Should I be starting TRT? (I'm in a predicament, this is why)

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Regas

New Member
Hello everyone,

I'm in a predicament with my decision whether I should start TRT or not. The decision is dependent on certain factors that would potentially deny me access to TRT in the future if I make a decision for one or the other route I could see myself going forward with.

First of, some stats. In the 3rd test, I've added some things that looked off in the test that my endocrinologist did. Most of the other numbers/lipids that aren't related to testosterone look good.

 

Test 1

Test 2 (306 lbs)

Test 3 (288 lbs)

Total testosterone

245

239 (197 - 669)

280 (250 - 860)

Estradiol (E2)

40

35.2 (<44.9)

(not measured)

SHBG

-

17.9 (11.5 - 54.5)

18 (18 - 54)

Albumin

-

7.2 g/dl (5.7 - 8.2 g/dl)

46 (35 - 52)

LH

-

3.5 (1.5 - 9.3)

4.3 (1.7 - 8.6)

FSH

-

3.4 (1.4 - 18.1)

2.2 (1.5 - 12.4)

Hematocrit

-

45 (<54)

46 (<54)

Prolactin

-

13.7 (<17.0)

16.5 (4.0 - 15.0)

DHT

-

-

190 (219 - 1140)

Inhibin B

-

-

115 (120 - 400)

Parathyroid hormone

-

-

44 (11 - 43)



I'm a 28 year old, 6'1 inches (186 cm) male from Europe with around 290 lbs right now. I was a competitive swimmer from 15-18. My body type is endomorph, wide shoulders and just a wide body in general. I'm what people would call "genetically gifted" in some areas. Strong legs, fairly wide shoulders despite being significantly overweight, without the hormones backing me up. Never really built any muscle besides my legs and was always the guy with "hidden strength". Since my genes are from Balkan, think of Jokic as a body equivalent without being this tall.

I don't work out and have been quite sedentary with my lifestyle due to the depression that usually comes with ADD (every 3rd ADD person usually develops symptoms in that direction). I do believe that some of my symptoms are compounding to my lack of physical activity, or that my lack of physical activity is the reason for it. Never been really thin even at the peak of my physical activity. I'm definitely fat as fuck right now, but I don't think my body type can support going below 200 lbs.

What I'm suffering with:
I'll hold it short and add more context on request.
Extreme lack of energy or lethargy. I'm running on power saving mode, physical activity in the morning knocks me out for the rest of the day and makes me incapable of working. Heart rate jumps high quickly (low 80, jumping quickly to 140-145 just from minor physical activity) - probably due to extreme lack of physical training. No morning erections since years, horrible erection quality and erections don't stay during sex making sex impossible. Anxiety rising during afternoon and peaking at night.

I have sleep apnea that's been treated for round about 3 years, without a single day missing. Before my sleep apnea diagnosis, I wasn't physically able to do anything, not even work at my desk job. My brain would shut off and refuse to work.

There is a certain possibility that I've never had genetically high testosterone that could lead to my subjective opinion of me never having had "visible muscles", or just me never really been super lean for it to be visible.

My predicament:
I'm from Europe and in the country where I live, there are no TRT clinics that I can throw money at to solve my problem. The only way to gain access to testosterone is through an endocrinologist or UGL, the latter not being an option for me personally.

Here's the situation I'm in.

My endocrinologist diagnosed me with "mild" secondary hypogonadism (lmao) with a recommendation to lose weight using a GLP-1 drug, hoping to improve my values with weight reduction. My numbers right now are bad enough that if I were to push it hard enough, I'd probably be able to get TRT prescribed with either this endocrinologist or a different endocrinologist that I have another appointment set up in August.

I'm usually all-in trying it the natural way by losing weight to restore testosterone levels. It makes sense that adipose tissue has more testosterone converting to estrogen, thus me simply having low testosterone potentially makes sense. So losing weight and fat tissue, lowering estrogen in the process and opening up more testosterone in my body makes sense.

Here's the problem though.

If I were to decide to do it that way, lose 80-90 lbs and potentially gain testosterone, I'm not sure if I would be able to recover enough testosterone for symptome relief. My estrogen is high, but even if estrogen gets reduced by half due to weight loss, would my gains in total T be significant enough to actually feel good? There is obviously a limit to how much testosterone you can free up by reducing weight. If I lose some weight and my numbers improve it to let's say 350-380 (fictive number), I'd get denied for testosterone at every doctor in my country while only have minor improvements to before.

This puts me in a position where I have two options:

Option 1:
Lose weight, pray that your body restores itself and that you free up enough testosterone due to reduction of fat tissue and hope that you'll feel good. Get 100% denied for TRT because numbers aren't "bad enough" yet for treatment after weight loss, even if no symptome relief. Since I have low SHBG, there's some potential to increase free T enough.

Option 2: Start TRT (+ GLP-1), lose the weight but be dependent on TRT injections (for life). Never know natural potential that I could've recovered from if I were to go natural. Potential infertility due to low Inhibin B that I won't recover from, despite HCG. HCG potentially not available in my country. Deal with potential side effects like HCT.

