Should I Start TRT?

Hi guys,

I registered to this forum because i felt that i could gather some useful information. A year ago I started to feel very bad about myself. I started to lose motivation, felt fatigued, had a brain fog, loss of memory and loss of sex drive, high anxiety,and etc. - and I am only 23 years old. I was diagnosed with hypothyroidism and I am taking desiccated thyroid. It works well. I get about twice a week morning erections, but it is not enough for me.

Can I start testosterone therapy (25mg Clomid EOD with 0.5mg Arimidex twice a week or testosterone injections 75mg twice a week with aromatase inhibitor) or should I just be eating healthy, lifting hard and see where I go from there. Doctors always told me it is in my head, but it is not. I know that my free testosterone,DHT and FT4 are low:

Testosterone 535 ng/dl 242-828 ng/dl
Free Testosterone 18.4 pmol/l 13.3-118.7
DHT 0.60 nmol/l 1.03-2.92
Pregnenolone 46μg/l 15-90
hCG <1.00 IU/l <5
FSH 3.6 IU/l 1.4-18.1
LH 5.43 IU/l 1.5-9.3
SHBG 30.0 nmol/l 17.0-66.0
Progesterone 2.87 nmol/l <4.11
Estradiol 102.1 pmol/l <146.0
Prolactin 220 mIU/l 53-360
DHEAS 9.22 μmol/l 0.93-15.40
IGF-1 319 ng/ml 115-360
Cortisol 384 nmol/l 138-690
PSA 0.84μg/l <1.40
Free Androgen Index 61.58 15-95
Creatinine 98μmol/l 59-104
TSH 1.5 mIU/l 0.40-4.00
FT4 12.42 pmol/l 11.5-22.7
FT3 5.39 pmol/l 3.5-6.5
rT3 0.053 nmol/l <0.128
Iron 15.1 μmol/l 11.6-31.3
Ferritin 141 mg/l 28-370
eGFR(MDRD) 81.51ml/min /1,73m2 > 60
TPO-Ab < 28kU/l <60
Thyroglobulin Ab <15 ku/l <60
Thyroglobulin 2.76μg <55

Were you hyperthyroid because you were not using iodized salt?
Is salt iodized there? Or dairy or bread?
Did your doctor ask about that?

TSH 1.5 mIU/l 0.40-4.00
FT4 12.42 pmol/l 11.5-22.7
FT3 5.39 pmol/l 3.5-6.5
rT3 0.053 nmol/l <0.128

TSH is too high, you are undermedicated.
FT4 should be mid-range or higher, yiur 12.42 is not near 17.1
fT3 is a good level.

Please check your oral body temperatures:

  • should be 98.7-98.8F, higher is OK, 97.3 is a problem
  • also check for 98.6F/37C mid-afternoon

Please read these stickies:

  • advice for new guys
  • things that damage your hormones
  • protocol for injections

Your TT is not low, but FT is. Sort of odd. E2 is a bit high but does not explain. Would like to see liver numbers AST/ALT as you may have higher TT because liver is not clearing [E2, T+SHBG] properly.

I agree with either TRT option. Some guys feel horrible on Clomid. Nolvadex does the same job without the risk of those side effects. Injections should be 100mg/week, do not start at 150.