Man 40 y.o. mg/ml (total testosterone) - is therapy adviced?

[Lisbon]

Hi to all,
I am 40 and thinking about starting taking testosterone, but I have questions and doubts.

A while ago my blood test showed I have 3.0 mg/ml of total testosterone.
I had an appointment with an endocrinologist and showed her the results, and she said that my testosterone is low, but still within the normal range. She said this might be due to that I was taking an antidepressant at that time. We decided that I would make another test after quit taking the antidepressant, and we speak then.
Well, I did another test 6 months after I quit medication and it’s the same - 3.0 mg/ml of total testosterone.

I need to add here that I suspect that my testosterone level was relatively low during my whole life. Although I am not tall, I was always slim, even was considered as sickly slim during my teenage years (which itself doesn’t indicate that my T was low, of course), but I also had very low muscular mass. It was before heroin looks became popular, so I was very much concerned how to gain some muscles or at least some weight, but without any success. My energy level has always been extremely low as well, even during my younger years. After I turned 27, things started ‘’improving’’ a bit – I managed to gain some mass, but that was fat on my hips, belly and waist.
During the last few years I attend gym with varying success, from a total beginner level to an advanced level where I follow my training program quite carefully, take supplements and drink protein shakes, but the only result I have is that I managed to get rid of that fat (in some areas, my belly fat is still there). There’s no progress in gaining neither muscles nor muscular strength. AT ALL.

So I think my testosterone in fact has always been below average, but now when I am 40, it’s at the lower limit of the normal range, and my physical and emotional condition leaves a lot to be desired.

By the way, what are the limits of the so called “Normal range”? Am I right - 3.0 mg/ml of total testosterone might be fine and within “the normal range” for a 70 year old man, but when you are 40, can this be considered as very low?

Now I need to specify - very important – I am NOT aiming at becoming a fitness model, in fact turning into something similar like those gym rats on supplements is one of my worst nightmares. My concern has no relation to fitness, gaining muscular mass etc.

What I am concerned about is my emotional state, the lack of energy and fatigue I feel all the time. I tried other therapy (antidepressants), and it’s not what I want to stick with. They don’t resolve the problem; the problem might be not in my brains, but in my body. Could it be the low testosterone level in my case? Is 3.0 mg/ml of total testosterone normal for a 40 y.o. man?
The ADAM Questionnaire says in my case ’’ Your answers indicate that you may have a testosterone deficiency’’.


Before I go to doctor again, can you help me to find out these things about testosterone therapy:

1. If started once, will I need to be on it for my whole life?

2. How do they do it – use injections like every week? We’re not talking about people who want to gain muscular mass – as far as I understand, these guys just take curses of testosterone time to time.

3. If I face some side effects or other problems – what happens if I stop taking testosterone in some years? Will I just return to the state where I would be without taking it by that time, or will it be worse? Not only my belly will come back, but this time I’ll also have titties and my voice goes thin?

4. If you’re on such therapy – what benefits have you noticed, has your physical and emotional state improved?

5. What side effects do you experience?

6. Apart from testosterone itself, what medication do you need when being on testosterone replacement therapy?

It would be really interesting to find out, especially from the people, who’s been taking testosterone replacement therapy for years.
*I am not looking for a “magic pill”, I am not going to try testosterone illegally, only in case if doctor approves and medication is advised

[Tinman1]

I was on TRT for about 3-4 months 200mg every 2 weeks injection in my quad did it myself
My testosterone was 320 which was low but average I talked them into therapy since I was having all sorts of issues. After 3 months it was up to 750 with the low dose of 100mg a week. This low dosage causes no problems like Gyno, liver tox but just takes a while.
I think those injecting 500mg- 1g are the ones that need medications after a cycle
The issues at 320 were fatigue, not sleeping, ed, no sexual desire and body fat
At 750 I have none of those problems lower body fat % and better muscle tone and went up about 75lb on my bench
I didn't go for my 3 month blood test yet is why I stopped, working too much
The dr told me when you get your numbers up some people stay up some start going back down it's an individual thing

[Mr.BB]

First, think you mean 3 ng/ml, so 300 ng/dl. Different labs, and different method of analysis will have different ranges, although 300 seems low it may be a bit higher on different lab (or lower), you need to look at range.
Second you should try to find out why you are low, most times there is a reason (different than getting older) for hypogonadism. Worst case scenario you can have a undercover condition, and you will only be patching up the symptoms with testosterone. Pituitary MRI and testicle ultrasound are usually part of this diagnosis with a competent doctor.

1. Yes, if you are low and cant fix the causes, once you drop treatment you will fall to at best your previous levels, usually it goes much lower after a few years of use.
2. Depends on location, in US the most used treatment is cypionate or enanthate testosterone injected IM once or twice per week. In europe and australia docs tend to use undecanoate testosterone (nebido) which protocol is 1 injection every 10-12 weeks.
3. Answered in #1. Your voice will not change, and you will only get tits if you get massive estrogen spikes, or get really fat.
4. There are benefits, but only if your symptoms are really due to low T, otherwise the benefits are small, although some ppl use higher dosages so they are almost using as it would be steroids, which will carry risks and side effects.
5. I use nebido, so not much side effects. Some ppl seem to be more affected than others. Usual side effects are high hematocrit (polycythemia), water retention, estrogen problems and reduced HDL.
6. HCG if you want to maintain testicular activity and an aromatize inhibitor if you need to control estrogen.

[Chicagotarsier]

The first second and third thing...you have not found out why you are low test. I would go to the doctor and do ultrasounds and labwork to find out the why. Until you do you are treating symptoms and not the issue.

4) 44 yrs old and feel like I am 18. I can pound away on a girl like no teenager ever could. I do not get all moody anymore and I can think straight. I had fits of rage before...not anymore. Had severe joint pain and lower leg pain...not anymore. It is a miracle.

5) Take your AI daily (Aromasin) and the sides are negligable. I do not see a raise in hemocrit with the dose I take. For me the AI to keep Estrogen low in range is critical. If it is not controlled that is when all the sides jump up and bite you.

6) depends. Most docs do not prescribe anything but testosterone. Future labs determine other substances except an AI. AI keeps estrogen in check. Some say HCG (artificial LH) but it is split down the middle. Half say dont use it half say do. I do not.

[TRTdrew]

I was in your same boat. I was nervous. TRT has made a big difference in quality of life. Good luck.