T Nation

Very Low T Numbers. Input?

I was recently diagnosed with low T. I am 38, and my testosterone was one of the lowest my doctor had seen - My total T was 31 ng/dL and my free was 6.9 pg/mL. I understand what the numbers mean, but not what others numbers are compared to mine. I know that is very low, but is anyone else have similar readings?

Second, I began therapy six days ago, and I feel like I’ve begun to experience depression. I just feel down. I am using Axiron solution 1 pump per armpit once a day. I have not noticed any other changes as of yet. I have zero sex drive, fatigue - basically my life is an advertisement for testosterone replacement therapy. I have a feeling my T has been low for quite a few years. I just don’t want to feel worse than before. How long before you started feeling better? What were the changes you noticed? Were they dramatic and sudden, or slowly drawn out over a period of weeks or months? Do you have recommendations for different treatment options? From the research I’ve done, it seems like injections spike your levels quickly, but then they fall off quite a bit by the time your next injection comes around. Basically, if anyone here has a few minutes to share their experiences when they first started therapy it would be great. Thanks for reading, and for taking the time to answer.

31ng/DL is very, very, very, very low, as in castrate low. Whether axiron works for you will be hit or miss, it depends on how well you absorb the T transdermally. You’ll find many individuals who say transdermal products are a waste of time and many who swear by them, it’s all individual, however it appears a larger portion of people (when compared to the injectables) are dissatisfied with TRT when on transdermal routes of T.

Injections depend on the dose and duration between intervals. 1-2x/wk shots of low dose T cause minimal fluctuations and are able to get you a HELL of a lot higher (levels wise) than most transdermal forms of T ever would.

I thought axiron (auxillary test) was taken off the market, do they have a generic or something now?

It is a generic, and I am really not liking how it is applied. I am already starting to feel that way about the skin application. I am going to call my doctor on Monday and speak with her about changing to injections. I also think that since my levels are so low, maybe I should see a specialist rather than my PCP, though she does seem well versed in TRT. So, in your opinion, twice weekly shots would work better and I wouldn’t suffer from testosterone crashes? I wish I knew why my levels are so low. I am overweight, but they do seem to be incredibly low. How quickly did you notice improvement when you started therapy?

Can you post your lab results with ranges?

Once weekly is a good starting point. However many docs prescribe shots E2,3 or 4 weeks.

If you see a specialist (which I’d recommend) you can potentially find out why you’re T is so low rather than just focus on treatment. I mean… If I had a pituitary tumour or something I’d want to know about it ya know.

If you could post up you’re labs I may be able to be of slight assistance

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As mentioned, can you provide your entire lab results?

I could tell a significant difference in two weeks. Increased energy and libido. I use injections, once a week. I cannot say I feel a difference from two days after an injection to six days after.

I’ll post them shortly. I’ve had numerous tests, and have already eliminated the pituitary tumor, among other things.

IMG_0406 IMG_0405

I have other tests but they were more on the metabolic side, but if you know which ones you think would help, just let me know and I’ll post them. Just not sure which are relevant, as my doctor pulled about twelve vials of blood out of me. So, from the feedback I’ve gotten so far, injections seem to be the better way to go. I don’t understand how dosing works with the topical solution I have. Why is it someone with a much higher number than mine would be prescribed the same amount as me? That seems off to me. Am I wrong?

The purpose is to try and get numbers into the normal range so someone with higher numbers (starting off) would indeed get the same script. In the end your HPTA shuts down, the same as someone who is in the 300s and starts a protocol. You are both medicating from 0 unless you’re on clomid or hcg which may preserve natural production.

I felt like garbage for almost 2 weeks after starting. I was at 71 total T. Felt like my brain turned to mush for a while then things started turning around at like day 10.

You only absorb a certain amount of the gel so you are probably getting like 10mg of a 50mg dose of gel coming out to 70mg a week compared to injecting 100mg and getting 100mg.

