Here’s a brief history. About 20 years ago I started feeling crappy, did some research and found I had all the symptoms of low T. I had an endocrinologist test me and it came back high, but the symptoms have just kept getting worse over the years, so I’ve rechecked about every 5 years and it’s always high. So last month, feeling kinda desperate, I made an appointment at a local clinic that specializes in TRT. They drew blood and at the follow up the Doc (an MD) said my T was as high as he ever sees. But he didn’t like my free T, thought it was out of balance with the total T. Said he puts more weight on the symptoms than the numbers. So I ended up with a topical from a local compounding pharmacy, 200MG/GM half a ml twice a day on inner thigh. Started 10 days ago. Is this crazy? Am I so desperate that I’ve fallen prey? From my reading here, it seems there are a lot of knowledgeable people on this site. Hoping to get some more perspective on this.
I’m 6’0’’ weigh 155 lb. 68yrs.old. Here’s some blood numbers, lab range in parenthesis.
Red blood cell 5.02 {4.20-5.80}
Hemoglobin 19.9 {13.2-17.1}
Hematocrit 49.2 {38.5-50.0}
Estradiol Sens 34 {<30}
Total T 914.22 {300-1200}
Free T 11.5 ng/dl 1.26% {3.4-24.6}
SHBG 78.7 {13.3-89.5}
TSH 2.08 {0.45-5.33}
T4 free 0.92 {0.61-1.24}
T3 free 2.9 {2.5-3.9}
Cortisol AM 15.6 {6.7-22.6}
Cortisol PM 5.4 {0-10.0}
I did find a test that was done in 2012 at age 59 that I thought was interesting, Total T was 894 {175-781}. Free T 132.2 {27.0-183.0} Why do I have these high numbers and yet feel like I’m depleted. I’ve never used anything for T enhancement. I hope ya’ll find this interesting. THANKS
The Free T is where the rubber meets the road and typically men are symptomatic in the 10-12 ng/dL range with some men feeling symptoms sooner. As for T cream for a guy with high SHBG, I would have gone with cypionate injections which should hammer that SHBG down considerably allowing the Free T to increase substantially.
The creams can rub off on the wife and kids, so be aware. Usually the cream is applied to the inner thigh, scrotum if absorption is not ideal in the inner thigh. You also can’t go swimming for up to 4 hours after application.
The lab testing from 2012 are nowhere as accurate and reliable as it is now. Also your testosterone levels fluctuate every day, high one day, lower the next but if not consistently high there will be symptoms.
Your SHBG probably wasn’t as high as it is now, binding up less of your usable (Free) testosterone.
Thanks for responding. To be fair to my Doc, he did suggest injections, I’m not a fan of needles so I went with the cream. He will be doing a blood test after a month so I can always reconsider then.
I thought my high T levels might draw a few more comments, so I’m now thinking it must not be that unusual.
I’m glad you brought up the fluctuating nature of daily T levels. I’ve always wondered if symptoms of low T also fluctuate over days and weeks? I told my doc that I have some really good days where I’m really motivated and full of energy and then within a few days it completely reverses. He said that’s not what he typically sees with low T, that it’s usually more constant. Anyone care to comment on this fluctuating aspect with their experiences?
Thanks!
This forum has seen it all. Personally at 68 with your numbers, I wouldn’t jump on TRT. I mean you have mid range free T and you’re 68. What exactly are your symptoms and is there anything else in your medical history or life that could be a root cause?
Thanks for responding BLSHAW, Symptoms are the usual lack of motivation, low energy, low mood, not enjoying the things I used to, ect. ect., I know it could be chalked up to many things like depression, anxiety, mood disorders ect., but it’s the physical stuff that got me looking at T. my strength just keeps going down, I’ve been going to the gym the last two years with almost no improvement, it just makes me hurt and tires me. If I go on a big bicycle ride, hike or dirt bike ride I’ll be on a high for a few hours then I’m shot for three days, just wana sleep. I’m puttting a little fat on, and that doesn’t work on a skinny guy, mostly I just feel frail and fragile’er. No real issues with libido or ED., interestingly when I told my doc my libido wasn’t a problem he pointed at his head and said “that’s up here”. What really motivated me to check into TRT AGAIN, was when I read that it could be helpful for arthritis, that’s been an issue over the last few years. I look much younger than my age, I’d just like to feel like I look. Is there really any risk at trying this for a while? just to rule it out.
Thanks
At your age, if it’s something you want to try, why the hell not. You will most likely see some benefits, not sure how impactful they will be since you are not terribly low now. If you were 30 I would say wait until you’re on older. Well you’re older… so why not see if this makes your life more pleasurable.
I’d welcome any opinion on this thread, I’d really like to hear opposing views so I can best make informed decisions. Others with similar problems will also be reading this so they could also be better informed. How about a paragraph with what your really thinking? Thanks
This could be higher. You could do that by lowering your high SHBG, via supplements or diet. Seems like you’re concerned you went on TRT without really needing it, and I’d agree, for now. If you can’t get SHBG down naturally, and don’t want to use an oral AAS, then TRT would probably be your best bet
So: If the result had come back low, he would have treated you. If the result had come back normal, he would have treated you. If the result had come back high, he would have treated you. Does that sound like rational, responsible medicine to you?
I asked my Doc how I could lower my SHBG and he said “change your genetics” So if you’ve got ways to do it naturally I’d be all about it. Don’t know what AAS is, I’ll do some searching.
Hey, Thanks for coming back. Honestly I’ve been contemplating this a lot, I’m comfortable saying I don’t think it’s crazy as long as I stay within normal range, that leaves me quite a bit of room to boost my free T.
I did a short search, what I read says boron will reduce SHBG, which will increase free T, but will also raise estradiol, and the reason SHBG is often high is because the male body is trying to control high estradiol. My estradiol is 34 (<30 norm), so maybe worth a discussion at my next doc appt… Also read that diet doesn’t normally work long term, eventually your body goes back to where it wants to be. Don’t know how true, I just read it.
Or until someone convinces me it’s a bad idea
Sure I have, have been for twenty years, I’ve tried all the fad stuff, diet, exercise, B12 shots, a full year without gluten, I’ve had every blood test you could think of, I even had a full bone marrow genetic workup! my blood counts have always been a little low, 10k later they said “it must just be normal for you” This probably sounds like I’m a hypochondriac always running to the doc but this is all over a long period of time. Every few years I get fed up and push the issue with my Doc, and it always leads down a dead end road. Then lately after searching the web and reading more, I realized Every Doc I’ve talked to about TRT new absolutely nothing about TRT, beyond reading a printed blood test. That’s why I’m here
What was the result of your evaluation with a psychiatrist (or similarly credentialed individual)? I ask because there’s tremendous overlap between widely-circulated lists of low-T symptoms, and psychiatric conditions such as anxiety and depression.