New Member Intro @ 50 y/o

Just turned 50 last month and had returned to lifting and cardio back in January in expectation of my new decade. I'm 5'10" and 175 lbs with no health issues or meds outside of taking finasteride for the last 15 years. Just noticed the decrease in libido, drive, focus, sharpness and mood about three years ago. No ED but noticeable diminished quality. Decided to get a full physical this month and describe all this to my PCP. I joined here because I don't know whether my results warrant a next step with an Endo, Urologist, or Clinic or should I just hope diet, exercise and supplementation will suffice?

Testosterone Free Direct

15.8 pg/mL

7.2 - 24.0 pg/mL


Testosterone Total

434 ng/dL

87 - 780 ng/dL


Hematocrit

44.9 %

40.0 - 54.0 %


Hemoglobin A1C

5.2 %

4.0 - 6.0 %


PSA

0.50 ng/mL

<4.00 ng/mL

 

DorianGray

Active Member
Have the symptoms you describe as occurring over a three year period gotten worse or about the same? Finasteride for BPH?
 
Fin for hair. Symptoms haven't gotten much worse but with all I'm doing with supps, diet and exercise, they haven't improved. The job change 3 yrs ago and move back east from the sunny west was my first thought and so I began D3 @ 5,000 iu last fall (and several other supps) heading into the gloomy winter. Previous winter gloom and 7am to 7pm office hours at extreme high stress/pace had me thinking about depression however I hit most of the factors in the ADAM survey for low T. I think the supps/diet/exercise helped but, then again, it's possible I've self-diagnosed and/or had the T forums do it for me since most of the well being guidance I've been getting is from videos and forums like this one. This 50th birthday I just decided to read up and go get a physical. Thanks!
 
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madman

Member
Just turned 50 last month and had returned to lifting and cardio back in January in expectation of my new decade. I'm 5'10" and 175 lbs with no health issues or meds outside of taking finasteride for the last 15 years. Just noticed the decrease in libido, drive, focus, sharpness and mood about three years ago. No ED but noticeable diminished quality. Decided to get a full physical this month and describe all this to my PCP. I joined here because I don't know whether my results warrant a next step with an Endo, Urologist, or Clinic or should I just hope diet, exercise and supplementation will suffice?

Testosterone Free Direct

15.8 pg/mL

7.2 - 24.0 pg/mL


Testosterone Total

434 ng/dL

87 - 780 ng/dL


Hematocrit

44.9 %

40.0 - 54.0 %


Hemoglobin A1C

5.2 %

4.0 - 6.0 %


PSA

0.50 ng/mL

<4.00 ng/mL




You need more blood work SHBG, estradiol, DHT, prolactin, adrenals (4 point saliva), full thyroid panel.

Did you fast and what time were labs done?

Although your TT is not robust your FT levels are healthy (mid-range) of the reference range.

Although TT is good to know FT is what truly matters as it is the active unbound fraction of testosterone responsible for the positive effects.

Seeing as your TT is not that high but your FT levels are mid-range than you most likely have lower SHBG.

I would be looking into thyroid/adrenals before jumping to the conclusion that your T levels are too low.

Regarding your FT you had the piss poor direct immunoassay done and it would be in your best interest to get a more accurate assay such as the gold standard Equilibrium Dialysis or Ultrafiltration (next best).



This is a very economical panel that includes: 1- Hematocrit: Portion of total blood volume made up of red blood cells. Testosterone replacement therapy can increase hematocrit. Hematocrit over 52 may increase blood thickness and cardiovascular risks. 2- Total (LC/MS- No upper Limit) and Free Testosterone by Equilibrium Analysis.

You can order this test through discountedlabs which is owned by the one and only our savior and the much loved Nelson Vergel.

This accurate testing method will tell you where your FT level truly sits as it may very well be lower than you think!
 
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madman

Member
This test would be more cost-effective and includes:

This discounted lab test panel for men includes total testosterone by liquid chromatography/mass spectrometry (the most accurate testosterone test), free testosterone (ultrafiltration), hematocrit, ultrasensitive estradiol, and prolactin hormone.
 
Great thorough/thoughtful replies, thanks. I should have been more prepared for the labs as the PCP was cool with adding the TT and FT to the list, however, ultimately I knew I was really there as step one of my 50 thousand mile check up and that a Urologist would be my next step. Libido is truly my main concern. Although PCP said go to an Endo, I haven't come across many testimonials where Endos were more commonly the solution. Thanks for the links to the labs of preference.
 
UPDATE: Urologist appointment went very well. Very knowledgeable and open minded when it comes to "normal" lab ranges vs symptoms. Stressed that I should get tested for lymes disease and also have a sleep study conducted for sleep apnea since I snore. Gave me a range of TRT options from creams, pellets, oral, patch and injections. I told him I'd prefer injections and he recommended Xyosted auto pen at 75mg to start until my first labs in 7 weeks. Not sure if the Xyosted will be covered by insurance so I'm not letting myself get married to the unbelievably easy and painless delivery.
 

