March 31, 2021, 6:59pm
So, background to these are 12 weeks off TRT, no alcohol at all, lots of running (I’m a marathon runner), good diet, strict Keto for the last 4 weeks.
52 yrs old, 6ft tall, 71kg, 16% BF
Blood pressure optimal most of the time, good at others
Haemoglobin 172g/L (130 - 170)
Haematocrit 0.498 L/L (0.38 -0.5)
Cholesterol ratio 5.8 (not too concerned with this)
Free T3 3.05 pmol/L (3.1 - 6.8)
Free Thyroxine 21.4 pmol/L (12 - 22)
FSH 11.6 IU/L (1.5 12.4)
LH 4.95 IU/L (1.7 - 8.6)
Estradiol 78.1 pmol/L (41 - 159)
Total Testosterone 21.9 nmol//L (6.68 - 25.7)
Free T calc 0.279 nmol/L (0.16 - 0.47)
Prolactin 140 mU/L (86 - 324)
PSA 1.12 ug/L (0 - 3)
On the face of it reasonable numbers but I’m symptomatic low T still. Zero libido, inadequate sexual function (in my mind at least) and just generally lacking that ‘spark’ in life.
Where to go from here I’m not sure?
Everything was fine/ no symptoms when on TRT?
March 31, 2021, 7:29pm
Well, not exactly…
Like many others I had got myself confused with protocol changes, high test levels and questioning myself whether it was all worth it for the perceived benefits.
Libido was better but not massively looking back.
Wanted to stop and reset and maybe try again, see how I feel?
Well, I think the keto diet coupled with endurance training is a recipe for a libido disaster. When was the last time you took an extended rest break from endurance training? Also, why the Keto diet? Most people are doing it for weight loss. As an endurance athlete it shouldn’t even be on your radar.
March 31, 2021, 7:36pm
Fair comment, mostly been doing it to support my wife who does need to lose weight…
Actually, I have noticed my energy has crashed over the last 4 weeks! Doh
Morning wood? Is the libido loss mental (no desire), or physical, where you just can’t get it up even if you wanted to?
March 31, 2021, 7:55pm
Mental mostly, just can’t be bothered most of the time
Doesn’t look hormonal. Libido is multifaceted
Edit: lower energy, keto + lots of running, all could push sex to the back burner
March 31, 2021, 9:31pm
April 1, 2021, 7:13am
Thanks Swoops, I’m arriving at the same conclusion sadly, I love my running though
April 1, 2021, 7:18am
When I started TRT I was borderline on the numbers but symptomatic and they were willing to give it a go thankfully.
My SHBG is quite strong, always has been so you’re spot on there, will look up the test number later.
Interesting thoughts on Oxytocin, will look into that thanks
April 1, 2021, 8:05am
SHBG 70.4 nmol/L (20.6 - 76.7)
With that kind of SHBG, I can almost guarantee that Calculated Free T number is completely wrong.
I had Total T at 1000ng/dL when I got on TRT. Thing is, my SHBG was at 80 nmol/L, so my Free T was at the very bottom of the range at 6 ng/dL.
Free T is what matters in terms of getting the good stuff you want out of Testosterone. With SHBG that high, I would bet your actual Free T is close to the very bottom of the range.
Get tested again and this time use the Dialysis (not Direct) method to test your Free T.
Also make sure you use the (ultra) sensitive assay for Estradiol, the other one isn’t precise enough for men.
April 1, 2021, 10:59am
Wouldn’t be surprised, it would explain a lot.
I don’t think we can specify what type of test is done with UK online providers. Also, no chance of getting it on the NHS unless a person is already chronically ill and then it’s an uphill struggle.
It’s always vexed me why the free T is a calculation and not an actual measurement…
I remember using a Free T calculator online and it was showing double of what my Free T actually was.
Your TT of 22 nmol/L translates to ~650 ng/dL. Mine was 1000ng/dL. Your SHBG is 70 nmol/L, mine was 80 nmol/L. My Free T was bottom of the range, I guarantee with your SHBG you’re at the bottom of the Free T range.
You have low T symptoms because you have low Testosterone, specifically Free T, which is the only metric that matters when looking at symptoms.
You mention you were on TRT for a while but didn’t get out of it what you wanted. What did you try? Which protocols? Dose / Ester / Injection frequency / subQ or IM? / AI? / HCG? And how long were you on each protocol before changing things up?
Eat normal . Run less. And see what happens.
In a couple weeks Retake free t, total t, shbg. I would add ferritin.
And b12 and folate too. Also dhea-s
Shbg can be affected by diet.
April 1, 2021, 1:44pm
So, total time on TRT until stopping Jan 1st 21 was around 20 months.
Been using HCG throughout at 250iu twice per week.
Started off on Sustanon 250 at 0.4ml weekly (approx 70mg actual test), seemed to be ok for a while, stayed on this for approx 6 months.
Estradiol was getting high from what I remember so switched to twice weekly Enanthate at 0.4ml total, similar actual Test to Sustanon.
Didn’t really help, felt ok but ‘flat’ on this ester, stuck with it around 4 months.
From there I’ve messed around with lots of combinations of very low dose 0.1ml twice a week of E to 1ml per week of Sust!
That’s where I’ve got into a mess with it…whatever I tried, didn’t feel any different to me.
Looking back I had more strength/energy/well being feelings whilst on the programme but the thing I really wanted, the libido etc, never Improved significantly.
It was the lack of libido reason I dediced to stop and sort the muddle out.
I’m quite e encouraged that my natural levels have bounced back quite quickly but that’s not saying much eh
If I’ve understood correctly, because my SHBG is so high, a decent dose of a longer ester is the best bet? I certainly felt better on Sust than E.
If the highest dose you tried was 80mg a week, you may just need more to overcome the higher SHBG. As said above, get your FT up and you’ll start feeling better, regardless of what your TT is
April 1, 2021, 2:31pm
Looking back, I had a crazy blood test result back in Sept 20, still can’t believe it’s correct.
Estradiol 60 (41 - 159)
Total Test 40.7!!! (6.68 - 25.7)
SHBG 24 (20.6 - 76.7)
Free test 1.175 (0.16 - 0.47)
Run up to this was 3 weeks of Enanthate at 0.9ml per week then 3 weeks Enanthate at 0.3ml per week.
Can’t be right surely