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TRT Advice - total test at 344, free at 8.5

Brickshthouse79

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Hi Everyone,

First, thank you in advance. I know we have some really smart people on the boards and I could use your input.

History: 33 year old male. 12 years of anxiety/depression issues, low libido, excessive sweating, irritability, bowel urgency after eating, poor sleep, very weak (hard to do anything) and it has been quite tough to exercise.

Went to primary care for a checkup after feeling so burnt out from these symptoms (should also add that I take a small dose of celexa). The doctor concluded that with the exception of having low testosterone, I am healthy.

Tested by LabCorp:
Testosterone, Total: 344 (range 348-1197)
Testosteron, Free: 8.5 (range 8.7-25.1)

Here are the other items that tested out of range:
LDL cholesterol: 104 (range 0-99mg/dl)
Bun creatinine ratio: 23 (rage 8-19)
Blood urea nitrogen: 21 (range 6-20mg/dl)
Vitamin D 1, 25-Dihydroxy: 95.9 (range 10-75 pg/ml)

Primary care took a 2nd round of bloodwork to check the HTPA axis and referred me to urologist. The urologist said I was certainly symptomatic of having low testosterone, but said I was "within range" and is sending me to an endocrinologist. He said starting T therapy is a big consideration and wants to be certain before going down that path.

Another consideration is that I am in my early 30s and will likely want to have a child within the next 2-3 years. If I start TRT, I assume using HCG and an AI will allow my boys to keep working at least at their current level.

Next week, I have an appt with a doc that is more liberal and I think will give me TRT if I want it. I'd appreciate input on the situation, particularly from anyone under 40 that has been in my shoes.

Thank you again
 

Incognito1

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Hey buddy, yep I'm in the same situation. I'm 33 and also booked into endo.
My results are around the 314/7.3 mark, so yes very low.
I am definitely pushing for TRT, but my wife is pregnant so I'm even more interested to get the ball rolling on TRT.
My advise would be as a precaution, put some of your boys on ice just in case your natural production shuts down. I only want one child but that's what I've done as a future precaution.
Nothing wrong with getting on TRT if your life is being affected by low test, just take the precautions.

Best of luck mate
 

kubes

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Before considering trt you really need a full hormone panel to see if there is anything else going on. You want to at least check your estrogen levels and lh levels. Any good endo should run those labs though. My dr treats anyone with total t under 400
 

Brickshthouse79

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Thank you guys. My primary care said she is "testing the axis." Does that generally involve checking e2 levels as well? I think she will put me on TRT.

Has anyone else started TRT before having kids? I'm assuming a fertility doc would put me on HCG when the time comes, but I would rather run the HCG and keep my natural test production going than wait until I need to see a fertility doc. On Monday, I am going to see another doc that seems to focus on the anti-aging area and see what he thinks.

One more detail. I've been taking pregnenolone and 7-keto dhea the past week and it makes me feel a bit better. Has anyone else tried using those substances vs. trt? I'm assuming they won't raise my test levels, but may help with some symptoms. Any input there would be greatly appreciated as well.
 

gogotren

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I find it crazy how fast a dr will Rx celexa or other head pills before test, which your body produces naturally. Taking TRT dose test is not going to shut off your sperm production. Even if it is on the "low side" it only takes 1. If its the right woman it will happen, just don`t tell her about this stuff it can f*ck with her head and stop her from getting pregnant.

My test levels were around 340 when my wife got pregnant.

TRT will make you feel better (from being at 344) but you need to address the anxiety/depression if you want some real quality of life... and I`m not talking about taking pills.
 

aduren

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Thank you guys. My primary care said she is "testing the axis." Does that generally involve checking e2 levels as well? I think she will put me on TRT.
The hypothalamic–pituitary–adrenal axis involves checking everything hormonal as the name implies. It is not 100% understood but for the most part the mechanisms have been studied. The need to test this before any treatment lies in the fact of possible diseases that could affect testosterone production to begin with without having much to do with your gonads (ie Thyroid levels).

Once on TRT you wikll be constantly monitored, if your test does shutdown the labs will show it. I would find a good Dr. you trust as they will also mantain healthy Lh/FSH levels.
 

Brickshthouse79

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I find it crazy how fast a dr will Rx celexa or other head pills before test, which your body produces naturally. Taking TRT dose test is not going to shut off your sperm production. Even if it is on the "low side" it only takes 1. If its the right woman it will happen, just don`t tell her about this stuff it can f*ck with her head and stop her from getting pregnant.

My test levels were around 340 when my wife got pregnant.

