Male, 34 - Bloodwork Results - Time to Start TRT?

Pharma TRT
1
  • age: 34
  • height: 6’
  • waist: 32"
  • weight: 184lbs
  • describe body and facial hair: normal facial hair (some sparse areas), very little upper body hair,average leg hair, normal pubic hair
  • describe where you carry fat and how changed: minimal but in stomach
  • health conditions, symptoms [history]:
  • harder time recovering, joints more achy and sore, low libidio
  • my mom has rheumatoid arthritis and uncle has diabetes
  • Rx and OTC drugs, any hair loss drugs or prostate drugs: none

- describe diet:

  • don’t know calorie intake – intuitive eating as always been quite lean; enjoy healthy foods that I cook for myself and rarely eat junk.
  • describe training: trained quite consistently for 10 years; used to be powerlifting until patellar tendonitis in knee made squatting impossible and now more bodybuilding style while also pursuing calisthenics goals (handstand, lever, etc.)

- testes ache, ever, with a fever: no

*- how have morning wood and nocturnal erections changed: almost never have morning wood

** additional context:** no kids and no desire to ever have them

Labs (Quest):

Glucose - Fasting: 96.0 mg/dL 65.00-99.00
Hemoglobin A1C: 4.9% 0.00-5.70
hs-CRP: <0.3 mg/L <1.0 optimal
BUN: 12.0 mg/dL 7.00-25.00
Creatinine: 1.19 mg/dL 0.60-1.26
eGFR: 82.0 mL/min/1.73m2 60.00-160.00
Sodium: 139.0 mEq/L 135.00-146.00
Potassium: 4.9 mEq/L 3.50-5.30
Chloride: 103.0 mEq/L 98.00-110.00
CO2: 31.0 mEq/L 19.00-30.00
Ferritin: 70 ng/mL 38-380
Protein - Total: 7.3 g/dL 6.10-8.10
Albumin: 5.0 g/dL 3.60-5.10
Globulin - Total: 2.3 g/dL 1.90-3.70
Calcium: 9.7 mg/dL 8.60-10.40
Alk Phos: 53.0 IU/L 36.00-130.00
AST: 30.0 IU/L 10.00-35.00
ALT: 15.0 IU/L 6.00-29.00
Bilirubin - Total: 0.7 mg/dL 0.20-1.20
Total WBCs: 3.5 k/cumm 3.80-10.80 [LOW]
RBC: 4.6 m/cumm 4.20-5.80
Hemoglobin - Male: 14.4 g/dl 13.20-17.10
Hematocrit - Male: 42.2 % 38.50-50.00
MCV: 91.7 fL 80.00-100.00
MCH: 31.3 pg 27.00-33.00
MCHC: 34.1 g/dL 32.00-36.00
Platelets: 176 10E3/µL 140.00-400.00
MPV: 11.0 fL 7.50-11.50
RDW: 11.6 % 11.00-15.00
Neutrophils - %: 43.9
Lymphocytes - %: 41.4
Monocytes - %: 10.1
Eosinophils - %: 3.2
Basophils - %: 1.4
Neutrophils - Absolute: 1537 1500-7800 cells/uL
Lymphocytes - Absolute: 1449 850-3900 cells/uL
Monocytes - Absolute: 354 200-950 cells/uL
Eosinophils - Absolute: 112 15-500 cells/uL
Basophils - Absolute: 49 0-200 cells/uL

Cholesterol - Total: 192 mg/dL 125.00-199.99
Triglycerides: 67 mg/dL 0.00-149.99
LDL Cholesterol: 117 mg/dL 0.00-99.99 [HIGH]
HDL Cholesterol: 59 mg/dL 40.00-100.00
Non-HDL Cholesterol: 133 mg/dl 0.00-129.99 [HIGH]

