Do I qualify for HRT? Posting my Blood Test Results.

[lobsterman]

Do I qualify for HRT? Posting my Blood Test Results. 53 Year old male.
Symptoms: No sex drive, loss of self, loss of the tenacity I used to have, apathetic, affecting marrage. Surgery for bi-lateral torsion testicles when I was 16. Got tested in late 20's - sperm count was OK.

My Testosterone levels tested very low in the spring.
May 2023 Testosterone Results: 7.9 nmol/L which is = 228 ng/dL

Testosterone Free

285

179-475

pmol/L

I have always tested at the low end for T-Levels. I had to really push my doctor to do something as it is really having a negative impact on my life and my marriage. Doctor made a referral to an endocrinologist and put a urgent rush on it, said they are all really backed up. My appointment is for May 2024 (10+ month wait). Welcome to socialized medicine in Canada. So I have contacted a private HRT clinic and got my first proper blood profile done which I am posting. If I qualify for HRT I will be contacted for a consultation in 7 to 10 days. Just wondering what to expect? Will I be considered a candidate HRT? If so based on my profile what should they be suggesting for treatment?

Thank you so much for your time and consideration, it is greatly apricated.

Dropped 20+lbs between Spring test results and the ones below:

September 2023 Results: Testosterone: 210 ng/dL

Testosterone Free

244

179-475

pmol/L

Estradiol		70	<162	pmol/L
Testosterone	LO	7.3	8.4 - 28.8	nmol/L

Thyroid Stimulating Hormone		3.76	0.32-4.00	mIU/L
Free T4		11	9-19	pmol/L
Free T3		4.8	2.6-5.8	pmol/L
FSH		5.1	1.0-8.0	IU/L
LH		3.1	1.0-7.0	IU/L
Prolactin		6.2	4.0-19.0	ug/L
Total PSA		0.71	<4.0	ug/L

Lipids
Hours After Meal		10		Hours
Triglyceride		0.59		mmol/L
	FASTING: <1.70 mmol/L NON-FASTING: <2.00 mmol/L
Cholesterol		3.70	<5.20	mmol/L
	Total cholesterol and HDL-C used for risk assessment and to calculate non HDL-C.
HDL Cholesterol	LO	0.99	>=1.00	mmol/L
	HDL-C <1.00 mmol/L indicates risk for metabolic syndrome.
Non HDL Cholesterol		2.71	<4.20	mmol/L
	Non HDL-Cholesterol is not affected by the fasting status of the patient.
LDL Cholesterol		2.42	<3.50	mmol/L

Glucose Fasting		6.0	3.6 - 6.0	mmol/L
Hemoglobin A1C/Total Hemoglobin	HI	6.0	<6.0	%

Creatinine	HI	130	67-117	umol/L
Glomerular Filtration Rate (eGFR)		54

Alkaline Phosphatase		82	40-129	U/L
Alanine Aminotransferase	HI	85	<50	U/L

Vitamin B12		287	138-652	pmol/L
	>220 pmol/L: Normal, deficiency unlikely 150-220 pmol/L: Borderline,deficiency is possible <150 pmol/L: Low, consistent with deficiency
Ferritin		249	15-275	ug/L

Hematology
WBC		5.3	4.0 - 11.0	x E9/L
RBC		5.57	4.50 - 6.00	x E12/L
Hemoglobin		166	135 - 175	g/L
Hematocrit		0.485	0.400 - 0.500	L/L
MCV		87	80 - 100	fL
MCH		29.8	27.5 - 33.0	pg
MCHC		342	305 - 360	g/L
RDW		13.9	11.5 - 14.5	%
Platelet Count		206	150 - 400	x E9/L
Differential
Neutrophils		3.3	2.0 - 7.5	x E9/L
Lymphocytes		1.4	1.0 - 3.5	x E9/L
Monocytes		0.4	0.2 - 1.0	x E9/L
Eosinophils		0.1	0.0 - 0.5	x E9/L
Basophils		0.1	0.0 - 0.2	x E9/L
Immature Granulocytes		0.0	0.0 - 0.1	x E9/L
Nucleated RBC		0		/100 WBC

 

[42HRT]

By your test results, I would think you would qualify. However, your RBC's are already high. Which will go up on TRT

 

[USMC]

IMO, you definitely qualify for testosterone replacement with those numbers. Also concerning is your A1C, liver and kidney function tests. Are they related to low T? I'm not a DR. so I don't have answers.. Metabolic Syndrome?? Others with more experience will be along.

