40 Years-old and 324 Total...

[GemStater]

Hello Excelmale community.

Here's a semi-quick summary of my developing Low T story.

I turned 40 last May.

Earlier this month I had my annual physical exam at my primary care family practice doctor. I talked with him about my symptoms of being tired, having low ambition, low libido, and fatigue.

He put me on the Antidepressant, 150MG Bupropion XL, daily.

Since I've heard testosterone starts to decline at age 40, I asked my doctor to order a testosterone test in my blood work, if for nothing else establish a baseline number for future reference. He agreed.

Lab work performed by Quest Diagnostics Nichols Valencia

Blood draw time: 3:35p.m.

Total Testosterone: 324

Free Testosterone: 31.9

My doctor promptly wrote me a perception for Androgel 1.62.

I have not picked-up or plan to start using the Androgel. Instead, I have an appointment with a secondary doctor who is known in my area to work with patients undergoing Hormone Replacement Therapy. I've been told this doctor favors pellets as a preferred testosterone delivery system. By contrast, he is treating my 68 year-old father with testosterone cream from our local compounding pharmacy. I have been researching all the different delivery methods for testosterone but have not determined the best one for me at this point? Suggestions with reasons why would be appreciated.

Speaking of my 68 year-old father, here is his recent, natural, testosterone numbers prior to starting his testosterone cream:

Total Testosterone: 490

Free Testosterone: 43.8

Wonderful! I have lower testosterone than a 68 year-old. Go figure!?!?

Some other information regarding my body, build, activity, habits.

Weight: 170 lbs.
Height: 5' 9"

I work in manufacturing and am on my feet moving around during a 10-hour shift, four days a week.

I work-out, pump-iron three days a week.

I eat mostly healthy; meats, fresh fruits, vegetables, salads, ets. Try for the most part to cut out added sugars.

I do not or have not used tobacco products.

I do not or have not drink more than one alcoholic beverage per week on average.

I do not or have not used recreational drugs, of any type.

I am married, happily, with three children, ages 4, 7, and 9.

I'm currently researching the best path forward. I've been Googling lots and watching a lot of different videos on YouTube which is where I found Excel Male.

Suggestions are greatly appreciated, thanks in advance!

 

[Systemlord]

There are probably millions of men who complain of depression to their GP's and are given antidepressants when in fact their depression is caused by low testosterone, our medical system is in sad shape.

Our grandfathers had higher testosterone than we do and the trend will continue. In fact in the last 10 years alarmingly doctors are seeing younger and younger men with the testosterone levels seen in 80 year old men, this kind of thing was unheard of 20 years ago.

There are a couple of effective ways to elevate testosterone, pellets isn't one of them, there's no way to keep levels elevated on pellets, you start out very high and end up hypogonadal towards the last couple of weeks before your next pellet insertion. If your levels end up way too high weeks after the pellet procedure, you're force to ride it out.

This doctor prefers pellets for one simple reason, he enjoys the level of income it brings in yearly, pellets is the most profitable version of TRT. So most profitable, least effect treatment. I leave you to draw your own conclusions as to your doctors true motivations.

Creams can work great if you're able to absorb enough and if you're able to control your levels, creams more closely mimic the natural rhythm, but by far and large injections is the most effective way to elevate testosterone and least profitable, 100 percent is absorbed.

It's easier to control your levels on injectable testosterone, you can change injection frequencies to manipulate testosterone and estrogen ratios.

Muscular responses to testosterone replacement vary by administration route: a systematic review and meta-analysis.

Intramuscular TRT is more effective than transdermal formulations at increasing LBM and improving muscle strength in middle-aged and older men, particularly in the lower extremities.

I don't know about you, but that's a deal breaker for me. ^^^^

 

[tmaxey1]

Hello Excelmale community.

Here's a semi-quick summary of my developing Low T story.

I turned 40 last May.

Earlier this month I had my annual physical exam at my primary care family practice doctor. I talked with him about my symptoms of being tired, having low ambition, low libido, and fatigue.

