First off, thanks to all the contributors in this forum. I am very new to this world and this knowledge is invaluable to a newbie like me. Given the symptoms listed below, I have been in search of a solution(s) for the last year or so, but found no relief:
• Lack of focus/concentration
• Mood swings (high motivation one day – extremely low the next)
• Difficulty putting on muscle despite hard work in the gym
• Higher than optimal BF% (skinny fat body)
• Never any ED or libido issues, though
• 40 years old
• 6’ tall
• 181 lbs
• 19% bf
• 96.5 temp upon wake
• Lift weights 4 days per week, 1-2 days of light cardio
Over the last couple of weeks I made my may to a “wellness” clinic in my area (NE Ohio) and after a blood test, the doctor in the clinic prescribed the following:
• Test C (200 mg/week)
• Anasrozole (0.5 mg 2x a week)
• HCG Troche (Sublingually 500iu 2x a week)
• Deca (0.5 ml 1x a week)
• DHEA supplement
After doing some research, I have come to the conclusion that the above is not in my best long term interest, but rather this doc/clinic pushing their product on me (~$400 a month cost).
Below are my blood results:
Triglycerides – 94 (<150)
Cholesterol – 160 (<200)
HDL – 62 (>40)
LDL – 79 (<100)
Chol/HDL ratio 2.6
T3 – 3.3 (1.8 – 4.6 range)
T4 – 1.36 (0.9 – 1.7 range)
TSH – 3.14 (0.27 – 4.2 range)
FSH – 8.3 (1.5 – 12.4 range)
LH – 7.2 (1.7 – 8.6 range)
Estradiol – 20.1 (7.6 – 42.6 range)
DHEA-S – 89.3 (88.9 – 427 range)
Dihydrotestosterone – 42.4 (11.2 – 95.5 range)
Test total – 449 (280 – 1100 range)
SHBG – 58 (10 – 80 range)
Free Test – 6.17 (1.9 – 27)
IGF-1 – 151 (70 – 192 range)
I would greatly appreciate any feedback you might have on how to improve my symptoms (and my body composition) and if I am a good candidate for TRT.
Oral and nasal hCG does not work as the very large peptide hormones do not cross membrane. Want to find out? Get a home pregnancy kit and you need to be positive.
If you are injecting T, you can inject 250iu hCG EOD.
You should self-inject T twice a week and take anastrozole at that time. We typically see a need for 1mg anastrozole for every 100mg T ester.
Morning 96.5F is very low. We also need to see how well you warm up mid-afternoon. Body temp may be reflecting non-use of iodized salt.
Are you using a statin drug to lower cholesterol?
Are you reporting T3, T4 or fT3, fT4? [these should be mid-range or a bit higher]
E2=20.1 is OK, TT is low, but all sort of meaningless with the ups and downs of weekly injections. You need steadier T levels so labs reflect where you are most of the time.
Labs with high LH/FSH imply that you reported pre-TRT labs and primary hypogonadism. - clarify
TSH should be nearer to 1.0, can be from low iodine.
Rx Deca? Insane. Do not report volumes, mg’s please.
TRT with 200mg T cyp/eth per week is rather stupid, but fashionable as T shops become drug pushers and profit by drugs they provide.
Please read the stickies found here: About the T Replacement Category
- advice for new guys - need more info about you
- things that damage your hormones
- protocol for injections
- finding a TRT doc
Evaluate your overall thyroid function by checking oral body temperatures as per the thyroid basics sticky. Thyroid hormone fT3 is what gets the job done and it regulates mitochondrial activity, the source of ATP which is the universal currency of cellular energy. This is part of the body’s temperature control loop. This can get messed up if you are iodine deficient. In many countries, you need to be using iodized salt. Other countries add iodine to dairy or bread.
KSman is simply a regular member on this site. Nothing more other than highly active.
I can be a bit abrupt in my replies and recommendations. I have a lot of ground to cover as this forum has become much more active in the last two years. I can’t follow threads that go deep over time. You need to respond to all of my points and requests as soon as possible before you fall off of my radar. The worse problems are guys who ignore issues re thyroid, body temperatures, history of iodized salt. Please do not piss people off saying that lab results are normal, we need lab number and ranges.
The value that you get out of this process and forum depends on your effort and performance. The bulk of your learning is reading/studying the suggested stickies.
These wellness clinics tend to care more about your hard earned money than your health and their protocols are on the high-end range of what’s normally prescribed. 200mg is at the upper limit for a weekly dosage, unless you metabolize testosterone quickly. $400 a month is absurd, you would do better going through Defy Medical paying a quarter what you’re paying now. A lot of guys chose this route because so many endo’s (HMO’S) don’t really understand male hormones the way they should.
The problem with doctors is they tend to group everyone within same TT range, everyone is biochemically unique therefore what’s low for you may not be low for someone else. It could very well be that you function better near the top of the range, there are those who function better in the midrange. This is where doctors fail their patients throwing everyone into the same range with such a huge diversity on this planet.
Thanks KSman, I really appreciate it. Yes, my levels are reported pre-TRT (this is my 2nd week of treatment).
T3 and T4 reported figures are free
No, I am not on any statins
Afternoon temp gets up a bit - 98.1 (I’ll definitely read more about iodine supplementation)
Thanks. I’ll check out Defy. The clinic I went to basically pulled a package off the shelf and sold it to me with no customization to my needs.