T Nation

Would I Benefit from T Shots?

I am experiencing the symptoms that other people are describing. For the past several years my labido has slowed down. Morning wood is zero. Even if I can get an erection it goes away while using it. I get tired quicker. I can fall asleep but wake up in the middle of the night several times. Piss poor memory. I have trouble building muscle and I have a pouch around my belly even though I’m 150 lbs and 5’10”.

Growing up I was super skinny. Turned out had an over active thyroid about 12 years ago. I’m 35 years old. My doctor put me on clomid to boost the T. First couple weeks it was great I felt like I could learn anything. I finished a lot of projects that needed to be done. And labido seemed better. After a while it just wasn’t the same. I went back to the doc expecting she would give me TRT but she said to keep taking clomid if it’s working well. I stopped taking it. Here are my recent lab results from March

Vitamin D 21 L (deficiency )

Total T 407 Reference Range: 250-1100 ng/dL

Free T

76.4 Reference Range: 35.0-155.0 pg/mL

Estradiol

26 Reference Range: < OR = 39 pg/mL

SEX HORMONE BINDING GLOBULIN

19 Reference Range: 10-50 nmol/L

T3

93, Range 76 -181 ng/dL

T4

1.2, Range 0.8 - 1.8 ng/dL

Your response to clomid is typical, good in the beginning and a decline in how you feel even with good numbers. Right now you are at high risk for cardiovascular disease at these levels.

Testosterone Threshold for Increased Cardiovascular Risk in Middle-Aged and Elderly Men:

The locally weighted regression showed that total testosterone levels of 440 and 480 ng/dL were associated with increased Framingham CVD risk and an increased probability of increased hsCRP, respectively. Men with sexual dysfunction (poor sexual performance, decreased morning erection, and loss of libido) had significantly greater CVD risk.

Any TRT protocol should be 10-12mg daily or 25mg EOD injections, anything else and results will be similar to clomid which is do in part to you having low SHBG which TRT will decrease even more probably <10. If your doctors starts playing the in range is normal BS, you will have to seek private care for TRT.

Do not expect managed healthcare doctors to know diddly squat about TRT, you will be figuring everything out by yourself because sex hormones are excluded from medical school as is TRT.

You now have a reason why doctor didn’t want to prescribe TRT,. she doesn’t know how to do it. TRT is not easy, it requires a person who can think outside the box, only in managed healthcare there are guidelines to follow.

You are lower than the average 35 year old, you are in the range of our current healthy US president, I do not need remind you of his age.

Truth is most men need Free T at the top of the ranges or higher do to the fact that direct immunoassay are inaccurate and overestimate Free T which is likely being used in your testing.

I agree that clomid will not be a long term solution. Given the symptoms described, with the post clomid labs, TRT is likely appropriate.

While we all respond differently, I would not start with multiple injections per week regardless. My SHBG was also 19 and I take a 200mg injection once a week. That had me at 900 total and 206 free, 2.28% free testosterone.

With your levels, you are at 1.87% free testosterone. Ideal is thought to be between 2-3%. You will probably do fine with a once a week protocol. The vast majority of guys on TRT, whether through a clinic or underground, take 150-200mg once a week. You’ll see more guys with higher injection frequency here. I’d start with 150mg once a week. You could always increase the dose and/or frequency down the road if not satisfied with your results.

By the way, President Trump’s total testosterone was reported to be 441 in 2016.

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Thank you so much for your reply to my question.

My doc I visit periodically for checking my thyroid is an endocrinologist. She did give me the “normal range” BS. But I spoke with her she is gonna start me on TRT. So that’s the good news. Is being on TRT going to yield the same effect that the clomid did initially? Cus for those first 2 weeks on clomid I got so
much shit done. My brain was on fire!!

Thank you so much for your reply.

Should I also start HCG ? Btw how much does it typically cost. I’m doing this out of pocket

If you are actively trying to conceive or concerned with testicular atrophy.

Prices are all over the place. Mine is $110 per month for testosterone, which includes office visits and all labs. Not sure, but I think hCG would add $60-75 to that.

Your age was not being considered when looking at your testosterone, elderly men score low normal, not youing men. If you look at the average man your age you’ll see most of them are high than 600 ng/dL.

Clomid usually doesn’t relieve all symptoms of low testosterone, TRT does if on the appropriate protocol. You may still have to fight with her on your protocol, injections every 2 weeks is common and is more than likely what she will prescribe.

My doc has prescribed Xyosted 50 mg. Your thoughts on that?