He put me on the Antidepressant, 150MG Bupropion XL, daily.

Since I've heard testosterone starts to decline at age 40, I asked my doctor to order a testosterone test in my blood work, if for nothing else establish a baseline number for future reference. He agreed.

Lab work performed by Quest Diagnostics Nichols Valencia

Blood draw time: 3:35p.m.

Total Testosterone: 324

Free Testosterone: 31.9

My doctor promptly wrote me a perception for Androgel 1.62.

I have not picked-up or plan to start using the Androgel. Instead, I have an appointment with a secondary doctor who is known in my area to work with patients undergoing Hormone Replacement Therapy. I've been told this doctor favors pellets as a preferred testosterone delivery system. By contrast, he is treating my 68 year-old father with testosterone cream from our local compounding pharmacy. I have been researching all the different delivery methods for testosterone but have not determined the best one for me at this point? Suggestions with reasons why would be appreciated.

Speaking of my 68 year-old father, here is his recent, natural, testosterone numbers prior to starting his testosterone cream:

Total Testosterone: 490

Free Testosterone: 43.8

Wonderful! I have lower testosterone than a 68 year-old. Go figure!?!?

Some other information regarding my body, build, activity, habits.

Weight: 170 lbs.
Height: 5' 9"

I work in manufacturing and am on my feet moving around during a 10-hour shift, four days a week.

I work-out, pump-iron three days a week.

I eat mostly healthy; meats, fresh fruits, vegetables, salads, ets. Try for the most part to cut out added sugars.

I do not or have not used tobacco products.

I do not or have not drink more than one alcoholic beverage per week on average.

I do not or have not used recreational drugs, of any type.

I am married, happily, with three children, ages 4, 7, and 9.

I'm currently researching the best path forward. I've been Googling lots and watching a lot of different videos on YouTube which is where I found Excel Male.

Suggestions are greatly appreciated, thanks in advance!

My story sounds similar to yours.
I measured at T level of 177 and free T at 7 and E2 at 7.
I am 43 and in good physical shape. I felt like I had the flu for the last 6 months or longer really.
I refused to start down the road of antidepressants. Especially because I was not depressed I was just tired all the time.

My advise.. spend the money on a place like Defy. With my low T levels I know I could get my insurance company to pay for my T treatment. But then I would be at the mercy of a local doctor who doesn’t know what he is doing or is only interested in pellets or Androgel or something we know doesn’t work.

Also when a man has 1 endocrine issue he sometimes has another. So have your thyroid levels check...not just your Total thyroid levels. But your reverse T3 levels. I found out my thyroid was being blocked by high levels of reverse T3. No way a normal doctor would have found this.

I’ve been on T and T3 for only 3 weeks now and it can be life changing for someone suffering from low T. You start to forget what having normal energy levels were like. I also have 3 kids close in age to yours. I’d much rather see you have the benefits of testosterone therapy over the black hole of mind altering effects of anti depressants. The pharmaceutical industry has our doctors on lock down unfortunately.

 

[Vtail]

My story sounds similar to yours.
I measured at T level of 177 and free T at 7 and E2 at 7.
I am 43 and in good physical shape. I felt like I had the flu for the last 6 months or longer really.
I refused to start down the road of antidepressants. Especially because I was not depressed I was just tired all the time.

My advise.. spend the money on a place like Defy. With my low T levels I know I could get my insurance company to pay for my T treatment. But then I would be at the mercy of a local doctor who doesn’t know what he is doing or is only interested in pellets or Androgel or something we know doesn’t work.

Also when a man has 1 endocrine issue he sometimes has another. So have your thyroid levels check...not just your Total thyroid levels. But your reverse T3 levels. I found out my thyroid was being blocked by high levels of reverse T3. No way a normal doctor would have found this.