Good read:

Testosterone and metabolic syndrome: The link - PMC

Metabolic syndrome (MetS) or “Syndrome X” which is a constellation of insulin resistance, hyperglycemia, hypertension, low high-density lipoprotein cholesterol (HDL-C), and increased very-low-density lipoprotein (VLDL) and triglyceride (TG) levels. ...

www.ncbi.nlm.nih.gov

 

[Vince]

I agree you're becoming a diabetic. You should be on metformin and consider going low carb. Low carb. If you stick to it will reverse your diabetes.

 

[aneuman]

Do I qualify for HRT? Posting my Blood Test Results. 53 Year old male.
Symptoms: No sex drive, loss of self, loss of the tenacity I used to have, apathetic, affecting marrage. Surgery for bi-lateral torsion testicles when I was 16. Got tested in late 20's - sperm count was OK.

My Testosterone levels tested very low in the spring.
May 2023 Testosterone Results: 7.9 nmol/L which is = 228 ng/dL

Testosterone Free

285

179-475

pmol/L

I have always tested at the low end for T-Levels. I had to really push my doctor to do something as it is really having a negative impact on my life and my marriage. Doctor made a referral to an endocrinologist and put a urgent rush on it, said they are all really backed up. My appointment is for May 2024 (10+ month wait). Welcome to socialized medicine in Canada. So I have contacted a private HRT clinic and got my first proper blood profile done which I am posting. If I qualify for HRT I will be contacted for a consultation in 7 to 10 days. Just wondering what to expect? Will I be considered a candidate HRT? If so based on my profile what should they be suggesting for treatment?




Thank you so much for your time and consideration, it is greatly apricated.

Dropped 20+lbs between Spring test results and the ones below:

September 2023 Results: Testosterone: 210 ng/dL

Testosterone Free

244

179-475

pmol/L

Estradiol		70	<162	pmol/L
Testosterone	LO	7.3	8.4 - 28.8	nmol/L

Thyroid Stimulating Hormone		3.76	0.32-4.00	mIU/L
Free T4		11	9-19	pmol/L
Free T3		4.8	2.6-5.8	pmol/L
FSH		5.1	1.0-8.0	IU/L
LH		3.1	1.0-7.0	IU/L
Prolactin		6.2	4.0-19.0	ug/L
Total PSA		0.71	<4.0	ug/L

Lipids
Hours After Meal		10		Hours
Triglyceride		0.59		mmol/L
	FASTING: <1.70 mmol/L NON-FASTING: <2.00 mmol/L
Cholesterol		3.70	<5.20	mmol/L
	Total cholesterol and HDL-C used for risk assessment and to calculate non HDL-C.
HDL Cholesterol	LO	0.99	>=1.00	mmol/L
	HDL-C <1.00 mmol/L indicates risk for metabolic syndrome.
Non HDL Cholesterol		2.71	<4.20	mmol/L
	Non HDL-Cholesterol is not affected by the fasting status of the patient.
LDL Cholesterol		2.42	<3.50	mmol/L

Glucose Fasting		6.0	3.6 - 6.0	mmol/L
Hemoglobin A1C/Total Hemoglobin	HI	6.0	<6.0	%

Creatinine	HI	130	67-117	umol/L
Glomerular Filtration Rate (eGFR)		54

Alkaline Phosphatase		82	40-129	U/L
Alanine Aminotransferase	HI	85	<50	U/L

Vitamin B12		287	138-652	pmol/L
	>220 pmol/L: Normal, deficiency unlikely 150-220 pmol/L: Borderline,deficiency is possible <150 pmol/L: Low, consistent with deficiency
Ferritin		249	15-275	ug/L

