I thought I would chronicle my TRT here since there are so many with knowledge on this site. I’ll take any advice I can get since talking about it is the only way I can learn more about it.
I am a Mechanical Engineer by profession. I also hold a private pilots license. I have learned a lot here as I have been lurking for a couple of years now. This is my first post.
One of the things I am careful about is not losing my private pilots license. The FAA can cancel your medical license (which allows you to fly) if you are taking any prescription drugs that are not approved by them, TRT included. This means that first a pilot has to go to an FAA doctor. That doctor gives them the run down about rules and regulations.
The FAA is mostly concerned that you are not doing anything that will mess with your mind. Nothing that will make you tired or interfere with your reasoning. Certainly nothing that will make you feel low or depressed. So I use caution before a doctor writes any prescription. My FAA doctor referred me to an endocrinologist for TRT.
Having a special written note about your TRT with special wording is needed to keep the medical license required to fly airplanes. Finding an endocrinologist for TRT done right is difficult enough without the FAA looking over their shoulder. My hope is that whatever I experience in my quest for better health under so many watchful eyes will be helpful to others.
After reading the stickies and advice of KSman and others here is my case information.
Height: 5 feet 11 inches
Body hair is minimal
I am carrying weight around my waist and some in my chest. No Moobs but its not muscle either. yuck! I used to be thin and no body fat. Like 2% to 5% when I was in my early 20s. After attaining my first engineering position (behind a desk) Fat accumulated to 10% to 12% with my weight around 165. Since hitting 42 it has been a steady climb to 190. I will exercise and work on my diet and get down to 180 but then I become discouraged and the weight comes back within a few weeks. When I am not working out and working on being healthy my eating habits are poor. So I am sure a permanent change to my diet would do wonders. I will be picking up better eating habits with my new TRT regimen. I will try to post progress (wins and fails) here in general terms. Not every meal.
In general for the last several years I have been feeling less and less energetic. I usually keep very busy but just want to sit and do nothing any more. People used to remark how much I used to get done. Now I get frustrated at what I haven’t achieved. It comes and goes in waves but the waves of energy to get things done are shorter now. I have become frustrated enough that concern of complicating my pilot license medical has be overtaken by concern of just being productive. Sex drive to me is a relative thing. I still have sex drive but it is not like it used to be. I would say it is about 25% of what it used to be. Instead of an enthusiastic Hell Yea! twice a day its more of a yea, okay once a week. The function is still there but its not everything it used to be. Nocturnal wood at times but becoming more rare. Morning wood at times but becoming more rare. Used to be every day in 30s now it is once every two weeks or so.
I am not taking any nor have I ever taken any hair loss or prostrate drugs. I do use Nyoxin hair shampoo and conditioner with a scalp gel. If that is important.
Training is weak. I would like to go more but just don’t. Diet is good (calculated and monitored) when training. When I’m not training then it is whatever satisfies the moment. Usually not healthy. So there is work I can do here.
Last but not lease here are the lab results. I’ll try to hit the important numbers. Let me know if there are others you want to see.
Labs done by LabCorp
Total Cholesterol: 184 mg/cL Range 100 - 199
Triglycerides: 64 mg/cL Range 0 - 149
Iron, Serum: 60 ug/cL Range 4- - 155
TSH: 1.290 uIU/mL Range .450 - 4.50
LH 3.4 mIU/mL Range 1.7 - 8.6
FSH 4.4 mIU/mL Range 1.5 - 12.4
Prolactin: 5.9 ng/mL Range 4.0 - 15.2
Free Testosterone (Direct) 4.4 pg/mL Range 6.8 - 21.5
Estradiol: 26 pg/mL Range 0 - 53
Vitamin B12: 323 pg/mL Range 211 - 946
Folate (Folic Acid), Serum 13.9 ng/mL Range >3.0
Cortisol: 7.9 ug/dL Range 2.3 - 19.4
Prostate Specific Ag, Serum 1.0 ng/mL Range 0.0 - 4.0
Vitamin D, 25-Hydroxy 13.9 mg/mL Range 30.0 - 100.0
Things of note. Low free T and Low Vitamin D.
On first visit I explained that we were in this together and that I would have questions about what he was requesting or prescribing. He said that was fair and we proceeded with the exam. He did not request E2 lab so I talked about E follows T and that I wanted a baseline on E2. He agreed that was a good idea but normally only requested that with men with gynecomastia. With this I though I was getting a doctor that was willing to listen.
Tests came back a week later and the doctor suggests Androgel 1.62% and Vitamin D 5000 units per day. I have requested T-cyp injection twice a week (he countered with once a week) I figure what he doesn’t know won’t hurt him, and I’m okay with the Vitamin D. I have asked for AI for the reasons stated in the stickies. He said no because my E2 was low and I didn’t need it. This tells me he doesn’t quite get it yet.
I also asked about testes shrinking and not producing pregnenolone. He agreed this was important, but countered that my LH was within normal range and so my brain was sending the right signals. Just my testes were not responding. I countered that yes but when the T is inserted into the system then the brain would stop sending the signal and LH would drop off the radar and the testes would retract. I then asked about HCG and its use. He pushed it off and said it was not FDA approved. Implying he could not prescribe it. Any thoughts or help on this would be appreciated. I have bounced this all off of my FAA doctor and will call my endocrinologist to have him write the prescription for t-cyp in the morning.
I will also hit him up again with the AI and a dosage. He treats a lot of women so he may be thinking I want those high dosages. I will suggest the 1 mg KSman suggested in his sticky.
Thoughts or observations on the test results or conversations are welcome. I’ll check in tomorrow with what is prescribed.