Health & HRT

nn&s

New member
This site has been really useful so far, thanks everyone for sharing and contributing. I thought I'd present my current position to try and get some addt'l perspectives.

I'm 30yrs old. I've essentially had an incredibly low libido most of my life and significant energy problems. I've gotten a lot done in my life, but I've always been tired, and it's gotten progressively worse with time: peaking about 3 years ago in grad school, when I hit a point where I was so lethargic I could accomplish almost nothing.

I began religiously following a very careful exercise, sleep, and nutrition plan which made a HUGE difference. (I don't drink, smoke, etc. either.) Saved my life, at least metaphorically speaking. I don't feel like a sedentary 60 year old anymore. I do still have major energy problems (and low libido). I usually have to crawl under a desk to sleep once or twice to get through a day and my ability to recover (never high) has gotten even worse -- making exercise much, much harder on my body.


I talked to my doctor about the issues and got some bloodwork done.
My Total Test is not high, but not ridiculously low (535). However, my more relevant %free testosterone (dialysis measure) is very low (1.6, lab range of 1.5-3.2), testosterone free is 86 (lab range of 52-280).
SHBG is 50 (20-60), and unfortuantely the doc didn't do a test for estrogen, FST, etc

These numbers are low on their own, but ridiculously low for my age and lifestyle. More importantly my symptoms are strongly consistent with hypogonadism. (I also have a strongly elevated CPK count indicating, in this case, major skeletal muscle breakdown/inflammation: so the soreness isn't in my head. :/ )

I tried to have a discussion with my doc about my levels, accounting for lifestyle, and the fact that andropause is much more variable in onset and correlation with straight numbers (I'm nearly finished with my doctorate in neuroscience myself; not medical, but I'm familiar with the literature.)

My doctor flat out said he doesn't support HRT, even in elderly patients. And that my lack of excess body fat (again, careful attention to diet) suggests that I'm fine.


Not sure what the next steps to take are. Going to call Maximus Hormone Replacement Therapy (HRT) and discuss the issue with one of their consultants (I assume they're not in on a sunday), but wanted to get some thoughts from the community as well.


If I stop exercising I crash. I become an almost non-functioning adult (it's happened a couple times, and I don't let it happen anymore!). Without the regular exercise and careful attention to diet (not calorie restriction mind you) I'm sure my test levels would fall into severely low range (they're barely acceptable for a much older, more sedentary individual now). I feel like my trying madly to tread water so as not to go under and as a result the lifeguard (doctor) refuses to throw me a life preserver because I;m not completely drowning... :(

Sorry for the long post, and thanks to anyone in advance.
 
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I know this is a forum primarily concentrated around the field of testosterone but I want to take a step back and look at the bigger picture before diving into TRT.

Low libido and low energy is not solely symptoms of hypogonadism but other conditions that you should rule out first. Hypothyroidism is one of those conditions and very prevalent in the US (although 80% of hypothyroid patients are women, but still). Another condition is adrenal fatigue. I am not too familiar with this condition so you may want to look into it on your own.

Since the thyroid regulates energy and metabolism it can indirectly affect testosterone scores. Since you are obtaining your degree you should have access to some studies but look up the study entitled, " Testicular dysfunction in men with primary hypothyroidism; reversal of hypogonadotrophic hypogonadism with replacement thyroxine." Thyroxine is the T4 hormone produced by the thyroid so by supplementing T4 because of an under-active thyroid (hypothyroidism), testosterone scores boosted.

If you want to check out your thyroid, do not let the doctor test simply TSH and T4. Have him/her check the following:

TSH
Total T4
Total T3
Free T4
Free T3
Reverse T3
Uptake T3
Thyroid Antibodies
Thyroid Globulins

Another item you want to check out is E2 (Estradiol) because your SHBG is in the higher range. I've seen some studies that using jus' an Aromatase inhibitor (AI), (aromatase-inhibitor) boosts testosterone levels. However, from what I've read, a higher E2 level doesn't usually present itself in the form of low energy or fatigue. I may be wrong here, but it seems it has more of an impact on mood and libido.
 
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