Am I a Candidate for TRT?

[MeanGreen]

Hello all.

I am a 45 year old male, 6'1", 206 lbs and 17% bodyfat. I train 5 days/week with a heavy split routine. I eat clean with 6 meals/day at maintenance calories. I have been experiencing the following symptoms: irritability, poor sleep, overall achiness, relatively low energy and ED (staying hard). Thinking low test might be the problem, I had my bloodwork done.

Some of the results:
Testosterone, Serum 360 ng/dL
Free Testosterone 8.1 pg/mL
SHBG 45.3 nmol/L
Estradiol 16.7 pg/mL
T4 Free direct 1.35 ng/dL

There's more, but I'm not sure what's relevant here.

I was told that I need TRT.

They recommended
Test Cypionate with HCG (7000ius) and Anastrozole.
B12/MIC be added to the TRT protocol. (Not sure what MIC is.)
Sermorelin (to induce naturally occurring HGH)
Danazol (to decrease SHBG levels & increase avail of free test)

1) Are my levels low enough to warrant being on TRT?
2) Are their recommendatons correct?

Thanks in advance for the feedback!

 

[3J]

this is more about how you feel??

energy levels??

libido??

do you recover well??

 

[MeanGreen]

My symptoms involve mood, sleep, energy levels, recovery/overall achiness. Libido drive is good, but have that ED issue.

 

[3J]

Test levels are low enough to qualify for it..

Just understand what you are getting yourself into.. Its a lifestyle change.. Weekly Injections.. Pills.. Donating blood quarterly

 

[halfwit]

What time was the blood draw done? Sounds like a pretty expensive protocol, but it's far better than most.

 

[Chiefy]

At a glance, yes.

But a lot of the other shit that your doctor wants to put you on is completely unnecessary, and could potentially cause more problems than they solve.

And is that 7,000IU of hCG weekly?

 

[MeanGreen]

What time was the blood draw done? Sounds like a pretty expensive protocol, but it's far better than most.

Last week. 9am after fasting for 15 hours.

Cost me $228.

4 vials drawn

Three tests ordered:
CMP14+LP+TP+TSH+CBC/D/Plt+P...
Thyroxine (T4) Free, Direct, S
Triiodothyronine, Free, Serum

 

[MeanGreen]

"Just understand what you are getting yourself into.. Its a lifestyle change.. Weekly Injections.. Pills.. Donating blood quarterly "


Yeah, guess I need to weigh the advantages and disadvantages. Not a fan of needles, but willing to deal if it works. Assuming the TRT will alleviate my symptoms, that is.

 

[MeanGreen]

At a glance, yes.

And is that 7,000IU of hCG weekly?

The TRT protocol would have the hCG in it is a 10 week supply.

 

[MeanGreen]

At a glance, yes.

But a lot of the other shit that your doctor wants to put you on is completely unnecessary, and could potentially cause more problems than they solve.
B]

What specifically is completely unnecessary?

 

[halfwit]

Last week. 9am after fasting for 15 hours.

Cost me $228.

4 vials drawn

Three tests ordered:
CMP14+LP+TP+TSH+CBC/D/Plt+P...
Thyroxine (T4) Free, Direct, S
Triiodothyronine, Free, Serum

They neglected LH and FSH though. I meant expensive as in everything they want to put you on. Getting all those meds usually happens at a wellness clinic or anti-aging clinic, which are often pretty expensive.

I do think that TRT could work, but I'd rather see what your LH and FSH were first. That will determine if there are alternatives or not.

 

[Chiefy]

What specifically is completely unnecessary?

The Anastrazole might be necessary, but it shouldn't be taken just for the hell of it. It should only be used if you're unable to manage your estradiol with protocol changes (dose and frequency of your testosterone and hCG). That's something that will be determined by follow up labs.

You're not a fat guy, so you probably won't have any issues with estradiol unless your testosterone dose is too high. What dose will you be starting on?

The B12 injections probably aren't necessary either. If yours is low, oral supplementation should be sufficient...and a lot cheaper. B12 injections likely aren't going to cause any problems, but there aren't many guys who get any measurable benefit from them either. Some do, many don't. Besides, we don't even know if you're deficient right now.

No clue what MIC is, but that's a pretty good sign that it's not something you absolutely need.

Sermorelin. For starters, it's usually expensive. You also don't even know if you are deficient in growth hormone. Everything has side effects, why take something if you don't need it? Your natural GH levels will increase with the use of testosterone anyway.

Danazol. Your SHBG isn't high, so it doesn't make any sense to take it right now. Exogenous testosterone will lower your SHBG over time anyway. Danazol also doesn't seem to result in any positive changes for the patient either. Dr. Crisler stopped prescribing it for that very reason. People were wasting their money on a drug that didn't help with any of their symptoms related to elevated SHBG...which you don't have.

 

[MeanGreen]

I do think that TRT could work, but I'd rather see what your LH and FSH were first. That will determine if there are alternatives or not.

My results say...

LH 7.1 mIU/mL
FSH 6.3 mIU/mL

 

[MeanGreen]

You're not a fat guy, so you probably won't have any issues with estradiol unless your testosterone dose is too high. What dose will you be starting on?

