T Nation

TRT Help Please

HI any help/advice would be greatly appreciated.

Went to the docs with ED problems and he did some blood test. It cae back that I had borederline thyroid results and low testosterone. Sorry I don’t have the results. I also suffer with low growth and strength increases and low moods.

He has given me testogel and told me to come back after 4 weeks and some more blood tests.

The testogel has improved my mood a bit but not much else.

Can you please give me some background info of what to ask him when I next have my appointment.

Thank you in advance

Get your complete labs with ranges postes asap. Thats the only way you will get any advice here.

How much gel are you on? gel converts to e2 more freely than injections so your e2 may have also elevated when you started the gel causing little to no noticeable difference.

With thyroid problems, you are part of a group that is famous for not responding to transdermal T.

Read the advice for new guys sticky.

Read the thyroid basics sticky.

  • report AM and mid afternoon body temperatures
  • report your history of iodine intake: iodized salt and in vitamins that list iodine

Always get and retain your lab reports. You need to take control of your health care. You cannot be passive.

Hi I’ve ben back to the docs for the results;

visit 1
GFR calculated abbreviated MDRD =>= 90
LEVELserum gamma-glutamyl transferase level = 20 U/L original result 20u/l (0-50)
serum alkaline phospahtes = 54 U/L Original resultr : 54u/l (0-125)
serum alanine aminotransferase = 21 u/l original result: 21u/L (0-41)
serum bilirubin = 8 umol
serum albumin 47g/l
serum creatinine = 81 umol/l
serum urea level = 5.7 mmol/l
serum pottassium 4.7mmol/l
serum sodium = 141mmol/l
serul ldl cholesterol =4.67 mmol/l
erum hdl cholesterol = 1.25 mmol/l
seum triglycerides = 1.71 mmol/l
serum cholesterol = 6.7 mmol/l
serum TSH =5.33mU/L Hgh original result :5.33mu/L (0.0-5.0)
serum testosterone 11.1 nmol /l
serum t4 level = 13.9 pmol/l

After 4 weeks of Testogel , 1 sachet per day

serum testosteron = 8.6nmol/l

-age: 31
-height: 6ft
-waist: 36 in
-weight: 210lbs
-describe body and facial hair: slender body, fat on stomach . receding hair facial hair grows patchy.

-describe where you carry fat and how changed: I carry most of my fat at the stomach

-health conditions, symptoms [history]: Ed problems. Inability to develop muscle since aged21 despite powerlifting. Strength gains are lost very quickly.speech problems. Socially quite
Any thoughts much appreciated

useless without lab ranges, [edit] in your post above, lower RH corner.

T-gel lowered T, so you are a non-responder

  • that suggests hypothyroidism
  • TSH suggests hypothyroidism
  • hypothyroidism makes you fat and can lower T

Please see my 02/05 and cover all of the issues there.

Needed lab work:
TT
FT
E2
LH/FSH, should always be done before TRT, stop TRT for 10 days to get done
TSH
fT3
fT4
prolactin

Can you please explain what the acronyms are so that I can ask the specialist to do the test .

Also can you please explain why I should get LH/FSH, tested before TRT. Any advice on how to approach the specialist would also be great. As I am a NHS patient rather than a paying patient in the USA the tests and routes explored are at the discrestion of our doctors.

Thank you again

Will get back with my temperatures and results asap.

TT
FT
E2
LH/FSH
TSH
fT3
fT4

All in the advice for new guys sticky.

Still need lab ranges.

Hi I’ve ben back to the docs for the results;(Directly copied from the doctors notes I hope this version contains the lab ranges?)

visit 1
GFR calculated abbreviated MDRD =>=90
serum gamma-glutamyl transferase level = 20 u/l Original result 20 U/L (0-50)
serum alkaline phosphatase = 54 U/L Original result 54u/L (0-125)
serum alanine aminotransferase = 21 U/L Original result 21 u?L(0-41)
serum bilirubin = 8 umol
serum albumin 47g/l
serum creatinine = 81 umol/l
serum urea level = 5.7 mmol/l
serum pottassium 4.7mmol/l
serum sodium = 141mmol/l
serul ldl cholesterol =4.67 mmol/l
erum hdl cholesterol = 1.25 mmol/l
seum triglycerides = 1.71 mmol/l
serum cholesterol = 6.7 mmol/l High
serum TSH =5.33mU/L High original result 5.33mu/L (0.0-5.0)
serum testosterone 11.1 nmol /l
serum t4 level = 13.9 pmol/l
Score 0.6 Method:QRISK2 for :Cardiovascular diseases

After 4 weeks of Testogel , 1 sachet per day

serum testosteron = 8.6nmol/l

-age: 31
-height: 6ft
-waist: 36 in
-weight: 210lbs
-describe body and facial hair: slender body, fat on stomach . receding hair facial hair grows patchy.

