High Total T, low free T, high E2 - feel like utter shit

[madman]

I did in the past, he told me i don't need TRT and i should try boron to lower my SHBG
Which Didn't work, might contact him again to see what he says though... as he was one of only three TRT doctors in the UK to actually message me back personally which is highly appreciated

He is one of the few in the UK that is knowledgeable regarding trt.

Take heed of his advice.....think deeply before you go and jump on the trt bandwagon.

As I stated earlier your FT is just barely under mid-range and by no means LOW!

I would look into thyroid/adrenals.

 

[fifty]

I got my prolactin down to 171 recently by a change in diet + taking calcium D glucarate and ashwagandha

What would taking DHEA do? i think i got my DHEA tested and it was fine

Dhea is the cheapest, quickest, and easiest thing to try at least in the US as it’s dirt cheap and readily available. Plus its half life is only a few hours if you don’t like it.

 

[madman]

As I expected, Reverse T3 is below range because you have conversion problems which seem to favor Free T4, only Free T3 is the active thyroid hormone which increases metabolism.

Free T3 should be at least mid-range or better to support proper metabolic function, Free T3 provides energy to all organs so when Free T3 is low, organ function slows down.

I don't believe Free T is even close to optimal, more like sub-optimal and do not expect managed healthcare doctors to approve TRT with those numbers. If this is the case your only option would be a private anti-aging clinic.

I'm getting a Free T percentage of 1.54 %, 2-3 percent is considered normal.

You'll probably need levels >800 to get Free T to the optimal ranges and managed healthcare doctors are unable to allow levels >800 do to insurance guidelines.

Insurance guidelines and managed healthcare doctor are still in the stone ages for knowledge in TRT, so it's makes little sense to seek treatment in managed healthcare.

What using the linear law-of-mass action model Vermuelen calculated method which has been shown to be inaccurate and in many cases underestimates ones FT levels!

Using the newer calculated TruT.....which you should very well know by now is on par with results obtained by the gold standard Equilibrium Dialysis.....his FT 22.84 ng/dL is just barely under the mean 23.5 ng/dL (mid-range) of the reference range 16-31 ng/dL

Your giving out advice based on piss poor testing methods whether using the direct immunoassay or the older calculated methods (law-of-mass action models or empiric equations)

Embarrassing that you would still choose to calculate ones FT using Vermeulen calculated instead of the newer TruT calculated method.....which everyone should be using if they truly want the most accurate estimates for FT.

You need to rethink the advice you are dishing out regarding FT!

 

[Vvs1]

Try DHT if you're in the UK. Testosterone goes into E2 or DHT by different enzymes, so it's worth noting that one pathway is higher.

I've also seen a doctors case where he had brain fog, hormonal issues by too much E2 and DHT. They blocked the pathways lightly with herbs (don't take Saw Palmetto) and he was improved 80% after a month.

I think its probably the number/or sensitivity of receptors and amounts of hormones that determine how you feel.

 

[bagelmatic]

Try DHT if you're in the UK. Testosterone goes into E2 or DHT by different enzymes, so it's worth noting that one pathway is higher.

I've also seen a doctors case where he had brain fog, hormonal issues by too much E2 and DHT. They blocked the pathways lightly with herbs (don't take Saw Palmetto) and he was improved 80% after a month.

I think its probably the number/or sensitivity of receptors and amounts of hormones that determine how you feel.

i've tried every herbal method possible tbh, ones that are meant to lower e2, increase free T, lower SHBG, increase DHT and nothing has worked thus far

I do agree with you on the latter part that androgen receptor density matters equally if not more than what your numbers say...
if you have low/weak androgen receptor density even with 'average' levels you wont feel good, and with good receptor density and average numbers you'll feel great

 

[bagelmatic]

What using the linear law-of-mass action model Vermuelen calculated method which has been shown to be inaccurate and in many cases underestimates ones FT levels!

View attachment 7757






Using the newer calculated TruT.....which you should very well know by now is on par with results obtained by the gold standard Equilibrium Dialysis.....his FT 22.84 ng/dL is just barely under the mean 23.5 ng/dL (mid-range) of the reference range 16-31 ng/dL

Your giving out advice based on piss poor testing methods whether using the direct immunoassay or the older calculated methods (law-of-mass action models or empiric equations)

Embarrassing that you would still choose to calculate ones FT using Vermeulen calculated instead of the newer TruT calculated method.....which everyone should be using if they truly want the most accurate estimates for FT.