I’ve been on T and T3 for only 3 weeks now and it can be life changing for someone suffering from low T. You start to forget what having normal energy levels were like. I also have 3 kids close in age to yours. I’d much rather see you have the benefits of testosterone therapy over the black hole of mind altering effects of anti depressants. The pharmaceutical industry has our doctors on lock down unfortunately.

Just curious - what was your RT3? I just had mine checked after 2 months into TRT, and my RT3 was 23. What were you prescribed for your high RT3?

 

[tmaxey1]

Just curious - what was your RT3? I just had mine checked after 2 months into TRT, and my RT3 was 23. What were you prescribed for your high RT3?

My reverse T3 was 26. I was prescribed T3 instead of the normal synthroid which is T4 because high reverse T3 means your body is converting high levels of T4 to reverse T3 instead of normal T3. So this is causing the reverse t3 to compete with the t3 effectively neutralizing the T3. Giving me T4 could lead to just more reverse t3.

This is how it was explained to me.

 

[Vtail]

My reverse T3 was 26. I was prescribed T3 instead of the normal synthroid which is T4 because high reverse T3 means your body is converting high levels of T4 to reverse T3 instead of normal T3. So this is causing the reverse t3 to compete with the t3 effectively neutralizing the T3. Giving me T4 could lead to just more reverse t3.

This is how it was explained to me.

Thanks - good info. Is taking T3 like Testosterone, where you will need it as a permanent supplement? Or does your doc expect the Thyroid to somehow sort itself out over time. I have a consult coming up with Defy and am glad to hear they know how and are willing to treat Thyroid issues. Also, in your case, how long after starting on the T3 did you notice a difference in energy levels?

 

[tmaxey1]

Thanks - good info. Is taking T3 like Testosterone, where you will need it as a permanent supplement? Or does your doc expect the Thyroid to somehow sort itself out over time. I have a consult coming up with Defy and am glad to hear they know how and are willing to treat Thyroid issues. Also, in your case, how long after starting on the T3 did you notice a difference in energy levels?

From my understanding there could be something happening inside the body that is causing the high conversion to reverse t3. It may be like testosterone where we don’t really know why my 69 year old father in law has a testosterone level of 700 while I eat clean, workout, look healthy and have a level of less than 200 at 43years old.

It seems the approach they are taking is to have all the same blood work done at 12 weeks and see if my thyroid levels (reverse and all) are the same then choose. I have read a theory that getting your testosterone and estrogen levels straightened out could improve thyroid function also. Everyone is different so it could be something we have to just monitor and adjust as needed.

I can say that taking thyroid makes a huge difference to energy level. Both test and thyroid together in my case makes me feel 15 years younger. My brain is clear. Focused. The strangest thing I noticed is colors look brighter....I still can’t explain this but red signs look so vibrant. I’m half thinking it’s in my mind..and maybe it is. But to me it’s like a fog has been cleared from my brain. So weird.

 

[GemStater]

Thanks everyone for the replies.

As far as my Thyroid is concerned, my recent blood work has TSH with Reflex FT4

Results: 1.07 (Free T4 not indicated)

I haven't studied Thyroid much but looking at this CHART from Discount Labs, it would appear a TSH of greater than 2.5 U/mL would be the circuit breaker for testing Free T3. Again, don't really know much about it. Just my understanding at this point.

Yes, I don't really know how it will go with this doctor. Really, the only reason I'm going to see him is my dad likes him telling me "he will do what I want". Plus as far as I know, he is the only game in town for being a pro hormone therapy doc. I think pretty much all the other doctors in my area are old school; if it's not below 250 we're not touching it with a ten foot pole sort of thinking. Anyway, if he doesn't work for me, I'll likely have to travel to find what I want.

I am firmly not doing pellets or gel. I am somewhat open to injections but unsure of the logistics of hypodermics and whether or not I want to integrate that into my lifestyle. I'm also interested in exploring 20% T cream applied to the scrotal tissue but my concern there is higher levels of DHT. I have noticed my scalp starting to thin so I don't want to help it along anymore than it has to.

