Considering TRT--Lab Results, Questions

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react5

New Member
I'm in my late 30s and have been having all the symptoms of low T for at least 5-6 years, but never thought that could "be it" given my age. I've had some sexual issues recently and decided to test the hormones. An at home lancet blood test (tested by a lab, not a card test) gave a 283 ng/dl result.

I had comprehensive tests ordered by a clinic and got these results back:
  • 390 ng/dl total
  • 84 free pg/ml
  • 170 bio available ng/dl
  • SHBG 17 nmol/L
  • Albumin 4.4 g/dl
  • Estradiol 40 pg/ml
  • Estrone 38 pg/ml
  • DHEA Sulfate 390 mcg/dl
  • LH 3.6 mlU/ml
  • Cortisol 19 mcg/dl
There were a ton of other readings, but these I think are the most relevant for these purposes. Everything on the panel was in range except estradiol, which was very slightly outside the high range (ref less than/equal to 39).

I was surprised to see total test ~25% higher than the initial lab. Between the two tests I'd taken a free sample of Tongat Ali (ten capsules, two per day), but had halted that a week before the draw, so don't know how much if at all that swayed the second test.

I think even the 390 is low for someone my age.

Considering these results and the symptoms (in addition to sexual), is TRT something to investigate further? Perhaps my most important question: If I decide to trial TRT along with HcG and in a few months determine it's not for me, is it possible to stop the protocol without long term lasting side effects?

I realize I'm asking individuals and not medical professionals, however after doing research on these boards for a while I respect the opinion of its members.

As an aside, I suspected high E/high aromatising activity due to sensitive nips as a teen, persistent love handles even when at ideal weight, etc. I imagine some sort of AI should be part of any protocol?

Thanks for your time
 
Defy Medical TRT clinic doctor
That's what I figured.

I'll have to talk to the doc about all this when we meet for the initial.

Regarding any potential TRT protocol, the low-ish SHBG is a concern. I've been taking fish oil regularly (apparently can lower SHBG) and am still 30-40lbs overweight after losing 40lbs this past year, so perhaps there is room to raise it through continued healthy living.

If I decide to proceed, I image "start low and go slow" is the desired route?
 
An at home lancet blood test (tested by a lab, not a card test) gave a 283 ng/dl result.
I think even the 390 is low for someone my age.
It's not even a debate, your levels are low given your age and you average level throughout the week may be somewhere in the middle (283-390).

I had symptoms of low-T while on TRT at 397 ng/dL.

If I decide to trial TRT along with HcG and in a few months determine it's not for me, is it possible to stop the protocol without long term lasting side effects?
The problem with this approach is HCG is a compound that some respond well, while some do not, so a trial with TRT in isolation is best.
 
With those numbers I would not consider conventional TRT yet. Your Vermeulen calculated free testosterone is 10.8 ng/dL, which isn't too bad if that's typical for you. The full reference range for Vermeulen FT is about 8-23. I view the healthy normal range as more like 10-20 ng/dL. Your total testosterone is low because of lowish SHBG. But free testosterone is more important, as that's what actually gets used.

The first step is to do some retesting. I'm guessing you're using Quest. You need to order this test for free and total testosterone. Discounted Labs offers it for a low price if you need to get it yourself. This test provides a different evaluation of free testosterone. Just as important is to retest estradiol with a sensitive method. The—presumed—immunoassay test you had can respond to C-reactive protein and give falsely-elevated values if CRP is also elevated. You need to sort this out. If CRP is high then that's a separate problem. If estradiol is truly that high relative to testosterone then micro-dosing an aromatase inhibitor could be viable as monotherapy.

If more accurate testing suggests free testosterone is low then you still have options short of full TRT. Regular TRT suppresses your own production of testosterone, disrupting many other hormones in the process, and sometimes causing new symptoms. A nasal gel product such as Natesto boosts testosterone with much less dispruption.
 
The HS CRP test was done as part of this and was 2.7 mg/L. According to the provided scale this is low-ish (range is <1.0 to >10).

Thanks for all the valuable feedback
 
Before starting a TRT protocol. I would first try enclomipene, some men have success with it, especially someone your age. It may bring your levels into a good range and you never have to try TRT.
 
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