T Nation

Testosterone Replacement


#1

I'm 54 and have been lifting pretty regularly for a year. I just found out I have Low T. So, I will be taking testosterone replacement. Will I see any changes as a result of the higher testosterone levels? More muscle mass? More fat loss? Thanks...


#2

Benefits: If otherwise healthy you can expect to gain muscle and loose fat. Libido will increase. Social interaction will improve, as well as energy and initiative. If you do not manage E2, many gains can be reduced.

Please read these stickies:
- advice for new guys
- things that damage your hormones
- finding a TRT doc


#3

Thanks. I've read the info and am still a little unclear regarding managing E2. Is this dependent on my current levels or is it recommended that everyone on TRT use pharmaceuticals to control E2? Thanks.


#4

Everyone should be monitoring and controlling E2. For some this results in not needing an aromatase inhibitor [AI]. There are a few rare sorts who simply feel better on E2 levels that would make most feel rotten.

The described method of calculating anastrozole dose will compute to large or smaller doses, or ever to no dose.

If your levels are low 20's without an AI, you don't need it.


#5

Thanks again. I go Monday for the extensive blood work. So I'll know more next week.


#6

I'm having more extensive blood work tomorrow. I should have full results in a few days.


#7

Ok, here's what I have so far...

Age 54
Height 6'0"
Waist 32"
Weight 172lbs
A little above avg body hair. Can grow a full beard in 10 days. Male pattern baldness for 20 years.
Fat around mid section
High Blood Pressure for 30 years.
Rx amilodopine/benaz 5/20. Propranolol 80mg.
Sups- fish oil, coq10, vit D3
Labs
CBC all wnl range
PSA 0.3 (0.0-4.0)
Test, serum 319 (348-1197 ng/dl)
Free test 6.5 (7.2-24.0 pg/ml)
Chol, tot 184 (100-199)
Triglycerides 147 (0-149)
HDL 42 (>39)
VLDL 29 (5-40)
LDL 113 (0-99) HIGH
T. Chol/HDL RATIO 4.4 (0.0-5.0)

Glucose, serum 92 (65-99)
BUN 15 (6-24)
Creatinine, serum 0.88 (0.76-1.27)
eGFR if non African am 97 (>59)
BUN/creatinine ratio 17 (9-20)
Sodium, serum 139 (134-144)
Potassium, serum 5.3 (3.5-5.2) HIGH
Chloride, serum 99 (97-108)
Carbon Dioxide, total 25 (18-29)
Calcium, serum 9.6 (8.7-10.2)
Protein, total, serum 7.5 (6.0-8.5)
Albumin, serum 4.4 (3.5-5.5)
Globulin, total 3.1 (1.5-4.5)
A/G ratio 1.4 (1.1-2.5)
Bilirubin, total 0.4 (0.0-1.2)
Alk Phos, S 85 (39-117)
AST 25 (0-40)
ALT 26 (0-44)

Hemoglobin A1c 5.4 (5.7-6.4)

RBC 4.72 (4.14-5.80)
Hemoglobin 15.7 (12.6-17.7)
Hematocrit 47.0 (37.5-51.0)


#8

Please post RBC, hematocrit

Because we see so many thyroid problems here:
- please check oral body temperatures as per the thyroid basics sticky
- Have you always been using iodized salt and/or vitamins that list iodine+selenium?

You do not have AST/ALT so we do not know if primary or secondary. But at your age that does not matter so much.

Please see the protocol for injections sticky.

Before you start TRT, you need:
PSA
and need a DRE [prostate exam].

Ubiquinol form of CoQ10 is very much higher bio-available than regular CoQ10
Do you have a chronic low level cough?
Not using a statin drug?

Routine TRT labs:
TT
FT
E2
CBC w hematocrit
AST/ALT
PSA
TSH
AM Cortisol if energy lacking

Potassium high: https://en.wikipedia.org/wiki/Benazepril#Side_effects


#9

PSA is listed. So are AST and ALT. I had a DRE and was completely normal. I'll edit the previous post to add the CBC. I didn't realize it was important...


#10

I am using ubiquinol coq10.
No cough at all.
Never used a statin drug. Isn't my cholesterol okay?
I don't add salt to any food. And if I did, it'd be sea salt. I don't have any of the typical thyroid signs. Eyebrows seem even, skin not dry, no throat issues. I hate the cold, but always have. I'll start taking temps tomorrow morning. Thanks...


#11

With heart meds and CoQ10, I thought that there might be more to the story.

I suggested routine labs for the future while on TRT.

"I don't add salt to any food. And if I did, it'd be sea salt."
This is very risky.

Vitamins that list iodine+selenium?

Blood looks very good. But with TRT, watch these numbers as hematocrit can become too high.

Weight loss needs optimal:
thyroid function
E2
cortisol


#12

I don't take a multivitamin. Should I? Should I find one with iodine and selenium? Do you have a recommendation? I really don't like salt and got in the habit of avoiding it because of HTN. I suppose I get some salt from restaurant food and canned veggies??

For a 54 year old guy, I was pretty happy with my physical overall.


#13

Salt is not the issue, it is iodine.

I have seen old people go onto low sodium diets who then end up with hypothyroidism caused by iodine deficiency. The last thing they needed was having their vitality taken away.

Prepared foods and restaurants typically do not use iodized salt, so its all up to you.

Men typically should avoid iron in vitamins and iron fortified foods.

A high potency B-complex multi-vit with trace elements including iodine and selenium, with no iron should be easy to find. Included chromium picolinate would be good too.


#14

I'm on it! Thanks again.


#15

Body temp today.

morning 97.7
3pm 98.1

morning day 2- 97.7
3pm day 2- 97.9

I got a multivitamin with iodine and selenium with no iron today.

Do I need to take temps for several days? Are my temps an indicator for the need to load iodine? Thanks.


#16

Since the experts have forsaken me, I went ahead and ordered the ioderal. I will take 25mg/day for a month.

I had more blood work done on Monday morning and do not have the results. The office is closed and won't reopen until this Monday! I assume I will need to make an appt with the doc before actually getting my prescriptions. I'm going to follow the twice weekly sq injection route for the T. I'll let y'all know what he/we decide on arimidex and HcG. I'm hopeful that I'll be starting the regimen next week. Looking so forward to feeling better!

Merry Christmas


#17

Injection protocol question. Can hcG be injected twice/week or does it really need to be injected EOD? Also, can Test and hcG be injected on the same day and time? Thanks.


#18

Body temps were a bit low. Hopefully response to iodine is good.

Half life of hCG dose not support injecting twice a week. You can try it.

I suggest that T+hCG be done at the same time to make the routine easier to live with.


#19

No problem on the hcG, I was just looking for a short cut...I'll do it EOD.
The ioderal arrives on Wednesday, I'll keep y'all posted on my progress.
I'm awaiting a call from the doc on my latest lab work. He's slammed because of the holidays! Hopefully I'll hear by the end of the day. I'll post new results.


#20

Big surprise, GP isn't comfortable prescribing hcG or an AI. He will refer me to an endo, but I don't have any faith so I'm embarking on a quest to find my own doc. As an aside, I'm a podiatrist and could theoretically prescribe this stuff myself. Hope it doesn't come to that!