James
Nydheart has not told us what his total T level is.
If I had no low libido or ED, I would not start TRT unless two fasting morning samples taken a month apart showed TT < 250 ng/dL. I know that sounds super conservative coming from me.
Yes, lower TT has been associated with higher risk of diabetes, heart disease, and metabolic syndrome. But the studies that looked into these associations did not measure free T and DHT.
Good libido and strong erections are things to cherish and protect. Introducing TRT and its HTPA shutdown may jeopardize these two factors.
Some men's bodies can do better than others with lower TT. Most of these men have free T over 3 percent of total and great levels of other androgens/metabolites like DHT and DHEA. Unfortunately, most TRT and hypogonadism studies have only measured total testosterone and not free T or DHT, two of the strongest factors in my opinion on sex drive and erection quality in men.
