Weight loss or TRT with blood results included...any advice?

[tattoobytony]

So I've been doing some asking and some contacting trying to figure out if I should

A. Go on TRT
B. Try to lose an ample amount of weight first
C. Maybe go on TRT to help with losing weight

I'm 37 and weigh around 375. I currently have no libido (which really blows because I have a smoking hot wife that is physically out of my league), no energy, and no motivation. Any and all advice/opinions are extremely welcomed.

Blood results
Estradiol 40 pg/ml (<39 pg/ml recommended)
Prolactin 13.3 ng/ml (4.0-15.2)
Free T 6.6 pg/ml (8.7-25.1)
Total T 181 ng/dl (264-916)
SHBG 37.6 nmol/ml (16.5-55.9)
FSH 3.1miu/ml (1.5-12.4)
LH 6.1 miu/ml (1.7-8.6)

 

[Vince Carter]

With LH and FSH such as they are you're Primary Hypo/problem is the testes. I'd lose a substantial amount of weight as just my opinion the weight is going to mask and otherwise obscure quite a bit but then with your T and FT such as they are I bet that's a big part of the weight loss issue.

 

[tattoobytony]

With LH and FSH such as they are you're Primary Hypo/problem is the testes. I'd lose a substantial amount of weight as just my opinion the weight is going to mask and otherwise obscure quite a bit but then with your T and FT such as they are I bet that's a big part of the weight loss issue.

Can weight loss help with primary hypogonadism?

 

[Gman86]

I wouldn't imagine losing weight would help your testicles respond better to the luteinizing hormone being sent to them by your pituitary gland, I could be wrong though.

My quick answer to your original question though would depend on whether you are trying to have children still or not. If you're not, I would hands down just go on TRT. You will lose a ton of weight on TRT just from having your hormones optimized. You might have to use an AI in the beginning due to having so much excess body fat and having increased aromitaization issues, but I would imagine you might eventually be able to drop the AI once you lose a lot of the excess weight.

If you still plan on having children, or more children, I might really try to get your body weight down first. But honestly, if I were in your shoes, I would go on TRT regardless if you are done have children or not. That's just my opinion though. Your numbers are so low that I'm not sure losing the weight, which would decrease your estradiol and prolactin, would really be enough to raise your other numbers into an acceptable range and give you the symptom relief you're looking for

 

[tattoobytony]

I wouldn't imagine losing weight would help your testicles respond better to the luteinizing hormone being sent to them by your pituitary gland, I could be wrong though.

My quick answer to your original question though would depend on whether you are trying to have children still or not. If you're not, I would hands down just go on TRT. You will lose a ton of weight on TRT just from having your hormones optimized. You might have to use an AI in the beginning due to having so much excess body fat and having increased aromitaization issues, but I would imagine you might eventually be able to drop the AI once you lose a lot of the excess weight.

If you still plan on having children, or more children, I might really try to get your body weight down first. But honestly, if I were in your shoes, I would go on TRT regardless if you are done have children or not. That's just my opinion though. Your numbers are so low that I'm not sure losing the weight, which would decrease your estradiol and prolactin, would really be enough to raise your other numbers into an acceptable range and give you the symptom relief you're looking for

I appreciate the advice. We are still on the fence about having children.

 

[Vince Carter]

TRT, AND having children and maintaining fertlity go hand-in-hand when HCG is used along with Cyp. I think the way you wrote that is that TRT=forget about children if I'm reading your post right.

 

[tattoobytony]

TRT, AND having children and maintaining fertlity go hand-in-hand when HCG is used along with Cyp. I think the way you wrote that is that TRT=forget about children if I'm reading your post right.

Good to know in regards to HCG.

 

[Vince]

Before you decide on trt, you definitely need a full array of Labs. I wonder if something else is causing your low testosterone levels and lack of energy.

 

[Matt Leiser]

Before you decide on trt, you definitely need a full array of Labs. I wonder if something else is causing your low testosterone levels and lack of energy.

I agree with Vince. Definitely need a full panel of labs and reference ranges. Including CBC, CMP, lipids, thyroid including ft4, ft3, reverse t3, antibodies, dht, iron, ferritin, fasting glucose, hba1c

What is your diet like? Are you diabetic, pre diabetic, insulin resistant? Any thyroid disease?

 

[tattoobytony]

I agree with Vince. Definitely need a full panel of labs and reference ranges. Including CBC, CMP, lipids, thyroid including ft4, ft3, reverse t3, antibodies, dht, iron, ferritin, fasting glucose, hba1c

What is your diet like? Are you diabetic, pre diabetic, insulin resistant? Any thyroid disease?

I've had almost all of those checked within the last 5-6 months and they were all normal. The only ones I haven't had were the dht, antibidies, and ferritin. The a1c was in the pre-diabetic range at 5.7 and my fasting glucose was 84.

 

[Vince Carter]

I've had almost all of those checked within the last 5-6 months and they were all normal. The only ones I haven't had were the dht, antibidies, and ferritin. The a1c was in the pre-diabetic range at 5.7 and my fasting glucose was 84.

Which doesn't mean much often times is much less that optimal, or even healthy. Lab ranges are onyl a sample of the population that the lab tests, no Dr or Scientist (etc) established those ranges.

 

[tattoobytony]

Which doesn't mean much often times is much less that optimal, or even healthy. Lab ranges are onyl a sample of the population that the lab tests, no Dr or Scientist (etc) established those ranges.

I'll talk to the urologist about that at my follow up at the end of May.

 

[Saul]

You should start taking steps to lose weight today. Don't make TRT or labs a prerequisite. Start eating less today. Start eating healthy today. Start exercising today. You should also figure out why you are overweight? IMO, that is first priority.

 

[Vince]

I wondering if you're on any meds that may be affecting your testosterone, any SSRIs?

 

[tattoobytony]

You should start taking steps to lose weight today. Don't make TRT or labs a prerequisite. Start eating less today. Start eating healthy today. Start exercising today. You should also figure out why you are overweight? IMO, that is first priority.

I'm already doing that and am down about 20 or so pounds.

 

[Saul]

I'm already doing that and am down about 20 or so pounds.

Congrats. That is great. I think the first stages of weight loss can be the hardest because it requires changes to be made, and change habits can be hard to do.
As to going on TRT, it gave me more motivation, energy, and even mental will power to be more active and eat better and thus made it easier to lose weight. I don't think TRT will cut the pounds though without exercise and better eating, which it sounds like you have handled. The other posts give better advice regarding whether you should or should not. Good luck and keep us posted.

 

[tattoobytony]

Congrats. That is great. I think the first stages of weight loss can be the hardest because it requires changes to be made, and change habits can be hard to do.
As to going on TRT, it gave me more motivation, energy, and even mental will power to be more active and eat better and thus made it easier to lose weight. I don't think TRT will cut the pounds though without exercise and better eating, which it sounds like you have handled. The other posts give better advice regarding whether you should or should not. Good luck and keep us posted.

Thanks! I really hope that this is something that can be done naturally and I don't have to go on TRT. It would be great to feel good again!

 

[CoastWatcher]

Thanks! I really hope that this is something that can be done naturally and I don't have to go on TRT. It would be great to feel good again!

The loss of the weight will pay dividends in its own right - that's great news. TRT...if necessary, of course. I wish you the best.

 

[tattoobytony]

The loss of the weight will pay dividends in its own right - that's great news. TRT...if necessary, of course. I wish you the best.

Thanks! I appreciate it.