T Nation

Low T, Trying to Come Up with a Plan

Hey guys. I have been on here in the past for low T and the furthest I ever got was a try one HCG monotherapy which instantly gave me a panic attack and I stopped. I am 34 years old, workout 5 days week, 165lb 5’11 pretty in shape. I quit drinking 3 1/2 years ago and got labs done right around then and had numbers of total T 450/ Free 8.0/TSH .863. I did the HCG as mentioned got off it and just forgot about it to be honest. Here is where I am confused (or just realizing I am in my mid 30’s). I have been crushing the gym religiously for the past 8 months or so, lifting like i never had in my life. I am without question in the best shape i have ever been in and actually have muscle to carry for the first time.

I was at the doctors two weeks ago and they wanted to run labs and I was all excited thinking my T has to be as high as it has ever been. WRONG!!! Its the lowest I have ever seen on paper and now I am at a loss. I pretty much live in a state of brain fog but it has become the norm so I am used to it. I definitely struggle off and on with the blues and anxiety is around here and there. After seeing this last lab and having several friends and family on TRT, I am wondering if its time. Totally honest, I am a bit nervous to try it but wanted to hear some feedback on those numbers. I appreciate any insight you guys have.


Your balls arent working as expected, or you have other issues like sleep anea messing with your ability to produce higher levels. Its what we all go through. My symptoms showed up at 38, I worked out and got into pretty good shape, but decline was happening. Depression hit me and looking back, what I experienced was like nothing Ive ever experienced before. So 6 yrs later I started pinning and never looked back. Its always scary, and the thought of having to do it forever sounds like a trap. But its actually a release from the issues that are lurking around the corner. So start with a sleep study, it could be the key to several things, and it could put TRT on the backburner for another 10yrs.

Thanks for the note brother. My sleep since the pandemic has been absolute garbage, 1-2am regularly. Does that effect your T?

Absolutely, nothing affects testosterone more than sleep. Poor sleep will also negatively impact the quality of your erections because when you are in stage 4 REM sleep, that’s when you get night time and morning erections which is providing blood flow your penis and is a kind of maintenance for your penis.

The question you have to ask yourself is which came first, the poor sleep or the low-T because low-T can cause poor sleep and poor sleep can cause low-T. One test I see missing is an SHBG measurement, this test was the first thing I thought of when I saw your Total T and Free T values.

I imagine it’s above midrange or slightly higher and is important because SHBG binds T (Total T) decreasing your Free T. A competent doctor would first order a sleep study before even considering giving you TRT.

Damn good to know. I was getting a full panel done and didn’t really put any emphasis on asking to drill down around T. I really thought the gym time and how much muscle I’ve put on it was going to be in the 7’s. I’ve kind of always been a night owl but I can definitely see a difference just even in erections when I’m going to bed much earlier from time to time so that makes sense. My step dad runs TRT. Dumb idea to try it for a week and see if I feel any difference?

TRT is not something you run for a week. You have to run it as cycle and then PCT if you want to see if it makes a difference. It will take 2 weeks of exogenous T to shut your balls down, and about 12 weeks to see any difference since your hormones will fluctuate and then stabilize. 1 week of TRT is pretending to TRT. LARPing so to speak.

It can take a full year to reap the full benefits of TRT provided you protocol is appropriate. Dialing in can take months or longer if you have unaddressed issues.

Do you have additional labs?

A couple of things:

First, I’d supplement VitD, 5000IU daily, though you may need more.

Second, many people have experienced sleep disruptions due to COVID. I would not waste time or money on a sleep study unless there is a possibility you have apnea. Could be part of the equation, but even if so, only a small part.

Third, you need testosterone. Your SHBG is high and while it may be nice to know for certain, it is irrelevant because your free testosterone is in the tank. It was 3 1/2 years ago. You might need a higher dose to get free testosterone up there.

Good luck.