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Pre TRT Labs - Seeking Opinions

I am looking for opinions on pre TRT labs. I am 52 years old. No prior anabolics. 6’-0”, 170 lbs., 16% body fat. Decent diet. Weightlifting history. I weighed 190 lbs years ago with low body fat. Currently active and lift 2 or 3 times a week.

For the last 8 or 9 years I have been suffering from daytime fatigue, headaches, brain fog, eyes hurt and eyesight has rapidly deteriorated and I can no longer tolerate the heat (sweat excessively). Labido is fine.

I left a good job because I was just too tire all the time. Dr prescribed Adderall and that is the only thing that has kept me functioning the last few years. I would hate to think TRT would have allowed me to keep working, as TRT is allowed and Adderall is not.

I have seen several eye doctors – no eye disease. Multiple sleep studies – no sleep apnea. CAC score – 0. B-12 was low - I have tried B-12 shots in the past and currently taking a supplement.

Three years ago TT was 496 ng/dL and FT was 109.6 pg/mL. Current labs in link.

Started TRT about 10 weeks ago but haven’t felt results yet. I am looking for opinions on my pre TRT labs to see if I am headed in the right direction.

You need TRT. Also, your reverse T3 is too high, given your free T3 of 3.0. Thyroid is not optimal. I would supplement Vit D3.

Pre-TRT labs shows Toral T matching elderly man territory and Free T on the bottom end, you needed TRT.

You say you’re 10 weeks into TRT and you feel no better, you need to describe your TRT protocol in detail.

Suggest testing Free T3, high Reverse T3 will negatively impact a lot of that Free T3 as Reverse T3 competes for the same receptor as Free T3.

Vit D lowers RT3?

No, separate issue, your D is low.

Would you have said I needed TRT three years ago when TT was 496 ng/dL and FT was 109.6 pg/mL? Because I felt like crap then too, but was under the impression FT of 109 was not that bad.

Had my first shot 8-21. 50 mg Test Cypionate every other week for first three weeks and oral B12 and Folate every day. Labs below are one week after third shot.

I almost think Dr was trying to crash the numbers so he could justify TRT. I had done my research so I knew what was going to happen. When I went back he immediately put me on 150 mg Test Cyp per week and let me self administer. No AI, which I’m assuming at this dosage is not an issue. So in reality I have been on TRT for four weeks.

He has me scheduled for labs this 11-16 (TT and FT only). One day before the next shot. And then labs again on 12-14, just before my next appointment. He only ordered TT and FT, but I can order others online if necessary.

Will start Vit D today. I had a major physical at the Mayo Clinic in September and Dr there recommended against TRT but didn’t offer any other solutions. My personal Dr is onboard and said he would be happy with TT of 600. So if that is the low at day 6, Would that be a good starting point? I feel like I really just need the Dr for the script, because I have to stay legal. I can order my own labs and stay on top of it myself with some direction. I know I need to watch TT and FT and E2 with the sensitive test. Any other labs I should monitor? Does E2 follow the same curve as TT? If so, what is the preferred range of E2 from peak to trough?

Yes, all things being equal (no thyroid issues, anemia, etc.), definitely would have started TRT. This is more than numbers on lab reports. Yes, labs are a guide, but not everything. Same with E2, go with how you feel and not the number, or even the type of test.

50mg every other week is crazy and your result was as expected. Cannot imagine why he did that. I know a guy who was given birth control pills for a month, had labs, and big shock, qualified for insurance coverage for TRT.

I think 150mg a week is a good place to start.

Regarding E2, everyone is different, some do not get much of a jump in E2, others, even with the same dose, do. Keep an eye on PSA and CBC.

Thanks

You can’t justify the TRT by doing the TRT. Once you are diagnosed hypogonadal then you are diagnosed. He started low because that is the usual PCP thinking. Mine did the same thing…it was awful.

It would be a good idea to check SHBG, once weekly injections may not be optimal for you. Everyone has their own optimal injection frequency, typically between 2-3.5 days if pharmacodynamics has anything to say about it, but some can stretch it a little farther out if SHBG is high enough.

Your doctor was quick to right the ship quickly, doctors that adapt quickly go far in their career.

I will monitor SHBG. Since Dr gave me the freedom to do my own injections, I will be able to adjust frequency as I determine, as long as I stay within the script. I hope the injections get better though. Thus far, they have been sore for several days. Of course the pharmacy was out of 23 g needles and gave me 21 g. Can you use 25 g needles with pharmaceutical Test Cyp? I have a bunch left over that I got for B-12 shots.

21g, ouch………25g? Yes.