What protocol would you recommend with these symptoms? (labs inside)

MusclesMarinara

New member
I have not posted here in probably 7 years.

Male, 6'1", overweight at 295lbs, 245 lbs would look pretty good on me for reference of my frame. 32 yrs old, Weight training for 14 years.

Previously (2) T only cycles 7-8 years ago with AI and PCT.

Symptoms which prompted a visit to the Dr. and bloodwork included:

Fatigue - particularly early evening and during workouts
Increased anxiety, irritability, and generally a depressed mood. Relationships were suffering as a result.
Lack of ambition in both career and personal life
Strength is waning and body fat rising. Muscular endurance has reduced significantly adding to the frustration of an already mediocre existence.

Feb 25
Initial blood panel taken at 8 AM (checking triglycerides, A1C, Thyroid, Free Test, etc) came back generally good with the exception that Test Serum came back "Low" at 296ng/dl (reference 348-1197). Free Test (Direct) came back at 10.4 pg/ml (reference 8.7-25.1) .


It was recommended that I improve my diet to lose weight, supplement with 50mg of DHEA sulfate daily, and check the levels again in 5 months. I couldn't wait (because I don't want to commit to feeling like ****) for another 5 months, so I went to an Endo. My visit was met with a lot of skepticism (due in part to my age) and the Endo did not seem concerned with my symptoms but was somewhat dismissive until more testing was performed. It was recommended I stop taking DHEA sulfate. I did and within 2 weeks had an additional panel (11 am) with more comprehensive tests. Results are as follows:

April 15
Test Serum - 332ng/dl (348-1197 reference)
Free Test Direct - 12.3 pg/ml (8.7-25.1 reference)
LH - 2.6 mIU/ml (1.7-8.6 reference)
FSH - 6.5 mIU/ml (1.5-12.4 reference)
Prostate specific Ag Serum - 0.9 ng/ml (0.0-4.0 reference)
Hemoglobin A1c -5.4& (4.8-5.6 reference)
Prolactin - 7.3 ng/ml (4.0-15.2 reference)
TSH - 1.260 uIU/ml (0.450-4.500 reference)
T4 Thyroxine Free Direct -1.18ng/dl (0.82-1.77 reference)
DHEA Sulfate - 237.8 ug/dl (138.5-475.2 reference)
T4 Thyroxine - 7.1 ug/dl (4.5-12.0 reference)
Ferritin, serum - 151 ng/mL (30-400 reference)
Estrogens, Total - 61 pg/mL (40-115 reference)


As most of the levels seem with "normal" range with the exception of Test Serum, how can I get my symptoms to improve and test to increase without causing more issues and throwing everything else out of balance?:confused: Did I miss anything that is a concern level? I would like an optimal level to support an active, high energy lifestyle, and demeanor. I'm reluctant to lose weight at the expense of hard earned muscle and I feel like a low test level will make this increasingly difficult. Do you think at my age a physician will help in this endeavor?
 
Have you thought about going to IMT . Your numbers might be low enough to be treated by them.

I'd like to explore my options safely and under the direction of a physician - so yes. I have health insurance so depending on what is/ isn't covered. Is their site down?

What are your thoughts on the numbers? What's to explain everything seemingly normal with the exception of test serum?
 
A good Doctor who is familiar with HRT will probably treat you with TRT. With two separate tests showing your low T, you are definitely low. Remember the reference ranges are from a broad spectrum of ages, so you are definitely low for your age.

A restart might be and option for you before you jump onto TRT though. Even though your LH and FSH are in range, something is not firing right for you.

I would try the restart first, just to make sure before you commit to TRT for life.

Either way, feeling like crap is no way to go through life.
 
Your blood work is similar to mine prior starting TRT about 6 months ago. If you're experiencing the symptoms you would probably benefit from TRT. Also yes your bloodwork confirms your testosterone is low, It could be worse but it's low for your age.
 
Your blood work is similar to mine prior starting TRT about 6 months ago. If you're experiencing the symptoms you would probably benefit from TRT. Also yes your bloodwork confirms your testosterone is low, It could be worse but it's low for your age.

Thanks...I just read one of your previous posts. Did you have any success that you could feel by increasing vitamin D before you went to TRT? For the cyp, does your doctor write you a script to dose at home per your schedule or is it in-office only?

I'm not sure who to talk to at this point. Do I require further diagnosis from a urologist or endocronologist to get to the root of the problem?
I'm trying to mentally prepare for the commitment of TRT if needed. It will take time, money, and may create some dependence on it. I do need to feel better though.
 
Thanks...I just read one of your previous posts. Did you have any success that you could feel by increasing vitamin D before you went to TRT? For the cyp, does your doctor write you a script to dose at home per your schedule or is it in-office only?

I'm not sure who to talk to at this point. Do I require further diagnosis from a urologist or endocronologist to get to the root of the problem?
I'm trying to mentally prepare for the commitment of TRT if needed. It will take time, money, and may create some dependence on it. I do need to feel better though.

Are you Australian?
 
Thanks...I just read one of your previous posts. Did you have any success that you could feel by increasing vitamin D before you went to TRT? For the cyp, does your doctor write you a script to dose at home per your schedule or is it in-office only?

I'm not sure who to talk to at this point. Do I require further diagnosis from a urologist or endocronologist to get to the root of the problem?
I'm trying to mentally prepare for the commitment of TRT if needed. It will take time, money, and may create some dependence on it. I do need to feel better though.

No I didn't bother with trying to increase the vitamin D just wanted results so straight to TRT. Yes my general Doc writes me a script for 200mg every week but most general/family doc are not on board with HRT. Your endo should be able to take are of you.
 
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