Would it be a mistake to try TRT? Attached bloodwork. 30 YO disappointing libido

[EmeraldCoast]

30 YO. 5’11” 150 lbs. workout 4x/week. Married with 2 kids. Experiencing a disappointingly low libido. I’ve been using Gene’s NO stack (Citrulline, Tadalafil) daily for the last few years to combat this successfully for the most part, but recently libido has been declining to a disappointing level. Went to my local trt clinic and they got my blood tested. They said my blood levels are within normal range, but because of my libido symptoms they said trt would help and agreed to treat if I want to go ahead with it. They charge $180/month. Here’s my blood results. Would it be a mistake to give it a try? Desperate to find a way to improve my libido. We’re done having kids. I was on Accutane for about 4 years in high school, if that means anything.
SHBG: 45 nmol/L
Total T: 579 ng/dl
Free T: 96.6 pg/ml OR 9.6 ng/dl
Albumin: 4.9 g/dl
Estradiol: 23 pg/ml
PSA: .44 ng/ml
TSH: 1.95 mclU/mL
Insulin growth factor: 140 ng/mL
LH: 7.3

 

[FunkOdyssey]

I don't think it would be a mistake to try it but keep your expectations low. Your free T is in the borderline grey area where it might or might not be related to your symptoms. Most of us who started TRT had lower free T than your 9.6 ng/dl.

I'd give you something like a 30% chance of success. High enough that it's worth the experiment, but not high enough for you to really get your hopes up.

 

[t_spacemonkey]

180month is insane., but you are definitely on the edge. 30% is prob a good guess!

 

[EmeraldCoast]

180month is insane., but you are definitely on the edge. 30% is prob a good guess!

Appreciate it. It seems like $200/month is about the average. Not sure where else to get it

 

[Guided_by_Voices]

While it likely wouldn't be a mistake to try, there are lots of things that can cause low libido. You sound very thin and under-eating could be an issue. You need to make sure you are getting a reasonable amount of quality carbs (rice, white potatoes, some fruit, around 200g per day). Avoid max effort lifts or anything else that could cause overtraining. Definitely add in cialis/viagra. Possibly try PT-141. Make sure you are supplementing vitamins and minerals, and not just a multi-vitamin. Eat plenty of beef. If you have any signs of a chronic infection get tested by an integrative doc. If you do decide to go the TRT route, I would strongly suggest starting with something that is minimally suppressive (fast acting T as written about elsewhere here, see the posts from cataceous) or non-suppressive (low dose clomid, enclomiphene). Bottom line is that you want to try to find the root causes if at all possible, and while T can be one of them, there are lots of other things as well that could be part of the problem, and which will eventually need to be addressed no matter what.

 

[EmeraldCoast]

While it likely wouldn't be a mistake to try, there are lots of things that can cause low libido. You sound very thin and under-eating could be an issue. You need to make sure you are getting a reasonable amount of quality carbs (rice, white potatoes, some fruit, around 200g per day). Avoid max effort lifts or anything else that could cause overtraining. Definitely add in cialis/viagra. Possibly try PT-141. Make sure you are supplementing vitamins and minerals, and not just a multi-vitamin. Eat plenty of beef. If you have any signs of a chronic infection get tested by an integrative doc. If you do decide to go the TRT route, I would strongly suggest starting with something that is minimally suppressive (fast acting T as written about elsewhere here, see the posts from cataceous) or non-suppressive (low dose clomid, enclomiphene). Bottom line is that you want to try to find the root causes if at all possible, and while T can be one of them, there are lots of other things as well that could be part of the problem, and which will eventually need to be addressed no matter what.

Thanks. I’ve wanted to try pt-141 but it can only be prescribed to women. At least that’s what I read. Or is that also something TRT clinics can provide?

 

[Guided_by_Voices]

Thanks. I’ve wanted to try pt-141 but it can only be prescribed to women. At least that’s what I read. Or is that also something TRT clinics can provide?

It's easily available without a prescription and I believe clinics like Defy can prescribe the compounded version. Melanotan 2 has the same (or better) affect but I would not use it if you get sun exposure as the tanning affect is way too strong IME. Read the threads here about starting with a low dose (100mcg or less) if you decide to try it. ]

Also, DHEA is something to try as well. I find it helpful, but like everything else, some people benefit and some people don't. A good clinic would likely also check your prolactin to make sure it is not too high.

 

[t_spacemonkey]

Appreciate it. It seems like $200/month is about the average. Not sure where else to get it

many here use defy medical. its prob around 100/month roughly for pure T. i can recommend them. what I do is get the T from defy and HCG from reliableRX. its 20usd vs 150usd for 10k IU. the HCG does great things for libido. but only if you are on T due to natural production shutdown. I would def recommend adding it in if you go the.T route.
some people order 'ugl' which are underground labs. the cost there is prob about 30usd/month but it is a bit of a grey are and I am not saying you should do it

 

[EmeraldCoast]

It's easily available without a prescription and I believe clinics like Defy can prescribe the compounded version. Melanotan 2 has the same (or better) affect but I would not use it if you get sun exposure as the tanning affect is way too strong IME. Read the threads here about starting with a low dose (100mcg or less) if you decide to try it. ]

Also, DHEA is something to try as well. I find it helpful, but like everything else, some people benefit and some people don't. A good clinic would likely also check your prolactin to make sure it is not too high.

