Candidate for TRT ?

[andre]

Hi All, I'm not on TRT but doc is suggesting I just start with 10% compound cream and "see what happens". I have read Nelson's book so I'm not totally ignorant. Here are my blood results, averaged over the past year with three different draws.

t-total: 380 ng/dl (350-1197)
t-free: 7 pg/ml (7-24)
estradiol: 27 pg/ml (7-42)
psa: 0.6 ng/ml (0-4)
lh: 5.7 miu/ml (1.7-8.6)
fsh: 5.1 miu/ml (1.5-12.4)
shbg 28 nmol/L (19-76)
dht: 20 ng/dl (30-85)
cortisol: 16.3 ug/dl (2.3-19.4)
pregnenolone, ms: 77 ng/dl (<151)
dhea-sulfate 222 ug/dl (71-375)
tsh: 2.6 uiu/ml (0.45-4.5)
prolactin 7.1 ng/ml (4-15)
vitaminD: 49ng/ml (30-100)

I'm 53yrs old, 5'7 and 185lbs (not fat)

My motivation for considering TRT is the carrot stick that my well being would be better, including restoring my strength levels in the gym which just seem to keep going down. However, I don't want any increase of fat around my mid-section that I've worked hard to minimize by working out most of my entire life. I understand that estrogen will be my worst enemy but I'm fearful that I won't be prescribed an anti-estrogen until my e-number is high and by that time it will be too late - i.e. -- I will already have developed fatty love handles. All in all, my motivation seems fairly self-centered.

thanks for any advise!

 

[Vettester Chris]

Andre, glad you joined. Couple things, your LH & FSH values look pretty good. Although, test serum isn't optimal, it isn't tanked either. With LH in the 5's, I'd think serum would be a bit higher, so wondering if maybe one of your testicles is underperforming? Not saying testosterone treatment isn't for you, but maybe just nudging you to have your physician dig a little deeper into the diagnosis and make sure you don't have any underlying conditions contributing to the sub-optimal production of endogenous test.

Also, look at estrogen in a different light. It can actually be one of your best friends, not your "worst enemy". The key is balance. Like testosterone, you need optimal levels of estrogen in your body. On a sensitive assay model, 25 to 35 IMO is a good place to be for most men. Start tanking E2 and you will start experiencing a myriad of potential issues from bone density to immune system problems. Embrace E2 at a close friend to compliment your TRT and your program will have a greater chance for success. Just keep an eye on it, keep it in check, and IMO only us AI's in a 'small' amount WHEN needed.

I'm not convinced that the thyroid is where you want it with just the TSH you provided. You really need a comprehensive thyroid panel with Free T4, Free T3, Reverse T3 and antibodies. Let us know if you have these, or look into trying to get them.

 

[andre]

Hi Chris,

So nice of you to give that analysis, more comprehensive that what I got from both LifeExtension Doctors and my own physician! Thanks.

Here are more thyroid numbers that go along with tsh

T4: 9 ug/dl (4.7-13.8)
T-uptake 38 % (30-39)
free T4 1.06 ng/dl (0.59-1.61)
free thyroxine index 1.06 calc (1.4-4.5)
tsh: 2.6 uiu/ml (0.45-4.5)

Its hard for me to tell the risk/reward for using TRT based on my numbers. My physician is so casual about just trying it.

you have any opinion ?

take care

 

[Gene Devine]

Elevated estrogen on transdermals in men is a very rare case...I wouldn't worry about it but do monitor it.

 

[Vettester Chris]

Andre, besides the TSH and FT4, the thyroid labs they ran for you are "spinners". They look cool, they sound important, but in the end they just spin like a load of laundry without providing much of anything!

FT4 is your storage hormone, and it's sitting at 46% of it's range value. When looking at range values, a lot of the folks in the thyroid community, including myself, look at aiming for FT4 and FT3 to be 50% to 80% of the range value, combined with keeping Reverse T3 in check when comparing the FT3/RT3 ratios. Ultimately, with the thyroid, we all need to know how effectively T3 is getting into our body. If you can get your Free T3- triiodothyronine (not the uptake or any of that stuff), Reverse T3, and antibodies (TPO and TgAb), I will be glad to give you my thoughts.

On the physician, I'd personally rather see one that is confident with knowledge from his/her experiences and training, as opposed to one that is "casual". Hormones is serious business, just make sure you're getting the very best care for your well being.