Should I get on TRT? Please help. new to the forum

[laq8ty]

Im 35 M and have noted a drastic change in the past few years. I'm 5'7, 165 around 15% body fat. I try to exercise at least 3-5 times per week and it includes lifting weights, boxing, yoga, and tennis.
Physical symptoms: fatigue, lack of energy, poor exercise tolerance, not much muscle tone nor results from working out. Erections are OK (prob 70% of what they were but it takes me a while to get there)
Mental symptoms: lack of motivation, diminished libido but not bad, definitely much less assertive/confident, mild chronic depression and anxiety.

I decided to get some blood work:
Total Test 351
Free Test 41 (L)
Ultrasensitive Estrogen 7
TSH, T3, T4 all normal
CBC Normal
Liver, kidney creatinine normal
Cholesterol panel normal
ESR/CRP WNL
Vitamin D 15 (very low)

I did not get an FSH and LH.

I'm seeing a urologist next week- he briefly mentioned clomid which I am reluctant to take based on my research and on many of the posts on this site. I feel overall healthy but just tired, depressed and not very motivated. Been feeling this way for a few years and I have no history of depression. My dad is 70 and his total Testosterone is 301 and his free T was 51.

Any suggestions? Should I just take some zinc and vitamin D and see if lifestyle modifications can work? Low-dose Clomid or HCG? Bite the bullet and request TRT?

 

[Vince]

Im 35 M and have noted a drastic change in the past few years. I'm 5'7, 165 around 15% body fat. I try to exercise at least 3-5 times per week and it includes lifting weights, boxing, yoga, and tennis.
Physical symptoms: fatigue, lack of energy, poor exercise tolerance, not much muscle tone nor results from working out. Erections are OK (prob 70% of what they were but it takes me a while to get there)
Mental symptoms: lack of motivation, diminished libido but not bad, definitely much less assertive/confident, mild chronic depression and anxiety.

I decided to get some blood work:
Total Test 351
Free Test 41 (L)
Ultrasensitive Estrogen 7
TSH, T3, T4 all normal
CBC Normal
Liver, kidney creatinine normal
Cholesterol panel normal
ESR/CRP WNL
Vitamin D 15 (very low)

I did not get an FSH and LH.

I'm seeing a urologist next week- he briefly mentioned clomid which I am reluctant to take based on my research and on many of the posts on this site. I feel overall healthy but just tired, depressed and not very motivated. Been feeling this way for a few years and I have no history of depression. My dad is 70 and his total Testosterone is 301 and his free T was 51.

Any suggestions? Should I just take some zinc and vitamin D and see if lifestyle modifications can work? Low-dose Clomid or HCG? Bite the bullet and request TRT?

If you decide to go on TRT. I definitely would get checked LH and FSh just to know if your primary or secondary. If you are secondary, you could try clomid or Enclomiphene.

enclomiphene excelmale.com

 

[Vince]

Enclomiphene?

I have secondary hypogonadism, and my doctor was able to prescribe me Enclomiphene from their pharmacy. My dose will be 12.5mg ED. Does anyone have experiences using Enclomiphene? How did your lab numbers change? What symptoms were improved? Any side effects? I'd love to hear your...

www.excelmale.com

 

[Systemlord]

Total Test 351
Free Test 41 (L)
Ultrasensitive Estrogen 7

You're looking at osteoporosis at these E2 levels. As for fixing these hormonal problems with lifestyle changes, in my opinion things are just too far in the wrong direction. Your levels aren't just low, they are dreadfully low and nothing short of medical intervention will do.

 

[laq8ty]

I used Quest Labs, according to their lab ranges an ultra-sensitive Estradiol of 7 is within the reference range. Should I have obtained a regular estradiol instead? Perhaps 7 is normal on ultra-sensitive but when converted to a regular estradiol would be higher?

Should be seeing an endocrinologist, urologist, or a hormone replacement center?

 

[Jake_from_StateFarm]

If you did your research on endos and uros, and you feel confident you're seeing someone who knows TRT protocols, stay the course with your appointment. You have plenty of time to pursue a TRT clinic. However, in my newbie opinion, if you're a type A personality and you know what you want/when you want/how you want, then a TRT clinic may be better for you out of the gate. Regardless, you've found a good community here for sure. Good luck and let us know how it goes with the Doc.

 

[Lookingforward]

Is there something else going on in your life? The symptoms don't sound that bad. I'm no expert (especially on interpreting labs) but I do know people. In the past, did you have confidence? Are you succesfull at your job? How are your relationships? Are you under stress? At 35 you should be rocking it....working out 5 times a week unless you have a physical job. Most people don't like to workout but, I can tell you, it will change your life and attitude if you do it. A lifetime of TRT may be avoidable if you can break out of what is weighing you down.

