30 going on TRT - need guidance

[tt350z]

Hello,

I tried to doing quick search and I’ve been watching videos and etc but I like to get you guys take on this....

I am 30, soon to be 31. I am 5’11 - 6’ and current weight is 180 with around 15% body fat all in midsection and love handles. I am eating extremely clean and intake is around 2000 calories daily. I do fast cardio daily and workout heavy five time a week (keeping heart rate between 135 to 160).

I have done a testosterone , Sex hormone and estrogen bloom work and results are:

Cholesterol - 259mg/dL Range 0-200
Triglyceride - 261mp/dL Range 35-150
Testosterone - 184ng/dL Range 300-1080
Sex Hormon - 15.2NMOL/L Range 16.5-55.9
Estradiol - 7.2pg/ml Range 10.0 - 42.0
Estrone - 10.0pg/ml Range 9.0 - 36.0
Estrogen Total - 17.2pg/ml Range 19.0 - 69.0

I am looking at TRT in hopes to A have more energy, clear my head and function better and more important actually drop weight since mine has been fixed for 3 weeks regardless of what I do - what are your thoughts on all of this and suggestions and expected results if I do?

Thanks

[Youthful55guy]

Hello,

I tried to doing quick search and I’ve been watching videos and etc but I like to get you guys take on this....

I am 30, soon to be 31. I am 5’11 - 6’ and current weight is 180 with around 15% body fat all in midsection and love handles. I am eating extremely clean and intake is around 2000 calories daily. I do fast cardio daily and workout heavy five time a week (keeping heart rate between 135 to 160).

I have done a testosterone , Sex hormone and estrogen bloom work and results are:

Cholesterol - 259mg/dL Range 0-200
Triglyceride - 261mp/dL Range 35-150
Testosterone - 184ng/dL Range 300-1080
Sex Hormon - 15.2NMOL/L Range 16.5-55.9
Estradiol - 7.2pg/ml Range 10.0 - 42.0
Estrone - 10.0pg/ml Range 9.0 - 36.0
Estrogen Total - 17.2pg/ml Range 19.0 - 69.0

I am looking at TRT in hopes to A have more energy, clear my head and function better and more important actually drop weight since mine has been fixed for 3 weeks regardless of what I do - what are your thoughts on all of this and suggestions and expected results if I do?

Thanks

First thought is that 2000 calories is not enough to support daily cardio and 5X weight workouts per week. Over exercise has been shown in numerous studies to lower testosterone, primarily through lower gonadotropin secretion. I'd reevaluate such an aggressive exercise protocol given your highly restrictive diet.


Having said that, your tests do show very low levels of total T, lower than normal SHBG and Estrogen. The Estrogen is easy to understand since it is manufactured from testosterone in the body, so low T usually means low E. Since men need E for normal libido, erections, and GH secretion, I suspect you are also deficient in those departments. Fix the T and you fix the E.

The low SHBG is probably also contributing to the low T. SHBG binds and protects T from liver metabolism, so guys with low SHBG usually also have low Total T. However, this is often compensated by higher levels of Free T, which is the more important lab and also missing from your post. I strongly suggest you add this to your next set of labs.

Bottom line recommendation based on what little we know is to back off on the exercise and retest in about 6 weeks. I'd also consider adding in first morning LH and FSH (although the test can be somewhat quirky). If you still come back with abnormally low Total and Free T, you might want to consider TRT. however, at your age, I'd attempt to fix the primary problem before going on a lifeline treatment program.

[kelkel]

Like 55 said, ease up a bit. Get LH and FSH to help determine root cause. Add in a thyroid panel as well to include TSH, FT3, FT4 at a minimum. Thyroid issues can be a major cause of hypogonadism. Consider prolactin as well.

That said, find the cause before you medicate. It would suck to start TRT decades earlier than necessary if it was not actually needed....

[Chrisp83TRT]

Your lips are high man ... you got to hangs your diet and get your health in order.

[tt350z]

Sorry guys I left out the free T results:

50.6PG/ML Range is 47 - 244

[Youthful55guy]

Sorry guys I left out the free T results:

50.6PG/ML Range is 47 - 244

As I suspected, Free T is in range (barely) even though Total T is abysmally low. This is because SHBG is also low. This is probably why you are not feeling like the walking dead with that T level. It's hard to say what will happen once you get Total T in order. I suspect that SHBG will increase as E comes back into range, which will happen after Total T comes back into range.

