T Nation

TRT, Trying to Figure Out What to Do


~4 months ago doctor tested me an free T, Serum was 384. Suggested I could go onTRT, but have been researching to better understand. Based on the info on this forum I had another blood test ran recently (see below). Any thoughts would be much appreciated. I’m 46, male, 6’2" 195lbs. Have been running into low energy levels and run out of steam during workouts. Also I have noticed a drop off in the “crispness” of my critical thinking skills. I assumed it was age catching up until the doctor talked about TRT and the symptoms of low T. Thanks in advance!


Should not test GH as is has very short half-life and is released in pulses.
IGF-1 is a better measure of GH status than GH it self.

You appear to have primary hypogonadism.

Ever had these tested: TSH, fT3, fT4, T3, T4?

Please follow these links in the 2nd post of 1st forum topic:

  • advice for new guys
  • things that damage your hormones
  • protocol for injections
  • finding a TRT doctor

There is a lot more to physical and metal fatigue than your T levels.


Thanks. Lots to digest here. I did not get all of the items tested, but did get some they are:
TSH 1.690
T4 7.1
T3 33
Free Thyroxine Index 2.3

Other details after reading the threads: 50+% bald and have been for 20+ years, good body temperature typically run hot rather than cold, waist is 36", carry fat around the waist and to a lesser extent the chest.

Thanks again. Lots of good information here.

Added Thyroid panel…


Always need lab ranges.



He’s a 46 year old male with eGFR of 68 - is this of concern?


Added Thyroid panel to earlier post.


We have had the option of fT3 for a long time and that makes T3 uptake and free thyroxine index obsolete, but docs keep using these indirect measures of T3 status.

TSH is a bit high and T4 is a bit below midrange. 7.1 vs 8.25

Low thyroid function can lower energy levels and mental clarity.
This can be from low iodine intake.
What is your history of [not]using iodized salt and/or vitamins that list iodine+selenium?
Do you get cold easily? - no
Are your outer eyebrows sparse?
Body temperatures unknown.

What is oral body temperature when you wake up and also mid-afternoon?


Your symptoms are probably a combo of lower T and some lower thyroid function.

Did you get any ideas reading the suggested stickies?

Your LH/FSH should support better T numbers *. Have you had your testes examine for any physical problems?

  • assuming that DHEA levels are adequate [labs would be for DHEA-S, not DHEA].

You are at an age where one stops trying to find things to get fixed VS accepting age related decline in T levels. There is a hint that the testes are the problem. TRT will improve your quality of life, but make sure that your thyroid is not the weak link.


Additional information:

  • Body temp - before getting out of bed 98.1, mid-afternoon 97.9
  • Yes, eyebrows are sparse on the outer edges
  • It has been a few years since I directly used iodized salt (may have been using via restaurants/processed foods, but unknown). I do regularly eat higher iodine foods such as salmon, cod, tuna, etc. May not be getting enough though.
  • I tend to eat 4-5 times a day. Good balance of protein, carbs, fat, and fiber. Keep sugar below 20% of carbs.
  • Training/exercise is typically 2-4 times a week (1 - 1 1/2 hr blocks each).
  • After reading through the stickies, I thought about injuries/medicines I have been on in the past. * There have not been any injuries (overall or directly to my testes). Recently I was on high blood pressure medicine, but worked my way off it via diet and training. In 8th grade, I took Accutane for acne for about 6 months. DId not have any (known) side effects other than dry skin for a few years, but that is gone now.
  • No physical problems with testes. Morning/sleeping “wood” still occurs, but not as consistently has when younger.