On the road to TRT...opinions/feedback appreciated!

[Megatron28]

Let me say this. I think TRT is literally a life saver. I love to spread the gospel of TRT to guys with hypogonadism. But at the same time, if I could go back to being Natty, I would do it in a second. I would love to have your Natty T levels.

 

[lancerevo]

I read that. You have to remember that the blood work is just a picture in time too.

Your TT has looked good in both sets of labs.

Well thanks for taking the time to humor me, honestly.

Looks like I'm gonna have to continue this journey alone. I've essentially ruled out all other (common) causes for my symptoms other than what I posted in the second post. I still feel that total testosterone is only part of the puzzle, and there is not enough focus on free testosterone around here, whereas everywhere else I've read that is the main thing they use.

Just to re enforce my point - my first testosterone level at 6.6 I was weak, fatigue, tired, depressed, everything u can think of for Low T. With all the meds and lifestyle changes and taking 3 weeks off gym, I brought that value up to 8.8 and felt much better, but still not optimal, despite my total T not increasing that much. So I think free test has a much bigger role. Of course if I can bring my total T up to 600/700 naturally then I'm sure i'll feel great, but I'm already running at optimal, so I highly doubt it will be any better.

Anyways, I'll be getting new blood work this weekend and will re evaluate.

I'll still update this thread if any would like to follow along.

 

[lancerevo]

Let me say this. I think TRT is literally a life saver. I love to spread the gospel of TRT to guys with hypogonadism. But at the same time, if I could go back to being Natty, I would do it in a second. I would love to have your Natty T levels.

Thank you for this man. I really do apprecaite it. I don't want to come across like I am desperate for gear, because I am not. There have been many days where I just can't even get out of bed because of how fatigued I am. at 26??? Acting like a 90 year old??

I'm trying to do everything I can naturally to get my levels up, but I'm STILL tired, fatigued, poor workout recovery, low libido, etc AND i've ruled out all other causes (see first couple of posts), and I have evidence of low free tesosterone. It's like saying it's not a duck when it quacks, walks, and talks like a duck.

but you guys have more experience than I do, and I respect that and will re evaluate at my next blood work

 

[novaman]

I would encourage you to explore other avenues first. Get a sleep study to check for sleep apnea. Be honest with yourself concerning porn and masturbation- that can kill your dopamine receptors and give you the symptoms you are having.

Once you go on TRT its for LIFE. Think hard on that

 

[lancerevo]

I would encourage you to explore other avenues first. Get a sleep study to check for sleep apnea. Be honest with yourself concerning porn and masturbation- that can kill your dopamine receptors and give you the symptoms you are having.

Once you go on TRT its for LIFE. Think hard on that

I watch porn/masturbate like once a week. Being 26 years old, after a whole week of no stimulation, I should be rock hard, and ejaculate buckets, but it's barely a couple drops (sorry for the graphic post)

And I stated in the first post I already got a sleep study and it was normal.

I understand TRT is life, but when I barely have one now (barely getting out of bed, not having energy to do fun activities, always want to stay inside and sit on my computer) seems like a small price to pay to get my life back...i'm in my 20's for goodness sakes!

 

[Megatron28]

I watch porn/masturbate like once a week. Being 26 years old, after a whole week of no stimulation, I should be rock hard, and ejaculate buckets, but it's barely a couple drops (sorry for the graphic post)

And I stated in the first post I already got a sleep study and it was normal.

I understand TRT is life, but when I barely have one now (barely getting out of bed, not having energy to do fun activities, always want to stay inside and sit on my computer) seems like a small price to pay to get my life back...i'm in my 20's for goodness sakes!

I can't remember/ Have you had a urologist perform a physical examination?

And what time of the day did you get your blood work done?

 

[cybrsage]

Sleep Apnea can cause the same symptoms. Have you had a sleep study done yet?

High stress levels can also cause the same symptoms. You sound like you are a very argumentative person, which is a big cause of high stress levels (even if you do not feel the frazzled type of stress). Try going with the flow instead of fighting the wind...relax, the problem could sort itself out by doing this alone. Stress effects sleep negatively, which then cascades into all other parts of your life. The high blood pressure and acid reflux are also indications of high stress levels. Try meditation (I prefer Chakra meditation myself) while getting yourself a sleep study done.


EDIT: Oh, and your B12 levels could be low.

 

[lancerevo]

I can't remember/ Have you had a urologist perform a physical examination?

And what time of the day did you get your blood work done?

I have not had a urologist do a physical exam. I have noticed my testicles have shrunk in size over the years though.

All blood work always done between 7-9AM on empty stomach.