As Kel mentioned, I suspect you thyroid hormones are also low and rT3 is high. This often happens with overtraining. It's your body's attempt to shut down metabolism to conserve fat. Low thyroid hormones will result in low SHBG. As T3 and T4 (and E) come back into range, SHBG should follow.

Again, bottom line recommendation is to take at least a week completely off from exercise and then back way off on frequency and intensity when you resume. Your body just cannot maintain that level. Many of those exercise protocols you read in magazines and on the internet need to come with fine print indicating they are designed for super humans and "enhanced" guys. The rest of us need to settle for less impressive gains and more balance.

As for me, I'm off to the Gym for 30 minutes of HITT cardio that I do 3 times per week, alternating days with 45-60 minutes of moderate weights that I very slowly increase over time using progressive resistance methodology.

[kelkel]

Your lips are high man ... you got to hangs your diet and get your health in order.

Yes they are. Forgot to comment on them. Op, if you're not already taking them, get on a good quality fish oil supplement to help your triglycerides. Also consider Slo-Niacin or Endur-Acin as well. Despite what you hear, total cholesterol is not all that important. A better measure for cardiac health is to divide your tryglycerides by your HDL. The goal should be 2 or under, at least in the ball park.

Next time you run blood work consider an NMR Lipo Profile. Basically an advanded (cholesterol) LDL particle profile. It will break down what type LDL you have. It can be eye opening.

[Chrisp83TRT]

Yes they are. Forgot to comment on them. Op, if you're not already taking them, get on a good quality fish oil supplement to help your triglycerides. Also consider Slo-Niacin or Endur-Acin as well. Despite what you hear, total cholesterol is not all that important. A better measure for cardiac health is to divide your tryglycerides by your HDL. The goal should be 2 or under, at least in the ball park.

Next time you run blood work consider an NMR Lipo Profile. Basically an advanded (cholesterol) LDL particle profile. It will break down what type LDL you have. It can be eye opening.

Learn something new everyday ! Thanks man!

[tt350z]

Thank you for all the fees back, for my cholesterol I am actually taken Rosuvastatin it’s a prescription and it’s been showing over the last 3 blood works that I’ve done it’s coming down, and it was high due to a failed keto diet and fatty liver (my mistake)

To sum it all my take away is find the underline cause of the low T by getting a LH, FSH,T-SHIRT,FT3 and FT4 done obviously I’ll share my results here in case someone is dealing with the same thing I can and based on that either start TRT or come up with alternative approach.
I’ve also stop working out this week but maintaining the same diet, I know my maintains calorie intake per day is 2500 and currently at 2000 so if it’s body stress from workout I should see a drop in weight a little.

[tt350z]

Update- as promised here is the updated results

TSH - 1.39 mIU/ml range - 0.40 to 5.00
Free T4 1.1 ng/dL Range - 0.8 to 5.3
Free T3 4.2 pg/ml Range - 2.8 to 5.3

[kelkel]

Keep an eye on your T4. Even with a normal TSH if FT4 drops to low it can be indicative of sub-clinical hypothyroidism.

[Youthful55guy]

Update- as promised here is the updated results

TSH - 1.39 mIU/ml range - 0.40 to 5.00
Free T4 1.1 ng/dL Range - 0.8 to 5.3
Free T3 4.2 pg/ml Range - 2.8 to 5.3

When you over exercise and/or put other stressors on the body, the body begins to convert T4 into rT3 (reverse T30 instead of normal T3. T3 is the most active form of thyroid hormones but rT3 is completely inactive. It binds to the same receptors but has no activity. This is your body's attempt to slow metabolism down to prepare for starvation. It also lowers testosterone for similar reason. This is why excessive exercise and calorie restriction is only effective for a week or so. The body is programmed to adapt.