Go to a specialist. They’ll put you on 200mg a week no question. They know how bad you need the hormone and will feel for you and dose you properly. I’d rather go high and lower as I go than low and experience hell until I get to the right dose.

Let me start out by saying gels are generally poorly absorbed by men, more often than not it’s a poor choice and indicates your doctor may be up to speed on TRT.

A once weekly protocol when SHBG is 11 nmol/L is the wrong way to start TRT, large infrequent doses is best for very high SHBG men. Lower SHBG men or should I say super low SHBG men typically have a rough time controlling free hormones, Free T and Free E2.

Lower SHBG men seem to have the roughest time dialing in TRT and large infrequent injections is a ticket to failure! Lower SHBG men typically do much better on EOD or daily protocol, sure there are a few outliers, but statistically EOD and ED are a much better choice.

Excess androgens is what higher SHBG men need, large infrequent injections is what lowers SHBG, the same protocol for a super low SHBG guys makes no sense. You need to opposite protocol, frequent injections.

Large injections will drive SHBG down and that’s not what you want. Sometime low SHBG is just genetic and other times is undiagnosed hypothyroidism. Hypothyroidism slows down every cell in your body including the liver production of SHBG.

Do not be fooled by your doctor who states you’re in range and therefore normal, this is untrue.

So, systemlord, just so I understand you, you are saying that I am a lower SHBG person, being at 11, and maybe a daily treatment would be better for me rather than the weekly injections? I called my doctor, and she left the choice up to me - I could use the transdermal application or injections. If I go with injections, she was going to put me on 100 mg x 14 days, and then check my levels in one month. With the AXIRON, I am on 60mg/day. I just absolutely hate the AXIRON. It is runny and I cannot imagine I am getting a very good amount of the medicine in my system the way it just runs down my sides. I am not well versed on this - what is it about the SHBG that makes one type better than the other? Thanks for your input. It is very appreciated.

Your doctor has no business prescribing TRT, she is incompetent indicated by the fact she was about to put you on a path to great suffering. There are clinical studies showing poor results on even 200mg every 2 weeks.

Without a doubt, when I was on 50mg twice weekly my SHBG was 16, when I started injecting 20mg EOD SHBG increased to 22 because excess androgens lower SHBG and we want the opposite of someone with very high SHBG which wants to see SHBG decrease. These smaller shots tend to aromatase less since there is less testosterone to convert to estrogen.

Typically lower SHBG men are overweight and is why frequency of injections is important. These large shots can cause problems and we men naturally produce 7-10mg daily anyway, so these large injections can spell disaster for those who are overweight or sensitive to estrogen.

I felt best on a daily protocol, but my liver couldn’t expel toxins quick enough and was force to return to an EOD protocol. I wish I could return to an ED protocol.

Axiron burned my armpits and had no effect on me, it wasn’t even enough to shut down my natural production. Strangely it did eliminate my heart palpitations.

I actually enjoy pinning myself with 29 gauge insulin syringes. I would never had attempted a daily protocol with those 18 gauges nails my doctors provided.

With your low SHBG, I would stick with the axiron for a bit as youre just starting out. Give you body a chance to start to rebuild itself. ALL your numbers are low. My TT at its lowest was like 150. Yours is even lower!

I started TRT with axiron and got my test levels up into the 700s.

I switched to injections due to price mainly. The gels are expensive as hell but mimic nature best I believe. The draw back other than price is that they are harder to dial in that with the precision of injections.

Also: 100mg injection every two weeks is a JOKE. Your doctor is a complete MORON.

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Switch doctors if she’s going to give you 100 every two weeks. That’s worse that’s not starting. I’d shop around and find a good doc who will prescribe a real therapuric dosage .

Email me I can give you 2 or 3 most guys here use. It’s easier than you think. You pay an initial fee, send labs and physical, talk to doc, and get your meds and suggested protocol. Within two weeks you can start and not have to deal with 100mg twice a month… that’s just torture imo… I felt bad on 100mg after 4 days had passed with low shbg.