T Nation

TRT For Mood Improvement?


#1

Im a male, age 29, in very deep Keto dieting which is the only diet to keep me at the lowest weight which is at 267lbs at 5ft 8, BMI 41 (morbid obesity) with great muscle tone.

link to the complete labs CBC https://goo.gl/xpHhUd

FSH 1.5 (1.5-12.4)
LH 2.3 (1.7-8.6)
Estradiol 25.9 (7.6-42.6)
Testosterone Total 123 (348-1197)
Bio avail T-84 (48-317)
Free T- 36 (20-135)
SHBG 13 (10-57)
Glucose Fasting 106 mg/dl (70 - 99) mg/dL
TSH 2.53 (.35-3.3)
VITAMIN D, 25 HYDROXY (33.3) ng/mL (20.0 - 50.0) ng/mL
PROLACTIN (10.7) ng/mL (3.5 - 19.5) ng/mL
VITAMIN B12 (658) pg/mL (213 - 816) pg/mL
PSA SCREEN (0.5) ng/mL (0 - 4.0)ng/mL
FERRITIN (134) ng/mL (22 - 322) ng/mL
IRON TOTAL (59 )ug/dL (42 - 135) ug/dL
ALBUMIN (4.2) g/dL (3.4 - 4.8) g/dL
Hematocrit (48) (37-51)

Lipid Panel

CHOLESTEROL 186 mg/dL 0 - 200 mg/dL

HDL CHOLESTEROL 28 mg/dL >=35 mg/dL (Low)

LDL CHOLESTEROL CALCULATION 126 <130mg/dL

TOTAL CHOLESTEROL:HDL RATIO 6.6 <4.0 (High)

TRIGLYCERIDE 162 mg/dL 35 - 160 mg/dL (High)

NON-HDL CHOLESTEROL 158 mg/dL 0 - 160 mg/dL

Update 12/21/16= Endocrinologist said that because my Free T was normal that he was not allowed to start TRT. The only way we could do it is off label for obesity except Free T has to be below normal as well as Total T in order for us to start TRT. I am interested in how to lower Free T for the next blood lab to get on TRT or should i be looking for another doctor?


#2

Hello friend!

We are almost exactly the same in history, situation and other details. I've been on this journey for years and I am 35. I started when I was 29 as well. No history of steroid use and tried many, MANY different medications for High Blood Pressure, depression, anxiety, sleeplessness.....you name it. None of them worked and realized the doctors were only treating the symptoms and not the causes. It has been a long road, and it will be for you as well, but please reach out with any questions so that you can bypass some of the missteps that I've made. Also, at your age, try to take HCG or other "reboot" drug to see if you might be able to get your natural production up and running. My numbers were that low and there was no salvaging my own production.

  1. Make sure you're going to an experienced TRT endo doc and not your GP
  2. TRT can make you feel better, but it is not instant and the constant balancing act of hormones can be tiresome.....be mentally prepared for the marathon, not the sprint to "Heroic God feeling" so many TRT patients hope for.
  3. Read all about dosing. Injections twice a week at smaller doses are typically far better than other cycles....don't do the "once every month" or "every two weeks stuff that many doctors prescribe as this will cause the "rollercoaster" effect that many of us were on for months or years.
  4. Don't wait to get an e-inhibitor. (Anastrozole for example) You and I are the same size and you will most likely convert a large amount of that newly injected T into lots of E. That is the balance that is so hard to find over the lifecycle of TRT.
  5. Learn to do the injections yourself....going back and forth to the doctors is not good.
  6. Almost every insurance will not cover the level of TRT that you need. Get ready to pay out of pocket for the ideal TRT program.
  7. Do not try gels!!! waste of time.
  8. Pay particular attention to adrenal fatigue and liver functionality. I'm now free of the following items in my diet: gluten, casein, drug (always have been), alcohol, caffeine and other foods that I found that I was allergic to. I'm also eating organic, taking vitamins for liver and vitamin D and drinking tons of caffeine free green tea and water.
  9. Get an allergy test....found out that I'm allergic to a lot of things, including beef :...(
  10. You've got to figure out what caused this low T initially. Mine was stress from childhood abuse and massive adrenal fatigue that taxed my mind, body and hormones to almost extinct.....literally!!

There will be more, but i wish you luck and will be chiming in whenever I can help.


