New member with blood tests

[Kram67]

Hi all,

First post, so just wanted to introduce myself.

My name is Mark and I am 52 years old, live in the UK, and have had what I think are low testosterone symptoms - low libido, apathy, brain fog, can’t seem to make a decision etc. I am reasonably fit, cycle between 40 to 100 miles per week depending on the time of year, and go to the gym 5 times a week. Eat reasonably healthy and drink moderately.

So I started looking into TRT and went tommy local GP who took my bloods. First ones came back with a testosterone level of 8 nmol/L, so then went for further tests which came back at 15 nmol/L. So the doctor then discharged me and said all within range. So left it a while but still felt the same so decided to go to an online company in the UK and they took into account my previous results and the new test (results below) which they provided and have said I am eligible for TRT.

It’s a big step to go on TRT as it is a lifelong commitment - looking at theses results what are people’s thoughts?

 

[Vince]

I wonder what would happen to your testosterone levels, if you quit cycling and just worked out with weights?

 

[Vince]

If that doesn't help.

Using Enclomiphene to keep GnRH levels

 

[Kram67]

The results above were taken last week and I have hardly done any cycling for the last few months as the weather hasn’t been great.

Why would cycling have a negative impact on testosterone level?

 

[Vince]

Chronic endurance exercise — such as cycling or running for hours — has been shown to decrease testosterone,” says Dr. Jadick. “High-endurance athletes tend to have higher levels of cortisol, which has the opposite effect of testosterone.
Piedmont Healthcare › living-better
The Best Exercises To Increase Testosterone | Piedmont Healthcare

The Best Exercises To Increase Testosterone | Piedmont Healthcare

 

[Kram67]

Ignoring the cycling aspect, and just taking into account my bloods am I a candidate for TRT?

As mentioned above my testosterone levels have varied from as low as 8 to 17 - curious as to why they are not more consistent? Always have bloods taken at the same time, first thing in the morning.

Even though online company are willing to prescribe TRT, I am wavering as it is a life long commitment and injecting yourself at least once a week.... doesn’t really appeal.

 

[Vince]

Ignoring the cycling aspect, and just taking into account my bloods am I a candidate for TRT?

As mentioned above my testosterone levels have varied from as low as 8 to 17 - curious as to why they are not more consistent? Always have bloods taken at the same time, first thing in the morning.

Even though online company are willing to prescribe TRT, I am wavering as it is a life long commitment and injecting yourself at least once a week.... doesn’t really appeal.

I would try every option before considering trt.

 

[Simon7]

Mark, focus on your symptoms. You seem displeased at how you are feeling. That should be your prime concern. Secondly, a Total t of 8 is low. Period. Total t of 12 with SHBG of 40 is marginal at best. Despite t being on the low end, your LH is also on the low end. This may suggest secondary hypogonadism.

Hence you could try hcg monotherapy for a few months and see if that alleviates your symptoms and raises your t. Injecting SUBQ with a 31g insulin needle is a breeze and painless, and you can start at 500iu twice a week and see how that works out for you.

You can stop hcg whenever you want. Contrary to exogenous testosterone, hcg does not shut down your body's t production but rather encourages and increases it.

 

[Kram67]

Thanks for the reply Simon, I wasn‘t aware of secondary hypogonadism. Reading up on it, the levels do point more towards that, however the likely causes of SH don’t appear to apply.

In studies for people with SH do you know how much on average HCG raises the T level by?

Certainly needs more investigation with the online company I am using.

I do think the cycling angle is a red herring as I have been cycling for over 20 years and only over the last year have I started feeling this way.

 

[Vince]

That's why I gave you the post to Enclomiphene. Because of your low LH.

 

[Kram67]

That's why I gave you the post to Enclomiphene. Because of your low LH.

That’s appreciated, however as I don’t know much about this, maybe some additional information as to what it is and why I may benefit from it, would have helped.

Thanks anyway.

 

[Vince]

That’s appreciated, however as I don’t know much about this, maybe some additional information as to what it is and why I may benefit from it, would have helped.

Thanks anyway.

Enclomiphene citrate is proposed for the treatment of some men who have secondary hypogonadism, especially that caused by dysfunctional, but reversible hypothalamus/pituitary activity. These men present with low total testosterone and low or inappropriately normal gonadotropin levels (LH and FSH).

Testosterone restoration using enclomiphene citrate in men with secondary hypogonadism: a pharmacodynamic and pharmacokinetic study

 

[Vince]

Are guys that do well on low dose clomid unicorns...or do they really exist?

