T Nation

Total T is Low-Normal. TRT Potential?

Came across this forum after getting my lab results back from a testosterone test. I have been suffering from many of the general symptoms of low T (fatigue, irritability, moodiness, depression, etc.).

I just wanted to see what my level was and the results came back at the lower end of the normal range, 291ng/dL. The lab’s range was 250-827.

Since I never had a test level done before, I am not sure if this is “normal” for me, or not. But I can definitely say the symptoms have been worsening over the last 18 months or so.

Would it be worth getting in with a TRT clinic or are my levels normal enough to not warrant further discussion? I don’t want to waste my time going somewhere if my levels are within expectations.

To clarify my situation, I’m 36, struggling with weight (5’10 and 290). The test was performed at 8:00 am and I had just finished up at the gym before the appointment time (after a shower). So the level was probably on the higher end of the average day/time.

No, TRT is not appropriate right now. It’s not about your levels, it’s about…

Spend the next 120 days viciously attacking fat loss before spending the next 45 years on medication. Start a training log, lay out your current training and diet, and go from there.

Dropping 40-50 pounds will be much more beneficial than simply adding Test to your current situation.

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This.

High levels of bodyfat will absolutely tank you T levels. If you get down to 200lb your hormone profile will be unrecognizable compared against the one you just had.

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5’10” 290lbs is obese. No nice way to say it. You’re feeling worse because your body was not meant to carry that much weight and it gets harder every day. At age 36 it will be harder than it was at 34 or 27. And it’ll be even worse when you’re 37. Get your diet under control immediately and you’ll be amazed how fast you drop the weight and how much better you feel.

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Thanks, Chris.

I know it is a major driving force. I’m down 35 lbs since the end of March. I am religious in my macro tracking which is relatively easy given the diet I’m following – 150 grams of protein through lean meat - either chicken breast of tuna, and 3 cups of fiberous veggies (green beans or asparagus) and a gallon of water every day – and I am in the gym 3-4 days a week.

The LP I’m on has shown some moderate improvement in physique (down 2 pant sizes) but I have not experienced any improvement to my quality of life in terms of fatigue, motivation, self-confidence, depression. It is a daily struggle.

But thanks for the advice. I am going to soldier on and hopefully have the remaining weight dropped within the next 160 - 180 days.

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That’s, like, per meal, right? That’s not all you eat all day long?

Awesome to hear you’ve dropped some serious weight already, but if you’re literally starving yourself on a low calorie, low fat, low carb, relatively low protein diet, that only leads to trouble.

What’s your target?

No, it’s per day. But I had a typo. It is 250 grams of protein.

After doing some reading I came across the RFL, I can’t remember the author’s name. It is similar to a keto plan, but without the fat. Basically 0.85 grams of protein per pound.

The yellow-fin tuna I have contains roughly 8.8 grams per ounce which results in almost 2 pounds of tuna. The chicken breasts from Kroger has roughly 5.5 grams per ounce which results in almost 3 pounds of chicken per day. I am not really ever hungry, except when it comes to dinner time (I work from 6 am - 3pm and it is an hour commute so dinner is roughly around 5-5:30).

I will admit I have had my off days, namely submitting to my gummy worm addiction, but I have been doing this fairly regularly since the end of March. I do not think the diet is having a direct impact on how I feel as the symptoms have been occuring for the past 18 - 24 months and have been steadily increasing in magnitude and thus the basis for me to have my T checked.

My target weight is currently 220.

Be careful of these TRT clinics, most of them force infrequent in office weekly injections that is suboptimal for a lot of men, your protocol should not be a one size fits all, everyone’s injection frequency will be different and SHBG levels can be a big factor because low SHBG men tend to metabolize and excrete testosterone more quickly then say a high SHBG man.

Your levels are normal for my father who is 87 years old and scoring 293 ng/dL, he naps throughout the day and has low energy and can be irritable and grumpy at times. We do not yet know your Free T, SHBG or estrogen levels.

If you think you can start TRT with just knowing your Total T, TRT is going to be a disaster for you. You cannot design a TRT protocol without knowing the above mention hormones.

So if we go by the data collected below, your Total T is lower than a 100 year old man.

Yrs old
25-34 = 617 ng/dL
35-44 = 668 ng/dL
45-54 = 606 ng/dL
55-64 = 562 ng/dL
65-74 = 524 ng/dL
75-85 = 471 ng/dL = President Trump
85-100 = 376 ng/dL
100+ 291 ng/dL = you.

Testosterone Threshold for Increased Cardiovascular Risk in Middle-Aged and Elderly Men:

The locally weighted regression showed that total testosterone levels of 440 and 480 ng/dL were associated with increased Framingham CVD risk and an increased probability of increased hsCRP, respectively. Men with sexual dysfunction (poor sexual performance, decreased morning erection, and loss of libido) had significantly greater CVD risk.

Absolutely, but you need to find an anti-aging or sports medicine clinic that specializes in TRT and not just selling the same package to every man that walks in the door. If they do not test for Total T, Free T, SHBG and estrogen sensitive, walk away.

systemlord,

I wasn’t thinking of simply using the one variable as the deciding factor to start a treatment, but was merely used as a guide to indicate there could be underlying issues with my testosterone levels.

I am far from deciding on a path forward aside from continuing down my current path. Though I do appreciate the words of warning. I’m significantly more risk-averse and wouldn’t even consider making a life-altering decision on a single variable that may or may not be accurate.

*EDIT: To add: I was able to get into the lab testing center quicker than it was to get into my primary care provider, thus I just had the simple Total count done (only one that was available) just to provide me with additional information that would help me chart the next step.

A large percentage of men never know why testosterone is low, guys who have testicular failure or a pituitary tumor have a reason for a low testosterone diagnosis. Testosterone is declining rapidly in western civilization and no one knows why exactly, it’s thought to be many things like pesticides, processed foods, sedentary lifestyle and living in and around heavily populated cities.

If you think you can go to an ordinary doctor (GP, endo, uro) for hormonal problems related to sex hormones, it’s excluded from medical school and most steer away from TRT and are clueless. Your GP is untrained and did not testing the free portion of testosterone circulating in the bloodstream which would be affected by your SHBG levels.

According to the guidelines prolactin and LH should be tested to investigate low testosterone, an MRI is needed as well to check for pituitary tumors.

Up to this point I have no preconceived notions. I have no knowledge of the appropriate path, and am currently conducting due diligence to identify the appropriate course of action to take.

If it’s the plan from Lyle McDonald, I believe that’s meant to be a very short term program, not something to be done for months on end. The Green Faces plan is a similar-but-different approach you could consider transitioning to.

The diet may not be a direct cause if symptoms started before you began the diet, but it’s definitely not helping in the sense that a low fat diet can compromise natural Test production. Also, before you started the diet, you were 330+ pounds. That level of bodyfat will send your hormone levels wonky.

I’d put a pin in any more research/thinking into TRT and divert that mental energy towards the diet and training. Talking to a clinic right now is like a guy with a broken leg going to the shoe store. Doesn’t matter what you find out because there’s more important stuff to deal with first.

Get some quality fats in your diet. People think eating fat is bad because it has the word ‘fat’ in it. It’s good to have a balance, but don’t go overboard. Add an avocado a day. Throw in some high fat yogurt (the less sugar the better).