Baseline

[Hoosierdaddy]

Full lab panel was done. Everything normal. Test related items below.
PSA was <1.

48 y.o. - not recovering quickly from athletics and training, tired a lot,
unmotivated, and libido iffy.

I realize ranges are relative and not knowing what my “normal” was 25 years ago leaves some doubt as to my ideal.

Appointment Monday.

What would you expect from doctor? What would be acceptable appproach if this was you?

 

[HealthMan]

You need a more comprehensive blood work including your thyroid levels (not only TSH). Your total testosterone levels are not bad at all however you have high SHBG so your free testosterone is on the low end of the range. Estradiol is probably the wrong one. You need the ultrasensitive test.
TRT is a possibility for sure but if I were you I would do further testing to rule out other issues (ex: thyroid). Given your high SHBG you would need to get your total testosterone probably to above range levels to optimize your free testosterone.

 

[CoastWatcher]

Welcome to Excelmale. Are you taking any medications, over the counter or prescription? Previous history of anabolic steroid use? What is your sleep like? Sleep issues, particularly apnea, can hammer hormones. Opiate use for any length of time?

 

[Hoosierdaddy]

Statin, SSRI. Nothing else. Sleep pretty good. No other medications.

 

[Hoosierdaddy]

I should add that my goals are not just to be a “fit” 50 y.o. I like 50-100 mike running and want to be able to train as needed for these types of things.

 

[FeelingLost]

Appointment Monday.

What would you expect from doctor? What would be acceptable appproach if this was you?

Are we talking medical insurance PCP? Oh your fine son all your numbers are completely normal for a guy your age. Now go away and stop bothering me about TRT I'm too busy to deal with my bosses (the ins company) paperwork to get you a half assed mono T program. cause we don't do AI's or HCG.
Or are you talking to a real TRT doctor? With an SHGB that high its a wonder you can get out of bed. You basicly have no free T (thats the T you feel)

I would check out Nelsons blood testing service and get a proper Pre- TRT MALE Hormone / Wellness Panel test ran.
https://www.discountedlabs.com/

 

[Hoosierdaddy]

Not my PCP. I’ll Ben honest - trying to decipher practitioners that are in this for money v know what they’re doing has been a struggle. TRT is big business now it seems and I don’t want snake oil.

 

[FeelingLost]

Not my PCP. I'll Ben honest - trying to decipher practitioners that are in this for money v know what they're doing has been a struggle. TRT is big business now it seems and I don't want snake oil.

I hear you. Those T mills with their pellets or 200mg/week shots scare the you know what out of me. My PCP attemped, bless his heart, but messed me up pretty bad I was lucky and found Defy a clinic out of Florida that does telemeds I have been very please with them. They advertize on this forum.

 

[Hoosierdaddy]

With an SHGB that high its a wonder you can get out of bed. You basicly have no free T (thats the T you feel)

I would check out Nelsons blood testing service and get a proper Pre- TRT MALE Hormone / Wellness Panel test ran.
https://www.discountedlabs.com/

What do you mean by the getting out of bed comment?

 

[FeelingLost]

What do you mean by the getting out of bed comment?

Hi Hoosier,
Sex hormone-binding globulin (SHBG) or sex steroid-binding globulin (SSBG) is a glycoprotein that binds to the two sex hormones: androgen and estrogen.
Yours is 65 that is really high. Meaning all your 642ng/dL of T is getting bound up so you can't use it. That is why your free T is so low and why you're (copy paste) not recovering quickly from athletics and training, tired a lot, unmotivated, and libido iffy. Hence my comment you don't have enough energy to get out of bed.It was just a metaphor.
You need a full pre TRT blood test and good TRT doc and he/she can fix your issues.

 

[OMI100]

Full lab panel was done. Everything normal. Test related items below.
PSA was <1.

48 y.o. - not recovering quickly from athletics and training, tired a lot,
unmotivated, and libido iffy.

I realize ranges are relative and not knowing what my “normal” was 25 years ago leaves some doubt as to my ideal.

Appointment Monday.

What would you expect from doctor? What would be acceptable appproach if this was you?