[swagger2011jack]

Testosterone and cholesterol are the two compounds and are both classed as steroids . Cholesterol is the ‘parent compound’ of all steroid hormones including testosterone as it is needed to form all steroid hormones. These two compounds are chemically related that testosterone might influence the amount and type of cholesterol, body produces. Cholesterol once synthesized in the liver, it converts into other hormones and finally testosterone. . The lipid is an auto-regulatory – what this means is that if your cells are running low, your liver will make more. However, some cells need an extra supply so without available cholesterol, we cannot synthesize enough testosterone, or any other steroid hormone for that matter. Without enough T your body cannot function optimally – you’ll lose strength and muscle mass, your libido will plummet and you’re long-term health risks such as weak bones and cardiovascular risk will increase. A high-fat diet doesn’t necessarily mean that your body fat is raised. Furthermore, low fat diets have been found to decrease T levels. Higher fat diets are essential for maintaining and optimizing your T levels.
According to your reports seen, the cholesterol level is at the maximum range. various reports showing its higher range between 200 to 220 mg/dl. Increase lipid/fat diet in your routine. It might be helpful. If you were done prolonged use of steroids then this would have seen as a side-effect. Otherwise, go for TRT.

[tt350z]

Thats for the input it was a great read and help!

[tt350z]

As I promised early on to keep everyone update, I finally got the prescription to start my TRT - I was given 200mg every two weeks so 400mg a month and its called Testosterone CYP (Cypionate ).
I also had a conversation with my Dr, about HCG and if its something I can combine with my TRT or instead of TRT, I like to get everyone input on that? and thats work in progress she mentioned its not normal to do that but we shall see!

Clearly I don't have a clear idea of dosage and if 400mg is enough per month so if you y'all have any input I like to hear it, also looking for any other advice and I hope to see some changes...from my daily mood to physical and etc.

[kelkel]

Absolutely horrible protocol prescribed by your doctor. It indicates she doesn't understand hormones or their half lives whatsoever. She's dosing you on basically it's terminal life not it's half life putting you on a hormonal roller coaster. Meaning extreme highs in the beginning followed by extreme lows the second week. If you're injecting yourself I'd strongly recommend nothing less than weekly injections, meaning 100 mgs per week. Even better would be 50 mgs x 2 per week which would lessen the need for AI's and help with hematocrit issues down the road.

Take some time and go through some of the more current threads in this forum and you'll find charts showing injection protocols and the resultant rise and fall of T levels. Once you visualize this you'll completely understand my recommendations.

HCG Mono is a rarely used form of TRT. It can work for some assuming you're not primary hypogonadal but the long term benefits just don't seem to be there with it. Just add HCG to your T protocol when you can at a dosage of 250 IU's x 2-3 per week. Again, your doctor is not up to speed on TRT or HCG to make such a comment. Ask her if it's normal to allow your testicals to whither away and atrophy. Ask her if she'd allow that to happen to her vagina. Then when she kicks you out of the office you can find a better doctor......

100 mgs weekly in either one shot or 50 x 2 is a solid starting dose. About 6 weeks into this protocol get blood work and this along with how you feel will reveal if you need to titrate up. Blood work is always key here and be sure to test your free testosterone as that is what works for you. Less is more with TRT.

[tt350z]

Kelkel, I am with you...I am actually going to do 100 a week instead of 200 every two weeks. This is still so new and have to do blood work to keep the trial and error on check! I am actually moving to Chicago soon and hopefully can find a good Dr there that can keep things in check for me and add HCG if needed.

[kelkel]

Kelkel, I am with you...I am actually going to do 100 a week instead of 200 every two weeks. This is still so new and have to do blood work to keep the trial and error on check! I am actually moving to Chicago soon and hopefully can find a good Dr there that can keep things in check for me and add HCG if needed.

You could always reach out to Dr. John Crisler in Michigan. You don't have to see him in person to be treated. He's one of the best in the business.

[Youthful55guy]

Absolutely horrible protocol prescribed by your doctor. It indicates she doesn't understand hormones or their half lives whatsoever. She's dosing you on basically it's terminal life not it's half life putting you on a hormonal roller coaster. Meaning extreme highs in the beginning followed by extreme lows the second week. If you're injecting yourself I'd strongly recommend nothing less than weekly injections, meaning 100 mgs per week. Even better would be 50 mgs x 2 per week which would lessen the need for AI's and help with hematocrit issues down the road.

Take some time and go through some of the more current threads in this forum and you'll find charts showing injection protocols and the resultant rise and fall of T levels. Once you visualize this you'll completely understand my recommendations.

HCG Mono is a rarely used form of TRT. It can work for some assuming you're not primary hypogonadal but the long term benefits just don't seem to be there with it. Just add HCG to your T protocol when you can at a dosage of 250 IU's x 2-3 per week. Again, your doctor is not up to speed on TRT or HCG to make such a comment. Ask her if it's normal to allow your testicals to whither away and atrophy. Ask her if she'd allow that to happen to her vagina. Then when she kicks you out of the office you can find a better doctor......