#3

Sorry to jump in here but LongJourney can you give us some more info on your adrenal fatigue? Diagnosis and treatment etc

Thanks in advance


#4

In a pre-TRT context, TT is typically the better indicator of one's T status than FT. FT is released in pulses and has a short half-life, so labs for FT and Bio-T are variable and results can be heavily influenced by random lab timing effects. In both cases TT is low.

LH/FSH indicate that you have secondary hypogonadism.

Your body weight is made worse by low T. But could also be from low thyroid function. You can check your overall thyroid function by checking oral body temperatures as per the thyroid basics sticky. If you have not been using iodized salt long term that is a strong factor. If outer eyebrows are sparse, you have a problem.

At your age, you need to be finding the root cause of this, not masking the symptoms with TRT without looking deeper.

Labs:
TSH
prolactin!!!
CBC
hematocrit
fasting cholesterol
fasting glucose
A1C
DHEA-S

Please read these stickies found here: https://forums.t-nation.com/t/about-the-t-replacement-category/38/2?u=ksman

  • advice for new guys - please provide more info.
  • things that damage your hormones
  • protocol for injections
  • finding a TRT doc

You will find that doctors are the biggest problem.

Yes there are mood problems and you can expect to mellow out.


#5

kodarian,

To answer your question, I feel better at 1100 than I do at 600 for sure. And I’d bet most men on TRT do. You also have to keep E2 right in the middle of the range.

Shoot high, but DO NOT let your total T rise above lab normal values, this will put your health at risk and most likely give you some nasty side effects. Expect lots of trial and error, but a good starting point for someone your size is:

150 mg Test Cyp per week injected EOD
1.5 mg Arimidex per week divided into daily doses
250 iu HCG injected EOD

Good luck!


#6

Just wanted to chime in:

My latest Natural T level was 660 (which was damn good for a 49 year old). I had been fluctuating for a while and had symptoms even at that level and I recently went on some HCG which brought it up to 962.

All I can tell you is I feel a world of difference in the upper normal range. I also added in 2 pumps of Androgel and lowered the HCG amount - and feel totally amazing!

Not sure if this feeling will wear off because it’s just new - but It has completely reversed all previous physical ailments I’ve had - including giving me a feeling of well being I have not experienced in decades.


#7

Thank you for your help. Good to know Free T is inaccurate indicator and TT is a better standard.

I have updated labs and doctor appointment results that you requested posted in the original post up top. The only one missing is DHEA-S from your list.

Thanks for your help.


#8

Thank you Surfer, We will use your TRT recommendation as our standard protocol.


#9

Thanks Longjourney,

We plan on following your list of instructions. We are looking forward to the mental marathon. Thanks for the fat = more E so starting an e-inhibitor is what we will do. Gels are out anyways as I am a massage therapist. We eat cruciferous vegetables only, no gluten, or drugs.

How did you get an allergy test? Our Doc refused to give us one.


#10

I am really suspicious that that you do not use iodized salt and would then be iodine deficient.

Please check you oral body temperatures to eval your overall thyroid function, this is quite critical and a common problem with guys here.

TSH is normal, but should be nearer to 1.0
Many with TSH levels like yours have serious quality of life issues.


#11

Honestly you may be correct because about a year ago my TSH was 1.0. I was taking Nacent Iodine. I will restart the supplement, it provides 150mcg a day, over a thousand servings per bottle. they make great stuff. We are calling Kingsberg Medical as they are specialized in TRT and they take insurance.
Here is a helpful list of Medical TRT Clinics that take insurance!

http://www.lowtestosterone.org/find-a-clinic/


#12

You can elevate your T with Tribex and other supplements. It is preferable to do it naturally IMO, and avoid the damn doctors.

Otherwise I personally wouldn’t know what to say, especially about intentionally lowering your free T. However you decide to go, best of luck!


#13

Thanks for your suggestion. We have tried all the natural ways and they do not work because of how each felt subjectively bad with different side effects like taking medication. We found out that spearmint at 4 grams twice a day lowers free T by more than half in a week with negligible effects on estrogen. However, the endocrinologist suggested we see a cardiologist first. He said this because of our past heart surgery. We told him donating bloodn lowers hematocrit to prevent heart attack and stroke because he kept saying we don’t know what the long term effects are about the heart. And we kept showing studies its safe. We are going to see a cardioloist and praying this will make him happy and we will begin TRT. We will update with more results.