Is TRT an option for me?

Symptoms are

1. Fatigue, especially in the afternoon

2)lack of motivation

3) Brain Fog

4)low libido

5)not as mentally sharp

Been like this since 2015, Dhea-s has always been high, no one has an answer for it. Was originally offered trt in 2016 but denied it cause I was still young and wanted to try to increase it with lifestyle choices. Diet is super clean, no excess sugar, only cook with ghee/butter no seed oils, etc. I'm just tired of feeling like this.

Pretty similar to me when I started. Decent total test but low end free t with all the symptoms you have except for the libido issues. Have now been on trt for over three years and am glad I started. Is it an option for you? Sure, it’s one option. Whether or not it’s the right one is up to you.

What is your current age? You say you were young in 2016, but that’s a pretty relative term. Also, how long have you been feeling like this and what other changes, if any, have you made to improve your symptoms without medication?

Guitarman5 said:

Dhea-s has always been high, no one has an answer for it.

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Why are you focusing on testosterone when your DHEAS is over the range? Thinking TRT is a panacea?

An adrenal tumor can increase DHEA-S. Low testosterone is a symptom, in other words low testosterone doesn't cause low testosterone, something else does.

You're not hypogonadal.

You might want to check thyroid labs checking TSH, fT4 and fT3.

Systemlord said:

Why are you focusing on testosterone when your DHEAS is over the range? Thinking TRT is a panacea?

An adrenal tumor can increase DHEA-S. Low testosterone is a symptom, in other words low testosterone doesn't cause low testosterone, something else does.

You're not hypogonadal.

You might want to check thyroid labs checking TSH, fT4 and fT3.

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I've checked thyroid several times and always come back perfect. I tried worrying about my dheas for years and seen several doctors about it and most just shrug their head. One did say that candida infection can cause high dheas and we treated that but levels didn't change. None have ever mentioned an adrenal tumor.

Guitarman5 said:

View attachment 48553View attachment 48554View attachment 48555
Symptoms are

1. Fatigue, especially in the afternoon

2)lack of motivation

3) Brain Fog

4)low libido

5)not as mentally sharp

Been like this since 2015, Dhea-s has always been high, no one has an answer for it. Was originally offered trt in 2016 but denied it cause I was still young and wanted to try to increase it with lifestyle choices. Diet is super clean, no excess sugar, only cook with ghee/butter no seed oils, etc. I'm just tired of feeling like this.

Click to expand...

What is your resting blood pressure?
"Dhea-s has always been high” Since 2015 when you started having these issues or already as child?
Would also test Cortisol, everything related to the adrenal gland.
Do you take any meds?

Your free T is not really low, however your symptoms match low T but could also be too much overall stress, not enough recovery time.

Seagal said:

What is your resting blood pressure?
"Dhea-s has always been high” Since 2015 when you started having these issues or already as child?
Would also test Cortisol, everything related to the adrenal gland.
Do you take any meds?

Your free T is not really low, however your symptoms match low T but could also be too much overall stress, not enough recovery time.

Click to expand...

My resting blood pressure is usually 130/90
Ever since 2015 my dhea sulfate was high after I took 7 keto dhea and had 2 panic attacks, I then took a 4 point saliva with dheas and Dheas was very high and my first two saliva Cortisol points were high. I was perfectly healthy before then and didn't do any blood work before that point.
I don't take any prescriptions at the moment. My current blood Cortisol is on the low side but in range and 4 point saliva are all in range.
Right now my life is pretty stress free except for my health. Sleep is OK too rarely get less than 7 hours. I just kinda ran outta hope I'll get this figured out.

Guitarman5 said:

My resting blood pressure is usually 130/90
Ever since 2015 my dhea sulfate was high after I took 7 keto dhea and had 2 panic attacks, I then took a 4 point saliva with dheas and Dheas was very high and my first two saliva Cortisol points were high. I was perfectly healthy before then and didn't do any blood work before that point.
I don't take any prescriptions at the moment. My current blood Cortisol is on the low side but in range and 4 point saliva are all in range.
Right now my life is pretty stress free except for my health. Sleep is OK too rarely get less than 7 hours. I just kinda ran outta hope I'll get this figured out.

