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Low Testosterone Symptoms. Do I Need TRT?

Hey guys,

I’m a 35yr old male from the UK and have been experiencing low energy symptoms since I was in my mid twenties.

I recently went for a CBC / Andropause check in the hopes that my bloodwork might give me a clue as to what is causing my issues.

I got the results back and checked my Total / Bioavailable values using a conversion tool:

Total T = 392 ng/dl
Free T = 5 ng/dl
Bioavailable T = 154 ng/dl

Looking through some of the other posts here, I’m struggling to identify if these values are okay or if I’m a prime candidate for TRT. I’ve got a follow-up chat booked with the GP (private, not NHS) to discuss but would like to confirm that I’m heading down the right path.

I’ve added my bloodwork below. Would like some assistance if possible!

The elephant in the room is Total T is low and SHBG high creating low levels of the free portion of testosterone. It’s not even questionable at this point, you need to elevate your testosterone period.

Struggling to identify your values (392 ng/dL), struggle no more. Men with low Free T are getting more aggressive forms of prostate cancer when compared with those who have high Free T levels. The majority of men never know why testosterone is low unless a testicular failure or pituitary tumor.

Men’s testosterone has been declining for several decades and we have reached a tipping point and it will only get worse.

Testosterone Threshold for Increased Cardiovascular Risk in Middle-Aged and Elderly Men:

The locally weighted regression showed that total testosterone levels of 440 and 480 ng/dL were associated with increased Framingham CVD risk and an increased probability of increased hsCRP, respectively. Men with sexual dysfunction (poor sexual performance, decreased morning erection, and loss of libido) had significantly greater CVD risk.

Testosterone and the Heart

Testosterone (T) has a number of important effects on the cardiovascular system. In men, T levels begin to decrease after age 40, and this decrease has been associated with an increase in all-cause mortality and cardiovascular (CV) risk. Low T levels in men may increase their risk of developing coronary artery disease (CAD), metabolic syndrome, and type 2 diabetes.

Hi Systemlord,

Thank you so much for taking the time to respond to my post! I’ll take your information to heart and bring it up with my GP. Fingers crossed the results will speak for themselves, though if not I will look for a specific TRT doc in the UK.

Oddly enough, the doctor who wrote some notes was more interested in the liver values in the blood test rather than the androgen results but from what I have read on these forums, this is very typical!

Thank you once again. I will be discussing with my doctor on Monday and I can put an update in this thread once I’ve been told what my options are. I was told previously when my blood was taken what my options were and they were either Nebido or Androgel. Neither of which sounded particularly promising but again, I will see if I can get other options.

Appreciate it!

It probably mean he isn’t very knowledgeable in sex hormones, very common problem worldwide. A doctor that sees in range levels, which yours are “in range”, only to those who have no education are not considering your age when looking at your levels.

The ranges includes 20 year old men to 80 year old men, the former typically score on the top end of the ranges and old men on the bottom of the ranges, so you levels are normal, for an 80 years old diabetic with heart disease.

The fact that androgel was even offered suggests he is not up to speed on TRT. You need Test enanthate or sustanon. Nebido will give you the hormone profile of an old man, the T-gel is poorly absorbed by most men.

He likely knows more about this than TRT.

Hey again,

So I went for my follow-up this morning. The doctor was happy to prescribe TRT based on the results but there were some caveats around it. I stated that Nebido and Androgel were out of the question due to the issues of stability and asked for Test Enanthate and HCG.

The doctor said it was fine to get Test Enanthate on the condition that I visit to get each shot (not very financially viable especially it I wanted an every-other-day protocol).

Regarding HCG, he said that he would only prescribe it if the exogenous testosterone shut down production of LH and that this was unlikely to happen as I’d be getting a replacement dose.

From what I’ve read, this seems to be in disagreement and that any exogenous testosterone will immediately shut down (or at least severly curtail) my own production and I did raise this with him but he wouldn’t budge on his position. I of course wish to remain fertile and I’d like to get a protocol that works for me as close to as right as possible on my first attempt without having to go through a process of trial and error where others have already blazed that path!

