Just Started TRT at 25 Years Old update

Pharma / TRT Testosterone Replacement
1

5"8
200 lbs
Tsh.2.0
Total t 310
Fasting glucose 106 ref 0-99
Shbg 16 10-55

Second test
Total t 386
Free t. 85.7 35-155
Shbg 15 10-55
Prolactin 9 2.0-18
Ferritin 286 20-345
Fsh 2.4 1.6-8.0
Lh 5.0. 1.5 -9.3

Started on test c 100mg split twice weekly I’m on second shot

Any advice. Is my shbg really low

Lyme disease screwed my test up in 2014 and I have tested low ever since

I’ve never grown a full beard

Long recovery time for work outs.

No sex drive.

Depression

Weak erections

Brain fog

2

There are several concerns:

You should be considering yourself diabetic for fasting glucose.
Get A1C tested. It is more specific.
Diet modification probably needed.
Thyroid probably making this worse.
TRT might help.

Low SHBG. That sometimes just happens. Sometimes low SHBG and diabetes go together. You will have less non-bioavailable SHBG+T and TT labs are then lower, accept that. You need to be looking at FT or Bio-T as targets.

TSH is too high. Please ignore “normal” and lab ranges.
Should be near 1.0
Problem may be from not using iodized salt.
Do you feel cold easier now?
Are outer eyebrows sparse?
Please describe history of life and event stresses.

Please see below re oral body temperatures to eval overall thyroid function.

Ferritin is quite high. Please do not use vitamins that list iron.
Please post Complete Blood Count CBC labs.

Mood:
Low T, low thyroid function and elevated E2 can be significant factors.
Ditto libido, sexual function and brain fog.

Labs: in 4 weeks
TT
FT
E2
CBC
hematocrit
A1C

Do labs halfway between injections to avoid changes that are driven by timing changes. Time of doctor visit can be wrong. Get lab orders and do labs at a lab station at the right time. Do labs two weeks before doctors visit so you can discuss results at the visit. Doing labs in the office and getting a brain dead update from an office assistant later is useless. Get and retain copies of your labs and/or get access to pdf of your labs.

Very often, guys need to manage E2 to feel right. Typical 0.5mg anastrozole at time of injections to get near E2=22pg/ml. A few do feel better with higher E2 than that. More reading required, see the stickies.

Fertility: You can expect your testes to shrink and perhaps 24x7 dull ache. And loss of fertility is a real risk. What? You doctor did not explain? [typical]. You need to inject 250iu hCG subq EOD.
Injections: Inject twice a week, subq, with #29 1/2" 0.5ml insulin syringe or other suitable small needle.

Please read the stickies found here: About the T Replacement Category - #2 by KSman

  • advice for new guys - need more info about you
  • things that damage your hormones
  • protocol for injections
  • finding a TRT doc

Evaluate your overall thyroid function by checking oral body temperatures as per the thyroid basics sticky. Thyroid hormone fT3 is what gets the job done and it regulates mitochondrial activity, the source of ATP which is the universal currency of cellular energy. This is part of the body’s temperature control loop. This can get messed up if you are iodine deficient. In many countries, you need to be using iodized salt. Other countries add iodine to dairy or bread.

KSman is simply a regular member on this site. Nothing more other than highly active.

I can be a bit abrupt in my replies and recommendations. I have a lot of ground to cover as this forum has become much more active in the last two years. I can’t follow threads that go deep over time. You need to respond to all of my points and requests as soon as possible before you fall off of my radar. The worse problems are guys who ignore issues re thyroid, body temperatures, history of iodized salt. Please do not piss people off saying that lab results are normal, we need lab number and ranges.

The value that you get out of this process and forum depends on your effort and performance. The bulk of your learning is reading/studying the suggested stickies.

3

Thank you Ksman for the quick reply
I usually run hot in my opinion
I have full eye brows
I doubt I use that type of salt
Here are some labs from April and May 2018

1527022239616619218370
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152702227239418895829243024×4032 5.47 MB
1527022292998784434290
15270222929987844342903024×4032 4.48 MB
15270223113041228478294
152702231130412284782943024×4032 5.46 MB

4

Was starting Trt the wrong move. I really just want my quality of life to get better and doctors give terrible advice…do my levels warrant trt

My overall stress stems from these health issues other then that I am living a pretty charmed life so to speak

5

CBC looks great. No sign of iron overload in RBC, hemoglobin or hematocrit.

LDL is really surprisingly low.

Perception of how warm you are does not necessarily translate to measured temperatures.

If using sea salt, pink or natural salt or kosher, you are not getting iodine unless the package states iodized. Common table salt is sold iodized and non-iodized in very similar packaging, need to read the labels.

6

I will start supplementing iodized salt and will track my temps as well…

This may sound stupid but you said trt might work
If I get e2 in check and proper diet started asap
Will I have a better chance of it being successful

I don’t know if I misunderstood what you said. But sounded like you may be doubtful that the 100mg test c split into two doses weekly will be of any help.