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Did you take any prescriptions before, e.g. psychotropics or anti-hair-loss?

Seagal said:

Did you take any prescriptions before, e.g. psychotropics or anti-hair-loss?

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Yes I took finasteride for about 10 months, then stopped because I thought it was making me fatigued, that's actually when I took the 7 keto was about a month after I stopped finasteride.

Guitarman5 said:

Yes I took finasteride for about 10 minutes, then stopped because I thought it was making me fatigued, that's actually when I took the 7 keto was about a month after I stopped finasteride.

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That was 2015. 10 months 1mg Fina?
You could measure serum DHT; I guess you didn't get those labs before starting Fina.
Best to avoid any anti-hair-loss stuff for now (shampoo, saw palmetto, minoxidil etc).

Before I make any further suggestions, let's see what the board gurus have to contribute.

Seagal said:

That was 2015. 10 months 1mg Fina?
You could measure serum DHT; I guess you didn't get those labs before starting Fina.
Best to avoid any anti-hair-loss stuff for now (shampoo, saw palmetto, minoxidil etc).

Before I make any further suggestions, let's see what the board gurus have to contribute.

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It was 5mg split into 4 so 1.25mg for 10 months. I've gotten blood dht measured before, doctor said it was fine at the time, I've attached that blood work

Systemlord said:

Why are you focusing on testosterone when your DHEAS is over the range? Thinking TRT is a panacea?

An adrenal tumor can increase DHEA-S. Low testosterone is a symptom, in other words low testosterone doesn't cause low testosterone, something else does.

You're not hypogonadal.

You might want to check thyroid labs checking TSH, fT4 and fT3.

Click to expand...

If he checks and is determined to have no issue with thyroid tumor or anything similar then what would you recommend? His thyroid is good, diet is good, physical activity is good, stress is low, and sleep is good. His free and bioavailable t are technically “within range” but definitely on the lower end.

Phil Goodman said:

If he checks and is determined to have no issue with thyroid tumor or anything similar then what would you recommend?

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If he can't find a smoking gun, and all other avenues are exhausted, a trial of TRT isn't unreasonable. Maybe TRT works, or only for a while, maybe it doesn't resolve his symptoms at all.

There's a lot of idiopathic diseases (endocrine disruption) out there, symptoms remain but no clear cause.

Guitarman5 said:

Yes I took finasteride for about 10 months, then stopped because I thought it was making me fatigued, that's actually when I took the 7 keto was about a month after I stopped finasteride.

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Here's the smoking gun. Finasteride is an endocrine disruptor. I recall other members have abnormal SHBG, estrogen and various other hormones out of balance after starting or stopping Finasteride.

@Guitarman5 likely has Post Finasteride Syndrome.

You are exactly where I was at in terms of numbers when I was in my mid 50s. If you're 34 now, by the time you reach your mid-50s, there's a good chance your T levels will be quite a bit lower.

By the time I reached my 60s my levels tanked into the low 400s. Enclomiphene citrate (25mg daily) as my version of T optimization was my choice after years of research and hesitation over frank TRT. I've been on it for a year and thus far have had no side effects. My total T level is now at 950, free T is in the mid 100s. Not bad for almost 65 and being in the best shape of my life. I didn't care about fertility, it just made the most sense to try a compound that would stimulate my gonadotropins to stimulate natural T production. For you, this might be of even greater benefit since you are 30 years younger than me and may still want to preserve fertility. Even if not, you could give it a try and see if your symptoms improve. You can always discontinue it anytime without any concern over HPTA shutdown symptoms. Your T levels will just go back to baseline. I get my Rx from Empower Pharmacy in TX, but you can become a member of Maximus and get it there, no problem other than it's more expensive. They always have a more advanced hybrid called Native Testosterone.