View attachment 5190

My mantra is next
********************************
First step is education....
********************************
Cannot tell how much research you have done on TRT.
If not a lot, I recommend you get a few books.
Get a few good books and educate yourself now:
1. Get Nelsons book "Testosterone: A Man’s Guide".
2. Get Lee Myer's book "Natural Versus Testosterone Therapy".
3. Get “Testosterone for life - Dr. Abraham Morgentaller “.
4. Get “The Definitive Testosterone Replacement Therapy MANual: How to OptimizeYour Testosterone For Lifelong Health And Happiness” by Jay Campbell.
These books will give you a much better understanding of TRT....
One other form that has great info that might be useful to you is:
http://www.peaktestosterone.com/
********************************
Second step might be to have a look at your thyroid and see if any issuesthere.
********************************
Do some research.
I do like Tiredthyroid as a starting point.
Easy to read sections.
References at the bottom of each section (and NOT from people wearing "tinfoil" hats)
See below:
Basic sources to research Thyroid issues and testing:
******************************************
https://stopthethyroidmadness.com/
Spend time here and get the 2 books, “STTM: The Revised Book” and “STTMII:Authored by Doctors”.
*******************************************
http://www.tiredthyroid.com/
Great simple to understand articles.
Get her book.... “Tired Thyroid: From Hyper to Hypo to Healing—Breaking the TSHRule”, https://read.amazon.com/kp/embed?asi...Channel=system
A lot of clear researched information that is easy toread and understand.
***************************
https://hypothyroidmom.com/
Good info here. Look around.
*************************
https://www.restartmed.com/?s=thyroid
A LOT of good articles and a youtube page.
Spend time here looking around and reading after getting labs back.
************************************
Need informationon on testing....
Read here:
http://www.tiredthyroid.com/what-labs.html
And here:
http://www.tiredthyroid.com/optimal-labs.html
and here:
https://stopthethyroidmadness.com/recommended-labwork/
and here:
https://www.restartmed.com/thyroid-tests/
and here:
https://www.restartmed.com/hormone-testing/
And here:
https://www.restartmed.com/normal-thyroid-levels/
**************************************
Some additional links to read before you recive the books you have already ordered
Go here:
http://www.allthingsmale.com/publications.html

and download:
TRT: Recipe For Success
Print out and file.
and
HCG Update.
and the TRT Power Point presentation.
Dr. Crisler is one of the "TRT Cutting Edge DR's" here in thestates....
Also go here:
http://www.drjohncrisler.com/the-cri...part-deux.html
and also print out the article.
***************************
ALSO look at the videos that are posted on this site. A LOT of great info to take in....
******************************
Now you will have a great reference library and knowledge base to go forward on

 

[Hoosierdaddy]

Hi Hoosier,
Sex hormone-binding globulin (SHBG) or sex steroid-binding globulin (SSBG) is a glycoprotein that binds to the two sex hormones: androgen and estrogen.
Yours is 65 that is really high. Meaning all your 642ng/dL of T is getting bound up so you can't use it. That is why your free T is so low and why you're (copy paste) not recovering quickly from athletics and training, tired a lot, unmotivated, and libido iffy. Hence my comment you don't have enough energy to get out of bed.It was just a metaphor.
You need a full pre TRT blood test and good TRT doc and he/she can fix your issues.

The naturopath I’m seeing said the same thing. I’m quite nervous about HRT so we’re starting lower 2x week 50 ng with hcg and AI. He did not believe Boron would work to lower the SHBG not would try if I preferred.

 

[Dr Justin Saya MD]

My mantra is next
********************************
First step is education....
********************************
Cannot tell how much research you have done on TRT.
If not a lot, I recommend you get a few books.
Get a few good books and educate yourself now:
1. Get Nelsons book "Testosterone: A Man’s Guide".
2. Get Lee Myer's book "Natural Versus Testosterone Therapy".
3. Get “Testosterone for life - Dr. Abraham Morgentaller “.
4. Get “The Definitive Testosterone Replacement Therapy MANual: How to OptimizeYour Testosterone For Lifelong Health And Happiness” by Jay Campbell.
These books will give you a much better understanding of TRT....
One other form that has great info that might be useful to you is:
http://www.peaktestosterone.com/
********************************
Second step might be to have a look at your thyroid and see if any issuesthere.
********************************
Do some research.
I do like Tiredthyroid as a starting point.
Easy to read sections.
References at the bottom of each section (and NOT from people wearing "tinfoil" hats)
See below:
Basic sources to research Thyroid issues and testing:
******************************************
https://stopthethyroidmadness.com/
Spend time here and get the 2 books, “STTM: The Revised Book” and “STTMII:Authored by Doctors”.
*******************************************
http://www.tiredthyroid.com/
Great simple to understand articles.
Get her book.... “Tired Thyroid: From Hyper to Hypo to Healing—Breaking the TSHRule”, https://read.amazon.com/kp/embed?asi...Channel=system
A lot of clear researched information that is easy toread and understand.
***************************
https://hypothyroidmom.com/
Good info here. Look around.
*************************
https://www.restartmed.com/?s=thyroid
A LOT of good articles and a youtube page.
Spend time here looking around and reading after getting labs back.
************************************
Need informationon on testing....
Read here:
http://www.tiredthyroid.com/what-labs.html
And here:
http://www.tiredthyroid.com/optimal-labs.html
and here:
https://stopthethyroidmadness.com/recommended-labwork/
and here:
https://www.restartmed.com/thyroid-tests/
and here:
https://www.restartmed.com/hormone-testing/
And here:
https://www.restartmed.com/normal-thyroid-levels/
**************************************
Some additional links to read before you recive the books you have already ordered
Go here:
http://www.allthingsmale.com/publications.html

