T Nation

To HRT or Not to HRT


I have been recently tested for my testosterone levels and came up with 15.9 nmol/L (or about 450 ng/dL) low normal according to my physician. My SBHG (I think it's called) was about 50, giving me a free androgen index of about 30. I didn't have any other tests done, like estrogen etc. This is all from memory, I don't have the results in front of me, but it should be fairly accurate.

I have a few of the textbook symptoms of low test - lethargy/lack of energy, some difficulty sleeping, etc. but not all of them, and not with any extreme severity. I'm also quite young (38).

So the question is, with borderline test results, and only minor symptoms, should I start HRT, a treatment that I'd be on for the next 40 years (god willing). Or am I better off trying to put it off for the next 5-10 years?

On a related note, injections and pills (andriol I believe it's called - the stuff that's absorbed through the lymphatic system) are covered by my provincial drug plan, cream and patch aren't.

What's the best delivery mechanism to start with if I decide to go ahead, given that androgel, the stuff that most people seem to start out with, is gonna be a lot more pricey than the injections or pills.


There are others who are a lot more experienced and knowledgeable than I, but if it were me, I would want ALL my levels (E, E2, FT, etc) checked before making a decision. If you decide to wait, at least have everything checked anually to establish a trend.









I'm guessing E is estrogen, but what are E2, FT and etc. referring to? What tests should I be asking for?


E2 - Estradoil. Its the nasty estrogen.

FT - Free Testosterone.

Check out those links.


estrone [E1], estradiol [estradiol-17 beta, E2], and estriol [E3])

This is a real useful site:




Your symptoms could be caused by issues other than testosterone. At 38, I'd be concerned about starting HRT unless I was absolutely sure that it was my only hope. Do you plan on having any children? HRT can make you sterile.

First off, get a complete blood workup including the thyroid hormones.

I'd also want to examine my nutrition and lifestyle choices.

In other words, do everything you can to eliminate the problems you're having before you turn to HRT. Your testosterone numbers alone don't really tell you much when you're in the range you're in.


Yes, injections are less expensive. I do not think that your T is low enough to get TRT. You really need to post E levels as well as %BF. E can spoil the effects of what T you do have. If you did not get E BW, go back for that. You need to get copies of all of your blood work and start to understand these things. Perhaps you can deal with a E problem and feel better.



Please move this post to the "over 35 lifter: forum.





That's low, no doubt, but is it HRT low? I'm on the fence. I think you'd probably jack that level over 500+ easily with some supps. Stuff like that Alpha Male and TRIBEX or what ever tribulus supplement you choose can help you. There are other things you should consider. If you have been training hard, and say your test was done later in the afternoon, you levels in the morning could have easily been pushing 600 nl/Dl. Acouple of days off could push you test levels up too. Zinc/Mag. supplementation should also help.

I'd say you on the cusp, but I don't know if I would have done HRT if I was over 400, I would have tried other methods. I was tested within 2 hours of being awake in the absesnce of stressful exercise in the surrounding days and I scored in the mid 3's. I chose to do it, because I believe my factors are genetic and my plasma levels when they should have been highest, were very low. By early afternoon/evening, I would have been in the 2's easily.

HRT is a pain in the ass, to keep up with, but absolutely worth it if you need it.
Being on the border, as you are, you can try two experiments. As is, go get tested again firsthing in the morning when the office opens after a couple of off days from the gym. Or, try the supplementation and get tested in the morning and see where it puts you.
Obviously, if you end up with HRT, go for the max dose....:wink: