T Nation

Low Levels and Dropping Further - Advice?

Hi All -

I’ve been lurking for the past few months after feeling some possible symptoms of Low T. Low sex drive, no energy, etc. Thought it may have been stress and finishing up grad school.

I went to the Endo to get some test and the results were alarming.

Test - 96 ng/dl
Free Test - 48 pmol/l
Test Bio - 32ng/dl

A few more are attached below. I’m waiting to hear back from the Dr but wanted to see what everybody here may have for advice…

I’ll be 30 in 3 months.

Follicle Test%20Bio%20Test%20Free%20Test%20Total

These are disease state levels and not even 90 year old men have levels this low, if these levels are do to testicular failure or pituitary failure, TRT is needed. Be careful most endo’s are clueless and dosing decisions need to account for pre-TRT SHBG and estrogen values.

If estrogen is in the mid-high normal ranges while testosterone is low, more frequent dosing will be needed. You should start out TRT on 60mg twice weekly unless estrogen is high, then you may need more frequent dosing using 27-29 gauge insulin syringes. You should inject in the shoulders and quads because larger needles will cause muscle tissue damages over the decades.

These low levels are most definitely the cause of stress which happens when operating on less than optimal hormone levels. If your doctor offers you 200mg every two weeks, run don’t walk away from this doctor because he doesn’t specialize in this area of medicine, there are no doctors in sick care that specialize in this area of medicine.

I have never seen such high normal SHBG levels in the company of such low testosterone levels. I’m surprised you can even walk let alone finish grad school.

Systemlord - Thanks for weighing in.

Just got off the phone with Dr. scheduling a brain scan to check on the pituitary gland.

LH Test - .5 mlu
Prolactin Test - 3ng.

Please provide reference ranges to all labs.

Another first, never seen LH this low on someone not on TRT. TRT will almost zero out LH since TRT suppresses the HPTA and crushes LH to between .1-.3 and will take years to zero out. Your pituitary gland (HPTA) is finished and the diagnosis is secondary hypogonadism.

TRT will crush FSH and render you almost or completely infertile which is most of the time reversible, freeze sperm now. You can always restart the HPTA later using clomid or add HCG and FSH injections to your TRT protocol and increase sperm production this way.

You should start TRT in isolation and dial in without any drugs, multiple smaller injections per week is ideal. Your trough levels will be higher (lowest point) and levels will spend less time declining giving you more stable higher levels the majority of the time.

Yikes - glad I got this checked out when I did. I’ve dropped about 50 pounds in the past two years and my calories we’re starting to get low and I thought that was the main reason for the general weakness. Little did I know reference ranges for the above two test are attached below.