Is it time to get serious about starting TRT?

[KCinToronto]

I've been dabbling with the idea of TRT for some time as my Free Test bloodwork has been in the low range for awhile. I'm 50 years old, pretty good shape (the photo is me last year) and I've only done 3-4 cycles of steroids. Maybe not a coincidence on the timing, as my Free Test recently seems really low.

Biggest symptom is low sex drive. Once I get going I am OK, but sometimes hard to orgasm and I just don't get excited easily any more. Damn, I am only 50.

I'm in Canada and finding a reputable doctor has been a challenge. Family doc sent me to a Urologist for BPH years ago, take a small dose of Flomax. Urologist says he knows all about TRT and can prescribe for it, so here is what we've found. (Sorry my measurements are Canadian, when I tried to convert it did not seem to make sense so I'll post in our unit of measure)

October 12, 2012 - FREE TESTOSTERONE: 53.1 PMOL/L

January 24, 2014 - FREE TESTOSTERONE: 16.7 PMOL/L
NORMAL RANGE IS: 15.6 - 146

So it seems to have dropped significantly.
Urologist says he can't prescribe anything as it is still in "normal" range. (Damn how close to the bottom do I need to be)

My last cycle was June 10, 2013 - Sept. 8, 2013
Test E -500mg Week / Mast E-400 mg week / Tbol -first 5 weeks, 60 mg week/ Anavar last 6 weeks, 80 mg week / Arimidex, .5 mg EOD / HCG 500 IU week throughout cycle. / PCT of Clomid/Nolva for 5 weeks.

Now I have tried S4 and Ostarine after PCT, and recently did some IGF1-LR3 trying to find a good bridge.

PCT ended October 17, so after PCT, it has been 3 months off (sort of beside SARMS etc)

Would 3 months be enough to get my levels back? Could it be why my Free Test is so low now?

I've finally taken this mor seriously and found a "Clinic For Advanced Health" recommended in my area. I see them on Monday. It is not covered by our countries insurance though so it could get pricey. I'll see what we find out.

Questions are:
1) Would you consider this to be low and to be concerned?

2) Would be honest and tell an Advanced Health Clinic about your steroid use?

3) Could my recent cycle have thrown me off and still need time to get going again?
(Keep in mind, even in 2012 when I had only done one cycle my level was still in low range)

4) How long would it normally take for Free Test to get back to normal levels after PCT?

Thanks for any advice/information you can give me.


KC

 

[Mprtz]

I am also 50 and started TRT about a year ago. My T levels were right at minimum (in-office test came out just above, labcorp just below).
I had never taken steroids. Took a few prohormones 15 years earlier. Prior to going in for TRT, I was getting fat and losing muscle and strength even though I was still working out.

I recommend the clinic approach. Yes, it costs some money but you won't have to fight to get proper treatment. Well worth it in my book, but your financial circumstances may be different.

1) I doubt you will be satisfied with the levels you tested at. You won't look like your avatar for long.
2) No, they do not want to know about this and you do not want to tell them unless you're looking for help with PCT
3 and 4) No personal experience, but consensus seems to be that cycles tend to hurt natural production permanently over time.

 

[Alpin]

KC.........
Problem is you went to CML. I can see from the ranges!!!
that's where you went wrong!!!!
Had you gone to other lab(s) you would have Low T on paper!!!!
shoot me a PM and I'll tell you what to do.
I would not disclose your past to said clinic....
you want to have this on paper and void any future coverage from insurance companies ?
You have no Test for TT or Bio Avail. T, no LH, No FSH though...
No endo or doc will treat you without seeing the entire picture and most don't even use Free T to diagnose low T....

 

[Megatron28]

Like Apollon said, you need a lot more blood work to see what is going on. Free T doesn't give the full picture. You need:

Total Testosterone
LH
FSH
Prolactin
Estradiol Sensitive Assay

Make sure you run the blood work first thing in the morning.

 

[KCinToronto]

Like Apollon said, you need a lot more blood work to see what is going on. Free T doesn't give the full picture. You need:

Total Testosterone
LH
FSH
Prolactin
Estradiol Sensitive Assay

Make sure you run the blood work first thing in the morning.

Thanks so much for your advice. I see the new Doctor tomorrow. Wish me luck.

And if anyone tells you healthcare is free in Canada, feel "free" to laugh at them. The free stuff means you wait 6 month to get see someone, then they cancel on you the day before because they went on vacation. Or the free service is so bad, you'll get much worse before they figure out what it is.

