Note: Testosterone was around 256 (Reference: 242 to 830) ng/DL
I had talked to many general doctors. They all wanted to prescribe me anti-depressants but I didn’t want to try them. They all said that my testosterone was all in my head.
I went to an anti-aging clinc that does TRT and they ordered the following test:
Note: Testosterone was around 438 (Reference: 242 to 830) ng/DL
I have an appointment with the TRT clinic next week but before I go to the appointment, I would like some opinions if it is a good idea to start TRT treatment based on my results.
When I went to the initial consultation (with only the bloodwork from October 31, 2019), they told me they might give me Clomid depending on my conditions. They were most worried about fertility at my age. With the bloodwork shown above, is Clomid a good idea or even TRT in general?
It’s common for doctors to get normal testosterone status wrong, most of it comes from a lot a doctors still believing TRT cause prostate cancer, heart attacks and strokes and refuse to consider testosterone being a problem.
Consider sex hormones, testosterone is absent from medical school and residency, so right out of medical school doctors know nothing about hormones, only that in range is normal which can only be determine by age.
You have iron deficiency indicated by low MCV and MCH. You lose the metabolism boosting properties of thyroid hormones when ferritin is <70, optimal thyroid function happens 70>.
Clomid is a short term solution and most guys can’t tolerate the side effects for very long. It is used to reboot the HPTA of someone doing cycles of testosterone in 8 week intervals. Clomid often doesn’t resolve symptoms even with perfect labs, the reason is clomid is a female fertility drug of which half the pill is pure estrogen.
I had both of these values below range in April and was in the hospital with iron deficiency, it’s called microcytic anemia. I’m assuming an iron and ferritin panel were ordered to check for iron deficiency?
Your doctor may not be telling you the whole story, it would look very bad to the medical board of your doctor prescribed TRT (steroids, very taboo is western medicine) to a 22 year old shutting down your HPTA of young man which hasn’t fully matured.
Use the search function and search for clomid success stories, they are unicorns which exist but in very small numbers. I’ve been here for over 3 years and only remember one successful case out of hundreds.
This includes multiple other forums, female fertility drugs tend to make men estrogen dominant and also stimulate estrogen receptors which is one reason why men don’t tolerate it well. Some get vision problems, severe moods problems, no libido and permanent eye floaters.
Steroids have way too much stigma in our societies, demonized due to the false beliefs steroids cause prostate cancer, heart attacks and strokes none of which is actually true. Sure is you already have heart problems, then TRT should be carefully monitored, including those with clotting disorders which is a very small percentage of the population.
Oh that is interesting then. They checked my ferritin level which was 232 ug/L (reference range: 22-275) and it was on a higher end of the range. One of my family members also did bloodwork and their MCV and MCH was very similar to mine (also low). However, their ferritin level was VERY low like 13 ug/L.
Yes I was especially worried about vision problems including eye floaters. I already have minor floaters and I’m pretty sure Clomid could worsen it. This is something that I was planning to bring up in the appointment as well. I plan to talk about injections, gel and creams. I think the doctor was most concerned with fertility because of my young age. I will know after my appointment on Monday.
Intramuscular TRT is more effective than transdermal formulations at increasing LBM and improving muscle strength in middle‐aged and older men, particularly in the lower extremities.
There are ways to deal with fertility on TRT, adding HCG and FSH injections to your TRT protocol is one way. The HCG will wake up the testicles to produce testosterone and the FSH will help with spermatogenesis.
Low MCH and MCV mean the mass and size of hemoglobin is too small. Thalassemia is more than likely what’s causing your symptoms, not low testosterone, because you’re not getting enough oxygen to your tissues.
The only explanation for low TT and good FT levels is you have very low SHBG, this is how your TT can be low and have good FT, your FT is close to the top of the ranges. Your FT ranges are 196-636 and your FT is 458 which is higher than midrange, even your bioavailable is close to the top of the ranges.
