Considering TRT / Levels

Pharma TRT
1

Hi all, I had two testosterone tests recently. These were done through the VA.

The most recent

Total testosterone : 264 ngdl

Free Test : 30.1 pg/ml

Two weeks prior

Total 444 ng/dl

Free 54.1 pg/ml

I’m 47. My wife and I have been struggling with my lack of libido, and honestly I am pretty low energy, I get enough gas to be present for a few hours a day, but when I get home from work I only have so much energy for my boy(8). I also sleep terrible, often going 4-5 hours a night for days on end. I have tried everything from no/carb to no caffeine and I can’t fix it.i wake up sometimes at 2 or 3 am and im wide awake

My symptoms aren’t horrible but they are significant, and I am wrestling with getting on TRT.

#1 the enormity of the decision, I mean once you go on it’s major to come off of it. It feels like a big commitment. Do I really need something this major possibly making a mistake messing with my endocrine system or is this no big deal and an answer that will help me be a better dad and husband?

#2 the tests fluctuate wildly, I mean my total was in normal range the first test, with my free being borderline. The second was low and my free T didn’t even make the reference ranges.

Are my levels just a little low where I can pull myself out of it somehow, or do I have a problem that warrants medical intervention. The differing scores have me confused. My primary doc (female) is dismissive and tells me to exercise. That’s hard to do when you aren’t sleeping great and have low energy.

Also the dependency aspect bothers me. I will no longer exist organically, but will be reliant on petermd to get me my medications which is external to myself. Maybe it’s just new and maybe I just have to get used to the idea. Something feels off about it. And I am worried I wouldn’t be quite myself. Or like maybe if it’s fake hormones im fake. I want to be me, not manufactured so to speak.

I know only I can answer all this, but opinions wanted. Do my levels warrant TRT, and is it possible at 47 to change all this with horrible sleep and a 45hour workweek?

I’m a family man and am trying to follow Jesus. I want to be reliant on him as well. However I believe if you have cancer you take the medication so obviously if I need to take t I’ll take it. .

Thoughts?

2

I started on TRT at around the same age. It’s a personal choice.

If your sleep is fucked, TRT isn’t going to do much to help with that.

I use Marek health. They offer a pretty expansive blood panel and once you get it done come back with a whole slew of suggestions. You can pick à la cart which direction you want to go.

If you are already have high body fat they will probably suggest a GLP1 of some kind. I haven’t used one but have been offered.

Sleep apnea, if you have it, will need to be corrected.

TRT increases your hematocrit, and can cause higher blood pressure, something to keep in mind if you are already having issues.

3

If your sleep is fucked, TRT isn’t going to do much to help with that.

Though anecdotal, I will say that I actually did experienced improved sleep with TRT, and my urologist said other clients have reported the same. My theory is that cortisol is the hormone that wakes us up, and it plays an antagonistic relationship with testosterone. When test is down, cortisol is up. When cortisol is up, it’s hard for us to stay asleep. I had no issue GOING to sleep when I was ill, and would frequently nod off, but I couldn’t sleep for longer than 20 minutes. I was effectively in a permanent state of “fight or flight”. Once my hormones got sorted out, I was able to actually relax enough to sleep deeply.

However, the part about trying no/low carb can ALSO be a culprit. And I say this as the resident “Captain Carnivore”, but I also recognize the impacts of the lifestyle. Carbs are ANOTHER way to help mitigate cortisol. So attempting to go low/no carb while also dealing with low test seems like a double whammy on the sleep side (and most likely explains my own issues as well). If someone does NOT have a need to restrict carbs, I’d definitely experiment with some carbs before bed to see how that helps with sleep.

4 Likes
4

That is interesting. My provider was more worried about sleep apnea more than anything.

I wear an Oura ring and I didn’t see any improvement after going on TRT. Things that effect my sleep the most are related to when I eat, how much caffeine I have and when I stop having it, sleep environment, and alcohol.

Thankfully I don’t have any sleep apnea.

1 Like
5

My provider was more worried about sleep apnea more than anything.

Yeah, that gets to a good point of diagnosis. Lots of things can jack up sleep, and if it’s apnea, TRT won’t help there.

1 Like
6

I’m going to second this angle. Whenever I drop carbs too low, sleep and libido are not happy with me. When I bring them back up, night and day difference.

Could be worth exploring going in the opposite direction there before taking the plunge…

1 Like
7

I also got sleep benefits from TRT. I woke up in middle of night numerous times, and also had to get up to pee up to 3 times a night. That’s all gone away and I sleep through night. I’d say it was really noticeable after 8-10 months.

I was same way, but much younger. I started at 33. While I was concerned about long term reliance on needles and testosterone, I finally rationalized it as no different than medicine. Unlike other medicine, blood thinners, statins, etc., I was already healthy otherwise and not treating a symptom without addressing the problem. At least with TRT, I was treating the problem. It’s incredibly accessible and very minimal impact to my life, for all the benefits I get.

2 Likes
8

You know, now that you mention it, I also used to pee a lot more at night prior to starting TRT. I honestly never really associated it to that but more to all the other things I started doing along with the trt. That is interesting.

1 Like
9

My doc brought it up during initial consultation, asking if I peed in middle of night. Said it’s a pretty directly correlated symptom, since I’m not older or way out of shape.

1 Like
10

Sorry if I missed this ITT, but what is your current lifestyle in terms of exercise, sleep, alcohol intake, body composition etc?

If you are stressed, short on sleep, exercising inconsistently, drinking with any regularity, high fat and low skeletal muscle, you can’t really trust those test results. Spend 12 weeks being healthy on all dimensions and retest before you make the very serious commitment to TRT

11

Thanks, oddly I think I might sleep better on low carb. Only problem is, that diet isn’t long term sustainable for me. At least not under 30carb a day

12

Ever try carb cycling?

13

So everything is healthy as far as I can control with the exception of exercise and well I’m a little overweight. 5”10 205. I don’t drink. I go to bed at 9-10 and wake up at 2 or so in the morning. I have been doing keto. Which helped with weight - I went from 223 to 195 but I hit a plateau with weight I can’t seem to get past. I’m skinny fat but have a lot more Chubb than what it looks like with clothes on. I do an office job 4-10s an hour from my house.

I decided to go on a 3 month trial of TRT as it seems that with only three months on your body can kick your own production back into gear. I do chop wood and do stuff around the yard on the weekends but nothing else.

I should probably try exercise and screwing with my diet but I just have no go, (I also fractured my tibia last last year and am still sorta recovering from soft tissue stuff, and honestly when I do workout I feel like it gives me more sleep issues. I’m probably making a premature decision but part of me feels like doing it for 3 months and seeing what it does for me. And if I can do the lifestyle of needles 2x a week for 3 decades…

14

No but I’ve seen the advertisements and it seems to make a lot of sense