Sleep Apnea can cause the same symptoms. Have you had a sleep study done yet?

High stress levels can also cause the same symptoms. You sound like you are a very argumentative person, which is a big cause of high stress levels (even if you do not feel the frazzled type of stress). Try going with the flow instead of fighting the wind...relax, the problem could sort itself out by doing this alone. Stress effects sleep negatively, which then cascades into all other parts of your life. The high blood pressure and acid reflux are also indications of high stress levels. Try meditation (I prefer Chakra meditation myself) while getting yourself a sleep study done.


EDIT: Oh, and your B12 levels could be low.

Lol. Man I appreciate your guys help and all but pls read my opening post. I feel you're just seeing my test level and saying go home. All your questions are answered there.

Edit- I'm not argumentative at all. But when you guys don't even read my post and ask me questions that I've wrote out in detail in the first post it tells me you're only looking at one thing, not everything I've done, and making wrong conclusions off of that - with your post being a perfect example. So that's what got me a little annoyed. I'm actually a very calm person and always meditate twice a day and deep breath.

 

[jice]

I have not had a urologist do a physical exam. I have noticed my testicles have shrunk in size over the years though.

All blood work always done between 7-9AM on empty stomach.




Lol. Man I appreciate your guys help and all but pls read my opening post. I feel you're just seeing my test level and saying go home. All your questions are answered there.

Edit- I'm not argumentative at all. But when you guys don't even read my post and ask me questions that I've wrote out in detail in the first post it tells me you're only looking at one thing, not everything I've done, and making wrong conclusions off of that - with your post being a perfect example. So that's what got me a little annoyed. I'm actually a very calm person and always meditate twice a day and deep breath.

I too am in my mid 20s.. 25 years old and have both TT and free t below reference ranges.I am finally seeing an endocrinologist tomorrow after waiting what seems like forever. I am most definitely going to discuss TRT with the doc as I can't imagine living with these symptoms much longer. Life quality has been less then poor and if trt for life provides me a solution I too would agree it's more positive than negative.

 

[cybrsage]

Lol. Man I appreciate your guys help and all but pls read my opening post. I feel you're just seeing my test level and saying go home. All your questions are answered there.

Edit- I'm not argumentative at all. But when you guys don't even read my post and ask me questions that I've wrote out in detail in the first post it tells me you're only looking at one thing, not everything I've done, and making wrong conclusions off of that - with your post being a perfect example. So that's what got me a little annoyed. I'm actually a very calm person and always meditate twice a day and deep breath.

Ah, I missed the sleep study in your OP. Sorry about that!

 

[Megatron28]

I have not had a urologist do a physical exam. I have noticed my testicles have shrunk in size over the years though.

All blood work always done between 7-9AM on empty stomach.




Lol. Man I appreciate your guys help and all but pls read my opening post. I feel you're just seeing my test level and saying go home. All your questions are answered there.

Edit- I'm not argumentative at all. But when you guys don't even read my post and ask me questions that I've wrote out in detail in the first post it tells me you're only looking at one thing, not everything I've done, and making wrong conclusions off of that - with your post being a perfect example. So that's what got me a little annoyed. I'm actually a very calm person and always meditate twice a day and deep breath.

You could always try running g a 12 week cycle to see if that alleviates all your problems. 500mg of test per week with proper ancillaries abs PCT should do the trick.

 

[lancerevo]

I too am in my mid 20s.. 25 years old and have both TT and free t below reference ranges.I am finally seeing an endocrinologist tomorrow after waiting what seems like forever. I am most definitely going to discuss TRT with the doc as I can't imagine living with these symptoms much longer. Life quality has been less then poor and if trt for life provides me a solution I too would agree it's more positive than negative.

definitely does suck having low testosterone. I hope all your issues get resolved, and are making progress every day in some way.

Ah, I missed the sleep study in your OP. Sorry about that!

That's not a problem!! also to your Vitamin B12 in your previous post my levels are actually on the higher end as I supplement with B vitamins among my multi vitamin.

You could always try running g a 12 week cycle to see if that alleviates all your problems. 500mg of test per week with proper ancillaries abs PCT should do the trick.

This is actually a good idea and one I hadn't thought about. My ONLY qualm with this is what if I truly become even more shut down and end up in an even worse situation than I am in now...that would be bad!

My plan was to try clomid and see if that does anything for my HTPA axis. I'll do an actual cycle right before I plan on getting on TRT...that way if my symptoms to get better and if I do get shut down I'll end up on TRT anyways. and If my symptoms don't get better from cycling and I can restore my axis with proper PCT then I know TRT is not the answer. and worst case scenario if TRT doesn't improve my symptoms and I can't restore my axis with PCT then I goofed hard.

