Questioning TRT Decision

Pharma / TRT Testosterone Replacement
1

Apologies for the wall of text. If I’ve left out any key info, let me know, but I’d really appreciate if anyone has some insight.

26, relatively active. So I went on self medicated TRT back in October last year. But I’m now questioning my decision. My adult life has been plagued by every symptom of Low T there is. I’ve been going to the Dr for them for many years, but they’ve never been able to pinpoint a cause. I’ve had fairly extensive tests on the NHS, none of which raised alarms, apart from SHBG/Free T (which they didn’t care about).

Now I didn’t just jump on TRT - I spent months researching and arming myself with knowledge, to the point I regularly contribute on forums like this one. But I do wonder if my decision was jaded by my desperation to just feel ‘normal’.

My Total T results, over 4 tests, ranged around the 400-450ng/dl mark, with one in the afternoon coming in at 180ng/dl (I also had one at 19/20 that was around the 400 mark). My LH was 2.8 U/L and FSH 7.6 U/L.

Now the problem was with my SHBG - which hovered around 50-55 nmol/l. This left me with my Free T levels under range, lower than the levels of some that would be instantly recommended TRT (<290ng/dl).

I’ve had a single Thyroid Test, for TSH & T4, which came back in range (TSH was 1.16 mU/L & FT4 17.8 pmol/L). In hindsight, it may have been better to get this tested further - Would this be worth further/more in-depth tests, and if so, which ones?

But I’ve got to say, I haven’t noticed a tonne of improvements these 9 months, which is why I’m questioning it. I do feel slightly better than I did, but then again, I was in a dark place mentally around that time(due to some events). I still don’t have much of a sex drive, my fatigue has gotten somewhat better, but it’s hard to say conclusively. My body has changed a little.

I don’t really want a ‘Western’ lifestyle, I enjoy nature and plan to get away from this all someday. I’m already feeling restrained when it comes to travel, I can’t just up and go, and see where the road takes me, as I’ve got to worry about medication. I just feel a bit stuck, and don’t know what to do.

2

Could you please post all of your lab results including ranges? Also please post your current TRT protocol including frequency of injections, hormone delivery system, and amount of injections in mg.

3

Here’s my ‘complete’ check from prior to commencing TRT.

Can’t find the separate ones for T & SHBG levels, but they are as stated in my original post.

My protocol is 75mg Test E every 3.5 days, alongside HCG EOD, which gives me good levels of around 700 trough and e2 consistently around 20. Due to TRT, my SHBG has now lowered to 25-30 nmol/l.

4

I would get your free t3 checked and wouldn’t be a bad idea to check out your reverse t3 to fully exhaust getting your thyroid checked out.

5

It’s likely your TRT protocol needs adjustments, an SHBG of 25-30 nmol/L is the optimal level. You are really missing a lot of thyroid labs, Free T3, Reverse T3, ferritin and cortisol. The HHS will refuse these tests because they believe TSH is the gold standard, it’s unreliable as it pertains to thyroid hormones.

The NHS is braindead stupid when dealing with hormone related issues, you must go private. Ignoring high SHBG as the cause of low Free T is a mistake, state healthcare doctors don’t receive any training whatsoever in hormones so it’s no surprise. What actually happen is the clueless doctors fixated on your total testosterone as being in range and ignored everything else because they know nothing hormones and they weren’t willing to spend the time to figure it out.

You say you’ve notice a change in your body and fatigue is improved, I myself need free T to be at the top of the ranges to feel normal. I suggest you get your Free T checked. Some men just don’t feel well on HCG, suggest stopping it for awhile to see how you feel without it. It can worsen depression and just make you not feel well.

How much HCG are you taking?