T Nation

Need Opinions on Whether to Start TRT (Labs)

Hi this is my first post, glad to be here.
I’ve been feeling kinda blah for a while now, low energy and motivation. Libido is ok and erections are good so no problems there. I got some labs ran and I’ve been prescribed trt and I’m just getting a little cold feet and I was looking for some informed opinions. Thanks for the help.

Can you provide some more info? How old are you? Are you overweight? How is your diet? Stress levels? Exercise? Was the blood drawn in the morning? Generally it is best to make sure your diet, sleep, weight, etc… are in check. If not you could raise it without TRT.

40, sleep is ok, a lot better since I started trazodone. Diet is so so I’m trying to eat better. I eat a lot of carbs not a lot of meat and little sugar. I’m 6’ and weigh 175-180 so not really overweight but higher bf % than I should be. Stress has been pretty high for the last few months as I broke up with the girlfriend. I was starting to feel a little better by the time the blood draw came around. It should be noted that I had symptoms before the breakup but we weren’t doing good for a while so I’m sure it’s a factor. My job is somewhat physical for a while I wasn’t going to gym but I started before the quarantine but it’s been a while.

My albumin was 4.4 g/dl 3.5-5 it got cut off the pic

You have low total T but very high Bioavailable T due to low SHBG. Kind of a paradox. Most guys with that low T have the related symptoms. Your depression may be related to low T and once your Test is optimal, your depression and your sleep will improve.

I’ve never understood the “cold feet” about getting TRT but I know everybody is different. As an analogy, I would ask you, if you were diagnosed as a diabetic, would you feel the same about life long insulin treatment? To me, its no different.

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Do you donate blood?

So my symptoms could be from low TT even though bio avail is decent?
Im nervous about getting libido issues or ED. I have no problems in either area so it’s like if it ain’t broke don’t fix it type of thing. But unfortunately I don’t feel that great so I need to weigh everything. I hear ya on the diabetes analogy.
No on donating blood. I think I should my hematocrit was 44.3%and hemoglobin was 15g/dl

I’m no doc but its seems possible. I understand the don’t fix what ain’t broke thing too, maybe you can wait while. Or ask your Dr about the connection to depression from low T. He’s he’s good, he should have read articles related to it.

I had higher levels than you and started TRT for reasons other than T levels. I suffered from depression and could never find anything that worked long term. Since starting TRT I’ve not had to deal with depression and it’s been years now. There’s a host of other issues that I didn’t even realize were issues until they were 1000x better. Libido and erections for example. Had you asked me if I had issues there I would have said no but once my dick got so hard that I didn’t recognize it I had the realization that before TRT I had a semi wet noodle (hard enough to use it but not ideal). My libido is all consuming these days. I can literally have sex all day & night until she taps out texts me the next day that she’s never been that sore. Before TRT sex felt like something I had to do so that I could get back to watching TV. TRT done right is as close to a miracle drug as I’ve seen (I’ve tried most of them). One thing to take into account is that it takes time to work and sometimes it requires you to go through periods of feeling less than ideal before you see the light but once you get there it’s life changing.

I think it would help my anxiety and depression for sure. One of my major concerns is having erection problems on trt. Right now It gets very hard and I have 0 issues there and am very nervous about messing that up, I read post after post about ED on the forums and many were fine before trt. As for the having sex to get back to watching tv I can absolutely relate to. Me and my gf of 2.5 years broke up in March so I’ve been a little extra depressed and I’m trying not to just jump on trt because I don’t feel great. My libido could be a little better but it hasn’t been an issue. I’ve been prone to acne and had to take accutane as a kid. I have a lot of pros and cons to weigh. If I knew for sure I wouldn’t have erection issues Id jump on it. I appreciate the response it was helpful.

Your mentioned symptoms could also be caused by your low Ferritin / iron saturation levels combined with your mentioned hemoglobin I would also question an Iron deficiency / anemia issue first if your concerned about TRT.

Your ferritin and TIBC indicate iron deficiency, strange that your iron levels are normal. I went on TRT with ferritin at the bottom of the ranges and a short time later TRT took it all the way to iron deficiency as my body used up more iron stores to create more red blood cells.

I was iron deficient with hemoglobin in-range, high RBC, TIBC at the top and MCV and MCH below range indicating the mass and size of my hemoglobin was too small. I would check your MCV, MCH and MCHC.

Your testosterone is lower and the low SHBG is defiantly helping matters freeing up more free testosterone and might not be low enough just yet to experience the more hardcore symptoms of low-T.

Here is some more results, I couldn’t fit the whole page great on a pic

Mcv 94.5 80-98
Mch 32 26-34
Mchc 33.8. 32-36
Rbc 4.69 4.2-5.5

If you have erection issues on 200mg it’s because it’s not 200mg of testosterone.

Yeah I hear ya, I just seem to see a decent amount of guys on here that struggle with it.