Hematology
WBC		5.3	4.0 - 11.0	x E9/L
RBC		5.57	4.50 - 6.00	x E12/L
Hemoglobin		166	135 - 175	g/L
Hematocrit		0.485	0.400 - 0.500	L/L
MCV		87	80 - 100	fL
MCH		29.8	27.5 - 33.0	pg
MCHC		342	305 - 360	g/L
RDW		13.9	11.5 - 14.5	%
Platelet Count		206	150 - 400	x E9/L
Differential
Neutrophils		3.3	2.0 - 7.5	x E9/L
Lymphocytes		1.4	1.0 - 3.5	x E9/L
Monocytes		0.4	0.2 - 1.0	x E9/L
Eosinophils		0.1	0.0 - 0.5	x E9/L
Basophils		0.1	0.0 - 0.2	x E9/L
Immature Granulocytes		0.0	0.0 - 0.1	x E9/L
Nucleated RBC		0		/100 WBC

I can't answer your question, but I can relate to your case and give you my experience. You got me at ", apathetic, affecting marrage". I know exactly what you mean as around that time, I was exactly in the same situation you are now, and my T and E2 levels were very similar to yours. At the time, my doctor said I was "okay" and I was probably depressed (welcome to capitalist medicine) and prescribe lexapro which made things much worse.

It wasn't until 5 years later, at 58, that I decided to go to a specialist and get treatment. I started with HCG monotherapy, which made things much, much better, for 3 weeks. Then switched to enclomiphene, which made my numbers much, much better, and brought some much needed improvement to mood, lethargy and apathy, but made sex worse. I then started combining both trying to devise my own winning formula, only to finally quit and started TRT at 60.

I cannot say it has been a miracle, but it has improved many areas or my life. I'm much less prone to anger fits, I overreact much less than before, I'm sleeping a tad better (without medicines) and my marriage is now in a much better place. Sex has improved as well, but I still do not have a cape, I still wear my underwear on the inside and I can't fly. I'm just a 60 year old with less problems than before.

It's been only 4 months, so maybe the cape comes later and well as flying abilities, but based on my experience, I think that I could have probably benefited if I had started earlier, at about your age. I would have avoided a lot of arguments, and would have enjoyed life more, I think.

Having said that, there are risks as well associated with TRT, such as having to inject for the rest of your life, it takes time, effort and frustration to find the right dose/protocol, some have increased blood pressure, erythrocytosis, etc. You should balance that with other medical conditions you may have . I suggest, when analyzing TRT, to take off any pink-colored glasses you may have, and look at risks and benefits with a naked eye so you can make a good decision.

I cannot recommend or discourage you from taking TRT as I am not a medical doctor and I don't know you or your health history, but your case looks similar to mine, and thus far I think it's a plus. Ask me after 10 years pinning twice a week, I hope my answer is still the same.

Good luck.

 

[aneuman]

I agree you're becoming a diabetic. You should be on metformin and consider going low carb. Low carb. If you stick to it will reverse your diabetes.

When I was about the OP's age, I was in a similar situation. My BP was high (140/90) my fasting glucose was 110, GFR was 60, Testosterone was 290 ng/dL, LDL Cholesterol was high, HDL was low, central obesity, all of those symptoms of metabolic syndrome (at the time called syndrome X) and my doctor told me in a very nonchalant way "you are pre-diabetic, you have kidney failure..." and I said what?! He still did not believe that I had low T, I was depressed instead.

I changed my diet, started eating less refined carbs, more healthy fats, exercising (lots of treadmill) and those variables improved significantly in less han 6 months. Even T went up, but many of the symptoms that the OP describe were still there.

So yes, TRT may not be the end all be all, but it may help. Getting into a healthier lifestyle helps a lot.

I don't know what the lifestyle, diet and nutrition of the OP are, but he can probably reverse a lot of those condition to a healthier state simply by improving his lifestyle. If he's already doing all that, then maybe some medical intervention is required.

 

[Systemlord]

Do I qualify for HRT? Posting my Blood Test Results. 53 Year old male.
Symptoms: No sex drive, loss of self, loss of the tenacity I used to have, apathetic, affecting marrage.

Technically, you do qualify for TRT from the establish guidelines, but qualifying under your insurance plan or government healthcare is a different question all together. That doesn’t mean someone who doesn’t technically qualify for TRT under the established guidelines, won’t show improvement and benefit from TRT.