I have tried to analyze my situation to come to a decision but I have too much personal bias involved to make a good judgment on my own situation. Looking for unbiased advice from people that actually know and understand TRT.

Thanks!
 
Defy Medical TRT clinic doctor
My endocrinologist diagnosed me with "mild" secondary hypogonadism (lmao) with a recommendation to lose weight using a GLP-1 drug, hoping to improve my values with weight reduction.
Your idiot endo is only looking at the numbers and is ignoring the SYMPTOMS which are quite severe!

Typical non-critical thinking endos! What many doctors fail to realize is that the ranges are an idea of what "might" be normal for an individual. Some men can't even tolerate testosterone on the higher end, they're not built for it.

Even if you lose substantial amounts of weight, it's doubtful you then end up feeling like a million bucks. That doesn't mean you shouldn't try it, because at least you'll be in a better place to then start TRT and may in fact allow you to avoid many of the side effects than if you to start TRT now.
 
Last edited:
yes loosing weight is 100% the thing that makes the most sense.

there is something called ozempic babies.. this is because people get VERY fertile when back to ideal weight.

loose weight, monitor and THEN maybe think about TRT.. your super young man and chances are you will double your test levels by loosing 80-90 lbs.. this will lower your estrogen aswell..

being a healthy weight will take care of 99% of your symptoms which are likely not from test (although yes test makes everyone more energetic lol just like adderal can help sleep apnea symptoms, doesnt make it the best way)

there is NO rush, ur super young and can recover much much easier and chances are your going down a rabbit hole and more and more issues if choose to trt at this point.

I know TRT is sold as a cure all, which its not, and teh salesman will come up with EVERY reason why you SHOULD take it and why every PCP is wrong... but thats mostly not true.

follow your DR advice loose the weight, once under 200 give it a few months and see how ur feeling... your test levels will take a little hit while loosing weight but eventually will come back after you stop "starving" the tissues.

taking TRT when ur overweight can just cause estrogen to shoot up, so need to take toxic AI. also will cause ur heart to be overworked and BP to creep up alot faster than it would at a healthy weight.

ur still within range so in good shape to get things pumping again. u really dont want to be on T for 40years.... also may want kids too, and not always easy..


anyway AGAIN, best approach is loose weight and see what happens. this is MUCH healthier than taking TRT to loose weight and not know what ur natural production can up to.. ur 28 and in range, forget T for now.
 
I agree with the others above, make big lifestyle changes, lose weight, eat right, work hard, sleep well. You're far too young to start on the Testosterone merry-go-round.
 
Hello everyone,

I'm in a predicament with my decision whether I should start TRT or not. The decision is dependent on certain factors that would potentially deny me access to TRT in the future if I make a decision for one or the other route I could see myself going forward with.

First of, some stats. In the 3rd test, I've added some things that looked off in the test that my endocrinologist did. Most of the other numbers/lipids that aren't related to testosterone look good.
 

Test 1

Test 2 (306 lbs)

Test 3 (288 lbs)

Total testosterone

245

239 (197 - 669)

280 (250 - 860)

Estradiol (E2)

40

35.2 (<44.9)

(not measured)

SHBG

-

17.9 (11.5 - 54.5)

18 (18 - 54)

Albumin

-

7.2 g/dl (5.7 - 8.2 g/dl)

46 (35 - 52)

LH

-

3.5 (1.5 - 9.3)

4.3 (1.7 - 8.6)

FSH

-

3.4 (1.4 - 18.1)

2.2 (1.5 - 12.4)

Hematocrit

-

45 (<54)

46 (<54)

Prolactin

-

13.7 (<17.0)

16.5 (4.0 - 15.0)

DHT

-

-

190 (219 - 1140)

Inhibin B

-

-

115 (120 - 400)

Parathyroid hormone

-

-

44 (11 - 43)


I'm a 28 year old, 6'1 inches (186 cm) male from Europe with around 290 lbs right now. I was a competitive swimmer from 15-18. My body type is endomorph, wide shoulders and just a wide body in general. I'm what people would call "genetically gifted" in some areas. Strong legs, fairly wide shoulders despite being significantly overweight, without the hormones backing me up. Never really built any muscle besides my legs and was always the guy with "hidden strength". Since my genes are from Balkan, think of Jokic as a body equivalent without being this tall.


I don't work out and have been quite sedentary with my lifestyle due to the depression that usually comes with ADD (every 3rd ADD person usually develops symptoms in that direction). I do believe that some of my symptoms are compounding to my lack of physical activity, or that my lack of physical activity is the reason for it. Never been really thin even at the peak of my physical activity. I'm definitely fat as fuck right now, but I don't think my body type can support going below 200 lbs.

What I'm suffering with:
I'll hold it short and add more context on request.
Extreme lack of energy or lethargy. I'm running on power saving mode, physical activity in the morning knocks me out for the rest of the day and makes me incapable of working. Heart rate jumps high quickly (low 80, jumping quickly to 140-145 just from minor physical activity) - probably due to extreme lack of physical training. No morning erections since years, horrible erection quality and erections don't stay during sex making sex impossible. Anxiety rising during afternoon and peaking at night.

