T Nation

Replace T or Lose Weight and See?

Am 47. 6’0’’ 250 muscular with moderate abdominal obesity.

T total 219ng/ml nl range 280-1100
Free 51.8 pg/ml nl range 50-210
Percent free 2.4% nl range 1.6-2.9%
Bioavailable T 144.3ngdl nl range 130.5-680.7
SHBG 17 nl range13-71
LH 2.2 mu/ml nl range 2-12
Estradiol 34 pg/ml nl range 18-42
progesterone 0.3ng/ml nl range 0.1-0.2
pituitary MRI normal
PSA .95
Prolactin normal
TSH 2.02
Take L thyroxine

I was wondering if I should start T replacement therapy or see if weight loss will result in bump of Total T by decreasing aromatase and E2 levels. Would appreciate any advice.

Thanks in advance.

Your TSH levels are elevated, and your LH is low. You may have a thyroid condition (hypothyroidism). Free T3 would be a good test to have; AM and 24-hour cortisol, and temperature recordings throughout the day would be useful as well.

TRT will bump TT and FT, and it’s an option if you want a quick (albeit temporary and less than ideal) fix. Losing weight will help as well. Dealing with the thyroid issue is probably the best way to go for a long-term fix, though it isn’t going to be quick (finding a doctor that will do the right testing, and treat HT even without ‘by-the-book hypothyroidism’, isn’t easy).

What’s your BF percentage? With such low T and the fact that you mentioned your on thyroid meds, I’m guessing it’s quite high.

I was facing the same problem myself recently and decided to lose weight first. A lot can change when you drop the excess weight and I wouldn’t start TRT without a pretty good baseline first. I’m now down 17 lbs. Thinking about dropping 15 more and then maybe going to get tested again.

At 47 years old you qualify for TRT. The next step is to find a good dr. Top 3 I recommend Dr overbeck (whom i work with) in north east, crisler - mid west, mariano - west coast. Currently in process of working with Dr’s in texas and arizona in the near future specializing in functional medicine and HRT.

I think My low T is a combo of low thyroid and being a bit fat. It is a vicious cycle. Got fat after an illness and injury. More fat then more low T then less energy then more fat then more low T…

Hypothyroidism certainly contributes to weight gain - depression, low motivation, low energy, and poor metabolism are all side effects of HT.

Weight gain in men is a vicious cycle, so that’s pretty typical. I had an extremely difficult time losing it until I began supplementing with ALA, Vitamin D, fish oil, garlic extract, green tea, and a few others (more for heart health than anything).

In my case, I believe that I’m in the very early stages of CVD and this was contributing to my symptoms. These supps brought my blood sugar under control and helped me lose 18 lbs in about 5 weeks.

TRT and lowering E2 will enable fat loss. That will not work very well if your thyroid status is still hypo. More on the later or from others.

Thanks for the advice. I am on thyroid replacement. Initially took armour thyroid and then was switched to L-thyroxine. I have started increasing my dose on my own since I have not had a recommendation to increase the from doc. I am doing it gradually only taking 75 mcg of L-thyroxine but am thinking about switching back to 50mcg of Armour.

I am stuck. I don’t know if I should start TRT to facilitate the weight loss or lose the weight to improve my testosterone levels. Any advice. Givent the fact that my LH is low, I think my gonads still work some.

please go read stopthethyroidmadness.com/things-we-have-learned and all of the links on the left. Get your thyroid and adrenals balanced out THEN see if you still need HRT.

Monitor waking body temps to eval status. Record. Temps near 97.0 or lower are a definite problem. Some say that 97.8 is ideal. Some use waking body temp as a dosing guide. A few also watching body temps during the day.

If fT3 is mid range and temps are low, that can be from elevated rT3. That can be from low cortisol. Low ferritin impedes response of cells to fT3. So there are some topics that you can study.

Are there real long term success stories with T replacement? My total is low but my bioavailable and free levels fall in the normal range. I don’t want to screw myself up any more.

go by symptoms not lab ranges. do you feel great, lots of energy, good morning wood, good libido, confident, driven?

most people who have long term success with T replacement don’t end up on message boards asking for help or offering advice. a majority are out there living life to the fullest.