T Nation

TRT QUESTION - Possible Repeat


Hey I have attached results of some bloodwork I had done. Trying to convince doctor to get me started on something. Am 48 and main symptoms are low libido, lethargy and poor gym performance. My doc keeps saying that my free test is within range although on low end. My serum test as you can see is below the range. I am a dumb ass but still confused as to which is most important regarding TRT. Any suggestions or info would be appreciated. Ready to start feeling good again. As side note, I maintain a lot of muscle at 235# 14%bf and this adds to my docs thoughts that levels are fine. Can a person maintain a lot of muscle with low test? I guess I know the answer, but curious if thats normal.

Thanks for any help in advance

Testosterone, Serum 221ng/dl range 241-827
Testosterone, Free 8.13ng/dl range 5.00-21.00
%Free Testosterone 3.68 range 1.5-4.20
TSH 2.695ulU/ml range 0.45-4.50
T3 3.6pg/ml range 2.3-4.2
T4,Free(direct) 1.21ng/dl range 0.61-1.76


any thoughts appreciated


Your doc is not very comfortable with hrt. Reading the stickie guides and excellent explanations will show you what is missing. If he/she were comfortable then more hormone levels would of been requested.

Your asking for thoughts so here goes. The whole idea of hrt for guys is a mystery. There is not a clear cut number that establishes abnormal vs normal. Reading medical articles on this the authors readily admit that the tests themselves are imperfect, some advocate the inclusion of SBHG into a calculation to further establish whether a given level is really low establishing the diagnosis of hypogonadism(www.issam.ch is website that gives the calculation tool). I mention this because there is a lot of subtlety that many doctors are not comfortable with and when faced with such things doctors(and like so many others) look for the easy path. "It's normal you are fine". Endocrinologists, Internists, Urologists etc. you can read the forums with many different shared experiences on the negative side.

Let's say you do find a doc whom you can work with, open minded, a person whom you can share legit articles for reputable journals that support your case. Are you ready for the baggage that goes with testosterone replacement? It's not cheap, you need a reliable source for the prescriptions whether you choose local pharmacy or whether you are daring enough to look for an online source.

Now to back up a little, the symptoms you describe could be due to many different things some physical, some emotional, some diet/lifestyle. Your doctor will probably want to explore this stuff well before jumping into something he/she does not understand or even want to undertake.

You may be absolutely convinced test is the problem. Do your self a favor and read the excellent stickies, spend some time reading the many posts before you stick a needle in your ass.


thanks. the only thing that has changed has been some additional work stress. to be honest i was kinda shocked how low my test levels were. nothing else seems to be physically wrong. my only other thought was doing a low dose cycle on my own and see if any of my symptoms improved. certainly not excited about prospect of going on long term trt but am gonna have to so someting