basically follow body for life diet. Very low fat. Very lean meats. many vegtables and fruits. whole food vegtable pills and antioxidant fruit juice supplement.

-describe training [some ruin there hormones by over training]: run twenty minutes at moderate pace about twice a week. Weight training about 40 minutes 3 times a week (high intensity)
-testes ache, ever, with a fever?
-how have morning wood and nocturnal erections changed: no change

Finally went to doc for first time in about 15 years to get a physical and full blood workup. Here are the numbers (blood given at noon on 6/26/2013…actually had two test in two successive days…some numbers may be from one day and others from the following day…hard to tell from report)

shbh:24 nmol/L (11 to 80)
TT: 239 (300 to 890) tested at 204 the following day
Testosterone Bioavailable: 138.9 ng/dl (130 to 680)
Testosterone Free: 48.7 pg/ml (47.0 to 244)
Prolactine, Serum: 4.1 ng/mL (2.1 - 17.7)
FSH: 6.2 mIU/mL (1.4 - 18.1)
LH Level: 6.2 mIU/mL (males 20-70 yrs 1.5 - 9.3 mIU/mL)
PSA 1.52 ng/mL (0.00 - 2.50)
Thyroxine Free: 0.86 ng/dL (0.76 - 1.46)
Cortisol Random: 11.5 mcg/dL (before 10 am 3.7 - 19.4 after 5 pm 2.9 to 17.3)

I am super careful about what i put into my body…i have suffered depression for years without taking antidepressants because of all the sideaffects they have. Have ready many people’s posts claiming relief from depression with TRT. Feel more comfortable with TRT since I am basically putting something in my body that my body already produces (as opposed to an antidepressant).

since i am super conservative i have spent at least 15 hours in front of this freaking computer doing all the research i can possibly to. i think i want to jump right into the most effective protocol suggested by this forum (100mg test cypionate or ethanate injected per week with two or more injections per week; 250iu hCG SC EOD [every other day]; 1.0mg Arimidex/anastrozole per week in divided doses.) Actually thinking of doing everything EOD as recommended.

DO YOU THINK THIS IS RIGHT FOR ME? Part of me is wondering if I should start with half recommended dose of hCG and anastrozole. Bsically for two reasons: 1) Starting slow and ramping up (as dictated by regular labs) may be better than dosing too much in the beginning and ramping down??? 2) I am anticipating being a hyper-responder (based on my reaction to other substances).

Lastly, I do not have kids yet and I want to maintain that option.

Thank you SOOO MUCH for ANY help you can provide!!!

What he’s he told you?

Is he saying your primary??

Why not try to get the body producing better numbers on its own?

Have you read the advice for new guys sticky carefully?

Read the lab testing sticky

What are your cholesterol levels?

DheA-s and a number of things should be tested before going on life long trt.

Low T is a symptom of a problem, here we try and help you find the cause of that problem.

Thyroid wasn’t checked or was I only see on thyroid measurement

Thanks iW84Aces! I copied your questions in below and responded to them. Great feedback! KSman could you please provide a second opinion?

What he’s he told you? he basically said i was on the very low end of the range so he was “willing” to give it a shot. but from what i have read elsewhere those ranges are for all adult males even up to age 80. I read elsewhere that my TT is lower than 95% of the men in my age range.

Is he saying your primary?? I am inferring that i am primary based on the fact that he said that there was no problem with pituitary functioning.

Why not try to get the body producing better numbers on its own? I am already basically obsessive about what i eat and about my excersise. I’m not sure i could do any better. What else to you recommend?

Have you read the advice for new guys sticky carefully? yes i have but reading again would surely be helpful

Read the lab testing sticky…Ok I will read that again

What are your cholesterol levels? Don’t know…i guess I will get another lab.

DheA-s and a number of things should be tested before going on life long trt. Ok I will get another lab

Low T is a symptom of a problem, here we try and help you find the cause of that problem.

Thyroid wasn’t checked or was I only see on thyroid measurement…not sure

Go see a naturopath or homeopath and take a holistic approach for now.

Lets see what the other numbers say and go from there.

I know this is a trt website but trt is not always the best solution. I believe it’s to soon to jump on trt


TRT will help with some of the symptoms you speak of, but like ACES said, It’s best to try and find what’s causing the testosterone to be low and treat that. There are many things that can cause testosterone to be low. We like to say it is a symptom of a problem and not the problem itself. Your LH/FSH numbers not too bad and would indicate a problem elsewhere. You need more testing per the blood test sticky. We see a lot of problems with thyroid here and there are a lot of tests that doctors won’t run unless specifically requested. 4-point cortisol saliva test to assess adrenal function. Morning fasting cortisol is not sufficient.

TRT is a long hard road for some. Myself included. It’s not a quick fix that comes without consequences. 16 hours of research is great. I doubt most of the guys that come here do much at all, but read as much as you can. The more you learn, the more you’ll realize you don’t know. I say this from experience.

Find out WHERE the problem is.

Thanks Aces and Kaynon! Excellent feedback AGAIN! STILL love to hear KSman chime in…but I don’t want to bug you guys too much now. I will be bugging you A LOT after I get my next round of labs back (as you suggested). Going to try to schedule tomorrow…one thing I am not sure about though. Aces you specifically suggested that I get DheAs tested and Kaynon you suggested a 4-point Cortisol saliva test. But neither of these are listed under the “Labs to be done before you start TRT” in the Blood Test (or labs??) sticky. All I see in that list is below and I have already had those. I’m sure you are right but I am a little confused now. Just want to make sure I get the right things tested as you guys suggested. Is there an clear listing of everything I would need to get tested so I can give you guys the info you need the first time without having to go back to the lab multiple times? THANKS AGAIN GUYS!

Labs to be done before you start TRT
-LH and FSH [LH/FSH]
-FT or bio-T
-Prolactin [optional in most cases]
-DHT [sort of a waist of time and blood if your testosterone levels are low]
-DRE: the dreaded digital rectal exam, doc gives you the finger.

That is really a very basic hormone panel and will tell us very little.

It may give us a picture but not the big picture…

Read down a couple posts in the lab testing sticky… Pure chance and ksman have listed a more comprehensive lab panel