You can expect to get TRT through this private clinic, otherwise these clinics would go out of business if they only catered to the men with abysmally low testosterone levels.

Testosterone Deficiency - Establishing A Biochemical Diagnosis - PMC

Testosterone deficiency is a common and often unrecognized disorder impacting the lives of many men. Symptoms related to low testosterone are relatively non-specific and clinicians must therefore ensure that a patients’ symptomatology is supported ...

www.ncbi.nlm.nih.gov

Many expert advisory panels and clinical guidelines have avoided strictly defined cut-off values for “normal” testosterone due to difficulties in measurement techniques and variability between institutions and patients over time. What form of testosterone should be measured and what method of measurement should be employed remain controversial but vitally important issues in the diagnosis and treatment of testosterone deficiency syndrome.

 

[Gman86]

I would say that u 100% qualify. And I would put money on u feeling a ton better once ur on HRT.

U really need to get ur diet and lifestyle factors in order tho to feel optimal. Ur bordering on being diabetic, and are also hypothyroid. U can most likely easily correct both through diet and lifestyle, and then at ur age, I would optimize ur test levels via exogenous testosterone

 

[sammmy]

1. Supplement B12 (methylcobalamin) and check for other common vitamin deficiencies: A, C, and D.

2. Check your diet - it is the foundation of your life and often can achieve health that drugs can't. Your blood glucose and creatinine are too high. Stick to low carb, no processed food diet.

3. Check your SHBG. High blood glucose often goes with low SHBG, so your body does not need to produce much total testosterone, to get normal free testosterone as is your case.

4. TRT is not a magic bullet. If you want a healthy life, you have to address the root problem not cover it up with drugs that compensate for it.

 

[Systemlord]

TRT is not a magic bullet. If you want a healthy life, you have to address the underlying problem not cover it up with drugs that compensate for it.

Because men that don’t address the underlying condition or lifestyle habits see a return of the same symptoms as before, while on TRT.

 

[lobsterman]

By your test results, I would think you would qualify. However, your RBC's are already high. Which will go up on TRT

Thank you. I am reading up on RBC's and why they might be high for me.

 

[lobsterman]

IMO, you definitely qualify for testosterone replacement with those numbers. Also concerning is your A1C, liver and kidney function tests. Are they related to low T? I'm not a DR. so I don't have answers.. Metabolic Syndrome?? Others with more experience will be along.

Good read:

Testosterone and metabolic syndrome: The link - PMC

Metabolic syndrome (MetS) or “Syndrome X” which is a constellation of insulin resistance, hyperglycemia, hypertension, low high-density lipoprotein cholesterol (HDL-C), and increased very-low-density lipoprotein (VLDL) and triglyceride (TG) levels. ...

www.ncbi.nlm.nih.gov

Thank you. I will read through the article you have shared. Thank you for posting it.

 

[lobsterman]

I would say that u 100% qualify. And I would put money on u feeling a ton better once ur on HRT.

U really need to get ur diet and lifestyle factors in order tho to feel optimal. Ur bordering on being diabetic, and are also hypothyroid. U can most likely easily correct both through diet and lifestyle, and then at ur age, I would optimize ur test levels via exogenous testosterone

Thank you. I am on the path to taking back my health which I have neglected. I was always very strict low carb diet, 4 days a week of very intensive weight training in my 20's to mid 30's then I started eating the carbs again and eventually switched to powerlifting and then started back on deserts in my 40's and didn't make the time to train enough. Getting back on track now. Working out 5 days a week and moving back to a low carb diet. Going to take 12 months to get back to where I really need to be.

 

[lobsterman]

1. Supplement B12 (methylcobalamin) and check for other common vitamin deficiencies: A, C, and D.

2. Check your diet - it is the foundation of your life and often can achieve health that drugs can't. Your blood glucose and creatinine are too high. Stick to low carb, no processed food diet.

3. Check your SHBG. High blood glucose often goes with low SHBG, so your body does not need to produce much total testosterone, to get normal free testosterone as is your case.

4. TRT is not a magic bullet. If you want a healthy life, you have to address the root problem not cover it up with drugs that compensate for it.