Insulin: 5.1 uIU/mL <18.4 optimal

TSH: 2.89 µU/mL 0.40-4.50

Testosterone Total: 528.0 ng/dl 250.00-1100.00
Testosterone Free: 53.9 pg/ml 35.00-155.00
Sex Hormone Binding Globulin: 63 nmol/L 10.00-50.00 [HIGH]
FSH: 3.5 mIU/ml 1.60-8.00
LH: 3.4 mIU/ml 1.50-9.30
Estradiol: 13.0 pg/ml 0.00-29.00
Prolactin: 7.5 ng/ml 2.00-18.00
DHEA-S: 153.0 µg/dL 93.00-415.00
T3, Free: 3.3 pg/mL 2.3-4.2
T4, Free: 1.3 ng/dL 0.8-1.8
PSA, Total: 0.20 ng/mL <4.0 optimal
Hemoglobin A1c - %: 4.9
GGT: 12 U/L 3-90

Iron, Total: 141 mcg/dL 50-180
Iron Binding Capacity: 249 mcg/dL 250-425 [LOW]
% Saturation: 57% 20-48 [HIGH]

Apolipoprotein A1: 154 mg/dL >115 optimal
Apolipoprotein B: 97 mg/dL <90 optimal [HIGH]
Apolipoprotein B/A1: 0.63 <0.77 optimal

This was my first comprehensive blood panel. Not looking to have kids, just optimize physical well-being and my ability to challenge myself in the gym and with sports while being able to recover and carry on relatively pain free.

Thanks.

2

Your hormone panel looks low across the board, the low estrogen being the worse and big contributer to lack of erections, the Free T isn’t much better.

The Free T is closely resembles how much testosterone you’re actually producing and isn’t anywhere near average.

The lack of morning erections, all your issues aren’t normal for a 32 year old.

Overtraining in the gym, cutting (starvation) can lead to high SHBG and low Free T.

3

Interesting - I hadn’t realized my E2 was low…looked mid-range so I thought it was fine.

Well I am definitely not starving myself and it’s hard to know if I am overtraining as I have a sample size of 1. Other than cut back on volume, is there much else I can do other than start TRT?

With my high SHBG and lower E2, was thinking starting at 120mg weekly, injecting twice a week and see where that puts my numbers.

4

Its not that low and considering your T levels it appears fine to me.

You have neither secondary nor primary hypogonadism. Yours is a case where SHBG is causing you slight issues with available FT. Do you need TRT? Likely not yet, but would it improve your quality of life? Probably a bit. If you are OK pinning for life then your action plan seems sound.

5

Get another hormone panel to see if it varies much.

If not, you don’t need trt.

TRT isn’t going to build you an killer body, fyi. So if you’re looking for a reason for legit test, just know it’s not going to help much. I personally feel that there is a trend of younger males trying to show low test levels, hoping to hop on trt. Any benefits from trt (and that means trt level test) aren’t staggering. At all.

Figure out instead how to increase FT or just start juicing in cycles. You don’t want life long trt nor need it imo. You could try some DHEA to increase e2 a bit.

6

Apologies I am unfamiliar with much outside of TRT. Is DHEA taken orally and under what name?

Also, I should have mentioned I am in Canada so not familiar with how I would go about getting test for cycles as we have pretty meagre offerings and don’t want to buy stuff out of someone’s gym bag lol. With a cycle would I have to take an AI or could that be avoided with a shorter duration?

7

Thanks for the additional feedback.

I am not looking to build a killer body - I am happy with my current shape. Just want to alleviate the feeling of slow recovery, achy joints and tendons and complete lack of morning erections. Libido is low, but no ED when my wife and I do decide to do the deed. So essentially to improve quality of life related to physical activity.

8

Normal adult male estrogen is 20>.

DHEA is a controlled substance in Canada. In the US you can walk into a pharmacy and buy it over the counter.

You don’t cycle TRT, it’s a life long treatment. You go on and stay on.

As for the AI, most don’t need an AI for normal levels.

Madman on Excelmale, a hormone guru is Canadian and can point you to a knowledgeable doctor.

9

Yes I know and am okay with the lifelong commitment of TRT if need be. I was responding to roscoe88’s comment ‘just start juicing in cycles’.

Helpful to know, hopefully they see this, otherwise I’ll try messaging them. If they do read this, I am located in Toronto.