Thanks. I checked out defy and thought I saw that they are also 200/month but will look again. They seem to be a good option as they are mentioned often on these forums.

 

[FunkOdyssey]

Thanks. I checked out defy and thought I saw that they are also 200/month but will look again. They seem to be a good option as they are mentioned often on these forums.

That's not how they do business -- you only pay for services as you use them. For example, a consultation is maybe $150 and you don't need to have more than a couple of those per year. The rest of the time, you just pay for your vials of testosterone as you need them and occasional bloodwork.

 

[Systemlord]

recently libido has been declining to a disappointing level. I was on Accutane for about 4 years in high school, if that means anything.

The fact your libido has been declining recently suggests it's not caused by Accutane, which was more than a decades ago.

There's little risk in trying TRT.

 

[Systemlord]

Your free T is in the borderline grey area where it might or might not be related to your symptoms. Most of us who started TRT had lower free T than your 9.6 ng/dl.

I'd give you something like a 30% chance of success. High enough that it's worth the experiment, but not high enough for you to really get your hopes up.

Studies show libido and loss of vigar are the first symptoms to appear as testosterone is declining, followed by ED, fatigue and loss of muscle mass.

I agree it's worth experimenting rather that surrendering and giving into defeat, however his lower libido might be multifactorial.

TRT is very low risk, if the Traverse study is any indication.

Less risk than going on an SSRI, which sadly are handed out like candy!

Things that affect libido:

• Obesity
• High blood pressure
• Diabetes
• Poor sleep
• Medications
• Stress/depression
• Low testosterone
• Infections
• High prolactin
• Low thyroid hormones
• Alcohol & drugs
• Surgery
• Heart disease
• High cholesterol

 

[madman]

30 YO. 5’11” 150 lbs. workout 4x/week. Married with 2 kids. Experiencing a disappointingly low libido. I’ve been using Gene’s NO stack (Citrulline, Tadalafil) daily for the last few years to combat this successfully for the most part, but recently libido has been declining to a disappointing level. Went to my local trt clinic and they got my blood tested. They said my blood levels are within normal range, but because of my libido symptoms they said trt would help and agreed to treat if I want to go ahead with it. They charge $180/month. Here’s my blood results. Would it be a mistake to give it a try? Desperate to find a way to improve my libido. We’re done having kids. I was on Accutane for about 4 years in high school, if that means anything.
SHBG: 45 nmol/L
Total T: 579 ng/dl
Free T: 96.6 pg/ml OR 9.6 ng/dl
Albumin: 4.9 g/dl
Estradiol: 23 pg/ml
PSA: .44 ng/ml
TSH: 1.95 mclU/mL
Insulin growth factor: 140 ng/mL
LH: 7.3

Keep in mind that although TT is important to know FT is what truly matters as it is the active unbound fraction of testosterone responsible for the positive effects.

Was your blood work done in the early am in a fasted state?

Your FT is definitely far from stellar and it may very well be slightly lower if you had it tested using an accurate assay such as the gold standard Equilibrium Dialysis.

An FT 5-10 ng/dL would be considered what we call the grey zone!

There are other options before jumping into full-blown TRT.

Tread lightly when it comes to those dime-a-dozen run-of-the-mill TRT clinics!

If you decide to give it a go make sure you have realistic expectations especially when it comes to libido/erectile function.

Do not get caught up in that more T is better mentality.

Forget trying to mimic/chase that honeymoon period which gets many hooked when first starting let alone when tweaking a TRT protocol (increasing dose T) or you will end up being sorely disappointed in the long run!

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[madman]

30 YO. 5’11” 150 lbs. workout 4x/week. Married with 2 kids. Experiencing a disappointingly low libido. I’ve been using Gene’s NO stack (Citrulline, Tadalafil) daily for the last few years to combat this successfully for the most part, but recently libido has been declining to a disappointing level. Went to my local trt clinic and they got my blood tested. They said my blood levels are within normal range, but because of my libido symptoms they said trt would help and agreed to treat if I want to go ahead with it. They charge $180/month. Here’s my blood results. Would it be a mistake to give it a try? Desperate to find a way to improve my libido. We’re done having kids. I was on Accutane for about 4 years in high school, if that means anything.
SHBG: 45 nmol/L
Total T: 579 ng/dl
Free T: 96.6 pg/ml OR 9.6 ng/dl
Albumin: 4.9 g/dl
Estradiol: 23 pg/ml
PSA: .44 ng/ml
TSH: 1.95 mclU/mL
Insulin growth factor: 140 ng/mL
LH: 7.3

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An eye-opener for most!

Especially those ones caught up on many of these so-called men's health/HRT forums.

Tread lightly on whom you take advice from as many are still clueless and would have you believe that T let alone high/absurdly high T is the answer to all that ails you.

