My TRT Dilemma: Confusing Numbers

Pharma TRT
1

All, sorry for the long post and appreciate all the advise but here is my story. I am a 40 yr old male. Work has been stressful the last few years with long hours, bad food, lots of travel and shitty work. About 4 years ago, I noticed that I was having issues maintaining erections, then I noticed I was feeling fatigued, had a lot of body fat, some anxiety, was getting lazier, etc. All this happened over a course of a couple of years. I was overseas and happened to go to a doctor (for something else but mentioned these symptoms as a side note). He suggested I get my T levels checked. They turned out to be low so he suggested I come back to the US and follow up with my doctor. Upon returning, I asked my primary care physician that I wanted to take these tests. Here are the results over time:

06/2017 - 289/54.3 (Total/ free), Prolactin - 9.1, TSH - 2.34, FSH - 1.8, LH - 2.2

08/2017 - 290/59.5 (total/ free)

He still wanted one more test to be sure. I also happened to take a one month vacation from work and got another test done in 09/2017. Results were:

09/2017 - 455/96.5 (Total/ free), Prolactin - 8.5, PSA - 0.3

With these numbers, he said everything was fine and not to worry. He gave me some Viagra for the erections but that didnt help much tbh. A year later at the next physical, I requested another set of tests. This time they were:

08/2018 - 222/41.1 (Total/ free), Cortisol - 16.6, FSH - 2.3, LH - 1.5, Estradiol - 36,

These were lower than the tests last year. So he almost agreed to put my on TRT. However, wanting to double check the tests again, he requested another set a month later. It was August again and I had another vacation coming (I usually dont get these long vacations but have started saving up vaca to take) and had a month off again. At the end of the month, the results were:

09/2018 - 455/79.9 (Total/ free)

Again, he said everything is fine and no need for TRT. But here are my questions:

  • Why are my TRT levels fluctuating so much? Its the same labs (quest).
  • Could the vacations be a factor? (Work is crazy stressful at times).
  • Sometimes I do take some herbs (Ashwagandha) but dont think the levels should fluctuate that much with them.

I almost just wanna try TRT for a year to see if it makes a difference but want to avoid long term issues like loosing ability to have kids, make own T, etc. I definitely feel I have all the symptoms so know something is up but the numbers are confusing me. Any thoughts or suggestions? Thanks!

2

Those are disease level numbers, however you are missing critical tests and suggest your doctor doesn’t diagnose hormone deficiencies very often. You will find the majority of doctors seriously lacking in knowledge related to sex hormones, we see it every damn day.

The large majority of time doctors aren’t running enough tests and this is a red flag. SHBG is an important test because it affects how your body regulates free testosterone and tells us your ability to hold onto testosterone.

SHBG will dictate the type of TRT protocol is best for you.

You need to post lab ranges for each test, because each lab has different ranges. Testosterone levels fluctuate, levels are highest in the morning and lower later in the day. Poor sleep consecutively over days or weeks will cause testosterone to plummet.

You should NEVER been seeing your numbers in the 200 range, or the range of a 100 year old man. Most doctors will completely fail at anything related to sex hormones, your garden variety doctor or endocrinologist just will not do!

If you start TRT with a doctor that doesn’t know what their doing, you will quit TRT thinking it just doesn’t for you when in reality it’s the doctor that isn’t working.

3

It’s not one of those types of things where you take it for a test drive. If you start TrT you are going to shut down your natural production. Then you are going to have to fight and pray that a restart would/could happen.

What are the times of the labs when blood is being drawn. Numbers are going to fluctuate greatly throughout the day. Best time for draw is roughly 1 hour after waking up with a full night sleep.

There are ways to tank your Test if you were serious about wanting to feel better or be on TrT.

4

No offense intended but you’re still thinking about having kids after 40?

1 Like
5

The only positive I can see there is that they can both go the movies and get discounts!! (This is a joke so don’t take me seriously here)

If it’s not inappropriate to ask, could you elaborate on this? Might be a handy piece of info to have if I decide one day (a year or two after I have my protocol dialed in) to try a blast.

6

The night before blood work, Dont sleep. Eat like shit and drink more than enough alcohol during the week of the blood work, stress also helps lower T

7

Thanks all for the replies. Edit to add that the very first test I did was at a non-Quest lab which was at 1pm and the result of that was 155 ng/ dl. It was only after that the doctor suggested I go to Quest, and get it done at around 10am which I did for all the remainder of the tests mentioned above. But just thought I’d mention that 1 pm number as well. In terms of ranges for the other test, I’ll include them as well as they were the same for all:

Test total - 250 - 1100.
Free - 35 - 155.
TSH - .40 - 5.50
Prolactin - 2 - 18
FSH - 1.6 - 8
LH - 1.5 - 9.3
Cortisol - 4 - 22
Estradiol - < 39