I have sleep apnea that's been treated for round about 3 years, without a single day missing. Before my sleep apnea diagnosis, I wasn't physically able to do anything, not even work at my desk job. My brain would shut off and refuse to work.

There is a certain possibility that I've never had genetically high testosterone that could lead to my subjective opinion of me never having had "visible muscles", or just me never really been super lean for it to be visible.

My predicament:
I'm from Europe and in the country where I live, there are no TRT clinics that I can throw money at to solve my problem. The only way to gain access to testosterone is through an endocrinologist or UGL, the latter not being an option for me personally.

Here's the situation I'm in.

My endocrinologist diagnosed me with "mild" secondary hypogonadism (lmao) with a recommendation to lose weight using a GLP-1 drug, hoping to improve my values with weight reduction. My numbers right now are bad enough that if I were to push it hard enough, I'd probably be able to get TRT prescribed with either this endocrinologist or a different endocrinologist that I have another appointment set up in August.

I'm usually all-in trying it the natural way by losing weight to restore testosterone levels. It makes sense that adipose tissue has more testosterone converting to estrogen, thus me simply having low testosterone potentially makes sense. So losing weight and fat tissue, lowering estrogen in the process and opening up more testosterone in my body makes sense.

Here's the problem though.

If I were to decide to do it that way, lose 80-90 lbs and potentially gain testosterone, I'm not sure if I would be able to recover enough testosterone for symptome relief. My estrogen is high, but even if estrogen gets reduced by half due to weight loss, would my gains in total T be significant enough to actually feel good? There is obviously a limit to how much testosterone you can free up by reducing weight. If I lose some weight and my numbers improve it to let's say 350-380 (fictive number), I'd get denied for testosterone at every doctor in my country while only have minor improvements to before.

This puts me in a position where I have two options:

Option 1:
Lose weight, pray that your body restores itself and that you free up enough testosterone due to reduction of fat tissue and hope that you'll feel good. Get 100% denied for TRT because numbers aren't "bad enough" yet for treatment after weight loss, even if no symptome relief. Since I have low SHBG, there's some potential to increase free T enough.

Option 2: Start TRT (+ GLP-1), lose the weight but be dependent on TRT injections (for life). Never know natural potential that I could've recovered from if I were to go natural. Potential infertility due to low Inhibin B that I won't recover from, despite HCG. HCG potentially not available in my country. Deal with potential side effects like HCT.

I have tried to analyze my situation to come to a decision but I have too much personal bias involved to make a good judgment on my own situation. Looking for unbiased advice from people that actually know and understand TRT.

Thanks!
Hey!

I get it, you're torn between trying to restore your natural testosterone levels through weight loss or opting for TRT. Both options have pros and cons.

Here's a neutral take: Losing weight can help, but there's no guarantee it'll increase your testosterone levels enough to alleviate symptoms. On the other hand, TRT can provide relief, but you'll be dependent on injections and might face potential side effects.

Consider your priorities: Do you want to try to restore your natural testosterone levels, or do you want to address your symptoms ASAP? Talk to your endocrinologist and weigh the pros and cons before making a decision.
 
Consider your priorities: Do you want to try to restore your natural testosterone levels, or do you want to address your symptoms ASAP? Talk to your endocrinologist and weigh the pros and cons before making a decision.

That’s the question I really can’t answer for myself. I don’t have a clear answer yet because my opinions are subjective if it’s about myself.

That’s why I’m in a predicament.

If there wasn’t a pretty high chance that I’ll get denied treatment despite symptoms in the future if my situation improves slightly, then my decision would be to just go all-in into losing weight and betting on the process that the human body can regulate and fix itself.

The reality here is that doctors will look at your reference range and tell you that they won’t treat anyone with 350 total T, despite the issue likely being the hormones.

That puts me into a “Zugzwang”, forcing me to make a decision where the outcome is nowhere close to being clear.
 
i wouldn't worry about the future and possibly not getting high enough T levels when loose weight thats alot of IFs and just crazy to mae a life decision based on that(test is easy enough to get man dont shoot yourself in your foot to spite your face). That is such a silly idea being worried your test levels will be normal so wont get T? chances are you will feel fine and wont worry about it if you do worry about it just gain weight... man the best thing is NOT going on TRT and having all kinds of issues because of it esp that your 28 which is CRAZY CRAZY young to go on trt esp when can be fixed by loosing weight.

loose weight and go from there, your so young that your natural levels can easily be in the 600-700 when get a good BMI. there is likely nothing wrong with your testies or pituitary and ur young so why cause them damage by injecting drugs u will then be addicted to for 45 years?

revisit TRT when over 35yo. good luck on your weight loss journey dont want to see you here again untill hit your goal weight and get your levels checked
 
Speaking from experience, once you start TRT it is very hard to go back for some people. I recommend losing weight, reassessing how you feel and reevaluating your numbers and then make a decision.

Once you let the genie out of the bottle, you may have a whole new set of problems. On the other hand, if you lose weight and you’re still symptomatic, the only thing you lost was time. At your age, you can afford that.

My two cents.
 
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