TRT if your test was normal?

[Galactus]

More of a philosophical question. I was on TRT for 5+ years. Kaiser tested me twice and my totals were in the low 200's. I stopped cold turkey a few years ago and miss many aspects of it.

I'm 50 now and am gaining a bit of fat and losing a bit of muscle. I don't have the sex drive I had when taking 75mg weekly. All of this makes me a bit depressed.

I was tested recently and was around 650 total test. Didn't get tested for free testosterone.

I may not NEED TRT but I like the way it made me feel. If your testosterone levels were fairly normal, would you still elect to take TRT?

 

[Vince Carter]

TT is the basis for treatment yet it's a bad indicator to whether a guy needs TRT. It's FT that matters and probably where you had found some improvements but FT isn't the diagnostic tool they use.

 

[Systemlord]

Kaiser is atrocious and doctors are unskilled at TRT and just seem uninterested in learning how to do it, I know I have Kaiser and do not use them for guidance. Kaiser doctors do not care about Free T, you know the free portion of testosterone circulating in the blood that does all the amazing things to your body unlike Total T which is bound to SHBG and not bioavailable.

For all we know your SHBG is elevated and Free T is in the basement. The 200 ranges is hardly considered normal, the average healthy 50 year old is considerably higher. Your levels were in the ranges of a 90 year old man and were at risk for multiple diseases and still may be if Free T levels aren't sufficiently elevated.

Testosterone Threshold for Increased Cardiovascular Risk in Middle-Aged and Elderly Men:

These data showed that a testosterone threshold of 440 ng/dL was associated with increased Framingham 10-year CVD risk in middle-aged and elderly men. Poor sexual performance, decreased morning erection, and loss of libido had an impact on the testosterone threshold for CVD risk. The threshold level was higher in men with sexual dysfunction.

 

[captain]

Lets say your total and free are all good. I think it would be foolish to start TRT. Then if your total and free are not normal with symptoms you are foolish not to. All things working normal without TRT would have to be better than TRT.

 

[JimBob]

TT is the basis for treatment yet it's a bad indicator to whether a guy needs TRT. It's FT that matters and probably where you had found some improvements but FT isn't the diagnostic tool they use.

And yet, will any competent HRT doctor prescribe TRT based on the FT alone, plus symptoms? In other words, would a competent TRT doctor prescribe TRT to some with a TT in the 600s, but a FT of 12-13? Yeah, these are my numbers. SHBG at 51. I guess I'll find out when I see my FNP in a couple of weeks.

 

[Vince Carter]

The only competent Dr that I know of that would at least talk to you about that is Dr Saya/Defy. @JimBob

 

[Galactus]

TT is the basis for treatment yet it's a bad indicator to whether a guy needs TRT. It's FT that matters and probably where you had found some improvements but FT isn't the diagnostic tool they use.

Yeah... they never measured FT (I didn't know anything about FT when I went in with symptoms, not even thinking I had low test)