Is TRT going to be my only way to feel better? How much could a better diet, more sleep, less stress and consistent exercise help me? Just looking for opinions… I’m 50 yrs old so I understand I’m not going back 30 yrs in any case but TRT is a huge decision so I’m trying to weigh out all options. I’m obviously very new to this, so any feedback from those who have experience and knowledge after looking at my labs would be appreciated…
You might want to redact the personal info, Jeffrey. I would be trying to figure out why the LH is so high. The other levels look okay, actually, but that pituitary is suspicious. Has anyone checked it out yet?
I think I fixed my personal info displaying on the labs… I hope so anyway. As for the LH, the way I understand things and I am by no means a pro at this stuff is that LH, FSH, and SHBG all typically go up while Total Test can look ok. All of this happens as free test takes a nose dive which mine has. So I’m not sure we are looking at a pituitary issue as much as a primary diagnosis of hypogonadism. However, again I’m all new to this…
IMO, your t level looks fine. I would get all the other things in order and then evaluate how you feel. You didn’t say what your definition of better is. You didn’t mention your exercise routine, your body comp, your diet. Improving all of these things if they currently suck will improve your outlook. But again, we need to know more about you.
Going on T is not a magic bullet.
Total T is fine, but from what I understand it’s the free T that does all the magic. Mine’s not so great. By better, I mean more energy, better libido, stronger, I’m still working out but not as much as I used to simply because I see myself sinking in the gym. Lets just say I’m not the machine that I once was for sure, gym or bedroom… Can’t get through 1/4 of my planned workout without feeling like I been hit by a truck… I’m slowly getting fatter without the ability to take it off without hard dieting etc. I think its the SHBG that’s binding all of my free T and causing all of the issues. however from what I understand my Total T would have to be around 1200-1400 range for my Free T to be optimal because of the SHBG eating it up basically… My pituitary is firing off all this LH and FSH in hopes to get enough free test flowing to help with my symptoms. The thing that scares me is that I know that Total test level for me will have to be really high to get enough free test to off set the massive amounts of SHBG which means I will most likely be on a pretty large dose of test if I decide to go with TRT and I’m just not sure how healthy long term high total test levels are…
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In other words, I’m getting old, which sucks…
Elevated LH means your pituitary is pushing your testes to maintain your level. That means that you have less production from the testes for some reason. SHBG usually goes up in response to diminishing test levels, it’s the storehouse for androgens.
okay, understood. I’m 49. I didn’t have any issues at the gym or bedroom. My only issue was that my efforts at the gym didn’t seem to be dropping the weight. Then I changed my diet. My body started to change. Then I went on TRT.
TRT can boost your energy, but it brings in other things(PSA, Estrogen, Liver, Blood pressure, stigma…) that you may have issues managing. I feel like the benefits of the extra T are worth me playing the numbers game at this stage in my life. You can try TRT for 6-8 months and see how you like it, stop if you want too. You will need to give it at least 6 months to stabilize inside you. If you like it, keep going, if not… stop. I think you should give it a try!
I have always loved working out. I tell people they sell motivation in a bottle, it’s called pre-workout.
The main problem here is your SHBG (produced in the liver) is in the stratosphere and your age, lifestyle and a little bit of genetics is responsible, SHBG increases as you age binding more and more bioavailable testosterone. The is only one way to decrease your SHBG which is excess androgens and therefore TRT is the only thing that will work.
Your pituitary gland is sending stimulating hormones to your testicles and at your age your testicles are not responding well anymore, it’s time for TRT or continue to decline and eventually end up with cardiovascular problems.
TRT may very well expose other weak endocrine glands, your TSH is already 2.1 and TRT will increase demand on your thyroid probably increasing TSH and we will see if your thyroid can handle youthful testosterone levels at 50.
Normal TSH median values are usually between 1-1.5 mU/L, over 2.5 and there are problems developing. The sick care TSH reference ranges are not normal as previously thought.
Testosterone (T) has a number of important effects on the cardiovascular system. In men, T levels begin to decrease after age 40, and this decrease has been associated with an increase in all-cause mortality and cardiovascular (CV) risk. Low T levels in men may increase their risk of developing coronary artery disease (CAD), metabolic syndrome, and type 2 diabetes.
Maybe not the only way to feel better, but the only way to feel a lot better.
I would check prolactin levels to rule out a hormone secreting tumor. Didn’t you have a previous set of labs with both FSH and LH elevated?
Yes both are elevated and going higher by the month looks like. I will go ahead and order the prolactin labs just to make sure. Thanks for your help…
I know that you have mentioned in other post that guys like me with higher SHBG levels will have to get total test up around 1200-1400 level to get enough free test to off set symptoms etc. Does that mean I would have to take larger doses than most men and is there a higher risk of side effects due to total test levels remaining that high long term? Thx
Your SHBG will fall naturally in response to having more androgens in your system, barring other medical complications. It goes up to hold on to your test when you are experiencing consistent low levels and drops when you have consistent high levels.
You will need more androgens to suppress SHBG, generally high SHBG men need more testosterone to have the same FT levels as someone with a lower TT and low SHBG. When my TT is 417 ng/dL I have FT at 15 (ranges 6.8-21.5 pg/mL) and I don’t need that much testosterone to get FT to the top of the ranges because SHBG is 14-22.
SHBG levels are always fluctuating, you lift weights and SHBG increases, you eat and insulin changes can reduce SHBG. Your FT levels if at the top of the range alongside another person with FT at the top of the ranges with a lower TT, both men have the same amount of active androgens regardless of TT levels.
TT doesn’t have any affect on tissue.
You won’t have to take a crazy high dose just likely more than 100mg/week that the low SHBG guys take. 150mg would likely be a good starting dose to see how you react. After a couple months you can assess how you feel and look at lab work to see which way to go. I have the same total T as you pre-trt and TRT has definitely improved most aspects of life. It’s like going from being at a disadvantage to having an advantage.
I like that description.
How is your diet? Sleep? Stress? Do you drink alcohol? Do you snore?
I also had relatively high SHBG, and similar TT and FT values. Everyone’s different, but I started out at only 140 Mgs, one injection per week, and my SHBG decreased by about 20 points within a couple months. My routine has evolved a little over time, but I’m still at only 80 mgs every three days, with a TT of about 1100 and FT at about 31. I’m only a few years younger than you, and I feel much better than before energy wise, libido wise, body composition, and all around just happier.
Why did you go from the 140 mgs once per week to 80 every three days? Did you start to get estrogen issues? Man I’m jealous of that FT of 31 you have there… What negative side effects have you experienced so far and how long have you been on test?
I could do better on diet, sleep and keeping stress down for sure. Dont smoke or drink. I have just declined so rapidly over the last 18 months or so that its kinda scary… and sucks for sure.
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