KC

 

[bowhunter01]

Be thankeful you made it to 50 lol. I'm 32 and on trt.

 

[Alpin]

Thanks so much for your advice. I see the new Doctor tomorrow. Wish me luck.

And if anyone tells you healthcare is free in Canada, feel "free" to laugh at them. The free stuff means you wait 6 month to get see someone, then they cancel on you the day before because they went on vacation. Or the free service is so bad, you'll get much worse before they figure out what it is.

KC

My experience so far in the Canadian medical system.....
Free = Garbage Health care!
I showed up to an Endo's office with 25 pmol Free T and 6 Nmol/l TT....
told me to live as is and he cannot give me anything cause it will cause cancer....
Told me I'm not abnormally low as well.
Nice health care eh ?

 

[Alpin]

The GP's I seen totally ignored my hypogonadism till I reported them to the powers that be. Then they changed their tune!!!
They initially told me I had depression and I should go on Wellbutrin.
Nice docs eh?
Band aid the problem with an Anti-d cause they don't know squat about T...
They need to get rid of these docs that were in medical school in the 70's.....
They are draining the health care system with nothing to show in terms of results.

 

[KCinToronto]

So I went to see the Advanced Health doctor and he explained everything I've read and is sending me for the following bloodwork:

- Progesterone
- Estradiol
- Free Testerone
- TSH Free T3
- FSH
- DHEA-S B12 Ferritin
- CRP

Does this sound like a good starting point?
The problem is he checked off Uninsured. Shouldn't these tests be covered? (Edited: My mistake, the only one uninsured would be Vitamin D, It is $30.00)

He also said that normally he would wait for the labs back before, but said he will start me on Testosterone cream. I can't read his writing too well so looks like Testosterone C. 150mg/ml .2 OD. He said it was equivalent to 30 mg of Test a day.

Any more opinions would be appreciated.


KC

 

[Mprtz]

Can't comment on the insurance since I'm not in Canada and don't know anything about it.

Other comments:

Is this the complete list of bloods? Strikes me as slightly odd:
FSH and no LH?
Free T and no Total T?
CRP and no lipids?
No CBC?

Definitely get a complete metabolic and lipid panel if you don't already have them for a baseline.
You can never go back and get a baseline, better too much than to little at this stage.

Is gel the only option or will he do injections too if you want? If no, that would be a deal breaker to me. Mine gave me the option but steered me towards injectables.

 

[KCinToronto]

Can't comment on the insurance since I'm not in Canada and don't know anything about it.

Other comments:

Is this the complete list of bloods? Strikes me as slightly odd:
FSH and no LH?
Free T and no Total T?
CRP and no lipids?
No CBC?

Definitely get a complete metabolic and lipid panel if you don't already have them for a baseline.
You can never go back and get a baseline, better too much than to little at this stage.

Is gel the only option or will he do injections too if you want? If no, that would be a deal breaker to me. Mine gave me the option but steered me towards injectables.

Looks like that is it. Seems to be a premade form for blood work with those and CRP was added by hand. I take it you're sure this is not enough?

I'm not sure how easy it would be to get him to change it. Do you think I should ask? In Canada we seem to have a fear of pissing off our Doctors. LOL


KC

 

[Mprtz]

Looks like that is it. Seems to be a premade form for blood work with those and CRP was added by hand. I take it you're sure this is not enough?

I'm not sure how easy it would be to get him to change it. Do you think I should ask? In Canada we seem to have a fear of pissing off our Doctors. LOL


KC

I'm no authority, just a guy like you who is a bit longer into it and spends too much time reading about TRT.
I do think there are a lot of people (myself included) that wish they had more bloodwork prior to starting, because it obviously tells you how it is affecting you. Maybe there is a way you can get some additional testing done in Canada - possibly someone else can help here.

Unfortunately not an option, but the "male hormone panel" on privatemdlabs.com is what I would consider pretty complete.

In my opinion (and I think many others will agree), you should think twice before starting with a clinic that offers only gels. Especially if you're paying, you should be able to make some choices.

 

[KCinToronto]

I'm no authority, just a guy like you who is a bit longer into it and spends too much time reading about TRT.
I do think there are a lot of people (myself included) that wish they had more bloodwork prior to starting, because it obviously tells you how it is affecting you. Maybe there is a way you can get some additional testing done in Canada - possibly someone else can help here.

Unfortunately not an option, but the "male hormone panel" on privatemdlabs.com is what I would consider pretty complete.