This is all pending my upcoming blood work of course. If my T levels improve then no need for any of the above!

Thank you for that!

 

[Underradar]

Great post and great job on doing your research and staying on top of... well everything...diet, sleep, bloodwork (as I understand it not many do).

I just had a crazy idea...could you have elevated Sex hormone-binding globulin SHBG) ? As SHBG has an affinity for both test and estradiol that could help explain the lower values of free test (biologically active) and lower estradiol? Just another thing to rule out. You can request the assay from an endo but if it is high I'm not sure how it would be treated.

 

[lancerevo]

Great post and great job on doing your research and staying on top of... well everything...diet, sleep, bloodwork (as I understand it not many do).

I just had a crazy idea...could you have elevated Sex hormone-binding globulin SHBG) ? As SHBG has an affinity for both test and estradiol that could help explain the lower values of free test (biologically active) and lower estradiol? Just another thing to rule out. You can request the assay from an endo but if it is high I'm not sure how it would be treated.

why thank you. I did countless hours of research for weeks on end before getting all the blood work and imaging I needed.

And yes I did get SHBG - it was posted towards the end of my first post. It was slightly elevated at 37 (16.5-55.9 nmol/L), which is why I believe, as you also suspected, why I have a relatively high total test and super low free testosterone. I've been trying to do everything i possibly can naturally to reduce my SHBG levels.

I think there's a medication called reversitol to take for elevated SHBG which is available in Europe, although I do not think I would want to go down this route myself, as from my reading having increased testosterone itself can lower SHBG, but of course having elevated SHBG will keep the free test low (kind of like a catch 22 lol)

 

[lancerevo]

Just wanted to give an update for some of you guys who say I don't have low test. According to the 2010 Endocrine Society guidelines, low testosterone can be diagnosed by either: 1. Low total testosterone, OR 2. Low bioavailable OR 3. Low free testosterone in patients with SHBG alterations.

#3 is my case

here is the link for reference:

Diagnosing Hypogonadism | Hypogonadism Pro

 

[Megatron28]

Just wanted to give an update for some of you guys who say I don't have low test. According to the 2010 Endocrine Society guidelines, low testosterone can be diagnosed by either: 1. Low total testosterone, OR 2. Low bioavailable OR 3. Low free testosterone in patients with SHBG alterations.

#3 is my case

here is the link for reference:

Diagnosing Hypogonadism | Hypogonadism Pro

I looked but didn't see where it said that in your link. Doesn't it just say Testosterone levels should be checked when SHBG is altered?


Free or bioavailable testosterone levels can also be evaluated for men with low total testosterone concentrations in whom SHBG alterations are suspected

 

[lancerevo]

I looked but didn't see where it said that in your link. Doesn't it just say Testosterone levels should be checked when SHBG is altered?


Free or bioavailable testosterone levels can also be evaluated for men with low total testosterone concentrations in whom SHBG alterations are suspected

If you look on the flow chart right below the section where it says the use free or bioavailable T if suspect alterations in SHBG in the next arrow it says "Confirmed Low t levels(low total T, or free or bio available T)

Just something to think about that total testosterone isn't the only thing to look at when evaluating a patient with low testosterone symptoms.

 

[Megatron28]

If you look on the flow chart right below the section where it says the use free or bioavailable T if suspect alterations in SHBG in the next arrow it says "Confirmed Low t levels(low total T, or free or bio available T)

Just something to think about that total testosterone isn't the only thing to look at when evaluating a patient with low testosterone symptoms.

Got it. I see it now.

We have always talked about looking at Free T AMD Bioavailable T around here to diagnose " Borderline Hypogonadism".

 

[lancerevo]

Got it. I see it now.

We have always talked about looking at Free T AMD Bioavailable T around here to diagnose " Borderline Hypogonadism".

So why were you guys so quick to say I didn't have low testosterone and I was fine when my free levels were clearly below range?

 

[Megatron28]

So why were you guys so quick to say I didn't have low testosterone and I was fine when my free levels were clearly below range?

Your TT is 515. When you have borderline low TT that is when you should look at what your Free T or bioavailable T is to diagnose hypogonadism. I think bioavailable is a better measure than Free T. Regardless, you are not in the borderline range for hyoogonadism which is 300-350ng/dl.

I know you don't feel good. And I wish hypogonadism was the answer for you because it can be treated very successfully, but the fact is that you are not hypogonadal. Are you optimal? No, but that is different issue.

There are things you can do to lower your SHBG and thus increase your Free/bioavailable T. You could look into some of those options with your endo.