Evaluate My Numbers for TRT

I am 58 and showing signs of low T but my test seems normal. I am waiting for the Mens clinic I went to call me to discuss but would like a objective opinion not by someone who will be getting $150 per month from me…
Results

ESTRADIOL (E2) 23.6 0.0 - 39.9 pg/mL
DHEA-SULFATE 170.1 34.5 - 568.9 ug/dl
TESTOSTERONE, TOTAL 555 280 - 1100 ng/dl
SEX HORMONE BIND GLOBULIN 61 22 - 113 nmol/L
TESTOSTERONE, FREE 7.4 3.9 - 22.5 ng/dl

You don’t need TRT, really. You need to lower this number and free up some test. Boron, more carbs, etc. can help.

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If you had a baseline done in your 20s-30s and your TT / fT were significantly higher at that time, you could still be experiencing low T symptoms simply due to the drop over time.

Judging by these numbers alone though, you probably don’t need TRT - but if you don’t mind spending the money, it could help ease symptoms. This being said, your labs look better than mine and I’m 28 so :man_shrugging:

+1 to what @swoops39 said about SHBG

Unfortunately, no consensus has been reached regarding the lower TT threshold defining TD, and there are no generally accepted lower limits of normal TT. This lack of consensus follows from the fact that no studies have shown a clear threshold for TT or free T that distinguishes men who will respond to treatment from those who will not.

I believe your symptoms are related to the lower end Free T value which isn’t even midrange. I have seen dozens of members with Total T and SHBG ratios like these over the years having symptoms of low-T that quickly diminish after starting TRT.

What time was your blood drawn?

While 550 is good, if it was first thing in the morning then you are likely low by the afternoon. I’m not sure that qualifies as Low T from a clinical standpoint, but if raising your SHBG does not work, you could eat like shit, over train, and drink hard for a few days, then get tested in the afternoon, and that number would likely be blow normal.

I would not base treatment entirely on the number. Regardless, this is always your choice and you know how you feel, so keep than in mind no matter what you hear.

SHBG is not a bad thing. I would not lower it. For starters, lower SHBG increases the risk of decreasing insulin sensitivity. I have guys who have stopped metformin after going on thyroid, which increases insulin sensitivity.

What I am seeing would not prevent me from going on TRT. Maybe DHEA as well.

To me, this reads that OP is interested to see if TRT is actually warranted, rather than seeking a way to artificially lower TT as a means of medically justifying treatment.

@tony2377 If you are just trying to get TRT prescribed, doing this:

would likely do the trick.

Agreed.

My humble opinion is that if he has low t symptoms and cannot alleviate them, then TRT is warranted.

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Also agreed :slightly_smiling_face:

Thanks for the replies! I’ll update when I talk to the Doctor at the clinic…

I did my blood test around 1130am and yes I do want to know if TRT is warranted. The money is not an issue, I don’t have a problem spending the $150 a month if it will improve my quality of life.
The low free T is what alarmed me more than anything. I do question wether or not my change in workout (or lack of) is affecting free T. Before Covid I was in the gym at 5am 5-6 days per week and have not done that for almost 2 years now. My ideal weight is around 195-200 and I am currently 215 and have lost some muscle mass.

Sypmtoms
Low almost non existent libido
increased belly fat although diet is not horrible and I don’t overeat or drink
extreme fatigue
And a few others…

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Personally I would check your thyroid and get a sleep study before starting TRT.

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You’re eugonadal, normal, likely not a candidate for TRT.

What are your symptoms? Some symptoms of hypogonadism are the same for other situations and conditions.

I am highly skeptical of clinics.

Timing of the day makes no difference.

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PURLs: It’s time to reconsider early-morning testosterone tests - PMC.

Has it been demonstrated what’s causal in the insulin sensitivity/SHBG relationship?

My low T symptoms began while doing some intermittent fasting and low carb with consistent exercise over a 2 or 3-year period. My SHBG spiked along with my insulin sensitivity as I cut out carbs and restricted calories.

Makes more sense to me that SHBG would spike as a defense mechanism to conserve energy if it is in a state of stress due to calorie or carb restriction. Survival would rank higher than reproduction in the body’s hormone hierarchy, one would think.

I’d be curious to know if independently lowering SHBG while still maintaining a lower carb diet and good exercise regimen lowered insulin sensitivity.

The correlation between SHBG and IR is evident in a number of cross-sectional studies. Probably several mechanisms which may account for this association. What you are suggesting makes sense and could certainly be one of them. I’ve noticed this on an observational level and I suspect there are many moving parts.

You need to be fasting as well, because a small subset of the population after eating will see a false low value.

That’s because it is. Come to a TRT forum asking about TRT and you’re gonna get a lot of people say “do it, I did”. No GP, endo or urologist will treat you. If you want to go to a TRT clinic will provide to almost anybody. Your call.

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You guys will be happy, I turned a guy away today.

image

:joy:

I’ve suggested this to a few ppl on carnivore and are dealing with high SHBG. I don’t know how much boron it would take daily to do that, or for us on TRT already an oral AAS or SARM would do the trick at a very low dose