100 mgs weekly in either one shot or 50 x 2 is a solid starting dose. About 6 weeks into this protocol get blood work and this along with how you feel will reveal if you need to titrate up. Blood work is always key here and be sure to test your free testosterone as that is what works for you. Less is more with TRT.

Kel is absolutely correct. Compare these two graphs for the daily amount of T released into your body from the T-ester (cypionate ). Both are approximately the total dose of T (200 mg every 2 weeks), but the first graph has it injected in a single huge dose as prescribed (1.0 mL) every 14 days. Keep in mind that the average adult male produces about 7 mg of T per day.


Compare this with the second graph which has approximately the same total amount broken up into injections every 3 days (0.22 mL) using an insulin syringe.


With the first protocol, you are in the super physiological range for the about the first 5 days and below what I consider and acceptable range the last 4 days. Whereas with an E3D protocol, you are within a constant physiological range the entire time.

I also agree that HCG monotherapy is probably not a good decision. It's MUCH more expensive and difficult to achieve effective ranges.

[tt350z]

Thanks ill try to reach out to him this Monday.

[tt350z]

Data point it makes perfect sense to me to control the ups and downs, I am curious if dosage is too low....if I am still making 200 and I am shutting down my internal and only adding 200 or 400 isnt that kind of same?

As Ive said before I share it all with you guys incase this can help someone else later on so latest results before start the injections ( BTW first one was yesterday)

Testosterone - 195 NG/DL - Range = 300 - 1080
Sex Horm Bind Globulin - 11.8 NMOL/L - Range = 16.5-55.9
Calc Free Testosterone - 58.7 PG/ML - Range = 47.0 - 244
Glucose - 107 MG/DL - Range = 70-99
Calcium - 10.7 MG/DL - Range = 8.5 - 10.5
ATL1 - 52 U/L - Range = 5-50
Ferritin1 - 456 NG/ML - Range = 30-400
RBC1 - 5.77 M/UL - Range = 4.10-5.70

Everything else I was in range for and seem healthy, I am getting an scan done for the Calcium thing to see if its producing too much or if large or not.

[Youthful55guy]

I don't understand why you would think that 200 mg is too low of a starting dose. Look at graph #2 above. The average male produces about 7 mg of T per day, yet 200 mg/2 weeks divvied into 44 mg E3D releases an average of about 10 mg T per day, which is about 48% higher than the average male.


Yes, with pretty much all doses of T your endogenous production is eliminated. That usually happens within the first week as the exogenously administered T is released from the ester. It happens to everyone. What is important is the manner in which you replace it. The best protocols keep it within physiological ranges at all times.


Per my prior post, your SHBG is a bit low, but so was your E. I suspect that as you bring your T up to more normal levels, that E will also return to more normal levels and that, in turn, will drive new production of SHBG to bring that in range. You need normal E for normal libido and erections, and you need normal SHBG as a buffer to absorb excess T and release it slowly. This helps slow down liver metabolism and excretion of T. I highly recommend that you wait at least 6 weeks after getting onto the optimum (E3D or 2X per week protocol) before making dose adjustment decisions. There is a cascade of hormonal changes throughout the body that occurs when you start TRT and you need to let it run its course before mucking with it again. This process takes about 6 weeks to come to a new normal.

[tt350z]

Thats a great advice, Ill be sure to keep that in mind.

[Amuuzen]

Great run down. Y55 and Kel, you two really know your stuff. OP, If you do not want to cut back on your overall training (I know for myself, I just really can't or won't as I need the gym to stay sane), at least up your calories to most likely over 3K while you stabilize (sounds like your up on the needed supplements). I recently started TRT myself, I can say that after the first 6 weeks, I felt much better, I'm guessing even sooner for yourself. I started feeling better about 2 weeks after starting TRT. That was perhaps psychological, but I don't think so. My T levels were comparable to yours and I was training intensely also which actually led me to figure out what was wrong. I started feeling MUCH better when I backed off my diet and increased calories. My BF continues to drop but my calories are more like 3.5k/day currently (although clean and low carb) and weight holding about 185. Perhaps you'll see similar results... anyway, back to the grind, great info and welcome to the forum.