However, at least I feel some progress has been made regardless of the rather frustrating comments made. So now my next step is to find a TRT doctor in the UK. I’ve got a lead to check out that seems promising and are CQC registered so I’ve got in touch with them to get the ball rolling.

I’ll put another update in this thread when I’ve got some further info.

This almost never happens, if you are expecting to skip the process of trial and error, you will be disappointed. You will not always be on the same dosage, over time your body will decide your current protocol is no longer enough or is too much testosterone forcing you to make changes every now and again.

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In terms of getting Test E + HCG presribed, I’d like to at least get these first instead of starting out on T alone then adding HCG into the mix but only if my doctor agrees.

I very much expect there to be a lot of trial and error on dosing though! Sorry for the confusion!

I would start out on the T alone so you know what it is affecting you. If you start with both and run into problems you won’t know what compound is causing it. Get balanced out on T then if still wanted, introduce HCG.

There’s a guy that does YouTube videos about TRT in the UK. His clinic was just approved to import test cyp, and he seems knowledgeable in his videos. It’s TMHC UK, the men’s health clinic, I think. Might be worth a google since your current doc doesn’t seem very up to speed.

Blockquote “There’s a guy that does YouTube videos about TRT in the UK. His clinic was just approved to import test cyp, and he seems knowledgeable in his videos. It’s TMHC UK, the men’s health clinic, I think. Might be worth a google since your current doc doesn’t seem very up to speed.”

Hi Swoops, I think you might be right about that. Before I left yesterday, I got another blood test (was around 10:30 in the morning) wheras my last result was in the afternoon.

He sent the results to me this morning and I was 525ng/dl. He said I wasn’t a candidate for TRT as my levels were normal.

He was keen for me to go back to look at my liver values again so before I go back to him, I decided to check to see if there was a correlation between high liver values and low testosterone. I found a couple of articles that linked ongoing TRT to a reduction of liver values which I’ll mention to him to see if I can at least bend his arm a bit.

Regarding TMHC, I’ll give them a go, I was looking at Optimale originally since their testimonials seemed pretty positive but still awaiting a response from them.


I have yet to see a man feel normal with Total T mid-range and with high SHBG, there is just not enough Free T in calculation which wasn’t even tested. The liver produces SHBG and is at the heart of the problem, but is not reversible and TRT is needed to make things right again.

TRT improved my liver function.

You have not been properly evaluated by someone experienced, mid-range Total T and high SHBG is a red flag to the more experience hormone doctors.

I expect this outcome and am not surprised at all.

Total T isn’t bad, would need to see what SHBG, e2, etc look like to know if you should try TRT or maybe a SERM protocol. Not from the UK but understand this can be tough to do there. Best of luck

Hey Systemlord,

Thanks for the response, it’s really good to know that you saw an improvement in your liver function following TRT! To be honest, I thought the liver thing was a bit of a red herring. The doctor said I should go in for an ultrasound but I’m not fully convinced; seems like misdirection and I’m not sure what the end-game would be if I went down that road and didn’t do TRT…so I won’t be doing that.

I’ll continue to hunt for a good TRT doctor in the UK. Think that’s pretty much all I can do at the moment!

Thanks again

Thanks for the feedback Swoops! I’ve booked an appointment with a TRT specialist. I also suggested the possibility of transscrotal cream (out of all the options available, this looks the most appealing to me) and he actually said he’d be onboard with it if I could find a compounding pharmacy to fill the order which is positive.

Regarding my SHBG, he didn’t test but I’m going to go on a hunch and assume it was as high as my previous test which was around 55.

I’ll let you know how I get on, thanks again for your help!

Empower Pharmacy makes a compounded cream that I’ve read good reviews about. They are online and ship all over.

Thanks Swoops - I’ve found a compounding pharmacy in the UK and got in touch with them. They confirmed they did Pentravan cream testosterone preparations.

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