 

[Simon7]

Thanks for the reply Simon, I wasn‘t aware of secondary hypogonadism. Reading up on it, the levels do point more towards that, however the likely causes of SH don’t appear to apply.

In studies for people with SH do you know how much on average HCG raises the T level by?

Often there is no apparent cause for the appearance of secondary hypogonadism. I'm not familiar with data on average T increase due to HCG. At any rate, every body is different and you need to try and experiment till you figure out what works best for you.

 

[Systemlord]

So I started looking into TRT and went tommy local GP who took my bloods. First ones came back with a testosterone level of 8 nmol/L, so then went for further tests which came back at 15 nmol/L. So the doctor then discharged me and said all within range.

If your levels at 15 nmol/L 1-2 days out of the week, but 8 nmol/L 5 days out of the week, that's no good. These blood based labs are a snapshot in time and don't really show what's going on under the surface.

You would have to test every day to gain a clearer picture, but at 52 years old T isn't expected to be steller. The clinicians are seeing men diagnosed with hypogonadism with LH in the 1-3 range on average.

 

[Kram67]

If your levels at 15 nmol/L 1-2 days out of the week, but 8 nmol/L 5 days out of the week, that's no good. These blood based labs are a snapshot in time and don't really show what's going on under the surface.

You would have to test every day to gain a clearer picture, but at 52 years old T isn't expected to be steller. The clinicians are seeing men diagnosed with hypogonadism with LH in the 1-3 range on average.

That‘s the problem, you just don’t know your true test level. Maybe the lower numbers are the anomaly and not the norm? I guess that’s why any diagnosis should be a clinical one rather than a laboratory one.

You say that clinicians are seeing a range of 1-3 for LH, what does that mean? Doesn’t that point to secondary hypogonadism as Simon mentioned above? If not, than what?

 

[Systemlord]

That‘s the problem, you just don’t know your true test level.

The other problem is you are catching your levels on a bell curve spiking at certain times, so timing is everything.

You say that clinicians are seeing a range of 1-3 for LH, what does that mean?

It means the majority of men diagnosed with hypogonadism have an LH between 1-3. That's not to say that men aren't diagnosed with LH higher, you have guys with high SHBG and high LH with low-T who don't have hypogonadism and still need TRT.

 

[Kram67]

The other problem is you are catching your levels on a bell curve spiking at certain times, so timing is everything.

I wasn’t aware that T levels varied that much.... over what period does it cycle?

Also, how do you know how much T to take as you don’t really know where you are in the cycle when you take bloods? I don’t want gym levels - just want to get levels back to where they were when I was younger.

It means the majority of men diagnosed with hypogonadism have an LH between 1-3. That's not to say that men aren't diagnosed with LH higher, you have guys with high SHBG and high LH with low-T who don't have hypogonadism and still need TRT.

So if the majority of men have an LH of 1-3 does that mean the majority have secondary hypogonadism? If that is the case, should these people really be taking T, when they could be taking other products as detailed above?

Sorry if these are basic questions, but this is all new to me, and I want to make sure I go down the right route for me.

 

[Cataceous]

I wasn’t aware that T levels varied that much.... over what period does it cycle?
...

Natural men have a daily cycle, typically peaking around 8 am in the morning:

Also, how do you know how much T to take as you don’t really know where you are in the cycle when you take bloods? I don’t want gym levels - just want to get levels back to where they were when I was younger.
....

Testosterone dose is trial-and-error. You start with something typical, like 50 mg T enanthate injected twice a week. Then you see what your serum level is in four to six weeks. You're aiming for physiological levels that resolve symptoms and make you feel good.

...
So if the majority of men have an LH of 1-3 does that mean the majority have secondary hypogonadism? If that is the case, should these people really be taking T, when they could be taking other products as detailed above?
...

The majority do have secondary hypogonadism, but the long-term success rate is relatively low with TRT alternatives such as SERMs and hCG monotherapy. Thus not everyone bothers trying them first, even though the idea of staying more natural has some appeal.

Don't be distracted by too much talk of specific LH levels. In natural men they are all over the place, see below. The general guideline is that hypogonadism accompanied by LH values near or over top-of-range are suggestive of primary hypogonadism. An hCG stimulation test is considered much more definitive.

 

[Kram67]

Natural men have a daily cycle, typically peaking around 8 am in the morning.

Appreciate we have a daily cycle, but why do my T levels vary so much on different days, weeks etc when they are taken at the same time each day?