and download:
TRT: Recipe For Success
Print out and file.
and
HCG Update.
and the TRT Power Point presentation.
Dr. Crisler is one of the "TRT Cutting Edge DR's" here in thestates....
Also go here:
http://www.drjohncrisler.com/the-cri...part-deux.html
and also print out the article.
***************************
ALSO look at the videos that are posted on this site. A LOT of great info to take in....
******************************
Now you will have a great reference library and knowledge base to go forward on

Well that’s an AWESOME post. Nicely done Orrin Israel!

 

[FeelingLost]

The naturopath I'm seeing said the same thing. I'm quite nervous about HRT so we're starting lower 2x week 50 ng with hcg and AI. He did not believe Boron would work to lower the SHBG not would try if I preferred.

I don't think boron would do much to drop ones SHGB either. Your first protocol sound pretty reasonable. An AI right out of the gate might be bad. An AI is usually not taken until you have high E2 problems meaning your blood test show a pretty high number and or you have signs of high E2 and there are many.

Moodyness would probably be the first. Once you start noticing signs of high E2 it is time for a mini blood test to confirm it. Then and only then should you take an AI. AI's are very powerful and you can crash your E2 pretty darn fast so be careful. The symptoms of crashed E2 and high E2 are very similar and you don't want to be in a guessing game of are you high or low.

I hope that helps.

 

[OMI100]

Well that's an AWESOME post. Nicely done Orrin Israel!

TY.
If you have any other references / books that you feel will add value let me know and I will add them....

 

[Hoosierdaddy]

Thanks - I’ll follow up

 

[OMI100]

Thanks - I'll follow up

Read here about E2:
http://www.peaktestosterone.com/Hdr_Estrogen.aspx

 

[Hoosierdaddy]

I don't think boron would do much to drop ones SHGB either. Your first protocol sound pretty reasonable. An AI right out of the gate might be bad. An AI is usually not taken until you have high E2 problems meaning your blood test show a pretty high number and or you have signs of high E2 and there are many.

Moodyness would probably be the first. Once you start noticing signs of high E2 it is time for a mini blood test to confirm it. Then and only then should you take an AI. AI's are very powerful and you can crash your E2 pretty darn fast so be careful. The symptoms of crashed E2 and high E2 are very similar and you don't want to be in a guessing game of are you high or low.

I hope that helps.

Started 150mg test cyp weekly w/ .5mg AI. Also HCG 2x/week (1 day pre and 2 days post Cyp). We’ll see. Nothing feels different yet, ha!

 

[FeelingLost]

Started 150mg test cyp weekly w/ .5mg AI. Also HCG 2x/week (1 day pre and 2 days post Cyp). We'll see. Nothing feels different yet, ha!

That is a very reasonable protocol congrads to your doc. Refresh my memory do we know your SHGB? Mine is 24.2 and 150mg/wk(50mg M/W/F) took me 1175 trough TT my FT was 33 and my E2 sens, 28 I was taking .125mg AL with every shot. HCG was 800/wk

 

[Systemlord]

It's going to take 6 weeks for blood testosterone to reach a stable state, after this you should slowly start feeling better with every passing month provided free thyroid hormones are in at good healthy level. SSRI will hinder TRT effectiveness as it's a mind altering drug, testosterone effects every cell in your body, even how you think. You may find once you have been on TRT for a few months that you may not even need the SSRI, you likely needed it because testosterone was low and causing problems.

Depression and anxiety is linked to low testosterone in a lot of men, much like a grumpy old man who is more than likely to have low testosterone.