Thank you! I will bring all of this up with the doctor and will keep this thread updated.
I most likely will push for injections as they are the most effective way and cheapest.
If I don’t add HCG and FSH injections to the protocol, I could still use them later in the future to restore fertility correct?
No they didn’t test iron. 2 different doctors told me that thalassemia causes MCH and MCV to be low. They seemed to have ruled out iron deficiency and refused to look further into it.
Unfortunately there isn’t much to treating thalassemia other than blood transfusion, iron chelation therapy, and folic acid supplements. I do recall that when I was younger, I had to do a blood transfusion but as I got older, I had no problems with it anymore.
There can be diagnostic confusion between thalassemia trait and iron deficiency anemia. Both conditions can have a low red blood cell volume (MCV) and a low amount of hemoglobin per red cell (MCH). Patient with thalassemia trait can have a high red blood cell count and mild or no anemia. Patients with iron deficiency can have a normal or low red cell count and generally get anemia as a later manifestation.
Do you believe that TRT would resolve some of my symptoms or at least give some relief?
Hey everyone. I have updated the thread. Based on my results, does anyone think that pursuing TRT would be a good idea? I will have my first appointment tomorrow.
Yes. Test levels of 8.8nmol/l are awful for your age. If a doctor tells you this is normal, tell him to make favor of the world and shoot himself.
BUT there is one big but. You should make sure an experienced hormonal doctor evaluates all your biomarkers like iron for example so you wont run into trouble on TRT. And do yourself a favor, try to inject as often as possible.
You are unable to carry oxygen through the body because of the thalassemia, I just don’t know with a 100% accuracy whether TRT will benefit you. I can tell you all the testosterone in the world didn’t increase my MCV and MCH when I was iron deficient, iron is what helped.
I have actually felt better off TRT for a couple of months and correcting the iron deficiency, I felt worse on TRT with iron deficiency.
One thing is for sure, TRT will increase red blood cells.
Yeah due to the mass and size of the hemoglobin. It seems like my body is creating more red blood cells than normal to compensate for the low MCV and MCH.
All of the doctors so far ignored the MCV and MCH and told me it was fine. I will explore this further.
Yeah all 2 of my GPs just shrugged that off and said nah it’s fine because it’s within the “range”. They ignored my symptoms too and just gave me Lexapro but I don’t want to take anti-depressants. That’s why I pursued an actual TRT clinic.
I will update with more information when my appointment is over tomorrow.
I believe your thalassemia is a mild case which is some cases may not require treatment, however blood transfusions may be required if your symptoms are severe and I believe they are waiting for it to escalate before treating you.
Blood transfusions are usually reserved for severe cases.
This 50mg once weekly protocol will have you hating life in the next couple of weeks. Find a doctor that knows what the h*** they’re doing. You’ll need at least a 100 mg per week minimum.
You have low SHBG and you’ll need daily injections because once weekly protocols are not usually good for men with low SHBG. I would not start TRT at all as long as your with this anti-aging clinic and seek a doctor that isn’t a complete idiot.
There is a lot of these anti-aging clinics out there and most are run be people who have no idea how to manage men on TRT.
Thanks! I was iffy about the 50mg ONCE per week as well. I will discuss this further with them first but if they still seem to be incompetent about this, I will be looking for another clinic. I will keep this thread updated
Why are you all just paying attention to total testosterone here. His Free Test (which is the only thing that matters) is above the average of the range. No SHBG was measured, which I would bet is low, but if Free Test is above middle range, at 22 I don’t think TRT is a good idea.
OP, how much body fat are you carrying? Do you get good sleep? You could be top of the range (which is what a good TRT doc aims for) with a few changes.
I’m skeptical if TRT will do anything for him, he has thalassemia and I believe this to be the cause of his symptoms. Getting the MCV and MCH up I believe will improve his symptoms through blood transfusion.
