Thinking about starting TRT. Advice?

[GoBirds23]

I’m on the fence about starting TRT. A little backround about me. 31(M) at roughly 16% BF with a healthy overall lifestyle. I workout 4x per week, eat healthy for the most part, and sleep 8 hours per night. Supplements I’m currently taking are a multivitamin, vitamin D, magnesium, zinc, and fish oil. I drink occasionally, and don’t smoke. I’ve noticed over the past year, my energy levels have been lower, it’s been harder to put on muscle, lack of confidence, and my anxiety is higher than it used to be. I’ve taken a few testosterone tests, all with similar results to the below. Here is my most recent test that was taken at 7:30am.

Total Testoserone - 358 ng/dL

Free Testosterone - 57.9 pg/mL

SHBG - 25 nmol/L

What’s everyone’s thoughts on if starting TRT would be worth it? Life just seems too short to sit at the levels I’m at currently. I’m aware it’s a commitment that can come with many ups and downs, but it seems like it could really improve my quality of life. I’m also looking to try for a second baby in roughly 2 years, so fertility is improtant to me. The plan would be to temporarily stop TRT and run HCG + enclo until my wife is pregnant, and then hop back on.

 

[Cataceous]

You're in a borderline zone, with Vermeulen calculated free testosterone at 8-9 ng/dL; some men are ok at these levels, others are not. I suggest a trial with testosterone nasal gel or low-dose buccal troches. Though less convenient, these forms of TRT let you experience higher testosterone with less disruption of other hormones—preserving fertility. The trial allows for a fair evaluation of whether you are currently in hypogonadal territory.

If you have good results that persist for at least a month or two then you could consider long-term options. Some would be able to continue with the fast-acting nasal gels or troches, but if you don't find them sustainable then you could look at other options. However, preservation of fertility becomes more challenging. Oral testosterone is intermediate in duration, and is getting favorable reviews for results as well as convenience. Otherwise you have the longer-acting options of topical testosterone and injections. With these you have to contend with HPTA shutdown and other possible systemic effects, but most men seem to tolerate these. Simultaneous use of hCG preserves fertility in many cases. Although rare, there are occasional cases where TRT harms fertility. In other cases it can take as long as a year or two to restore fertility after stopping TRT. If you opt for conventional TRT then you could bank sperm in advance as insurance against future problems with fertility.