In my opinion (and I think many others will agree), you should think twice before starting with a clinic that offers only gels. Especially if you're paying, you should be able to make some choices.

Thanks again for your advice/comments. He was pretty cool about it and said he does not feel the others are necessary, but it's never bad to have more. So I got a new requisition. Here is how this one looks:

- Free Testosterone
- Progesterone
- TSH - FREE T3
- CBC
- SHBG
- DHT
- Estradiol (MINE DOES NOT MENTION SENSITIVE ASSAY, SHOULD I WRITE IT IN?)
- DHEA-S B12 FERRITIN
- LH
- FSH
- Prolactin
- Cortisol (AM & PM)
- Lipid Assessment
- PSA
- IGF -1
- Vitamin D

Last requisition had CRP, this one does not, so I am asking if it is something we need.
I don't see Total Testosterone, so I guess he doesn't need it. I have a test from 2012 if I need an idea.

How does this look? More complete I imagine?
Time to fast and get it done I guess.

He is not against injections, he just wanted to start with the cream and see where it takes me. He personally felt the creams keep your levels more stable taking the same amount every day. I did not want to explain I was pretty comfortable with needles for obvious reasons. LOL

No mention of HCG or Arimidex either. Lots of vitamins he wants me on though.

Will my balls shrink on cream?

Thanks again,


Kevin

 

[Mprtz]

I would say that looks more complete. Still puzzled by the lack of TT (which is a much cheaper test than Free T). Like you said, youi have a somewhat recent baseline. CRP isn't important for a baseline, do you have CV issues?
E2 you can go with either test, the main thing is to always do the same one for relative comparison. If I had the choice I'd always do the sensitive because it's more accurate in the range males typically exhibit.

Your balls will still shrink on cream, hopefully you can get him to consider hcg down the road. You're probably going to want an AI too. I'd kind of want to know that my doctor is not somehow dead set against either so that they can be added down the road. Maybe you can verify that with like you did with the injection issue.

 

[KCinToronto]

I would say that looks more complete. Still puzzled by the lack of TT (which is a much cheaper test than Free T). Like you said, youi have a somewhat recent baseline. CRP isn't important for a baseline, do you have CV issues?
E2 you can go with either test, the main thing is to always do the same one for relative comparison. If I had the choice I'd always do the sensitive because it's more accurate in the range males typically exhibit.

Your balls will still shrink on cream, hopefully you can get him to consider hcg down the road. You're probably going to want an AI too. I'd kind of want to know that my doctor is not somehow dead set against either so that they can be added down the road. Maybe you can verify that with like you did with the injection issue.

Thanks again, What is CV? I complained about joint pain, so I believe this is an inflammation test? With how active I am, there'll always be inflammation somewhere. LOL

This Doctor does seem a bit laid back. I'll verify the HCG and AI later, I guess he only looks at the AI when he sees the estrogen after being on for a bit. (I'm guessing)

If worse comes to worse, I've seen a couple of other clinics in my area for this type of thing, and can switch out if I am not happy. He seems pretty open though. My main concern is that he is about 75 years old (but looks 60). Not sure how long he'll be practicing.

Thanks again,


KC

 

[Mprtz]

Thanks again, What is CV? I complained about joint pain, so I believe this is an inflammation test? With how active I am, there'll always be inflammation somewhere. LOL

This Doctor does seem a bit laid back. I'll verify the HCG and AI later, I guess he only looks at the AI when he sees the estrogen after being on for a bit. (I'm guessing)

If worse comes to worse, I've seen a couple of other clinics in my area for this type of thing, and can switch out if I am not happy. He seems pretty open though. My main concern is that he is about 75 years old (but looks 60). Not sure how long he'll be practicing.

Thanks again,


KC

CV = cardiovascular
CRP is generally a marker for inflammation and infection, so that makes sense. At our age it's nice to have a doctor make you feel young. Better than coming in and thinking "Is it bring your kid to work day again?", which happens more and more often

 

[KCinToronto]

CV = cardiovascular
CRP is generally a marker for inflammation and infection, so that makes sense. At our age it's nice to have a doctor make you feel young. Better than coming in and thinking "Is it bring your kid to work day again?", which happens more and more often

No real cardiovascular problems, except I hate doing cardio. LOL

Just a general question, do you feel much better since starting TRT? Can you describe your results, impressions? I'll likely ask more directly in the forum too.


