31 y/o newbie, Low Free Test, Looking for some advice

[JimmyB]

Hi guys

So, I’ve read a number a number of posts across multiple TRT forums, and I feel like I’ve learnt a lot, but equally feel like I’ve opened up a huge can of worms!

I recently had a blood test to confirm a long-held belief of mine; that I had low testosterone. I’m now at a decision point, and I would really appreciate your thoughts on my position and predicament.

Firstly, I’ll give you some of my stats;
Age: 31
Height: 193cm
Weight: 80kg
BMI: 21.4

Then my first lab result (taken @ 07:25);
LH 1.8 IU/L
FSH 2.9 IU/L

Albumin 52 g/dL
SHBG 34 nmol/L
Testosterone 1.9 nmol/L (343.22 ng/dL)

Free Test 0.212 nmol/L (1.78%)
Bioavailable Test 5.98 nmol/L (50.2%)

Swiftly followed by the 2[SUP]nd[/SUP] full blood count lab result (taken @ 08:20, c.7 days later);

Albumin 52 g/dL (carry over from the 1[SUP]st[/SUP] test)
SHBG 34 nmol/L (same as 1[SUP]st[/SUP] test)
Testosterone 8.4 nmol/L (242.27 ng/dL)

Free Test 0.146 nmol/L (1.73%)
Bioavailable Test 4.10 nmol/L (48.8%)

TSH 3.03 mIU/L
Free Thyroxine 16.4 pmol/l
Free T3 4.3 pmol/L

Essentially my free test level is through the floor, but at the age of 31, I don’t know if I am ready to go straight on to full TRT. I’d love the result I’m sure, but I wonder if I could get my natural levels back up.

I’ve done two cycles in my life, both were over a year ago and were ‘relatively’ low dose, i.e. no more than 450mg per week for 12 weeks, plus full PCT protocol.

I went on those cycles as I struggled to make progress in the gym, even with perfect diet, and routines, etc. I, therefore, believe I have always been low, however never had a test beforehand, so can’t be sure.

I think my choices are either;
1. Clomid with an AI, or maybe just HCG?
2. Test with HCG (TRT)

I don’t think I’m interested in gels, or any of the other stuff that gets mentioned but please correct me if you think differently.

I’d like to get my levels up to 600-800 (ng/dL) in the long term, with a suitable free test level, but would be happy with it slightly lower for the short term if it meant keeping my natural production alive.

I might be living in a dream world – and please feel free to shake me out of it – but I would really appreciate any advice, tips, thoughts any of you may have….

 

[Vince]

Because of your age I definitely would try a restart with Clomid, if that doesn't work you can always go on trt. It's hard to remain fertile when you're on testosterone replacement therapy.

 

[CoastWatcher]

I think your answer is in the second/last paragraph. You sensibly would like to keep your natural production alive, given your age and other concerns. As Vince noted, a restart protocol, under the direction of an experienced doctor, is where I would focus my attention. Which raises the question: do you have a physician who inspires your confidence?

 

[JimmyB]

Which raises the question: do you have a physician who inspires your confidence?

Thanks for the replies!

So to get to where I am now, I used Balance My Hormones (UK based HRT 'specialist'). They have been very understanding, can relate to all the symptoms and thinking, etc. but they do obviously have a vested interest in getting you onto full TRT. BMH will put me on a restart protocol, the choice is mine, they just seem to assume I will go down the full TRT route or prefer talking about that option more.

I booked an appointment with my GP yesterday (standard two-week wait in London) to see if that route is an option. I'll go with my blood results and see what they say. However, the NHS is generally against supporting TRT, and my total test level is within range, so I'd have to point them to my free test, and probably end up pushing for a referral to an endo - all of which seems like a lot of work.

I agree, I think the Clomid route makes sense, plus if it doesn't work, like you say, I can just go onto full TRT. I am struggling to find anyone who has even medium-term success with it though. Any success stories out there anyone...??

 

[Vince]

Are guys that do well on low dose clomid unicorns...or do they really exist?

https://www.excelmale.com/forum/sho...-dose-clomid-unicorns-or-do-they-really-exist[SUB][SUP]
[/SUP][/SUB]​

 

[OMI100]

Welcome.
My MANTRA below.
Take what you need.
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First step is education....
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Cannot tell how much research you have done on TRT.
If not a lot, I recommend you get a few books.
Get a few good books and educate yourself now:
1. Get Nelsons book "Testosterone: A Man's Guide".
2. Get Lee Myer's book "Natural Versus Testosterone Therapy".
3. Get “Testosterone for life - Dr. Abraham Morgentaller “.
4. Get “The Definitive Testosterone Replacement Therapy MANual: How to OptimizeYour Testosterone For Lifelong Health And Happiness” by Jay Campbell.
These books will give you a much better understanding of TRT....
********************************
One other forum that has great info that might be useful to you is:
http://www.peaktestosterone.com/
GREAT article onE2 – A MUST READ
http://www.peaktestosterone.com/Hdr_Estrogen.aspx
********************************
Dr Saya's Videos on Testosterone Therapy and Side EffectManagement
https://www.excelmale.com/forum/showthread.php?15207-Dr-Saya-s-Videos-on-Testosterone-Therapy-and-Side-Effect-Management
**********************************
Second step might be to have a look at your thyroid and see if any issues there.
********************************
Do some research.
I do like Tiredthyroid as a starting point.
Easy to read sections.
References at the bottom of each section (and NOT from people wearing "tinfoil" hats)
See below:
Basic sources to research Thyroid issues and testing:
******************************************
https://stopthethyroidmadness.com/
Spend time here and get the 2 books, “STTM: The Revised Book” and “STTMII:Authored by Doctors”.
*******************************************
http://www.tiredthyroid.com/
Great simple to understand articles.
Get her book.... “Tired Thyroid: From Hyper to Hypo to Healing—Breaking the TSHRule”, https://read.amazon.com/kp/embed?asi...Channel=system
A lot of clear researched information that is easy toread and understand.
***************************
https://hypothyroidmom.com/
Good info here. Look around.
*************************
https://www.restartmed.com/?s=thyroid
A LOT of good articles and a youtube page.
Spend time here looking around and reading after getting labs back.
************************************
Do you have Hypothyroidism?
The CompleteHypothyroidism User Guide for Patients (2018 Edition)
https://www.restartmed.com/hypothyroidism/
*********************************
Need information on thyroid testing....
Read here:
http://www.tiredthyroid.com/what-labs.html
And here:
http://www.tiredthyroid.com/optimal-labs.html
and here:
https://stopthethyroidmadness.com/recommended-labwork/
and here:
https://www.restartmed.com/thyroid-tests/
and here:
https://www.restartmed.com/hormone-testing/
And here:
https://www.restartmed.com/normal-thyroid-levels/
**************************************
Some additional links to read before you receive the books you have already ordered
Go here:
http://www.allthingsmale.com/publications.html
and download:
TRT: Recipe For Success
Print out.
and
HCG Update.
and the TRT Power Point presentation.

Dr. Crisler is one of the "TRT Cutting Edge DR's" here in the states....
Also go here:
http://www.drjohncrisler.com/the-cri...part-deux.html
and also print out the article.
***************************
ALSO look at the videos that are posted on this site. A LOT of great info totake in....
******************************
Now you will have a great reference library and knowledge base to go forward on!