TRT will make you feel better (from being at 344) but you need to address the anxiety/depression if you want some real quality of life... and I`m not talking about taking pills.
Thank you gogotren. I've been working on anxiety reduction techniques for years. I've tried cognitive therapy, several SSRIs, benzos, hypnotism, mind entranment and acupuncture/chinese herbs (i'm sure i've left many other things off). Exercise certainly helps, but I have such little energy that is tough to get moving. It has resulted in a fair amount of coffee drinking which is probably only making things worse. If the underlying symptom is low test, i'm hoping that i may feel good when I start. Already mentioned the low T to my girlfriend who is awesome. She is very understanding and supportive of whatever I want to do. I'm a lucky guy to have her.
 

Brickshthouse79

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The hypothalamic–pituitary–adrenal axis involves checking everything hormonal as the name implies. It is not 100% understood but for the most part the mechanisms have been studied. The need to test this before any treatment lies in the fact of possible diseases that could affect testosterone production to begin with without having much to do with your gonads (ie Thyroid levels).

Once on TRT you wikll be constantly monitored, if your test does shutdown the labs will show it. I would find a good Dr. you trust as they will also mantain healthy Lh/FSH levels.

Thank you aduren. Right now, I went from primary care to urologist. The urologist is sending me to who he calls the "best" endo doctor in manhattan. To your point, he wants to be sure there is not something else going on before treating me for the low T symptoms.
 

steel71

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Thank you gogotren. I've been working on anxiety reduction techniques for years. I've tried cognitive therapy, several SSRIs, benzos, hypnotism, mind entranment and acupuncture/chinese herbs (i'm sure i've left many other things off). Exercise certainly helps, but I have such little energy that is tough to get moving. It has resulted in a fair amount of coffee drinking which is probably only making things worse. If the underlying symptom is low test, i'm hoping that i may feel good when I start. Already mentioned the low T to my girlfriend who is awesome. She is very understanding and supportive of whatever I want to do. I'm a lucky guy to have her.
For Depression and Anxiety, look into high dose 'Niacin" 2000-3000 mg QD.
More info: DoctorYourself.com - Niacin Therapy Details
 

chemical engineer

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celexa gave me those same symptoms that you describe. Change to lexapro[I did] and you will see a big difference. Also , celexa is like a first cousin so to speak to lexapro. I would do that first and then go with the blood panels if fatherhood is an issue.
 

Brickshthouse79

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Update

Hi Everyone,

Its been a hell of a week.

1) saw primary care and was given results above, doc also did a 2nd round to check hpa

2) went to a urologist, he said surgery is his speciality and he referred me to an endo. Unfortunately the endo is not in my insurance network

3) went to a local internalist/anti aging doc. He ran a bunch of tests on me, gave me a shot of b12, said I have hypothyroidism (sufficient t4 that is not converting) and gave me a rx for 5mcg t3 2x a day and suggested giving me clomid instead of trt since I am only 33 and may want kids. He based the thyroid conclusion on my symptoms and the following:

T4, Free, direct 1.36 (range 0.82 to 1.77) - so i am making or have t4 is what i think he said
TSH, 3.22 (range 0.45 to 4.5) - since i am over 3, i am in the grey area of hypothyroidism (b/t 3 and 5.0)

The problem here is he doesn't have availability for a follow-up appt for 3 months! So, I took 1 dose of t3 and noticed immediately that i felt quite good, actually almost high or manic.

4) went back to primary care to get the hta results. Also told doc about my experience with urologist and anti aging guy. Doc was surprised he would give me t3. Said its effect was due to it causing a bit of a high and was not fixing any underlying problem since she thinks my throid is fine. My 2nd round of blood work showed the following:

LH: 3.9 (range 1.7 to 8.6)
FSJ: 2.4 (range 1.5-12.4)
Total Test: 279 (range 348-1197)
Free Test: 6.9 (range 8.7-25.1)

So both total and free are lower and apparently my brain is providing the right signal to the testes, but they are not creating enough test.

Based on that my primary care wants me to see an endo and thinks trt is likely the way to go. She disagrees with clomid and t3. Any imput would be greatly appreciated.
 
Last edited:

maxvta1977

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HRT in 30's

I'm on HRT and in my mid thirties as well. Doc has me taking DHEA and Pregnenolone supps too. I went from feeling like crap to feeling like I'm about 25 yrs old again! Best of luck to you!
 

mg1228

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Hi Everyone,

Its been a hell of a week.

