Please take a look at my dad's blood work before he starts TRT. Is it safe to start?

Hi guys could you please give input on my dad's results? He's 61. Is it safe for him to start TRT?

PSA 3.31 ng/ml Ref: 0.00-4.00

TSH 2.32 uIU/ml Ref: 0.5-2.5

FSH 7.19 mIU/ml Ref: 1.5-12.4

LH 5.12 mIU/ml Ref: 0.8-7.6

E2 8.3 pg/ml Ref: 7.6.-42.6 **Not sensitive, not available in this country**

Test 534.8 ng/dL Ref: (Male 50-99): 181-758

Could not find anywhere offering Free T tests


Please see attached photo for cholesterol and complete blood count (CBC)

Now, granted his e2 test isn't sensitive, but that's pretty low regardless isn't it? This tells me that regardless of his T levels not being horrible, that he may benefit from an increase. His PSA isn't above 4 which is good, I'm guessing that it's on the high side of normal because of his age. But if he starts TRT I told him how important it is to keep an eye on that.

His hematocrit is ok as is, but another item he'd need to keep an eye on if he started TRT. His "bad" cholesterol is high, I'm not sure if TRT would impact that at all. I'm guessing he needs to have a better diet.

Anyway, is there anything that stands out to anybody that I might be over looking? Does it appear safe that he would start TRT? There's no TRT doctors in this country. It's useless to even try. So we're doing our best to do research and do things safely.

Any input is greatly appreciated!

While I'm sure it's safe, with those numbers I wonder if it is necessary. Numbers are good and total T is also quite good. I started TRT 8 months ago and my total was 370 at that time. I am 62.

What symptoms do you expect TRT to address? That's the more important question. Is he working out at all? I was doing resistance training alternating with cardio every other day and getting no where, declining each year. If you say bodyfat, fatigue, and low libido and he's doesn't workout, then I'd start there. Put in some work before you make the jump, clean up diet, do resistance work with a moderate amount of cardio and commitment to training for 6 months or so first. The answer could simply be lifestyle.

I look at TRT as a way to optimize what I've been doing since I was 13, not a shortcut.

Just my thoughts. Maybe some guys with a better understanding of lab results will have a different perspective.

Thanks for the response, Mountain Man. I agree with you. He's pretty stubborn in that he doesn't want to physically do anything to actually take care of the problem. I think the main problem is his diet and lifestyle. Because indeed his numbers don't look to bad and yet he has similar symptoms to low T. His estrogen is low though, isn't it?

As for your father's results, he'd not be a candidate for TRT in my doctor's practice. The focus would be on diet, exercise, and other lifestyle issues. I began TRT when I was 57 and had a total testosterone under 200; it changed my life - but it is no quick-fix.

That E2 is painfully low, I had almost that exact level. 8.6 to be exact.

Seems like that is being ignored, and your dad appears to be a low aromatizer.

What are his symptoms?

Hematocrit is at a decent level, nothing concerning.

He will never have sufficient E2 with the way he aromatizes it seems.

Still, I'd retest everything, and add SHBG and DHEA-S.

Low E2 is something I wouldn't wish on anyone.

Although his PSA is rather high, I'd retest that to make sure, and tell him to avoid any form of sexual activity for 48 hours, weight lifting, or bicycle riding.

His symptoms are that of similar to low testosterone. Which I have found online that low estrogen can provide pretty much the same symptoms. Somebody had mentioned their father had success raising their E2 with a DHEA supplement. So I have intentions to get my dad in to have DHEA checked.

Does anybody know off hand other ways folks have had success combating naturally low E2 aside from a DHEA supplement? Aside from that, his symptoms could absolutely be from poor eating habits and lifestyle. His LDL is in the high end. So that has kind of inspired him to maybe start exercise and eating healthier (We'll see if that happens haha)

But aside from a healthier diet and exercise, and a DHEA supplement should it turn out he require it, how might he combat the low E2 without T injections?

chasedat said:

His symptoms are that of similar to low testosterone. Which I have found online that low estrogen can provide pretty much the same symptoms. Somebody had mentioned their father had success raising their E2 with a DHEA supplement. So I have intentions to get my dad in to have DHEA checked.

Does anybody know off hand other ways folks have had success combating naturally low E2 aside from a DHEA supplement? Aside from that, his symptoms could absolutely be from poor eating habits and lifestyle. His LDL is in the high end. So that has kind of inspired him to maybe start exercise and eating healthier (We'll see if that happens haha)

But aside from a healthier diet and exercise, and a DHEA supplement should it turn out he require it, how might he combat the low E2 without T injections?