You need to rethink the advice you are dishing out regarding FT!

That's all fine and dandy but it doesn't take away from all the symptoms i'm facing, likely it could also be an androgen receptor density problem as i stated in the previous post

 

[madman]

That's all fine and dandy but it doesn't take away from all the symptoms i'm facing, likely it could also be an androgen receptor density problem as i stated in the previous post

Has nothing to do with AR density.....if anything it would be sensitivity of the AR or AR resistance which would be more common in older men or possibly men that have abused testosterone/AAS.

At your age highly unlikely you have any issues with AR sensitivity let alone AR resistance.

You are just fishing here.....dead set that it is a low-t issue when in fact your FT levels are barely below mid-range using the TruT calculated which is on par with results obtained by the gold standard Equilibrium Dialysis (which all other FT testing methods are compared to).

Do you truly need higher FT levels.....sure but again your FT levels are by no means low and I would be looking into thyroid/adrenals before jumping head first into trt.


From your first post:


Just a short intro:
i've been feeling like utter shit for about 2 years now and i think i suffered from low T and high E during my puberty but about 18 months ago i started eating very healthily and consistently working out about 6 days a week on a PPL routine with cardio.
Despite this i still find it really hard to put on muscle and lose fat and my body composition/body fat deposition would look very 'Skinny fat'
Other things i've been facing for about a year or more
-Loss of libido [gotten alot worse over the past few months to the point where it's hard to even get erections sometimes, and NO morning wood at all ever]
-Alot of brain fog
-Constant low level to medium level depression
-Gynocomastia i got during puberty seemingly feeling worse




i started eating very healthily and consistently working out about 6 days a week on a PPL routine with cardio.
Despite this i still find it really hard to put on muscle and lose fat and my body composition/body fat deposition would look very 'Skinny fat'

-should be the least of your concerns regarding jumping on trt

-diet/training protocol/quality sleep.....let alone ones genetics have a far greater impact on body composition (muscle gain/fat loss) than simply just having healthy TT/FT levels

-having healthy T levels resulting from use of trt doses will improve ones body composition (minor increase muscle/decreased adipose) but it is in no way comparable to the muscle/strength gains one would attain from the use of high doses of testosterone.....we are on trt here not steroids!

- too many seem to think that jumping on trt will result in packing on muscle and getting lean which is laughable.



Other things i've been facing for about a year or more
-Loss of libido [gotten alot worse over the past few months to the point where it's hard to even get erections sometimes, and NO morning wood at all ever]
-Alot of brain fog
-Constant low level to medium level depression

-ED is multifaceted.....sure unhealthy T levels can have a negative impact on libido/erectile function but it is not always the sole cause.

-cardiovascular health/endothelial dysfunction, lack of quality sleep, excess stress, depression/anxiety, poor lifestyle habits, lack of exercise, thyroid/adrenal dysfunction

-brain fog, depression can have many causes aside from just unhealthy T levels.....thyroid/adrenal function would be key players here





Do understand that thyroid dysfunction can mimic many of the same low-t symptoms!

 

[bagelmatic]

Has nothing to do with AR density.....if anything it would be sensitivity of the AR or AR resistance which would be more common in older men or possibly men that have abused testosterone/AAS.

At your age highly unlikely you have any issues with AR sensitivity let alone AR resistance.

You are just fishing here.....dead set that it is a low-t issue when in fact your FT levels are barely below mid-range using the TruT calculated which is on par with results obtained by the gold standard Equilibrium Dialysis (which all other FT testing methods are compared to).

Do you truly need higher FT levels.....sure but again your FT levels are by no means low and I would be looking into thyroid/adrenals before jumping head first into trt.


