T Nation

Should I Start TRT or No?

Hello all, have been reading from the forums for a while now, but finally signed up and this is my first post.

About me:

36 year old male
6’4" 265lbs (more bodyfat than I would like)
lifted off and on since I was 17 but have taken a few years pretty much off. Diet hasn’t been great.

Have a script for Klonopin due to panic attacks (have been taking for approx. 6 years and never had to increase dose)

Most recent labs:

Free T: 73 pg/ml
Total T: 363 ng/dl
SHBG: 27 nmol/L
% Free T : 2.0%
Cholesterol: 179 mg/dl
Triglycerides: 113 mg/dl
HDL: 53 mg/dl
LDL: 103 mg/dl
Prostate Specific Antigen: .91 ng/ml
Glucose: 96 mg/dl
Thyroid Stim 3rd Gen: 1.470 uIU/ml
Free T4: 1.03 ng/dl
white blood cell: 6.2 K/uL
red blood cell : 5.03 M/uL
Hemoglobin: 15.0 g/dl
Hematocrit: 44.3%

BP: 116/68
Heart rate: 63 bpm

Hair growth rate varies.
Symptoms are much lower sex drive/desire (no problems with erections, though they’re not as solid as before)
Lack of motivation
Low energy
Higher bodyfat/bodyweight
Lower muscle strength and mass

I also have a vericocele of the left testicle… not sure how much this lowers T levels, but size wise it is smaller than the right, but not a huge difference. Not sure how much it changes sperm count, but my girlfriend and I are currently expecting (so I know I had at least one good swimmer!) lol

I know a lot of people are able to raise levels with diet/exercise/sleep etc… with the vericocele i’m not sure if i’d be able to, as my previous test (5 years ago, when I was lifting heavy etc) was only low 400s.

I have no issues sleeping, never have. But with the other symptoms, I want to know if everyone thinks TRT would be right for me. My insurance covers any type that would be prescribed, so that’s not an issue.

As for the klonopin, from early age up until about age 16-17 I had panic attacks and from 16-17 through the age of 29 or so, I had ZERO…then they came back very heavily, and I began taking the Klonopin… it makes me feel “normal” and doesn’t cause any side effects nor have I ever needed to raise the dosage… but looking at the ages that I was free of attacks, it makes me wonder if it is hormonal reasons causing it, as I had none when my natural T would’ve been at its highest?

Anyhow, sorry for such a long post… looking forward to any suggestions, advice and questions.


Also I forgot to note this in my original post, but my doctor check ups are normally in the mornings, and my temps are usually 97.something, but raises closer to the 98s by mid day.

all blood work numbers above were from a 16 hour fasted state and within 2 hours of waking up.

When I do follow a better diet and taking my lifting seriously, I have no issues adding strength, losing fat and showing muscle definition, despite what many would believe with the use of klonopin

So from looking at my #s etc, should I be looking at starting TRT, and if so, what protocol seems to work best (not worried about price, as my insurance covers TRT)?

About two years ago I started withdrawing off Klonopin after 28 years and let me tell you it was hell, do yourself a favor and talk to your doctor about trying something else because the longer you’re on it the harder it will be to come off it. I’m no longer a believer of medication because they’re over-prescribed and don’t do your body any favors in the long term, I had no problem sexually when I was on Klonopin, however during and after withdrawal I did.

Your testosterone is already low you’re possibly going to need TRT anyways, so now is the time to (with the direction of your doctor) see if TRT can do what Klonopin is doing for you now. You’ll be healthier for sure in the long term. Klonopin can reduce sex drive in every way the longer you’re on it and long term nobody can say for certain what damage it will do to any particular person. I’ll always be wondering if Klonopin cured my tourette’s syndrome being on it long term, had it really bad as a kid. Went on Klonopin and it vanished and hasn’t return since being off it.

As for protocols avoid anything where you’re injection 2-3 weeks, it doesn’t work out! Minimum once to twice weekly. Also don’t waste time with gels, injection are far more effective.

I definitely agree about the Klonopin… I was prescribed .5mg twice a day about 6 years ago…its been a great help, but I wish I’d tested my hormones before starting, as I bet that was the root cause of my panic attacks! I slowly tapered myself all the way off and stayed off for a year before the panic attacks became too much again…if I had it to do over, I’d have looked into TRT back then and only taken something as needed instead of daily.

I’ve tapered off before without any big issues, allowing myself to stabilize and cut further every 10-14 days…plan to wean myself off again, once the baby is born.

Thank you for the advice and support, it does help!

As for the TRT, I’m like you as in not wanting to be on any more meds than necessary… i’d like to avoid A.I. if possible…and am unsure about HCG…honestly I think the testosterone shots EOD would help me a great deal, but I do worry that it could worsen the panic disorder instead of helping it…but I guess I won’t know until that time comes.

At the beginning TRT did give me a sensation of aggressiveness (urgentness) usually within hours but didn’t last long, then was mostly tired and fatigued. Eventually it passed (two months) and started feeling stronger, some see improvements sooner while others take months (like me) to start feeling the effects. I felt fantastic the first week before feeling old and tired. Once you get your dose at the sweet spot there should be zero side effects. I’m on 75mg weekly no AI, and no hcg. I wouldn’t worry about the AI or hcg at the beginning, I’ve seen some prescribed an AI before blood tests reveal one even needs it. The nice thing about testosterone is your body doesn’t know the difference.

TRT will change your life in positive ways even if you still require something to help with the panic attacks and even might allow you to better deal with them. It will give you better emotional control, I remember I would go from happy to angry in an instant and now I have more control.

You need more comprehensive blood work to diagnose the cause. Needs to include FSH/LH and probably prolactin. TRT is for life so if you want to avoid sticking yourself bi-weekly forever you could try to diagnose and restart HPTA first. Up to you.

We need lab ranges with lab results. - not always the same

When T levels are low you need to test these to find out something about why:

If LH/FSH are high, the testes are the problem.
If LH/FSH are low, the pituitary is the problem.

TSH should be closer to 1.0
fT3 and fT4 should be near mid-range or a bit higher
fT3 is the active hormone and not tested/
Please see last paragraph to eval overall thyroid function.

Many here have low-T and some thyroid issues.
Thyroid issues easily from not using iodized salt.

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.