Also, just for the sake of knowing, I want to find out if I have Primary or Secondary hypogonadism. I do get a healthy discount on labs through my insurance company if I stick with in-network providers. I do wonder what typical lab costs are for tests like LH, FSH, GnRH, PSA, etc? For example, my Free and Total testosterone labs were billed at $62ea., but after my insurance discount, I paid $24ea. Is this in line with the other lab costs? I'd like to have a baseline on all my natural markers before I start therapy. Again, just wondering what typical lab costs for these tests?

Thanks again!

 

[Gman86]

My reverse T3 was 26. I was prescribed T3 instead of the normal synthroid which is T4 because high reverse T3 means your body is converting high levels of T4 to reverse T3 instead of normal T3. So this is causing the reverse t3 to compete with the t3 effectively neutralizing the T3. Giving me T4 could lead to just more reverse t3.

This is how it was explained to me.

What is your protocol, in regards to TRT and thyroid? Always curious to hear what someone is doing when they’re feeling so great. Thanks.

 

[Gman86]

Thanks everyone for the replies.

As far as my Thyroid is concerned, my recent blood work has TSH with Reflex FT4

Results: 1.07 (Free T4 not indicated)

I haven't studied Thyroid much but looking at this CHART from Discount Labs, it would appear a TSH of greater than 2.5 U/mL would be the circuit breaker for testing Free T3. Again, don't really know much about it. Just my understanding at this point.

Yes, I don't really know how it will go with this doctor. Really, the only reason I'm going to see him is my dad likes him telling me "he will do what I want". Plus as far as I know, he is the only game in town for being a pro hormone therapy doc. I think pretty much all the other doctors in my area are old school; if it's not below 250 we're not touching it with a ten foot pole sort of thinking. Anyway, if he doesn't work for me, I'll likely have to travel to find what I want.

I am firmly not doing pellets or gel. I am somewhat open to injections but unsure of the logistics of hypodermics and whether or not I want to integrate that into my lifestyle. I'm also interested in exploring 20% T cream applied to the scrotal tissue but my concern there is higher levels of DHT. I have noticed my scalp starting to thin so I don't want to help it along anymore than it has to.

Also, just for the sake of knowing, I want to find out if I have Primary or Secondary hypogonadism. I do get a healthy discount on labs through my insurance company if I stick with in-network providers. I do wonder what typical lab costs are for tests like LH, FSH, GnRH, PSA, etc? For example, my Free and Total testosterone labs were billed at $62ea., but after my insurance discount, I paid $24ea. Is this in line with the other lab costs? I'd like to have a baseline on all my natural markers before I start therapy. Again, just wondering what typical lab costs for these tests?

Thanks again!

Hopefully this doctor is able to help you out. Is he considered an “in-network” provider to your insurance?

Not sure about the lab costs and if those are typical. I have Healthconnector through the state of MA, and it literally covers my labs 100%. Idk how, but they do. Usually 4K worth of labs each time.

But if things don’t end up working out with this doctor, I would just give Defy a call. They’re cheap, extremely knowledgeable, couldn’t be nicer and more understanding, and will definitely take care of you. They do everything over the phone, so you can be in any state and still use them. Just need a physical each year with your primary, and fax it to them.

 

[tmaxey1]

What is your protocol, in regards to TRT and thyroid? Always curious to hear what someone is doing when they’re feeling so great. Thanks.

Testosterone 70mgs twice per week. So 140mgs per week. Cytomel T3 15 mcg every morning, 25 mg DHEA before bedtime, 200 mgs DIM. No AIs at this point because my E2 was only 7 due to test being 177. I’m gyno prone though so I have 0.125 in case. Haven’t needed it yet. HCG 500 2x week.

I will say that I think I will need to bump up testosterone a little in the future. A good amount of my feeling better could be T3 related. I’m curious how much the Hcg and 140mgs test brings me up since I started at such a low T level.