 

[laq8ty]

I really appreciate all the feedback. A few years ago I just completely lost all motivation with working out because I wasn't seeing any results compared to my 20's and even late 20's. I've always run on the lowish end for testosterone. When I checked it a few years ago at 33, I was around 400. My dad was mentioning that he also tended to run low when he was my age. I think you make a valid point. It might be stress, could be depression. Maybe will try to eat right and exercise better ( I am doing full body HIT weights about 3 times per week, plus a day or two of tennis/boxing per week).

 

[Lookingforward]

You should be seeing results from that excersising. If not you may be taking in too many carbs and sugar. Maybe a personal trainer could get you on track. Either way you need to find out where that stress is coming from and get rid of it. A good job (you enjoy) and a good woman will also keep you motivated. Before I started TRT I went to a functional medicine doctor who evaluated everything. He said that my stress was causing all kinds of problems. My testosterone levels were low, I had lime desease, I had insulin issues....yada yada. He treated the lime and put me on a bunch of supplements. It helped a lot and my testosterone levels came up significantly.

 

[laq8ty]

Just saw the urologist. He mentioned my level of 350 is lowish-normal for someone my age and he suggested an in-office injection of 200 mg of Test Cypionate to "see how I felt in a few days" to determine whether we should continue. This didn't make much sense to me since most of the results of testosterone take time and you can't rule out a placebo effect so I said I would think about it. what do you guys suggest?

 

[Jake_from_StateFarm]

Sounds like anyone with 4 solid hours reading this forum will know more than that Dr. Have you tried posting a request here asking for a referral to a Dr near you? Also boggles me why he thinks you'll feel results in a few days ... and a 200mg right off the bat. I was started at 75mg given my body was still producing T.

Trying to be an optimist, it's possible the Dr. is simply wanting to administer the first 200mg so he can document (what you say in a few days, hint-hint) for the file whether it was/wasn't beneficial and, if it is, THEN feel comfortable getting you on a protocol.

 

[laq8ty]

yeah I'm not sure this guy knows what he's talking about. He mentioned that "200 mg once every 2 weeks is the standard dose." I doubt he will understand AI's- I showed him my labs with an estrogen of 7 (ultra-sensitive) and he made no mention of it. He didn't comment on my free T at all which was low even by the lab's standards. Im starting to realize finding someone who can even interpret your labs is hard. I don't think traditional urologists or endocrinologists get trained in this.

 

[BigBamBoo]

You need to research a bit more. “In range” for labs in generally far from optimal.

your thyroid can be “in range” but can make you feel like you are feeling.
If it is in your labs, please post your TSH number.

As for your doctor....find a new one. Obviously he knows little about TRT.

Good luck and hang in there.

 

[Lookingforward]

Yes. Get yourself a good Male health doctor. If you are depressed regularly see a good therapist

 

[Golfboy307]

Agreed. Do not go back to that doctor. Plenty of TRT experts out there. He's giving you the standard dosing from 20 years ago. Recipe for failure.

 

[Paco1973]

I'd try to restart natural production before going on TRT. There may be other factors, such as stress, dragging your levels down. TRT is a one way door, in my opinion. Once you're on, you're on for life. I have yet to see one person successfully quit TRT long term after starting. Eventually, they all come back.

 

[Jake_from_StateFarm]

There's a massive population of men low on T who have no idea TRT exists or they do and they think it's $teroids. Instead they do nothing or they try diets, exercise, psych meds, CPAP you name it, the lists goes on and on and on. My point is, they start & stop those too and then lose what they gained and start-up again. My personal opinion with TRT fails is that there are a lot of guys overdoing it in quantity and complexity (i.e. add-ons) and when things go haywire they have no idea what's causing it so they stop all together. Guys that take 50 mg or 75 mg per week probably don't feel much of a significant improvement but may also be less less prone to feeling "complications." In sum, I suggest trying TRT at a low dose for 3mos and see how you feel with just a 50% improvement in your lab numbers rather than a sudden 150% spike.

 

[Paco1973]

There's a massive population of men low on T who have no idea TRT exists or they do and they think it's $teroids. Instead they do nothing or they try diets, exercise, psych meds, CPAP you name it, the lists goes on and on and on. My point is, they start & stop those too and then lose what they gained and start-up again. My personal opinion with TRT fails is that there are a lot of guys overdoing it in quantity and complexity (i.e. add-ons) and when things go haywire they have no idea what's causing it so they stop all together. Guys that take 50 mg or 75 mg per week probably don't feel much of a significant improvement but may also be less less prone to feeling "complications." In sum, I suggest trying TRT at a low dose for 3mos and see how you feel with just a 50% improvement in your lab numbers rather than a sudden 150% spike.

I agree. In the beginning, less is more. It takes time, and a lot of guys don't have the patience. They want instant results. It just doesn't work like that.