KC

 

[Mprtz]

No real cardiovascular problems, except I hate doing cardio. LOL

Just a general question, do you feel much better since starting TRT? Can you describe your results, impressions? I'll likely ask more directly in the forum too.


KC

KC, you might be sorry you asked

My experience has been great. I always worked out and in my late forties I could tell something was changing - I was accumulating fat around the midsection, though my weight never changed much. I could feel my forearms getting thinner. I was definitely getting weaker. That 135lb bench that used to be a warm up weight was now a struggle to lift. Though my life circumstances are pretty good (retired early), I was pretty unhappy. After hesitating a few years, I got myself tested at a clinic: just under 300, no surprise. I took the plunge, wrote a check and went home with my first shot in my rear. Starting dose: 200mg/week, .5mg adex, 500iu hcg 2x/week.

Nothing happened for a few weeks, and I was just starting to get impatient when things started to happen fast. Fat disappeared from my midsection and I had visible abs. I went from about 167lbs to 175, then 180, 185, 190+lbs.
I did make some other changes: vastly reduced alcohol consumption, especially beer. Cleaned up my diet eating high protein, moderate high fat and low carb. Worked out hard in the gym. My 1RM on bench press is about 275-280lb now, I'm far stronger than I have been at any time in my life.
Intimacy in my marriage went from near nothing to better than ever before, and that helped put my marriage back on solid ground. My physical well being is hugely increased. My mental outlook is so much better I can't even put it into words. Do I sound enthusiastic yet?

recent pic:

View attachment 556709

 

[KCinToronto]

KC, you might be sorry you asked

My experience has been great. I always worked out and in my late forties I could tell something was changing - I was accumulating fat around the midsection, though my weight never changed much. I could feel my forearms getting thinner. I was definitely getting weaker. That 135lb bench that used to be a warm up weight was now a struggle to lift. Though my life circumstances are pretty good (retired early), I was pretty unhappy. After hesitating a few years, I got myself tested at a clinic: just under 300, no surprise. I took the plunge, wrote a check and went home with my first shot in my rear. Starting dose: 200mg/week, .5mg adex, 500iu hcg 2x/week.

Nothing happened for a few weeks, and I was just starting to get impatient when things started to happen fast. Fat disappeared from my midsection and I had visible abs. I went from about 167lbs to 175, then 180, 185, 190+lbs.
I did make some other changes: vastly reduced alcohol consumption, especially beer. Cleaned up my diet eating high protein, moderate high fat and low carb. Worked out hard in the gym. My 1RM on bench press is about 275-280lb now, I'm far stronger than I have been at any time in my life.
Intimacy in my marriage went from near nothing to better than ever before, and that helped put my marriage back on solid ground. My physical well being is hugely increased. My mental outlook is so much better I can't even put it into words. Do I sound enthusiastic yet?

recent pic:

View attachment 556709

Whoa, you look fantastic. You sure do sound happy. You could be their spokesman. LOL

I may have missed it. How old are you now? How tall are you? My avatar is me, 51 in April, 5'9". I've been really lucky. I've always had a good metabolism and been athletic. I tend to eat too much junk still and manage to keep my abs. I'm going to have to start trying a bit harder. For years I only cheated on weekends. Always high protein in my diet and I don't drink at all so that helps a lot.

Our stats are so similar. I still bench 315 for 3 clean reps (when my shoulders feel good) and I weight 192 today. When I was first tapering off strength wise, I did my first ever "cycle" and did two more within 2 years. It got me back to where I wanted physically, but I've suspected low T for awhile. Bloodtests (when I was off cycle for awhile) for the last couple of years have been in the lower range of what they call normal. The last one freaked me out, so time to move on this.

I'm so looking forward to the intimacy going up. I've just had no desire for a long time.

So your starting dose: 200mg/week, .5mg adex, 500iu hcg 2x/week. What is your dose now and how long have you been on it.

Thanks again for communicating, it's awesome to hear results direct from people.


Kevin

 

[Alpin]

Why Test Free T3 and not Free T 4 as well ?
PM cortisol too ? w.t.f ?
I'd assume you are going in first thing in the morning for this bloodwork due to lipids being tested...
I hope he told you to be there for 8 AM... 9 AM at latest.
Why no Total T ?
Most endos or TRT clinics don't even go by Free T....
Could be low and they don't care about it.
They diagnose based off TT and Bio Avail. T
I would not write anything in except TT
as that in my opinion is real important.
I'd put the $55 bucks down and do the bloodwork for Bio Avail. T as well since you are going in to do this....
Get the total picture bro.