Trt

[Ty Nordic]

I finally got my numbers back from the lab. Total test: 319. Free test: 36.9. Everything else is in normal ranges. I can get exact numbers if helpful. Now, what is the next step? Am I eligible to get a prescription for TRT? I have no idea what to do next. Thanks for your help in advance.

 

[Gene Devine]

Ty - We need to see your complete labs with ranges.

What you posted clearly indicates you are hypogonadal but from what?

Are you Primary or Secondary?

If your Doctor pulled these labs and didn't tell you what you need to do NEXT to get a more complete diagnosis and a subsequent medical protocol you may need to find a Physician who understands TRT in men and who can help you.

The forum and website is loaded with all the information you need to make an informed decision about next steps in your course for optimal health.

Welcome to ExcelMale TY!

 

[Ty Nordic]

I will get all of my numbers, and share them here. Thank you so much for your help. The Doc I'm using is an Orthopedic Surgeon, and knows nothing regarding this field. However, he is willing to help me. I live in a small town, and can not find a Doctor with ANY knowledge. My family doc said, "You look terrific. What do you need more testosterone for? Your energy level and abilities decrease with age. Just accept the fact you are getting older." Uh... NO! Guidance from all of you is SO appreciated!

 

[robs2nd75]

I will get all of my numbers, and share them here. Thank you so much for your help. The Doc I'm using is an Orthopedic Surgeon, and knows nothing regarding this field. However, he is willing to help me. I live in a small town, and can not find a Doctor with ANY knowledge. My family doc said, "You look terrific. What do you need more testosterone for? Your energy level and abilities decrease with age. Just accept the fact you are getting older." Uh... NO! Guidance from all of you is SO appreciated!

I would be lmao at ""You look terrific. What do you need more testosterone for?" if so many men weren't subjected to this stupidity. Physicians don't recognize all the hard work, dedication, and sacrifice you have put in. Definitely try to determine why you are hypogonadal as Gene stated. Primary or secondary, Diabetes, Sleep Apnea, Obesity, Hypothyroidism, AAS...... Get the labs and post them here w/ reference ranges. You are in great hands here. I am often educating a couple of my physicians with the info I find on here.

 

[Ty Nordic]

Finally got ALL my numbers. I have no idea whatthey mean, and neither does my Doctor (I live in a small town). You have noidea how much I appreciate your help and guidance! I'm 46 years old.

Total Test: 319 (250-1100)
Free Test: 36.9 (35-155)
Sex Hormone BG: 39 (10-50)

WBC: 4.3 (4.3-11)
RBC: 5.05 (4.44-5.67)
Hemoglobin: 14.9 (13.4-17.4)
Hematocrit: 43.4 (40.2-50.8)
MCV: 85.9 (82.5-98.5)
MCH: 29.5 (27.5-33.5)
MCHC: 34.3 (31.9-35.7)
RDW-CV: 11.9 (12.1-14.5) LOW
RDW-SD: 37.0 (38.3-49.1) LOW
Platelet count: 225 (156-367)
Mean Plt Volume: 10.1 (9.4-12.9)
Neutrophil ABS: 1.64: (1.8-7.8) LOW
Lymphocyte ABS: 2.15 (1.0-4.0)
Monocyte ABS: .3 (.2-.9)
Eosinophil ABS .13 (.00-.45)
Basophil ABS: .03 (.00-.20)

Glucose:91 (70-100)
BUN: 29 (5-23) HIGH
Creatine: 1.16 (.5-1.4)
Sodium:136 (135-145)
Potassium: 4.1 (3.5-5.5)
Chloride: 103: (96-108)
Bicarbonate:27 (18-30)
Anion Gap:6 (5-16)
Calcium: 9.5 (8.5-10.5)
Protein Total: 7.3 (6.6-8.2)
Albumin: 4.5 (4.1-5.0)
Bilirubin Total: 1.5 (.1-1.3) HIGH
Alk Phos: 64 (38-114)
AST (SGOT): 46 (17-59)
ALT (SGPT): 33 (0-60)

Cholesterol: 179 (100-200)
Triglyceride: 147 (30-150)
HDL: 43 (40-125)
LDL: 107 (0-130)
Chol/HDL Ratio: 4.16 (0-4.97)

TSH: .718 (.3-5.0)
T4: 9.3 (5.5-12)
THBR 1.29 (.76-1.23) HIGH
Free T4 Index: 12.0 (3.8-13.5)
Free T4: 1.27 (.8-1.8)

PSA Total: .52 (.0-4.0)

Estradiol: 18 (0-56)
FSH: 4.4 (1.4-18.1)
LH: 2.9 (1.5-9.3)

 

[Gene Devine]

To me, it looks like the classic age related androgen deficiency.

SHBG and Albumin are fine.

Estrogen is a tad low; are you a lean man?

PSA is excellent.

Thyroid is fine.

LH/FSH are suppressed and probably age related and is associated with your low Testosterone serum levels.

Would have liked to seen Prolactin.

In my personal opinion you are a clear candidate for TRT; I know my Doc would prescribe.

Tell us more about your lifestyle, any meds you are taking, diet, exercise...things like that.

 

[Nelson Vergel]

This is the questionnaire that, along with blood work, is used to justify and prescription.

https://www.excelmale.com/blood-tests-needed-before-and-during-testosterone-replacement-therapy/

 

[Ty Nordic]

Thank you for the prompt replies. I'm pretty lean... stay round 13% BF. Was 7% just 10 years ago. I train 5 days a week, and diet is pretty darn good. So the increase in BF is a huge concern for me. Actually stronger than I've ever been, but training is becoming harder with age. I will fill out the questionaire.
Thanks again!!

 

[Ty Nordic]

Crap... "Yes" to 7 out of the 10 questions...

 

[Ty Nordic]

Gene: My Doc said he will prescribe if y'all think I'm a clear candidate, but he knows nothing about it. What should I ask for? I'm 46 and in great shape for my age. I train 5 days a week, but it's getting SO much harder with every passing year, and I'm gainng BF even though diet hasn't changed, and training has increased.
Thank you for your help!!

 

[robs2nd75]

I'm certain you will get a lot of differing suggestions here but I think less is more. Testosterone is king so start w/ that and adjust TRT/HRT protocol as needed. The question is do you prefer gel or shots. The gel is often considered the best as it mimics a mans natural production best but it is significantly more expensive and transference to loved ones can become an issue. The shot is cheaper and you will feel a change rather quickly. Most physicians will want to start you on 1/ 200 mg shot every 2 weeks = insane. 100mg Test. Cyp. IM per week is a great place to start. You will need labs done in 4-6 weeks to see how you are responding. Make sure these labs include TT, FT, e2 and hematocrit (and as Gene stated prolactin). I'm assuming your BUN is elevated from a high protein diet given your postings on the ISSN page. (This is reaching, any more knowledgeable members correct me if I'm wrong, but have you had your A1c tested recently? Low PSA is often found in men w/ diabetes and you know all the new research on the potential for long term low carb diets to cause insulin issues).
BTW great to have you here. I hope that you post in the nutrition and exercise areas as I'm sure you have more than a wealth of info in these areas.

 

[Nelson Vergel]

Ty, starting dose is 100 mg per week via injections or 5 grams per day Androgel or any other gel of that nature. You should watch this and you will know what you need to know before you talk to your doctor. I am not great on videos but I give my honest opinion on things.

https://www.excelmale.com/?s=16-Practical-Tips-for-Testosterone-Replacement-Therapy

or this one (slide show)

https://www.excelmale.com/?s=107-Testosterone-Replacement-Slide-Presentation