I’m trying to decide what my next step should be here. I’ve actually got T in hand, but my total T came back far higher than expected considering it was at 263 6 months ago. Further hormone testing? Start on TRT at suggested weekly protocol of 200mg of T and 1mg of anastrozole, or adjust it considering my T is 200 points higher than it was when prescribed the T and my E2 is only an 11.4? I feel good overall, but tired of having the libido of an 80 y/o woman. Any feedback is appreciated.
-age: 36
-height: 6’
-waist: 32.5"
-weight: 180 lbs
-describe body and facial hair: Moderate, same as always
-describe where you carry fat and how changed: midsection, legs, hasn’t really changed
-health conditions, symptoms [history]: ultra low libido, weakened wood, low WBC (2.7)/neutrophils (1.3), high BUN (22)/Creatinine Serum (1.33), high FSH (17.5), low free T (6.9), total T between 263-478 (2 readings taken 6 months apart), mildly high LDL (111). I feel good otherwise and BF is around 14%.
-Rx and OTC drugs, any hair loss drugs or prostate drugs ever: None
-lab results with ranges
*LH 4.4 1.7-8.6 mIU/mL
- FSH 17.5 HIGH 1.5-12.4 mIU/mL
- Prolactin 12.9 4.0-15.2 ng/mL
- Testosterone, Serum 478 ng/dL 348-1197
- DHEA-Sulfate 321.2 ug/dL 102.6-416.3
- Estradiol 11.4 pg/mL 7.6-42.6
- Prostate Specific Ag, Serum 0.2 ng/mL 0.0-4.0
Other abnormal results:
- Creatinine, Serum 1.33 High mg/dL 0.76-1.27
- BUN 22 High mg/dL 6-20
- WBC 2.7 Low x10E3/uL 3.4-10.8
- Neutrophils (Absolute) 1.3 Low x10E3/uL 1.4-7.0
- eGFR If NonAfricn Am 68 mL/min/1.73 >59 (Low and dropped 17 points since last reading 6 months ago, but not low enough to indicate kidney disease at this stage)
-describe diet [some create substantial damage with starvation diets]: Just came off a 6 week cut that started with a 5,250 cal weekly deficit and tapered to a 1,750 cal deficit. A typical day’s diet:
- protein shake for breakfast with either a yogurt or buttered roll
- chicken/veggies/rice or potato pre-gym
- PWO protein shake and banana(s)/pomegranate juice
- 85-90% lean ground beef on a bun w/ fresh onion/garlic
- PBJ sandwich (yep, still eat them!)
- single-serving dessert (ice cream usually)
- depending on what I’ve burned for the day, there might be another meal tossed in
-describe training [some ruin there hormones by over training]: Upper A, Lower A, rest, Upper B, Lower B, rest, rest. Weather permitting, I walk 2-5 miles per day 5-6 days per week with my dogs as well.
-testes ache, ever, with a fever?: No.
-how have morning wood and nocturnal erections changed: Both a thing of the past. On the rare occasion when they occur, they’re weak.
LONG VERSION W/ BACKGROUND BELOW (optional reading)
Last year I started experiencing a very noticeable decline in libido. At first, I thought little of it and just chalked it up to age (36) and the effects of marriage (10+ years). Then I started a temporary job that required me to work 60+ hours per week, dropped me down to 6 hours sleep per night (at best), cut into my gym time, and affected my nutrition as well. After a couple months of this I really took a downturn. At the gym, I was toasted after 1-2 exercises, I had ZERO libido, and was generally very fatigued all the time. In November, I went to the doc and had some blood work done, which showed (borderline) low WBC/RBC, total T of 263.3, and free T of 4.24. Unfortunately, I did not have any other hormone tests at the time. When the results came back, my doc told me I was “fine” and to take some DHEA (I haven’t been back to this idiot.). Around this time, I took my first long hiatus from the gym ever, which would last about 60 days and began looking into TRT.
Fast forward to January. My temporary assignment had ended 2 days after Xmas and after about 3 weeks of rest post-assignment, I was starting to feel better so I went back to the gym. After the first few weeks of being a reborn newbie, things were going well. My energy levels were up and I just felt good overall. Nonetheless, I had made up my mind to start on TRT in the coming months. Last week I finally went for another round of blood work, which I primarily did to give me a baseline before I started TRT. That’s not quite what happened though. As it turns out, my free T remained low (6.9), but my Total T was 478 (not great, but over 200 points better than my reading 6 months ago). My E2 was only 11.4 and LH was normal, but my FSH was quite high. So now I’m not so sure what my next step should be.