 

[Gman86]

Testosterone 70mgs twice per week. So 140mgs per week. Cytomel T3 15 mcg every morning, 25 mg DHEA before bedtime, 200 mgs DIM. No AIs at this point because my E2 was only 7 due to test being 177. I’m gyno prone though so I have 0.125 in case. Haven’t needed it yet. HCG 500 2x week.

I will say that I think I will need to bump up testosterone a little in the future. A good amount of my feeling better could be T3 related. I’m curious how much the Hcg and 140mgs test brings me up since I started at such a low T level.

Well at least you give hope to guys on HCG that it’s possible to not use an ai. Seems like most of the guys that don’t need an ai, aren’t using HCG. And ya optimizing thyroid makes all the difference. I have an appointment coming up to try and get on thyroid medication.

How long have you been on this protocol, and when do you expect to get labs?

 

[tmaxey1]

Well at least you give hope to guys on HCG that it’s possible to not use an ai. Seems like most of the guys that don’t need an ai, aren’t using HCG. And ya optimizing thyroid makes all the difference. I have an appointment coming up to try and get on thyroid medication.

How long have you been on this protocol, and when do you expect to get labs?

Hopefully I can continue to not need an AI. I am not one of the guys that is scared of AI's though. About 20 years about in my younger dumber days I did a steroid cycle of Sus 250. . This aggravated my puberty gyno pretty bad. I was dumb and didnt have quick access to Novaldex or any AI's. My parents took me to our family doctor when I was about 12 due to gyno. The guy said its normal and will go away. I'd like to go back and slap him. It didnt go away. The guy should have given me an AI or SERM back then.

I have no problem taking an AI over getting any gyno flare ups. I may be vain but Im not one of the people that will walk around looking like I need to be wearing a training bra.

It's only been 3 weeks so far. Labs are scheduled for 12 weeks out. So far I like the HCG. I have not noticed anything negative.

Good luck with the thyroid. I give most of the credit to how much more energy I have to getting this part right.

 

[GemStater]

I’m curious what you guys pay $$ for HCG? Are you getting it from your compounding pharmacy and mixing it yourself?

 

[Gman86]

I’m curious what you guys pay $$ for HCG? Are you getting it from your compounding pharmacy and mixing it yourself?

For Pregnyl, I was having CVS order it, and then with a GoodRX coupon, it was $113 for a 10,000iu bottle.

With Empower Pharmacy, I pay $40 for 6,000iu’s. That’s without shipping costs.

 

[GemStater]

For Pregnyl, I was having CVS order it, and then with a GoodRX coupon, it was $113 for a 10,000iu bottle.

With Empower Pharmacy, I pay $40 for 6,000iu’s. That’s without shipping costs.

Great! Thanks!

Next question. How many applications does 6,000iu’s work out to? 10,000iu’s?

Is that pre-mixed ready to use or do you mix the HCG power and bacteriastatic water yourself?

Also I thought I heard the HCG has a 36-hour shelf life. Is that true?

 

[GemStater]

Hopefully this doctor is able to help you out. Is he considered an “in-network” provider to your insurance?

Not sure about the lab costs and if those are typical. I have Healthconnector through the state of MA, and it literally covers my labs 100%. Idk how, but they do. Usually 4K worth of labs each time.

But if things don’t end up working out with this doctor, I would just give Defy a call. They’re cheap, extremely knowledgeable, couldn’t be nicer and more understanding, and will definitely take care of you. They do everything over the phone, so you can be in any state and still use them. Just need a physical each year with your primary, and fax it to them.

Yes, the doctor I’m going to see is “in-network”. Actually he is technically a Physicians Assistant (PA).

$4,000 dollars in labs each time??? I sure hope not.

 

[Gman86]

Yes, the doctor I’m going to see is “in-network”. Actually he is technically a Physicians Assistant (PA).

$4,000 dollars in labs each time??? I sure hope not.

Haha yup. One time I got the bill by accident and almost sht my pants. I get less labs now, but still a couple thousand worth.