Vince

Super Moderator
Injecting with easy touch insulin syringe is pretty simple. No need for a Xyosted auto pen, Just a waste of money.
 

madman

Member
UPDATE: Urologist appointment went very well. Very knowledgeable and open minded when it comes to "normal" lab ranges vs symptoms. Stressed that I should get tested for lymes disease and also have a sleep study conducted for sleep apnea since I snore. Gave me a range of TRT options from creams, pellets, oral, patch and injections. I told him I'd prefer injections and he recommended Xyosted auto pen at 75mg to start until my first labs in 7 weeks. Not sure if the Xyosted will be covered by insurance so I'm not letting myself get married to the unbelievably easy and painless delivery.


Very knowledgeable and open minded when it comes to "normal" lab ranges vs symptoms.

This is key and luckily you found a doctor that understands.


Gave me a range of TRT options from creams, pellets, oral, patch and injections. I told him I'd prefer injections and he recommended Xyosted auto pen at 75mg to start until my first labs in 7 weeks. Not sure if the Xyosted will be covered by insurance so I'm not letting myself get married to the unbelievably easy and painless delivery.

For convenience and ease of use sure but the cost is the biggest factor $$$ and you would be far better of getting pharma-grade Depot-Testosterone (testosterone cypionate) or Delatestryl (Testosterone Enanthate) prescribed and learning how to inject at home using a fixed insulin syringe.

Many even use compounded Testosterone (cypionate/enanthate) but seeing as he is pushing the Xyosted than he is in the pocket of the big boys!



Screenshot (1787).png

Screenshot (1788).png
 

Systemlord

Member
I told him I'd prefer injections and he recommended Xyosted auto pen at 75mg to start until my first labs in 7 weeks.
A 75mg weekly dose is on the low end for TRT, most need quite a bit more. Your doc is pushing Xyosted because it's profitable do to the patented auto-injector.

It's difficult to fine tune your dosage/levels with these auto-injectors because of the limited doses available (50/75/100mg).

A 20mg increase can see a pretty noticeable increase in testosterone, so you can't really fine tune levels on these auto-injectors.
 
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madman

Member
A 75mg weekly dose is on the low end for TRT, most need quite a bit more. Your doc is pushing Xyosted because it's profitable do to the patented auto-injector.

It's difficult to fine tune your dosage/levels with these auto-injectors because of the limited doses available (75/100/150mg).

So you start out on 75mg and your testosterone levels after 6 weeks are still low, you go to 100mg and now levels are still a bit suboptimal, so you go with the 150mg auto-injector, a substantial increase and big move when trying to dial-in on TRT and now levels end up way too high.

A 20mg increase can see a pretty noticeable increase in testosterone, so you can't really fine tune levels on these auto-injectors.

You might want to fix that as Xyosted is available in 3 strengths 50mg/75mg/100mg.
 
You might want to fix that as Xyosted is available in 3 strengths 50mg/75mg/100mg.
Correct.
A 75mg weekly dose is on the low end for TRT, most need quite a bit more. Your doc is pushing Xyosted because it's profitable do to the patented auto-injector.

It's difficult to fine tune your dosage/levels with these auto-injectors because of the limited doses available (50/75/100mg).

A 20mg increase can see a pretty noticeable increase in testosterone, so you can't really fine tune levels on these auto-injectors.
Whatever the reason, I'm fine with a few free samples to get started while the Xyosted rep works out the insurance. In the meantime, I found what seems to be a great Dr within 20 miles of my home (no online cookie cutter program) and I'm in treatment ... and have an "easy button" to boot. Once I get my feet wet, I'll be fine doing my own injections of T Cyp if the Xyosted isn't covered. Otherwise, if it is indeed covered, I'll weigh the cost/convenience of staying on it or switching to syringes. For now, "slow and low" until my first lab is my plan and then maybe talk about bumping up to 100mg/wk depending on how I feel.
 
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Update: Just crossed week 7 on 75mg enanthate 1x/week via Xyosted autopen. This past week has been great as I feel much more energy, enhanced mood and libido. The day before injection, I can feel a dip in all those benefits.

Insurance won't cover the Xyosted anymore, so I'll be going on cypionate in a few weeks. No regrets thus far. First blood panel to be run in two weeks.
 

DorianGray

Active Member
Just curious so as to educate myself. The OP seems to have jumped on the TRT bandwagon but didn't post any other lab results as suggested my @madman. So, what was the basis for prescribing? How was Dhea level? What about trying Dhea supplements and Prenenolone?
 
Today is exactly 60 days since my initial Urologist appointment on Aug 17th and approval for 75mg/week enanthate via Xyostead auto inject. Had my first follow up with my Urologist this week and everything went great. My insurance declined me for continuance of Xyostead which is just as well since last week it gave me an abdomen bruise the size of two U.S. $ quarters (if placed side by side). My Dr has switched me over to cypionate at 100mg/week (ridiculously cheap via Good Rx) which I will administer via the easytouch 27ga pins recommended here, likely every 3.5 days. Everything in my lab panel was perfectly normal however, for obvious reasons a couple posts earlier, I'm not posting my labs as I'm too old and busy to deal with forum drama. I'm immensely appreciative for this forum as I am 100% convinced that, without the resources and referrals here within, I'd still be bouncing around between quacks and shills and no nearer to optimization.
 

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