T Nation

What Advice Would You Give?


#1

I have been doing alot of research after I had some blood work done this week( taken at 9am), and trying to learn as much as possible about TRT and whether it may help me.

My story: 33YO active guy 6' 255# lift heavy 4-5 days a week. always been into lifting or sports. Been powerlifting since Feb and having a blast. WIth that said my doctor ordered a blood test last week to help figure out why I am so run down, sleepy all the time, and just feel like crap in general. Many days I barely feel like I can get off the couch. Just have zero energy and feel like I need more sleep.

I was diagnosed with Depression a little over a year ago and have been on medication since then and doing very well but I would love to be off of the meds!. I have also had ED issues in the past as far back as 5 years ago and was prescribed Viagra then Cialis both of which I stopped taking because of the side effects I was having. I pushed my Dr. to also check my test levels which he was highly against doing for whatever reason.

Here are the results.
WBC 7.9
RBC 5.13
HGB 15.6
HCT 45.8
MCV 89.2
MCH 30.5
MCHC 34
RDW 13.5
PLT 204
MPV 8.8
Segs 68.5
Lymphocytes 22.8
Monocytes 5.6
BUN 15
Creatinine 1.4 High
Alkaline Phophatase 93 High
Albumin 4.4
EGFR 58 Low

TSH 1.03 Range .34-5.60
Free T4 .85 Range .61-1.62
TT 409 Range 348-1197

No idea if any of this is helpful. I am scheduling another blood test next week and going to check Free and total test. I have read some research on TRT and improving depression. That combined with maybe helping the ED and giving me my energy back is why I am taking a look at my options. I would love to get any info or advice you guys can offer.


#2

Just got a follow up call from my primary DR and he said he won’t give me a referral because my TT level was in the normal range.


#3

Have you read all of the stickies? I’d suggest starting with Finding a TRT Doc. This isn’t a doctor you want working for you anyway as he didn’t even test free T or your estradiol.

Trust me when I say you don’t want to begin going down the path of TRT lightly. That being said, you also want to get all of your ducks in a row before you begin and have a Dr who’s familiar with TRT and the potential issues; one who will keep an aromatase inhibitor on hand if needed and also hCG at the get go to keep your testicles healthy.


#4

Labs:
TT
FT
E2
LH/FSH - very important
If LH/FSH low, do prolactin as follow up

Need labs posted in list form with ranges please.

Read these stickies:

  • advice for new guys
  • things that damage your hormones
  • finding a TRT doc

Do labs out-of-pocked if need be.

Have you always used iodized salt or are you iodine deficient?
Many here have thyroid/iodine issues.

Eval your overall tyroid function by checking oral body temps:

  • when you first wake up should be 98.7-98.8, higher OK, 97.3 is a problem
  • also check for 98.6 mid-afternoon
  • this is important

#5

Thanks guys, I really appreciate it. I am going to get labs done myself and I’ll make sure to get all those items checked. I am quickly realizing I need to track down a different doc if it looks like there could be potential benefits. I have read most of the stickies but I’ll go back over them. I’ll post my new results as soon as I get them. Hopefully it will shed more light on how things are looking. Thanks again guys.


#6

I guess my biggest surprise was how stand offish my DR was when I even mentioned adding the testosterone check to my current blood test he was already running. Is this isolated or are many docs like this?


#7

Many docs are idiots. There is a thread active now that discusses related stories.


#8

I have a meeting with someone who from my research seems to have a handle on trt. I am going to bring all my research with me on Thurs when we meet and see how it goes. What questions are “must ask”? I’ll make a list to go over and add it to my pile


#9

Update: I had an appointment with a TRT Dr in my area yesterday. She was extremely knowledgeable and was able to answer and explain all the things I had come up with in my research. We did some more blood work to fill in the gaps from my other work and I get results back today. After chatting with her it looks like I am going to start at 100 once a week.

She is allowing me to self inject and we will keep an eye on my blood work and see if I need to use HCG or adjust the dosage. I was very impressed with both the knowledge level and the fact that she didnt rush me through everything like my PCP. Thank you for help the help so far. I am sure i’ll have more questions. I am looking forward to starting to feel better.


#10

[quote]agentjoedirt wrote:
Update: I had an appointment with a TRT Dr in my area yesterday. She was extremely knowledgeable and was able to answer and explain all the things I had come up with in my research. We did some more blood work to fill in the gaps from my other work and I get results back today. After chatting with her it looks like I am going to start at 100 once a week.

She is allowing me to self inject and we will keep an eye on my blood work and see if I need to use HCG or adjust the dosage. I was very impressed with both the knowledge level and the fact that she didnt rush me through everything like my PCP. Thank you for help the help so far. I am sure i’ll have more questions. I am looking forward to starting to feel better. [/quote]

That’s great news, but I would suggest if hCG was an option at the get go you should have jumped on it.

Do you understand that your testicles are going to begin to atrophy because your body will no longer produce LH?

You do know that sperm production isn’t the only thing our testes are responsible for, right?


#11

[quote]agentjoedirt wrote:
Update: I had an appointment with a TRT Dr in my area yesterday. She was extremely knowledgeable and was able to answer and explain all the things I had come up with in my research. We did some more blood work to fill in the gaps from my other work and I get results back today. After chatting with her it looks like I am going to start at 100 once a week.

She is allowing me to self inject and we will keep an eye on my blood work and see if I need to use HCG or adjust the dosage. I was very impressed with both the knowledge level and the fact that she didnt rush me through everything like my PCP. Thank you for help the help so far. I am sure i’ll have more questions. I am looking forward to starting to feel better. [/quote]

Also, if she’s allowing you to self inject, you should start off with 50 mg injected twice per week. This will decrease aromatization of T to estrogen. You’ll feel better and it will decrease the chance that you’ll need an AI (aromatase inhibitor).

Also, are you planning to harpoon yourself with the huge needles?

I self inject twice per week with insulin syringes sub cutaneously (not intramuscular) in my quad and my total T levels stay right around 900-1100 with much smaller peaks and valleys.


#12

"we will keep an eye on my blood work and see if I need to use HCG"
That is meaningless, all that labs could do is show LH/FSH–>zero and that always happens.

Have you looked at the stickies suggested above.

Also must read: protocol for injections

==========================
Eval your overall tyroid function by checking oral body temps:

  • when you first wake up should be 98.7-98.8, higher OK, 97.3 is a problem
  • also check for 98.6 mid-afternoon
  • this is important

I don’t know why most guys don’t take this seriously


#13

My temp this am was 98.4. I’ll check again this afternoon. I will talk to her again about hcg. I am still learning about everything and trying to educate myself. I have went through the stickies multiple times but that doesn’t mean I remembered or comprehended everything. I’ll take another look. Thanks for the input. Still waiting on my shbg to come back will update when I have my other results.


#14

98.4 when you woke up?


#15

Yep, that was right when I woke up. Just checked it again and it was 99.2.


#16

I also started taking a new vitamin pack today. This one includes iodine which my old one didn’t.


#17

Does it also have selenium?


#18

With those body temps, low thyroid function does seem to be not on the list of causes for depression. Also see if someone else hits 98.6 on the same device as a confidence measure.


#19

98.3 this am and 98.6 this afternoon. My wife’s temp was just over 98.6 this afternoon so it looks like it checks.


#20

It’s does, 200mcg’s