 

[EmeraldCoast]

Keep in mind that although TT is important to know FT is what truly matters as it is the active unbound fraction of testosterone responsible for the positive effects.

Was your blood work done in the early am in a fasted state?

Your FT is definitely far from stellar and it may very well be slightly lower if you had it tested using an accurate assay such as the gold standard Equilibrium Dialysis.

An FT 5-10 ng/dL would be considered what we call the grey zone!

There are other options before jumping into full-blown TRT.

Tread lightly when it comes to those dime-a-dozen run-of-the-mill TRT clinics!

If you decide to give it a go make sure you have realistic expectations especially when it comes to libido/erectile function.

Do not get caught up in that more T is better mentality.

Forget trying to mimic/chase that honeymoon period which gets many hooked when first starting let alone when tweaking a TRT protocol (increasing dose T) or you will end up being sorely disappointed in the long run!

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Thanks, yes they instructed me to go first thing in the morning after fasting. Appreciate the links, I rabbit holed a few of those last night before posting. I filled out the contact form on DefyMedical and will talk to them and see if I end up going through with it, or trying PT-141 first. I am thinking it would be the right choice to do a trial run for a year or so, try to get dialed in while not expecting too much.

 

[Guided_by_Voices]

Studies show libido and loss of vigar are the first symptoms to appear as testosterone is declining, followed by ED, fatigue and loss of muscle mass.

I agree it's worth experimenting rather that surrendering and giving into defeat, however his lower libido might be multifactorial.

TRT is very low risk, if the Traverse study is any indication.

Less risk than going on an SSRI, which sadly are handed out like candy!

Things that affect libido:

• Obesity
• High blood pressure
• Diabetes
• Poor sleep
• Medications
• Stress/depression
• Low testosterone
• Infections
• High prolactin
• Low thyroid hormones
• Alcohol & drugs
• Surgery
• Heart disease
• High cholesterol

I would add low salt to the libido list and delete high cholesterol, although low cholesterol might be a problem.

 

[Ribeye]

30 YO. 5’11” 150 lbs. workout 4x/week. Married with 2 kids. Experiencing a disappointingly low libido. I’ve been using Gene’s NO stack (Citrulline, Tadalafil) daily for the last few years to combat this successfully for the most part, but recently libido has been declining to a disappointing level. Went to my local trt clinic and they got my blood tested. They said my blood levels are within normal range, but because of my libido symptoms they said trt would help and agreed to treat if I want to go ahead with it. They charge $180/month. Here’s my blood results. Would it be a mistake to give it a try? Desperate to find a way to improve my libido. We’re done having kids. I was on Accutane for about 4 years in high school, if that means anything.
SHBG: 45 nmol/L
Total T: 579 ng/dl
Free T: 96.6 pg/ml OR 9.6 ng/dl
Albumin: 4.9 g/dl
Estradiol: 23 pg/ml
PSA: .44 ng/ml
TSH: 1.95 mclU/mL
Insulin growth factor: 140 ng/mL
LH: 7.3

I admittedly don't have the experience of some of the others on this site. If you are having low T symptoms, then it may be worth a try. However, most of the real experts agree, it doesn't take a lot of testosterone for most men to perform, and libido is a very complex and multifactorial process. It depends on more than just T. Prolactin can influence it, dopamine is a big factor as well. If you can get erections, and keep them, but just don't have the desire, it's probably not your T. Although as others have pointed out, you are border line free T, which is the important one to look at. Also, I would add most experts would suggest your estrogen is a little low too, and regardless of what some of the guys here will say, estrogen does NOT lower libido, if so, I would have no libido and I have tons. My estrogen run around 120 on sensitive testing. Your TSH may be on the lower end of the window too (5.5 being at the higher end on most labs), you may want to get a free T4 and Free T3 to see where the rest of your thyroid hormones are. They can also cause issues for you. If your TSH is on the low end of the window, and your free T 4 and free T3 are not at least middle of the range it could possibly explain a few things as it would give the impression of possibly being hypothyroid. Best bet, find a real doc who can sort this out for you.

 

[TLR]

I wouldn’t do it yet….go to a doc that knows what to look for in the way of other factors that may be causing your issue….dont shut down a working system at 30 yoa when your only symptom is libido related. As stated, more T doesn’t necessarily solve that problem.

 

[Nixter]

I would try everything else first. My initial T level was lowish as well. TRT helped lots of things but libido actually got worse. It's not a cure all

 

[cjp360]

I would try everything else first. My initial T level was lowish as well. TRT helped lots of things but libido actually got worse. It's not a cure all

I agree. I started at 550 t levels with decent free - so many great things about TRT - for me - libido is the opposite of natural. That was the one area I never seemed to have trouble with or ED - on TRT have had weird bouts of ED - super libido- no libido. 2 years in now - still can't figure it out - did at least 10 blood tests - tried all different stuff, HCG, no HCG, various dosages and protocols. The best I felt libido wise - was my trough - was close to my natural levels. At that level I lose a lot of the mental effects. but when I go north I lose libido.