Thank you Sammy for the quick reply. As for nutrition & exercise plan - I am getting back on track, I know what I need to do, I have not been making the best choices. I will ask about getting SHBG levels checked. I have begun to address the root causes.

 

[lobsterman]

Because men that don’t address the underlying condition or lifestyle habits see a return of the same symptoms as before, while on TRT.

Thank you. I am cleaning things up now. Moving back to the low carb lifestyle and back in the gym 5 days a week.

 

[lobsterman]

I can't answer your question, but I can relate to your case and give you my experience. You got me at ", apathetic, affecting marrage". I know exactly what you mean as around that time, I was exactly in the same situation you are now, and my T and E2 levels were very similar to yours. At the time, my doctor said I was "okay" and I was probably depressed (welcome to capitalist medicine) and prescribe lexapro which made things much worse.

It wasn't until 5 years later, at 58, that I decided to go to a specialist and get treatment. I started with HCG monotherapy, which made things much, much better, for 3 weeks. Then switched to enclomiphene, which made my numbers much, much better, and brought some much needed improvement to mood, lethargy and apathy, but made sex worse. I then started combining both trying to devise my own winning formula, only to finally quit and started TRT at 60.

I cannot say it has been a miracle, but it has improved many areas or my life. I'm much less prone to anger fits, I overreact much less than before, I'm sleeping a tad better (without medicines) and my marriage is now in a much better place. Sex has improved as well, but I still do not have a cape, I still wear my underwear on the inside and I can't fly. I'm just a 60 year old with less problems than before.

It's been only 4 months, so maybe the cape comes later and well as flying abilities, but based on my experience, I think that I could have probably benefited if I had started earlier, at about your age. I would have avoided a lot of arguments, and would have enjoyed life more, I think.

Having said that, there are risks as well associated with TRT, such as having to inject for the rest of your life, it takes time, effort and frustration to find the right dose/protocol, some have increased blood pressure, erythrocytosis, etc. You should balance that with other medical conditions you may have . I suggest, when analyzing TRT, to take off any pink-colored glasses you may have, and look at risks and benefits with a naked eye so you can make a good decision.

I cannot recommend or discourage you from taking TRT as I am not a medical doctor and I don't know you or your health history, but your case looks similar to mine, and thus far I think it's a plus. Ask me after 10 years pinning twice a week, I hope my answer is still the same.

Good luck.

Thank you for sharing your experience, hope you continue to make improvements until the cape fits perfectly. Much appreciated.

 

[lobsterman]

When I was about the OP's age, I was in a similar situation. My BP was high (140/90) my fasting glucose was 110, GFR was 60, Testosterone was 290 ng/dL, LDL Cholesterol was high, HDL was low, central obesity, all of those symptoms of metabolic syndrome (at the time called syndrome X) and my doctor told me in a very nonchalant way "you are pre-diabetic, you have kidney failure..." and I said what?! He still did not believe that I had low T, I was depressed instead.

I changed my diet, started eating less refined carbs, more healthy fats, exercising (lots of treadmill) and those variables improved significantly in less han 6 months. Even T went up, but many of the symptoms that the OP describe were still there.

So yes, TRT may not be the end all be all, but it may help. Getting into a healthier lifestyle helps a lot.

I don't know what the lifestyle, diet and nutrition of the OP are, but he can probably reverse a lot of those condition to a healthier state simply by improving his lifestyle. If he's already doing all that, then maybe some medical intervention is required.

Thank you for the quick reply Aneuman. It's going to take me 10 to 12 months of hard work in the gym and making proper nutritional choices to get to where I need to be, hopefully by then my blood work will start to show improvements.

 

[lobsterman]

I agree you're becoming a diabetic. You should be on metformin and consider going low carb. Low carb. If you stick to it will reverse your diabetes.

I am returning to a low carb diet (doing it over 4 weeks), eliminated all the deserts, never did fast foods, I simply eat far too much food; to much east indian food which is white rice and fats from cooking oils - they have to go. Too much rice, white potatoes' and flour. They get phased out this weekend. Fruits over 50 on the glycemic index will follow the week after that. Then I will work down towards 75 to 125 grams of carbs a day until weight loss plateaus then reassess and look to see if I need to go below 50 grams of carbs a day to go into ketosis to get back down below 14% body fat . Going to take a long time to get there but I will enjoy the journey. I have done it before, I will do it again!!! Thank you Vince.