-describe where you carry fat and how changed: I carry most of my fat at the stomach

-health conditions, symptoms [history]: Ed problems. Inability to develop muscle since aged21 despite powerlifting. Strength gains are lost very quickly.speech problems. Socially quite
Any thoughts much appreciated

T-gel lowered T, so you are a non-responder

  • that suggests hypothyroidism
  • TSH suggests hypothyroidism
  • hypothyroidism makes you fat and can lower T

Hard to work without the lab range data.

Please review my prior posts for things that you need to do and appear to have overlooked.

Read the thyroid basics sticky.

  • do you have dry skin?
  • brittle hair or nails?
  • get cold easily?
  • have low body temperatures?

Hi back to the specialist tomorrow can you please explain

LH/FSH, should always be done before TRT, stop TRT for 10 days to get done

Also I do have brittle hair, get cold easily and have dry skin.

Thank you again for all of your time help and knowledge

If you read the advice for new guys sticky you can answer "LH/FSH, should always be done before TRT, stop TRT for 10 days to get done " yourself. You need to read that stuff!!! TRT shuts off LH/FSH. You need LH/FSH to understand what is wrong.

Also I do have brittle hair, get cold easily and have dry skin.: You have hypothyroidism.

Read the thyroid basics sticky.

  • report AM and mid afternoon body temperatures #$%%$^$%^$%^$#%$#%@#$%@#$#@$@
  • report your history of iodine intake: iodized salt and in vitamins that list iodine ditto

You have a reading disability, do your home work, post the requested info.


serum testosterone 11.1 nmol /l

After 4 weeks of Testogel , 1 sachet per day

serum testosteron = 8.6nmol/l

We know that inability to absorb T is a symptom of hypothyroidism. And testogel lowered your T levels. You will need to inject T, you cannot use Transdermal T products. Very few docs have any understanding of this ‘syndrome’.

We cannot help you if you will not cooperate.

Hi again sorry for not doing all that you need to help.

My morning body temperatures have been ,soryy but I have not done afternoon temperatures. These were all taken a week apart from each other.

36.6
36.6
36.6

my latest results are
testosterone 9.3 nmol/l 10.0-28
Serum SHBG 33 nmol/l 14-71
free testosterone 0.18 nmol/l 0.25 - 0.79
Luteinising Hormone 2.3 IU/L 1.7-8.6
Prolactin 107 mU/L 86-324
Serum FSH level 2.0 IU/L 1.5-12.4

He diagnosed me with Primary Hypogonadism due to testicular failure. I have a normal sperm count and am going to freeze sperm as my wife and I want children. He has mentioned Clomiphene treatment at the point we are ready but until then basic TRT probably Nebido. He has not taken any E2 reading, I will insisit at the point before I go on TRT. Are their any other tests that I should insist.

Can you please explain/help /give me feedback.

Thank you again for your time and effort and sorry for the earlier post errors.

Sorry I forgot my iodine intake

Many years of sea salt consumption - recently moved to iodised salt , perhaps for the last 6 months
No vitamin supplementation until reading this site I now probably 5 days out of 7 take an Omega oils capsule and a multivitamin that contains Iodine 150 ug 100% EC RDA

A reading disability eh… Ksman you are a dick to people and u don’t answer the questions… Some people might not understand and alot of people here have brain fog so get off your high horse…

Testicular failier? Lh and fsh would be elevated…

You look like secondary to me…

What are they doing about the thyroid problem?? This is a real problem and it needs to be addressed… Sounds like you need a new doctor bud

Do not start iodine without checking antibodies…

Iodine at 50 mg can be dangerous period…

Look on page 18 if you want reassurance

Your doc is wrong

Thank you , is that good news ? What treatment would you suggest or what should I say to my doc?

I suggest treating the thyroid…

Step one: demand a thyroid ultrasound

Step two see a good endocrinologist who is versed in thyroid well, do your research on doctors and ask to see the one you want.

Step three retest lh and fsh and testosterone after your thyroid numbers are back online.

When dealing with thyroid issues( I also am and have tried trt) one may feel worse or not at all better on trt. The metabolic demands of the replacement may be to much for you to handle.

Secondary is much better then primary in the fact that you may have a chance to get the pituitary working again.

Do I have hyper or hypo thyroidism? what should normal ranges be? can you recommend a good place to read up on thyroid issues pleas?

Lol ask your doc why you have normal sperm count with testicular failier??

If they were failed would they work?!

U could try an hcg challenge if this increases testosterone you would be called secondary and ur balls are fine…