T Nation

New to TRT, Looking for Guidance

Hi everyone, I’ve been thinking low test might be my problem for years now, I’m fairly young (24) and felt like this since I was 16/17. I got my bloodwork done at 17 and received a call that my levels were (3.5 out of 5) and I’m in the normal range.

I’ve got daily brain fog, tired and fatigued every day all day, lack of focus, no libido (I can get hard and have sex, just feels dead and don’t want to). I have low motivation most days and feel super inadequate. I struggle to gain weight since I’m not hungry usually. I eat around 2500-4000 calories a day.

Below are my lab results, I’m hoping someone here can point me in the right direction in what to do.

Age: 24

Height: 6’3

Weight: 180 lbs

Lifestyle: fit, W/O 4 days a week, high fat, low carb diet, no sugar. Daily cardio + IF sauna (10 min each). No drinking, drugs, smoking. 6-9 hours of sleep everyday.

Supplements: D3 (15,000IU), Boron (9-12mg), Zinc (50mg E3D)

T3, FREE: 3.5 (Range: 2.3-4.2)
T4, FREE: 1.4 (Range: 0.8-1.8)
TSH: 1.29 (Range: 0.40-4.50)

E2: 28 (Range: < OR = 39)

Free Test: 108 (Range: 35-155)

Total Test: 748 (Range: 250-1100)

FSH: 11.8 (Range: 1.6-8.0)

LH: 5.1 (Range: 1.5-9.3)

Prolactin: 8.8 (Range: 2-18)

SHBG: 45 (Range: 10-50)

E2, SHBG, and FSH are all high. TSH looks on the low side. My levels are pretty good as far as ranges since it’s in the 700’s. I think that may be do to watching and reading and doing every “How to raise your testosterone naturally” ever made.

I think maybe I’m one of those people that needs even more to feel good and normal, I’d just like to see some of the thoughts of the experienced folks and Endocrinology enthusiasts as to what I should do.

Thanks in advance.

You are fine. Get more sleep, take a harder look at thediet.

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This is probably way too much. You’re probably well over the reference range. I’d get it checked, maybe just drop to 1,000 IUs.

Your levels are better than most people your age.

E2 is not high and TSH is pretty close to perfect (under 1.0).

I’d check for diabetes. People with your natural levels of testosterone and thyroid would usually feel pretty good or descent at least.

You should also stop all supplements and reintroduce them one at a time for 30 days straight each. Only keep what helps your energy, otherwise stop.

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Sleep more than 9 hours?

What’s your trt protocol, and how long have you been on this protocol?

I don’t think more testosterone is the answer here. Have you considered psychological causes for your symptoms?

He doesn’t have one, those labs are on nothing.

More than 6, when someone gives a range of 6-9 that typically means usually 6. You don’t have a physicall issue.

No one saw that?

Can you retest after some time total t, LH, FSH and albumin?

“I think that may be do to watching and reading and doing every “ How to raise your testosterone naturally ” ever made.”

Everyone saw that, it doesn’t mean anything if he’s monkeying around with everything. It’s like getting a thyroid massage right before thyroid bloods.

Ive discussed such values with progressive doctors. But this one seems tricky. Yep I know FSH is highly pulsatile. On his place I would retest it at lest

I think the free T threw me off.

If it were me, I’d check everything I possibly could, BEFORE committing to trt.

Will do, I can’t find much on high FSH. Just usually low and the problems that come with that online.

It looks to me based on your comments, your mind is made up, and not interested in the details or helping. Its not typically 6 for me.

Yeah, not sure what they could be honestly. I’ve looking into pre-diabetes, addictions, sleep apnea, positive thinking and visualization, etc.

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Yes, ny mind is made up. You are foolish and seeking a non-existent solution. Your E2 is not in the same universe as high. Neither is your SHBG, it’s actually a marker for longevity to be running that level. And your TSH is definitely not on the low side, it would be ideally a little lower according to some, bt it’s pretty much perfect in the opinion of most. And there is no such thing as an “Endocrinology enthusiast”, it’s not a hobby. It’s a profession for some, a diagnosis from the DSM for others. Don’t invent issues, you don’t have any outside of that skull from the look of those numbers.

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Lots of animosity, can only imagine its because of the age, I’m sure you’re older than I am, yet you still need to grow up. if you’re not going to assist, why bother? “endo enthusiast” is referring to the many sticky posts about amateur endo’s. Good luck with that anger.

Bro, your case looks complex.

Take these tests I mentioned above again and find a really knowledgeable optimization specialist, private practice. The endocrinologists would be a waste of time in 90 percent of the cases. They will tell you your hormones are ok and may give you antidepressant.
I have a theory but Im not a doctor so sharing it might be counter productive for you.
I will just tell you a few things - your TSH is PERFECT, FREE T3 looks very good, FREE T4 as well .So as much as blood work can be trusted you thyroid looks AWESOME.
Your SHBG is not high at all, the value is very good. E2 is also good I would say a bit low even. From what you have posted the FSH only looks concerning to me.

This is most likely your answer:

Eat good quality carbs and don’t jump on the stupid low carbs trend.
You will drop your SHBG a bit, free up more testosterone and feel better I hope.
You don’t need any TRT at your age with your hormones values.

Your thyroid is really good, testosterone panel equally as good. There are half a dozen other diseases that could be causing your symptoms, the high FSH might be the key to unlocking what is causing your symptoms.

The endocrinologists are more than likely going to be a waste of time in my opinion, seek out a urologist to investigate the high FSH. More than not most docs aren’t going to invest a great deal of time looking for the cause of your symptoms, the SSRI is the cheap go to method in a medical system that is unregulated (increasing healthcare costs) and overwhelmed.

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