 

[aneuman]

Thank you for the quick reply Aneuman. It's going to take me 10 to 12 months of hard work in the gym and making proper nutritional choices to get to where I need to be, hopefully by then my blood work will start to show improvements.

Based on my experience, it may not take you that long. Granted, I can be quite obsessive (or so my wife, my friends and my psychiatrist say ;-) but if you clean up your diet, and exercise moderately, you can see changes in a shorter period. Here are some of the changes I made in less than 6 months (from February 16 to June 24, 2018. I was 54 yo)

Body weight: 187 ->165 lbs
Body fat: 25->19%
Blood Pressure: 140/90 -> 124/71
Cholesterol: 205 -> 174
Triglycerides: 187 -> 72
HDL: 38 -> 51
LDL: 129 -> 107
Glucose: 99 -> 80
Vit. D3: 38 -> 60
Vit B12: 383 -> 2000
eGFR: 60 -> 106.7

What I remember is that:

• I walked on the treadmill every day, sometimes 30 min, sometimes 1 hour, not more than 3-4 mph (couldn't do more back then)
• started taking stairs instead of elevators
• started walking everywhere as opposed to driving
• reduced added sugar to basically 0g
• no glutten (bread, pizza, pasta, etc)
• no juices, sodas, deserts or anything sweet
• most of the food was grilled, not fried
• lots of vegetables
• no alcohol
• and I think I did intermittent fasting for a short time

I continued to do most of the things above, not all, I'm more relaxed now, so I have the occasional beer or desert. I have put on weight (on purpose), still 20% body fat. My heath markers are good, but not as good as they were in June 2018. Blood pressure still the same.

So what I mean is that you probably take it a little less to the extreme than I did, and with more moderation, you could achieve something similar in 6 months probably. The most important thing is to rule out any existing condition that cannot be fixed by lifestyle changes. For that, you need to see a doctor.

Notice however, that with weight loss and cardio, your testosterone probably will suffer a bit, so that doesn't rule out exploring TRT.

Hope this helps.
Good luck.

 

[tareload]

Based on my experience, it may not take you that long. Granted, I can be quite obsessive (or so my wife, my friends and my psychiatrist say ;-) but if you clean up your diet, and exercise moderately, you can see changes in a shorter period. Here are some of the changes I made in less than 6 months (from February 16 to June 24, 2018. I was 54 yo)

Body weight: 187 ->165 lbs
Body fat: 25->19%
Blood Pressure: 140/90 -> 124/71
Cholesterol: 205 -> 174
Triglycerides: 187 -> 72
HDL: 38 -> 51
LDL: 129 -> 107
Glucose: 99 -> 80
Vit. D3: 38 -> 60
Vit B12: 383 -> 2000
eGFR: 60 -> 106.7

What I remember is that:

• I walked on the treadmill every day, sometimes 30 min, sometimes 1 hour, not more than 3-4 mph (couldn't do more back then)
• started taking stairs instead of elevators
• started walking everywhere as opposed to driving
• reduced added sugar to basically 0g
• no glutten (bread, pizza, pasta, etc)
• no juices, sodas, deserts or anything sweet
• most of the food was grilled, not fried
• lots of vegetables
• no alcohol
• and I think I did intermittent fasting for a short time

I continued to do most of the things above, not all, I'm more relaxed now, so I have the occasional beer or desert. I have put on weight (on purpose), still 20% body fat. My heath markers are good, but not as good as they were in June 2018. Blood pressure still the same.

So what I mean is that you probably take it a little less to the extreme than I did, and with more moderation, you could achieve something similar in 6 months probably. The most important thing is to rule out any existing condition that cannot be fixed by lifestyle changes. For that, you need to see a doctor.

Notice however, that with weight loss and cardio, your testosterone probably will suffer a bit, so that doesn't rule out exploring TRT.

Hope this helps.
Good luck.

You rock My Man!!

Congrats and well done. Badass post.