7

Split doses are a good start, but there are other needed things.

TRT can help with blood sugar metabolism. So can better thyroid function.

8

Okay I am going to get all the labs needed that you said
I will be starting a diet low carb low sugar
Iodized salt

My last question before I become bothersome, you said there are other things I need.
My main concern is will trt give me the benefits my doctor hopes for, such as the fatigue and loss of motivation and sex drive… help with fat loss and building muscle? I understand the fertility risk and will be bringing that up…But I’m starting to feel doubtful about testosterone…My goal should be to bring free t up and manage e2 for a successful trt?

9

Thyroid has a large influence on fat, energy levels, mood and sexual performance and libido.

E2 influences fat, fat patterns, sexual issues and mood. With elevated E2 guys can be intolerance bitches.

T works better on muscles if E2 levels are good.

TRT will bring up FT and FT levels may be higher VS T dose than with other guys.

I assume that you did glucose in the morning with no food after 8PM the prior night, and no drinks or coffee with milk or sugar etc.

There are complexities, but easily managed if your doctor is not an idiot.

10

My doctor told me no food or drinks past midnight
So no I ate around 930 probably not the best meal either…And took test at 730 am

This isn’t my first time on trt. Back in 2014 with the Lyme I was on shots twice a week and was 154 pound and felt great…I had to stop due to loss of work and insurance. And just kind of let it go until now so I have gained alot of weight…

In 2014 there was no work up on my thyroid how ever if tests come back okay for thyroid do you see a problem with me having good results and benefits from trt

11

My pre-TRT labs were similar to yours, lower SHBG and my calculated Free T on paper was within the 2-3% expect I felt like I was dying, 6 weeks after I began TRT I started feeling good again. There’s a lot of guys who come here with hypothyroidism and low testosterone and doctors are only treating the low testosterone ignoring the thyroid simply because levels are in range.

In range doesn’t mean you are alright, something few doctors understand. Any doctor that only tests TSH without thyroid hormones is incompetent. Check body temps per thyroid sticky.

Are you taking any medications?

12

Current meds are klonopin twice daily

Is the Iodine salt to help hypo or hyper thyroidism

Also will I not feel any benefit from trt untill I optimize my thyroid. Are you treating your thyroid ?

Thanks for the reply

13

That’s why you have no sex drive, I was on Klonopin for 30 years and you can expect to remain asexual while you remain on it. Klonopin is a mind altering drug, it changes your brain chemistry and lowers your hormone levels. That might explain why your LH is good and testosterone is low.

Klonopin will seriously hamper TRT’s effectiveness. Get off it while you can, when I started tapering off after 30 years I suffered pituitary damage. I wouldn’t be surprised if testosterone is low because of Klonopin. You and your doctor need to have a discussion.

14

I understand the effects of benzo use on hormones and on sex drive and mental well being.

Problem is I had low t long before I ever touched klonopin.

My hopes are to fix my health issues. Balance my hormones and taper off the klonopin

I feel low testosterone has been hindering my journey to health for quite some time so im.going to tackle that before the tapering of prescription klonopin

15

You’ll have the advantage of retaining your testosterone levels while withdrawing off Klonopin, I believe losing testosterone production during withdraw is what made it so much worse. Grab an oral glass thermometer and track body temperatures upon waking and 2pm, if you fail to reach 97.7 upon waking and 98.6 at 2pm then thyroid hormones are low.

Sometime supplementing iodine and selenium is all that’s needed, unless things are worse than a simple iodine deficiency. My advice is when you are ready to come off Klonopin, go nice an slow. You may need to inject more often do to low SHBG, TRT doesn’t work effectively (SHBG 18 nmol/L) unless I inject smaller doses EOD, some must inject every day the closer SHBG gets to 12 nmol/L.

16

I should keep my current protocol of 50 mg e.3.5 day until I get bloods drawn in a few weeks correct?

Also can I buy a iodized salt supplement at CVS or vitamin shop. And what should I look out for in regards to taking it…if I am deficient what would changes be. And what would prompt me to stop using if I am not deficient

17

I would maintain your current protocol until you get labs, your labs will indicate how well you hold onto testosterone and will guide estrogen management should you change to EOD and require an AI. Typically low SHBG men have more free T and free estrogen than a guy with high SHBG, this might sound better at first until one learns that SHBG activates testosterone on androgen receptors.

I expect your SHBG to decrease closer to 10 nmol/L, if that happens you may need injections everyday. There are some guys who feel very little from TRT do to low SHBG.

How do you feel so far?

18

So far I’m only on my second shot. But I have had a sense of clarity I can’t really describe. Something’s there. But I guess to early to tell

I’m still very confused on what to look for and what to look out for using the salt

19

image
image2448×3264 2.17 MB

From any grocery store.

20

You may start to feel bad in a couple weeks, it’s just your pituitary gland (HPTA) shutting down, by week 6 you should feel as if you’re coming out of the woods. It happens to most of us and is nothing to worry about.