No, not fat. Im not sure if my bf is really 17%. Did pinch caliper test at chest, ab & thigh. Have a little lower ab fat and cant see abs yet.

I haven't followed up with doctor yet, so not sure of dosing just yet.

Which leads to another question:
If I am going to do this, should I be dosing with a result 1000-1100 ng/dL target in mind?

 

[MeanGreen]

The B12 injections probably aren't necessary either. If yours is low, oral supplementation should be sufficient...and a lot cheaper. B12 injections likely aren't going to cause any problems, but there aren't many guys who get any measurable benefit from them either. Some do, many don't. Besides, we don't even know if you're deficient right now.

I was complaining of lack of energy, so prob that's why recommended.

According to bloodwork, my B12 is 537 pg/mL
I take a daily multivitamin that has 50mcg of B12.

 

[MeanGreen]

No clue what MIC is, but that's a pretty good sign that it's not something you absolutely need.

Agreed. I will ask doctor today what that is.

 

[MeanGreen]

Sermorelin. For starters, it's usually expensive. You also don't even know if you are deficient in growth hormone. Everything has side effects, why take something if you don't need it? Your natural GH levels will increase with the use of testosterone anyway.

I do not see hgh on bloodwork. Could it be called something else?

Doc says Semorelin will induce my own pituitary gland to produce more of its own hgh.
Increase my energy, help with mental clarity, improves mood, improves immune system, huge metabolism increase, lowers blood pressure, protects the heart, decreases bodyfat and increases muscle mass

For Sermorelin Acetate, $350/vial (1month)

 

[MeanGreen]

Danazol. Your SHBG isn't high, so it doesn't make any sense to take it right now. Exogenous testosterone will lower your SHBG over time anyway. Danazol also doesn't seem to result in any positive changes for the patient either. Dr. Crisler stopped prescribing it for that very reason. People were wasting their money on a drug that didn't help with any of their symptoms related to elevated SHBG...which you don't have.

My SHBG of 45.3 falls within the reference range of 16.5-55.9.

Doc says the lower the better, as lower SHBG levels increase bioavailable free test.

I agree that it is unnecessary, especially now that I know the level will lower after I start pinning.


$175 for 30 (1 month supply)

 

[Slhardee]

Like the others have stated, know what you're getting yourself into. It's a lifelong journey and pinning twice a week or every week is not easy for everyone, along with the other maintenance steps.

Good advice on the B12, some people have great results and some people don't notice much difference. I personally take B12 in the injectable form once or twice a week depending on how I feel.

I can also speak to the Semorelin. I took it off and on for a couple of years. Studies have shown you need to take it in excess of four months for it to start showing positive effects. I personally did not think it was worth the money. IMO if your going to spend the money and dose yourself every day, your better off just using HGH. All those positive effects you stated from Semorelin sound great, but you will notice more of a difference with TRT than you will with Semorelin.

It sounds like you're definitely dealing with one of the antiaging clinics? They like to sign you up and dump lots of money because they make money off the prescriptions. I tried this route at the beginning, and after becoming more informed I went to my primary care physician for my TRT. As many can attest to, finding a good knowledgeable doctor about TRT is not easy.

My suggestion is the following, I would not start taking all those different things at once. Start slow and try one medication at a time. If you need TRT start with TRT and possibly hCG. Get blood work done and go from there. Good luck!

 

[Chiefy]

No, not fat. Im not sure if my bf is really 17%. Did pinch caliper test at chest, ab & thigh. Have a little lower ab fat and cant see abs yet.

I haven't followed up with doctor yet, so not sure of dosing just yet.

Which leads to another question:
If I am going to do this, should I be dosing with a result 1000-1100 ng/dL target in mind?

Don't go into this with a specific number in mind, use symptom relief as a better gauge. Lots of us actually feel better when our total T is in the 800-900 range. More is not always better when it comes to TRT.

Having higher testosterone also means that your estradiol will be higher and/or difficult to manage, so keeping T at reasonable levels usually works best for most. There are definitely guys who feel better closer to ~1100, but that's something you'll have to figure out on your own.

I was complaining of lack of energy, so prob that's why recommended.

According to bloodwork, my B12 is 537 pg/mL
I take a daily multivitamin that has 50mcg of B12.

Reference range?

I do not see hgh on bloodwork. Could it be called something else?

Doc says Semorelin will induce my own pituitary gland to produce more of its own hgh.
Increase my energy, help with mental clarity, improves mood, improves immune system, huge metabolism increase, lowers blood pressure, protects the heart, decreases bodyfat and increases muscle mass

For Sermorelin Acetate, $350/vial (1month)

Most doctors use IGF-1 to gauge your growth hormone levels.

Sermorelin may have some benefits, but I've read plenty of stories from men who've noticed no difference besides a lighter wallet from using it. If your natural IGf-1 is low it might make sense, but if yours is normal I don't see much reason to use it...especially at that price tag.

My IGF-1 was fine before TRT, but testosterone has done plenty to drive mine up since then. Mine is at the top of the range without the use of Sermorelin.