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Any hot flashes, joint pain, excessive thirst, excessive urination(more urgency to go than it is pure volume), near zero libido, anhedonia, and anxiety?

Do you mind posting a picture of the rest of the labs?

Do you know if you had SHBG ran? That is really really important, and I suspect due to many things including his age, that it is very high. This will lead to low free testosterone, thus possibly causing his low E2 and low testosterone symptoms.

SHBG increases as we age, and at 60, I'd expect he's at 50-60 for SHBG.

I've heard people mentioning DHEA as a means of raising E2, but I've never ever seen any reports of someone using it, or labs or anything for that matter.

Low E2 with "normal" testosterone is exceedingly rare, and I had that essentially, although my test was lower, but "normal" according to most doctors. I wasn't able to find ANY information on it, and I am pretty decent at googling. So any questions you have, or your dad if he's good with a computer, feel free to ask me.

Really, if DHEA doesn't work, the only other way is to raise testosterone. Exogenous E2 isn't given to men very often, at least not unless he's transgender, but I don't know that I'd recommend clomid.

Your dad is 61, and not to be insensitive, but average life expectancy is 78 years for a man. I don't think it's as bad as myself in my 20's.

One thing I will say, is I would not willingly go back to that hell on earth of low E2 under almost any circumstances, I'd trade 10 years of my life expectancy without thinking about it.

Perhaps I missed it, but what is your father's attitude toward TRT? You said he was open to the idea of exercise and a better diet, but what abiut the idea of a TRT protocol?

CoastWatcher said:

Perhaps I missed it, but what is your father's attitude toward TRT? You said he was open to the idea of exercise and a better diet, but what abiut the idea of a TRT protocol?

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He'd be open to it if he'd need it. But as it stands, it appears that perhaps he wouldn't require it. But his estrogen is very low. And unless DHEA helps that, I'm not sure how to raise his estrogen aside from raising his T levels by starting a TRT protocol. I think he'd benefit from TRT to a certain extent. But maybe that's just me believing everybody should optimize their hormones.

Unfortunately we're on our own here with my personal research. As the country we reside do not have any doctors that'd be able to help in regards to TRT. With the exception of a HRT doctor about 5 hours away that is very expensive. He can't afford that.

He's pretty lazy. He's more open to a TRT protocol than he is exercise. But his cholesterol is high. He needs to pursue a healthier diet and some exercise before it gets worse. I feel like he'd be a little more motivated if he got his hormones more leveled out. His estrogen is clearly abnormally low

Honestly I'm kind of stuck, I was hoping that he had a basic low T blood work that I could utilize my knowledge on to help him safely start a TRT protocol. But I've never heard of anybody with such low estrogen and normal T levels. He's willing to pay to have his DHEA checked when I go in to have my own follow up blood work done. He will come along to have DHEA-S checked as well. So hopefully all he requires is some DHEA supplementation. I think if he doesn't absolutely require a TRT protocol, it's best to not have him commit to that. Since it's a life long situation for the most part. HCG is very hard to find here as well. So it'd be a huge pain in the ass should he ever want to stop TRT. Testosterone injections is hard enough to find as it is.

He's pretty lazy. He's more open to a TRT protocol than he is exercise. But his cholesterol is high. He needs to pursue a healthier diet and some exercise before it gets worse. I feel like he'd be a little more motivated if he got his hormones more leveled out. His estrogen is clearly abnormally low[/QUOTE]

This is the problem. Sounds like your father has started to give up. A lot of men do. The biggest thing at our ages, I think, is sex drive. Once that is lost, it becomes kind of like "what's the point?" All men, especially older men in our 60s and beyond, need something that gives them drive and motivation. For me personally, they are exercise and sex. Very fortunate to have a wife who still wants and desires sex three times per week.

Don't get me wrong, I believe that some men, myself included, are lucky enough to have some innate motivation for these things. I do believe that staying good shape over the course of a lifetime keeps this motivation fresh. I would suggest you get him walking, simple walking to start every day. Throw in some light stretching and some body weight exercises when he is ready. If he takes to this, start some weight training or resistance work.

If your dad is a typical 60-year-old guy, he's probably wouldn't have some excuses about joint pain. If he does, stay away from the weights get him some quality resistance bands. I've had tons of orthopedic problems in surgeries over the years, and I swear by these. They're all l have used for training for the past two years and they work great, enabling me to build muscle without any joint pain at all.

