T Nation

Would You Go on TRT with My Levels?


I was on TRT for almost a year with a very reputable clinic. My experience was not positive. I overrespond to AIs and HCG ( 400iu twice/week) would shoot my E2 up.So I went through high and low E2 all the time and It was the worst time of my life.

I came off in May 2019 and been off since then. My restart, although painful was successful and my lab results are slightly better than prior to being on TRT.

Now that I am back to my baseline, I am facing all the low T symptoms that made me start TRT in the first place. It is not terrible, so to answer your question, I can survive without TRT but I also do not feel like my age(29 years old) most of the times; Lipido is low, getting in shape is hard, motivation, drive and confidence is low and life is just not enjoyable. What really confuses me is that some days I would feel like I’m completely fine and have no low T symptoms at all ( energy and lipido, sense of well being…etc is great) however, this is usually short lived and the Low T symptoms would hit me again . I am having an appointment with the clinic in few weeks and based on the below results I feel like they would suggest that I go back on TRT.

Would you go on TRT with my levels taking in consideration that I am 29years old, do not care about fertility for now as I know that when the times come, there are many ways to conceive .Also anyone went through the same experiences and would like to share, please do.

Thank you!

Iron Bind.Cap.(TIBC) 296 ug/dL 250 - 450

UIBC 237 ug/dL 111 - 343 01

Iron 59 ug/dL 38 - 169 01

Iron Saturation 20 % 15 - 55

Vitamin B12 709 pg/mL 232 - 1245 01

Folate (Folic Acid), Serum 12.3 ng/mL >3.0 01

Ferritin, Serum 187 ng/mL 30 - 400 01

Testosterone, Serum 465 ng/dL 264 - 916

Free Testosterone(Direct) 11.3 pg/mL 9.3 - 26.5

Estradiol, Sensitive 18.9 pg/mL 8.0 - 35.0

Sex Horm Binding Glob, Serum 31.4 nmol/L 16.5 - 55.9 01

DHEA-Sulfate 272.6 ug/dL 138.5 - 475.2 01

Dihydrotestosterone 31 ng/dL

LH 4.5 mIU/mL 1.7 - 8.6 01

T4,Free(Direct) 1.30 ng/dL 0.82 - 1.77

Thyroid Peroxidase (TPO) Ab 13 IU/mL 0 - 34 01

Triiodothyronine (T3), Free 2.8 pg/mL 2.0 - 4.4 01

Reverse T3, Serum A 19.7 ng/dL 9.2 - 24.1

TSH 2.130 uIU/mL 0.450 - 4.500 01

Prolactin 12.0 ng/mL 4.0 - 15.2

Insulin-Like Growth Factor I 195 ng/mL 98 - 282 01

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Regardless of your age your Free T levels are low and causing symptoms, it will be hard to critique your previous protocol since it is unknown. If you have problems with estrogen then frequent injections will lower estrogen, we have men doing daily injection and loving it using 29 gauge insulin syringes in the shoulders and quads.

It sounds like your Free T levels are dipping low on certain days and not on others, levels aren’t static and do fluctuate day to day. Sure you can survive without TRT, but those with lower levels live shorter lifespans. You can always use FSH injections to increase sperm.

Yes, and considering your symptoms, another yes. Take a look at your thyroid as well, with a reverse T3 of 19.7, your free T3 needs to be 4.0 or higher.

I can’t believe any doctor would put you on TRT at your age with those numbers. Your balls seem to work have you looked in to Clomid or HCG to increase your natural T production. Personnaly
I would look elsewhere for your "Lipido is low, getting in shape is hard, motivation, drive and confidence is low and life is just not enjoyable. Do you have a job or career? Are you financially sound or living from paycheck to paycheck. There are lots of reasons to have the symptoms you are discribing.

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didn’t know T fluctuates this much, this would explain the inconsistently in the way I feel. Thank you

" Take a look at your thyroid as well, with a reverse T3 of 19.7, your free T3 needs to be 4.0 or higher." mine is 2.8pg/ml which appears to be within the “normal” range, how bad is it ? could I be mistaking low T3 symptoms or an under active Tyroid with Low T symptoms ?. Also, TSH is below 2.5 which is supposed to be optimum, could you explain more ? thx

I am financially stable and successful in my career, not living paycheck to paycheck and as of lately have minimum to no stress except for the way I feel. It is not psychological as I was feeling great when on PCT coming off TRT ( during that time I had lab work done to make sure that my body was responding to the clomid and Nolva and My Test level came back in the upper 600’s .
I tried Clomid and Felt GREAT on it but even on a super low dose (6.25 mg eod) i developed eye floaters :slight_smile: so I had to come off. As of the HCG, it is my undestanding that HCG is supressive as it mimics LH so why not just do TRT?

A testosterone deficiency is your glaring issue, sure it’s nice to have Free T3 high normal. There are those with normal thyroid labs and are actually having problems using thyroid hormones and feel much better in the high normal ranges. TSH below <2.5 indicates no problems most of the time.

There are some who try to optimize thyroid and feel no different in the high normal ranges, it means your body is happy where it was for the same reason men have T levels that are low and have no symptoms.

HCG suppresses the top half of the testicles while simulating the bottom half, probably the reason why it doesn’t work well in place of TRT. Then AI’s can’t control E2 produced inside the testicles forcing you to lower the dosage and sacrifice good T levels.

HCG doesn’t always stimulate all hormonal pathways.

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From what I understand, my T3 levels are low normal but what makes it worse is that my Reverse T3 is high which is limiting the biding of my T3 hormones. guess I’m gonna need to tackle each issue on its own

Through diet and exercise I was able to lower Reverse T3 from 22.4 to 17 in 6 weeks. TSH is .683 and Free T3 3.6 (range 2.0-4.4) which is .2 over midrange. I have thought about optimizing thyroid, but want to dial-in TRT before I go down that route.

I responded quickly to TRT.

Sure, I’m not saying go on thyroid (“take a look”), but consider the possibility that your elevated rT3 and not great fT3 levels could be part of the puzzle.

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I had simIlar bloods to you and was around a similar age when starting. I am also still trying to get dialled in … think the HCG might be complicating things as well.

and how long have you been trying ? this is really what scares me the most, just keep trying to dial in for the rest of my life

Not long around 2 months and is better than before starting. Had a few weeks where it was good, so I know how I want to get it.