1) saw primary care and was given results above, doc also did a 2nd round to check hpa

2) went to a urologist, he said surgery is his speciality and he referred me to an endo. Unfortunately the endo is not in my insurance network

3) went to a local internalist/anti aging doc. He ran a bunch of tests on me, gave me a shot of b12, said I have hypothyroidism (sufficient t4 that is not converting) and gave me a rx for 5mcg t3 2x a day and suggested giving me clomid instead of trt since I am only 33 and may want kids. He based the thyroid conclusion on my symptoms and the following:

T4, Free, direct 1.36 (range 0.82 to 1.77) - so i am making or have t4 is what i think he said
TSH, 3.22 (range 0.45 to 4.5) - since i am over 3, i am in the grey area of hypothyroidism (b/t 3 and 5.0)

The problem here is he doesn't have availability for a follow-up appt for 3 months! So, I took 1 dose of t3 and noticed immediately that i felt quite good, actually almost high or manic.

4) went back to primary care to get the hta results. Also told doc about my experience with urologist and anti aging guy. Doc was surprised he would give me t3. Said its effect was due to it causing a bit of a high and was not fixing any underlying problem since she thinks my throid is fine. My 2nd round of blood work showed the following:

LH: 3.9 (range 1.7 to 8.6)
FSJ: 2.4 (range 1.5-12.4)
Total Test: 279 (range 348-1197)
Free Test: 6.9 (range 8.7-25.1)

So both total and free are lower and apparently my brain is providing the right signal to the testes, but they are not creating enough test.

Based on that my primary care wants me to see an endo and thinks trt is likely the way to go. She disagrees with clomid and t3. Any imput would be greatly appreciated.
u need to have a free t3 and rt3 lab run for thyroid....your t4 could be converting to rt3 instead of t3....

dumbass endos!!!!
 

Brickshthouse79

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u need to have a free t3 and rt3 lab run for thyroid....your t4 could be converting to rt3 instead of t3....

dumbass endos!!!!
Thats the concern of the anti aging doc. If you have t4 converting to rt3, would most docs supplement with t3 or is there another solution?
 

aduren

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Thats the concern of the anti aging doc. If you have t4 converting to rt3, would most docs supplement with t3 or is there another solution?
First of all to call someone with 20 years of school stupid is well preposterous. No where in the thread was an endocrinologist seen... so I would reserve my comments of superiority to myself.

The first line of treatment will not be T3, it will most likely be levothyroxine (t4) since the use of T3 is not that wide used. Every Doctor is different but a lot of studies are conflicted as to which is the best approach, levothyroxine or levothyroxine with T3 combined.

What we know is that is levothyroxine is combined with T3 there is an overall weightloss (but this is not solely attributed to T3, double bind studies showed this).

The goal is to achieve eurothyrodism (normal levels of TSH). Maybe you will respond to levothyroxine perfect (unless you are a primary hypothyroid) maybe you will need the combination because of therapy and weight issues but only an Endo can decide.

ONe thing is for sure you need to move fast to an Endo as there is always the case for another underlying disease.
 

Brickshthouse79

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First of all to call someone with 20 years of school stupid is well preposterous. No where in the thread was an endocrinologist seen... so I would reserve my comments of superiority to myself.

The first line of treatment will not be T3, it will most likely be levothyroxine (t4) since the use of T3 is not that wide used. Every Doctor is different but a lot of studies are conflicted as to which is the best approach, levothyroxine or levothyroxine with T3 combined.

What we know is that is levothyroxine is combined with T3 there is an overall weightloss (but this is not solely attributed to T3, double bind studies showed this).

The goal is to achieve eurothyrodism (normal levels of TSH). Maybe you will respond to levothyroxine perfect (unless you are a primary hypothyroid) maybe you will need the combination because of therapy and weight issues but only an Endo can decide.

ONe thing is for sure you need to move fast to an Endo as there is always the case for another underlying disease.

Thank you. This thursday I am seeing a doctor who I have been told is "the best in the business." I'll keep everyone updated.
 

Brickshthouse79

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Update. Went to an endo that is supposed to be excellent. He ran additional blood tests and said my test "came back low normal." Based on that he put me on androgel. Looking forward to see how I feel after a month or so.
 

Big D 51

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Update. Went to an endo that is supposed to be excellent. He ran additional blood tests and said my test "came back low normal." Based on that he put me on androgel. Looking forward to see how I feel after a month or so.
Update us and let us know if this helps with your anxiety/depression. I am on 20mg celexa as well. Sucks. Considering trt too.
 

kubes

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Update. Went to an endo that is supposed to be excellent. He ran additional blood tests and said my test "came back low normal." Based on that he put me on androgel. Looking forward to see how I feel after a month or so.
Hope it gets you to normal range :)
 

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