Work with him on two things, exercise and motivation. Keep it simple, real simple, you have to build his motivation from the inside first. It might be as simple as 10 minute walks for starters. Don't overdo it, a guy like your dad gets a few aches and pains and freaks out, fearing that he will get hurt. Don't let that happen!

I'm sure some other old guys have some ideas as well. For me, being physically active in sexually active is the key to creating motivation. To be honest, I don't think he needs TRT, he needs to be motivated and get his drive back. You cannot push him to do this, but you can nudge him along.

Great advice and I agree! That's a good point about taking things slowly. I had mentioned that he needs to change his diet, which I've offered assistance on as well as start jogging at the track in the evenings. But some speed walking would perhaps be a better start and he can work his way up. He seems willing to get some healthier items in the house. I believe diet plays a huge role in ones general motivation. I've preached to him plenty about his diet, but it took until seeing his cholesterol levels for him to show some motivation. So we'll see how it goes. When I go in for my follow up blood work I'll bring him with me and check his DHEA-S as well and see if we can't just get him some simple supplementation, a better diet, and some physical activity going. That'll make a world of difference I think.

Thanks everybody for the input. I'll follow up here about his blood work and perhaps if a DHEA supplement turns out being the solution for his low estrogen. This way people in the future perhaps can benefit from the info

My dad got his bloodwork back. I'm unfamiliar with DHEA results as it's not been an issue for me. I'm also unfamiliar with the unit of measurement he was given on his results.


DHEA-S 2.55 µmol/L

Reference range 1.30-9.80


Would he benefit from a DHEA supplement considering his low estrogen levels, and what appears to me, a DHEA result on the low end of the range?

Has your dad been working out? If not, then he is only kidding himself.

He's been walking daily. Been changing his diet for the better as well. I'm curious how his DHEA results by look. If maybe he'd benefit from DHEA supplement

chasedat said:

He's been walking daily. Been changing his diet for the better as well. I'm curious how his DHEA results by look. If maybe he'd benefit from DHEA supplement

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Maybe he needs more time working out. Even with his good T levels, time is a factor. A 61 year old body simply does not build like a 31 year old one. Just encourage him to continue to work out, throw in some resistance work, and enjoy the positive reinforcement of that. Building muscle is more reinforcing than cardio in my opinion, because you can see, as well as feel, the results. When sex drive returns, he'll be hooked.

I don't know about the dhea, others will be able to answer that. I can tell you that if sex drive and performance return for a guy in his 60's, motivation will return. While he may need other adjuncts, like viagra or cialis, it is a great motivator to look and feel better and to have a sex life that is satisfying. Whether we think so or not, when a man stops having satisfying sex, something kind of dies in him. The "I'm too old" tape starts to play and pretty soon he believes it. Being out of shape seals the deal.

chasedat said:

He's been walking daily. Been changing his diet for the better as well. I'm curious how his DHEA results by look. If maybe he'd benefit from DHEA supplement

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I wouldn't add DHEA to a man not on TRT, when I tried and was not on TRT. It only raise my E2 and lowered my testosterone. It made my feel terrible, now on TRT, I do supplement with DHEA. To keep normal levels.

Vince said:

I wouldn't add DHEA to a man not on TRT, when I tried and was not on TRT. It only raise my E2 and lowered my testosterone. It made my feel terrible, now on TRT, I do supplement with DHEA. To keep normal levels.

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His estrogen is at 8. So we were intentionally trying to bring that to a healthier range by supplementing DHEA. I just don't know if his DHEA blood work is considered low or not

DHEA-S 2.55 µmol/L

Reference range 1.30-9.80

chasedat said:

His estrogen is at 8. So we were intentionally trying to bring that to a healthier range by supplementing DHEA. I just don't know if his DHEA blood work is considered low or not

DHEA-S 2.55 µmol/L

Reference range 1.30-9.80

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Personally I wouldn't add DHEA to a man not on TRT, It will lower his testosterone and raise his estrogen. He could try DHEA but I believe he will feel worse.

chasedat said:

His estrogen is at 8. So we were intentionally trying to bring that to a healthier range by supplementing DHEA. I just don't know if his DHEA blood work is considered low or not

DHEA-S 2.55 µmol/L

Reference range 1.30-9.80

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Listen to me, the reason your dad feels like shit is because his E2 is 8, for some reason everyone here seems to be ignoring that. DHEA is not proven to raise E2, and it's shown to cause a small increase in testosterone levels.

There unfortunately, doesn't seem to be much of a way to fix this low E2 problem, other than by fixing the testosterone problem(which isn't that low to begin with).