I’m 36, can’t have no more kids(Vasectomy), and I’m relatively healthy at 6ft and 173lbs. Lift weights 4 times a week, very limited if any cardio, and eat a fairly clean high protein diet. Avg. 150g protein. Been feeling tired and kind of depressed for a while. My last blood tests were:
TT- 474 ng/dL
FT- 44.6 pg/mL
Bioavailable T- 95.6 ng/dL
SHBG- 49 nmol/L
Estradiol- 25 pg/mL
Albumin- 4.7 g/dL
Can anyone help explain why my Free T and Bio T are on low side? Thanks in advance @systemlord @highpull
Special thanks to those I tagged. I’ve already learned quite a bit from you.
SHBG is on the high side. Total testosterone is mediocre. I do not know why he is using Clomid instead of testosterone. Did you have FSH and LH tested?
Considering you don’t want kids.
I would, personally, go for TRT (especially if a weekly injection is not a hassle for you).
You can keep stable levels right at the upper limit with no problems.
You can take a small dose of a DHT derivative to lower SHBG if necessary and an AI if estrogen becomes an issue.
I think it is a stretch making these comments, especially given the lack of information we have. “Frightened of TRT”? You do not know his doctor’s approach and thought process in this case. Hopefully, he explained his rationale for starting Clomid to Kenny. The fact that he is on the internet with questions is not reassuring. Secondary hypogonadism is reasonable assumption, but for us, that is all it is.
Only time LH and FSH were tested was just over a year ago on 7-20-21 by PCP. And that was during a calorific deficit as I was trying to lose some belly fat.
PCP then put me on small dose of anastrozole and referred me to urologist. Who then pulled tests again on 11-19-21 while still on anastrozole and were as follows:
TT- 448 ng/dL
FT- 57.3 pg/mL
Estradiol- 35 pg/mL
Not sure why urologist didn’t pull more detailed tests. I do remember feeling better at that time. I am thinking because of better FT levels?
Results I originally posted are from 6-3-22 after dropping calorific deficit diet and dropping Anastrozole for 3 months.
TT- 474 ng/dL
FT- 44.6 pg/mL
Bioavailable T- 95.6 ng/dL
SHBG- 49 nmol/L
Estradiol- 25 pg/mL
Albumin- 4.7 g/dL
Urologist said he didn’t recommend T cyp injections because he didn’t want to push T too high. He explained the process of raising T via endogenous vs exogenous, but didn’t mention any of the side effects of Clomid that I have currently been reading about.
That is what is taught. This is the reason private, outside of the mainstream, TRT clinics exist. There are some urologists who will not follow that model, but not most.
Raising endogenous testosterone…with an exogenous drug, a chemical, rather than giving you a natural hormone. Not that Clomid does not have a place, but you need to be aware of what to watch, especially visual disturbances and headaches, which are not all that rare.
That’s exactly what you need because that data shows reduced risk of cardiovascular events above 550 ng/dL, yet doctors are taught to target mid-range levels therefore keeping you at or under this threshold.
This is a strange comment considering clomid would do exactly that, pushing T higher. Your urologist probably still believes TRT, high testosterone causes prostate cancer, heart attacks are strokes therefore fearing high testosterone.
Ok. Thank you for your advice on the side effects. Here are the FSH and LH results you asked for.
LH- 3.5 mlU/mL
FSH- 2.7 mlU/mL
Prolactin- 4.4 ng/mL
Does that make Clomid any better of an option in your opinion? I must admit, I am a total newbie with all of this stuff.
Yeah, he made it seem like T cyp would raise it too much compared to Clomid. Here are another set of labs from last year on 7-20-21 while on low calorie diet. Whats your opinion on them? Thank you.
TT- 527 ng/dL
FT- 40.9 pg/mL
Bioavailable T- 82.4 ng/dL
SHBG- 62 nmol/L
Estradiol- 51 pg/mL
Albumin- 4.4 g/dL
LH- 3.5 mlU/mL
FSH- 2.7 mlU/mL
Prolactin- 4.4 ng/mL
He’s probably only considering 200 mg every 2 weeks protocol, which in the first half of the week levels would be supraphysiological. It’s almost like this urologist believes there’s only one set cyp dosage, like you can’t adjust the dosage or injection frequency to get the desired levels.
You can tell he doesn’t really get it and I wouldn’t want this guy incharge of my treatment for low-T.
You didn’t provide normal ranges, which varies from greatly depending on which lab company you use.
Multiple peer-reviewed papers state that “testosterone deficiencies” are more prevalent and “desirable testosterone” levels in men are actually much higher than what is currently being considered as “normal” in doctors’ practices across the country. Case in point: A cross-sectional study of Swedish men ages 69 to 80 years showed the risk for premature death from any cause26 and the risk for suffering a major cardiovascular event were inversely correlated with the total serum testosterone concentration (i.e., the higher the testosterone levels, the lower the risk of death).
Specifically with regards to cardiovascular events, men in the highest quartile of testosterone (at or higher than 550 ng/dL) had a lower risk of cardiovascular events compared with men with lower testosterone.
More importantly, details from this study show that it did not matter if a man’s total testosterone was very low (below 340 ng/dL ) or moderately low (up to 549 ng/dL ) – all men with T levels below 549 ng/dL had a similar increased risk for suffering a cardiovascular event. Only when total testosterone exceeded 550 ng/dL did cardiovascular risk drop.
In my opinion, no. I was trying to figure out where he was coming from with that recommendation. You’re 36, had a vasectomy, free testosterone is in the toilet. I wouldn’t screw around, go with TRT, it’s healthier anyway.
Thanks for all the advice guys. I appreciate it. So it seems that pinning 2x/week with T cyp is the way to go. From what I comprehend, that will bring up TT and FT for sure and should bring down my SHBG, not increase it like Clomid. Thus my FT should have 2 things working in it’s favor? And if E2 goes up some, that’s not necessarily a bad thing? Seems like I’ve read about 2 schools of thought on E2 levels. I guess what I’m asking is at what E2 levels should I be looking at taking some anastrozole? And I’m leaning towards 2x/week inj on Monday and Thursday. What do you all think would be a good starting dose considering my TT is not exactly in the toilet?
