T Nation

Thinking About Stopping TRT. Any Advice Based on This Bloodwork?

I started TRT as prescribed by the doc in 2017 at the age of 36 with 5g of 1% Androgel daily. Doc said my test was “within range” but I told him that I was lacking drive, started to have mild ED and no morning wood some days so he said we could try TRT.

I am 6’, about 210 lbs with some extra body fat (maybe 25%?) but at the time I was closer to 190 lbs and about 18% bf which was about the leanest I’ve ever been. Used to lift weights for about 7 hours a week and eat a low carb, low fat diet with very limited alcohol and sugar intake. Always struggled to build muscle. Now, for the past year or so I’ve been getting more carbs and fat as well as alcohol and sugar on the weekends and only lift about 4 hours a week. I take a daily multivitamin and Omega 3.

I started to feel better immediately after taking androgel but that didn’t last. My pharmacy was substituting a generic brand called Taro. I later (probably a year) realized that Taro just didn’t work so I ensured that I always got Androgel after I figured that out. Results were positive but not life changing. Fast forward to today and I’ve been finding the original low T symptoms seem to be back. Additionally a nurse said that my blood is really thick now too… She tried to get a sample to test blood sugar and she couldn’t get it to run enough… Had to try a couple times.

I got my blood work from my doc from when this all came about in June 2017. Second blood tests were from Oct 2017 after TRT. It’s obvious that the initial blood tests weren’t nearly as thorough as the third one taken Apr 2018. Haven’t had any blood work since for some reason and I’d like to get in to do that but I’m not sure how possible that is going to be with the pandemic going on right now.

Can anyone shed any light on this blood work? When I go back, should I ask for any other tests? My doctor doesn’t give me the impression that he knows what’s up. He said that my estradiol is fine but I’m suspicious.

Ranges in [brackets]

June 2017

B12 388 pmol/L [156-672]

LH 2.06 IU/L [1.5-9.3]

Prolactin 7.22 ug/L [2.1-17.7]

Albumin 41 g/L [35-50]

Testosterone 27.46 nmol/L [8-32]

Bioavailable Testosterone 3.98 nmol/L [2.5-10]

SHBG 57.7 nmol/L [13.5-71]

Oct 2017

Albumin 40 g/L [35-50]

Testosterone 37.38 nmol/L [8-32]

Bioavailable Testosterone 5.82 nmol/L [2.5-10]

SHBG 62.4 nmol/L [13.5-71]

April 2018

Albumin 42 g/l [35-50]

Testosterone 34.02 nmol/L [8-32]

Bioavailable Testosterone 5.28 nmol/L [2.5-10]

SHBG 61 nmol/L [13.5-71]

B12 397 pmol/L [156-672]

Estradiol 131 pmol/L [0-146.1]

FSH 1.4 IU/L [1.4-18.1]

LH 0.77 IU/L [1.5-9.3]

Prolactin 4.32 ug/L [2.1-17.7]

Total Bilirubin 8 umol/L [3-17]

Direct Bilirubin 1.4 umol/L [0-3]

Aspartate Amino Transferase 14 U/L [15-37]

Alanine Amino Transferase 33 U/L [16-63]

White Blood Count 3.8 10e9/L [4.0-11]

Red Blood Count 5.0 10e12/L [4.5-6.2]

Hemoglobin 154 g/L [130-175]

Hemoglobin A1C 5.2% [4.5-6.2]

Hematocrit 0.47 L/L [0.4-5.4]

Mean Corpuslar Volume 93.6 f/L [76-96]

Mean Corpuslar Hemoglobin 30.8 pg [27-32]

Mean Corpuslar HBG CONC 329 g/L [310-360]

Red Cell Distribution Width 0.127 [0.115-0.145]

Red Cell Distribution Width SD 42.6 fL [35.1-43.9]

Platelets 9.5 fL [150-400]

Mean Platelet Volume 9.5 f/L [7.4-12.4]

Neutrophils (Auto) 0.36 [0.4-7.4]

Lymphocytes (Auto) 0.5 [0.19-0.48]

Monocytes (Auto) 0.13 [0.03-0.09]

Eosinophils (Auto) 0.01 [0-0.07]

Basophils (Auto) 0.005 [0-0.015]

Neutrophils # 1.4 10e9/L [1.9-8]

Lymphocytes # 1.9 10e9/L [0.9-5.2]

Monocytes # 0.5 10e9/L [0.2-1]

Eosinophils # 0.0 10e9/L [0-0.8]

Basophils # 0 [0-0.2]

TSH 0.574 mIU/L [0.358-3.74]

Ferritin 293 ug/L [26-388]

PSA 0.38 ug/L [0-4]

I really appreciate any help you can give.

Labs are useless without range

Thanks for the info. I’ve updated the post.

Why were you on therapy
Your levels are high in 2017

Was just grasping I guess :man_shrugging:

If you’re thinking these are low T symptoms, why not try testosterone injections?

I would stop the gel and go to injections or cream, either would probably help you better than Androgel

Stop the gel, start injections, done.

The statement that your T is/was ok or high is wrong. Free T is what matters and is still low or on the lower end at the very least (due to high SHBG).

Was never provided with the option to inject. Been reading on how to lower SHBG for the past hour… Seems like a tall order.

When I read your reply I couldn’t help but think maybe I could stop the TRT and just figure out how to lower SHBG… After reading for an hour about everyone else’s efforts to reduce SHBG I’m starting to think I’m wasting my time with the notion that I’d be able to do that without just following your advice on injections…

I guess I’ll have to ask the doc about injections… Maybe I should find an endocrinologist or do my own research first because my doc doesn’t seem to be very knowledgeable in the area. I’m kind of worried I’m going to make matters worse somehow.

Really appreciate everyone’s feedback.

Honestly I don’t think that your symptoms are testosterone related at all. Most studies point to testosterone being the cause of ED and low libido only if testosterone levels are low/very low.

Lowering SHBG on it’s own is next to impossible… Mine was 150+ when I started TRT so I was investigating the same thing but basically the only things that I could find that lower SHBG also shut down natural production, so you end up needing TRT anyways. Since then most people I’ve seen take Danazol still had issues with not feeling very great despite it lowering their SHBG. IMO you’re better off increasing T as much as necessary (If that is your issue) and letting SHBG do whatever it does. Get to the free T that works for you with T only is what I would suggest

It’s really really tough to find a doc that knows much about TRT. Lots of us have switched to clinics that specialize in it, though even then there are tons of them that suck.

The standard of care that most endocrinologists follow is 200mg every OTHER week, which is both a fairly low dose if you look at it on a weekly basis, and it’s not nearly often enough to give stable enough levels to feel normal all the time. If it were up to me, most people should start at 150mg/week, injected 3x a week (I do Mon/Wed/Fri)