From your first post:


Just a short intro:
i've been feeling like utter shit for about 2 years now and i think i suffered from low T and high E during my puberty but about 18 months ago i started eating very healthily and consistently working out about 6 days a week on a PPL routine with cardio.
Despite this i still find it really hard to put on muscle and lose fat and my body composition/body fat deposition would look very 'Skinny fat'
Other things i've been facing for about a year or more
-Loss of libido [gotten alot worse over the past few months to the point where it's hard to even get erections sometimes, and NO morning wood at all ever]
-Alot of brain fog
-Constant low level to medium level depression
-Gynocomastia i got during puberty seemingly feeling worse




i started eating very healthily and consistently working out about 6 days a week on a PPL routine with cardio.
Despite this i still find it really hard to put on muscle and lose fat and my body composition/body fat deposition would look very 'Skinny fat'

-should be the least of your concerns regarding jumping on trt

-diet/training protocol/quality sleep.....let alone ones genetics have a far greater impact on body composition (muscle gain/fat loss) than simply just having healthy TT/FT levels

-having healthy T levels resulting from use of trt doses will improve ones body composition (minor increase muscle/decreased adipose) but it is in no way comparable to the muscle/strength gains one would attain from the use of high doses of testosterone.....we are on trt here not steroids!

- too many seem to think that jumping on trt will result in packing on muscle and getting lean which is laughable.



Other things i've been facing for about a year or more
-Loss of libido [gotten alot worse over the past few months to the point where it's hard to even get erections sometimes, and NO morning wood at all ever]
-Alot of brain fog
-Constant low level to medium level depression

-ED is multifaceted.....sure unhealthy T levels can have a negative impact on libido/erectile function but it is not always the sole cause.

-cardiovascular health/endothelial dysfunction, lack of quality sleep, excess stress, depression/anxiety, poor lifestyle habits, lack of exercise, thyroid/adrenal dysfunction

-brain fog, depression can have many causes aside from just unhealthy T levels.....thyroid/adrenal function would be key players here





Do understand that thyroid dysfunction can mimic many of the same low-t symptoms!

Alright, so i should be looking into taking thyroid medication?

Everything is a multifaceted issue, but more often than not i find people using this kind of terminology as an excuse to not say 'I don't really know the answer or answers as to what could help you tbh, but i want to put forward a vibe of intellectualism so i'll say this'.

Don't get me wrong, i appreciate all the replies here and differing opinions but i've been trying to address every facet of this 'multifaceted' issue for just over 2 years now and spent 1000s of my hard earned money on appointments with endocronologists, VARIOUS diet changes and supplement changes recommended by them.. to no Avail

In the end they chalk it down to 'multifaceted' issues too, which again i see as a complete cop out answer.


Ultimately when your dicks not working and you constantly wake up feeling moody/depressed and to top that off you're seemingly doing everything right, of course you'd be upset...
My reasons for wanting a solution aren't from 'wanting more muscle' or something, they are mainly from wanting to feel better by any means necessary
Even if this will involve injecting my ass every week for the rest of my life, even if that makes me feel 30% better i'd take it, rather than further waste more time chasing this magical pixie dragon of 'multifaceted' issues that i've been doing for over 2 years

 

[madman]

Alright, so i should be looking into taking thyroid medication?

Everything is a multifaceted issue, but more often than not i find people using this kind of terminology as an excuse to not say 'I don't really know the answer or answers as to what could help you tbh, but i want to put forward a vibe of intellectualism so i'll say this'.

Don't get me wrong, i appreciate all the replies here and differing opinions but i've been trying to address every facet of this 'multifaceted' issue for just over 2 years now and spent 1000s of my hard earned money on appointments with endocronologists, VARIOUS diet changes and supplement changes recommended by them.. to no Avail

In the end they chalk it down to 'multifaceted' issues too, which again i see as a complete cop out answer.


Ultimately when your dicks not working and you constantly wake up feeling moody/depressed and to top that off you're seemingly doing everything right, of course you'd be upset...
My reasons for wanting a solution aren't from 'wanting more muscle' or something, they are mainly from wanting to feel better by any means necessary
Even if this will involve injecting my ass every week for the rest of my life, even if that makes me feel 30% better i'd take it, rather than further waste more time chasing this magical pixie dragon of 'multifaceted' issues that i've been doing for over 2 years

Again as I stated already.....look into thyroid/adrenals!

If issues still persist after addressing this than give trt a go.