I am 32 years old, 6"1 around 200lbs. I’ve ran multiple cycles of anabolics like Epistane multiple times when I was around 18-21 years old (dumb move, I know). I also ran test cyp cycles multiple times from 25 to 29. I believe I have low T now from AAS usage an test but I also have testicular atrophy a pain. I have all the symptoms of low T currently.
I recently had bloodwork ran, my levels were as follows:
Creatinine:13
Sodium:141
Total testosterone:815 (weird considering I have all the symptoms of low T)
Free testosterone:8.4 (very low)
T4:1.2 ng/dl
TSH: 2990
ACTH:1.9 (abnormally low)
T3:2.8
Cortisol:6.3 ng/dl
Any advice on what I should do? I am seeing a urologist soon and he told me TRT is an option as is clomid… I was thinking possibly a small cycle of HCG to see if it regrows my testes but am unsure. Any opinions?
Your situation is little different from my labs pre-TRT with the exception of SHBG @11. The only way you could have a high Total T, low Free T is high SHBG.
SHBG can be elevated due to starvation diets or cutting. This is usually not reversible.
Clomid is a no go, your SHBG is high, clomid increases SHBG. You will have a hard time getting the Free T up as long as the SHBG is high.
Your urologist doesn’t seem very knowledgeable given that he suggested clomid for a person who clearly has high SHBG if the Total T and Free T ratios have anything to say about it.
Your testes aren’t making that much T anyway, if your Free T is any indication. The HCG will likely be futile. My advice, waste no time trying to control SHBG, most of the time it is impossible.
my sleep has been 50/50, diet has been great… stress has been rather elevated since I’ve been dealing with a lawsuit. I am on anti anxiety medicine because of this. Training has been not as much upper body as usual as I have also had a surgery on a strained nerve in my elbow. So I have been focusing mostly on my legs @Andrewgen_Receptors
As for TRT being the only option, I still do want to have kids in the next 5 years or so and am worried running TRT without doing any HCG/etc to regrow my testes may make them too small to actually make the correct amount of sperm possibly? I do want to get on TRT but I don’t want it to impair my ability to have kids in the future. @systemlord
prescription: clonazepam/clonidine and remeron (FDA has clonidine labelled for blood pressure but off-label its for anxiety/sleep disorder).
I really want to get back on TRT, but I am just worried that my balls will shrink into little acorns that cannot produce babies in the future but I don’t know if there is truth to this or not. I’ve been out of the gym lately due a pinched elbow nerve surgery for past 6 months so I’ve just started back recently… I have also noticed a tiny bit of hair loss on my temple areas (I assume this is normal?) I am going to be buying minoxidil drops to put on my head of day to keep the thickness. @Andrewgen_Receptors
Is TRT the best/only move or would you recommend trying some kind of AI maybe or something that stimulates LH/FSH naturally to rebuild that damaged/low SHGB issue if possible to get test flowing properly in my body naturally or if its just perm, I may as well just go full TRT @ 32 yrs old an if I want to have a baby, use hCG with possible low dose of clomid? I was reading this an got the vibe that’s what recommend Recovery of spermatogenesis following testosterone replacement therapy or anabolic-androgenic steroid use - PMC
The drugs that will stimulate the LH and FSH will make your SHBG situation worse as stated before. The AI is a bad plan that won’t do sh** but deprive you of estrogen compounding your issues.
The AI might increase the Free T a little, but it will never be enough to make a difference.
TRT suppresses the SHBG unlike natural T, that’s your silver bullet.
I would still test the LH and FSH prior to starting TRT, because if it’s primary however unlikely, that would change any fertility plans in the future. I would even get your sperm tested.
None of these seem to have ties to lowered testosterone, did a google search (for whatever that’s worth).
TRT will shut your balls down. This can be countered with HCG to allow you to stay fertile, or you can add in HCG later when needed to be fertile.
I would start by addressing lifestyle changes before anything else, fix your sleep, reduce your stress (obviously only what is manageable), try to get off any unnecessary meds (I don’t entirely believe in medicating away anxiety… it’s a natural thing, but feel free to ignore this). I gotta ask: you said your diet is great - are you getting in at least 0.3g/lb bodyweight of fats? If not, correct this and you should see a rapid improvement, otherwise feel free to disregard.
sorry I left a few things out I didn’t think were important, here is the full list:
Glucose:91
BUN:12
Creatinine:0.9
eGFR:116
BUN/Creatinine ratio : 13
Sodium:141
Potassium:4.9
Chloride: 101
Carbon Dioxide: 24
Calcium 5.3
Protein total:7.4
Albumin:4.6
Globlin:2.8
A/G Ratio: 1.6
Bilirubin:0.3
Alkaline Phosphatase: 94
ALT(SGPT): 9
Total T: 815
Free T (direct): 8.4
T4:1.2
TSH:2.990
ACTH plasma: 1.9
Vitamin D:30.4
Throid Peroxidase (TPO) Ab: <9
T3(free):2.8
Cortisol -AM: 6.3
This was everything I was tested for, anything you recommend I ask the doctors to test for specifically? Also, I have a full head of hair currently that is very thick (family has good hair genetics), To avoid losing any of my hair, should I be taking any supplements if I decide to start TRT? @systemlord@Andrewgen_Receptors
got back from urologist today an he said my total t being <800 even with free T being low, he would not give me test nor recommend it… any advice on finding a doc that would prescribe? I am able to get it by other means but I want to be under a doctors treatment so I can get blood work an labs done every few months.
This is common, the high SHBG confuses doctors by elevating the Total T while not affecting the Free T. Your doctor clearly doesn’t know the difference between the bound and unbound portions of testosterone.
This is NOT taught in traditional medical schools.
There are private options that are preferred and especially in your case, because you will need a Total T possibly 1200> to get the Free T up and if the doctor isn’t very knowledgeable, will not allow this.
My first recommendation is Defy Medical, cost wise this is the best route and the doctors can run circles around your average and even above average urologist and or endocrinologist.