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Author Topic: 33 years old, Should I start TRT?  (Read 2367 times)

Clive

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33 years old, Should I start TRT?
« on: July 01, 2019, 07:45:56 pm »
First time poster here, have been reading lots of great info on the forum.

So about three years ago I had some bloods run for the fertility clinic, and total T came back at ~250. I've had three repeat tests since then, ranging from 220 to 270 ng/dL which is 8-10 nmol/L (normal range >350 or >10). Each time my LH and FSH has been middle of the range (when they should have been elevated really). SHBG ranging from 39-45 (relatively high normal). Prolactin has come back once about 10% higher than normal but nothing exciting. TFTs, IgF1, FBC, U&E and LFT all normal. GP referred me to NHS endo who has offered a trial of TRT plus MRI as reckons I have secondary hypogonadism.

My conundrum is whether to trial TRT or not... I've got two kids now with no immediate plans to add to this (partner only wants 2, tho I would be partial to completing the hatrick). In terms of symptoms, well I must admit my libido has always been low, I am pretty tired most of the time and facial hair is spectacularly sparse. But I have always felt like this. I'm in good shape and pretty active. Never taken steroids. At these levels, do you guys think I may benefit from giving it a go? I'm kind of interested to see what would happen to have normal levels of hormones and wonder if I've bene putting up with low T for years... What do you think? thought it would be useful to ask guys who presumably have started TRT at these kind of levels.. Thanks for any replies

golfboy307

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Re: 33 years old, Should I start TRT?
« Reply #1 on: July 01, 2019, 09:08:06 pm »
First of all, those levels are low by most anyone's standards (even traditional medicine, kudos to your GP who recognized this).  At your age, you might want to first discuss a trial run of Clomid (low dose) to see if this would boost your T levels.  If not, TRT would certainly be an option.  If you do choose that route, make sure you give it 3-6 months with your levels optimized before you decide if it really helps.  It certainly did for me, but it took a bit to dial it in. 

Best of luck to you! 
Age 51, 5'10, 155 lbs
Cholesterol 162 (HDL 59, LDL 87, Trigs 88, LDL-P 850)
Fasting Glucose 65 (down from 97 pre TRT)
A1C:  5.0 (down from 5.7 per TRT)
Homocysteine:  12.4 > 11.0 > 10.2 > 8.9 using B vitamin therapy.  MTHFR positive 

BP  120/78 (using improved diet and 10 mg Lisinopril ACE Inhibitor)  145/90 prior to meds.

Current protocol:  60 mg Test Cyp IM every 5 days.  No AI.
2/15/17 labs:  Total T (peak day): 1169 (250 - 1100 ng/dl).  Free T 198 pg/ML (46-225).  Sensitive E2: 40 High.  Previously 32. PSA 0.2  Hemocrit 44.2. SHBG: 32
9/15/18 labs:  Total T (trough day):  598 (250 -1100 ng/dl)  Free T 73.9 (46-225) Sensitive E2: 21  Hemocrit 43.7  SHBG 34
2/20/19 labs:  Total T (mid point):  776 (250 -1100 ng/dl) Free T 115.6 (46 - 224 pg/ml) Sensitive E2 24 (<29), DHT 43 (16-79 ng), DHEA-s 244 (70-495 mcg/dl)


Supplements:  Multivitamin, plus additional B12, B6, C, D, K2, Red Yeast Rice, Magnesium, and Coq10  Evening:  Kyolic Garlic, 2mg Cialis, LEF Endothelial Protection

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Re: 33 years old, Should I start TRT?
« Reply #1 on: July 01, 2019, 09:08:06 pm »


Flyingfool

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Re: 33 years old, Should I start TRT?
« Reply #2 on: July 01, 2019, 09:08:48 pm »
Well put it this way. At 33 years old, you have the T levels of a 70 year old or older man.

Being young I would say to try clomid, but that raises SHBG which is already fairly high, so it would most likely not result in and gain in free usable testosterone.

Moat men start to feel low T symptoms woth a free T of about 10. Using shbg of 40 and total T of 250 yields about 4 for a calculated free T level. Again that would indicate you really are pretty low.

Did rhe dr say what kind of protocol, dosage and frequency he was recommending?

If you do try trt. You may want to add in HCG to maintain fertility just to meep options open. Also some men just feel better taking it.

You can always try it. And if donít like you can always stop. You should return to your previous level, or the level you would have been when you stop.

Also keep in mind that T level production decreases with age. So with such low levels now, you will probably be on trt at some point in the future in order to feel well.

Just my thoughts. Others may have different opinions.
54 year old, 5í-7Ē and 174 lbs.
exercise: nine really. Cancer & surgery & covid restriction closed swimming
Pool :(

Blood tested 2/9/21

Total = 614  ng/dL (250-827) up from 520
Free T= 13.68 (5.6- 21.0) measured
Free T TruT calc 19.9

SHBG= 31.9 (11.2-78.1)

Bio-avail= 321 (110-575)

Estradiol = <10 (11-44) male range
Estrone not measured

DHES = not measured
DHEA = not measured

Currently on 50mcg Synthroid (T4)
TSH = 0.937
Free T4 = 1.03 (0.78 - 2.19)= 17.7% of range
Free T3 = 3.73(2.77-5.27) = 38.4%  of range

Current protocol: 100mg DIM once per day. 

NOT on TRT.

ghce

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Re: 33 years old, Should I start TRT?
« Reply #3 on: July 01, 2019, 09:22:58 pm »
Regarding SHGB and Clomid, not every one gets their SHGB raised by using Clomid, mine remained low between 9 and 14 on Clomid.

As Golf Boy says low dose Clomid ie 12.5 mg to 25 mg every other day would be the best start point.
Age:60, Height 6' 3" weight 100KG
2014 Androderm Patches
2014-2016 Oral Andriol 160mg Daily
June 2016 Clomid/Serophene 12.5mg EOD
September 2016 no TRT all natural and supplements for the time being
February 2017 Testosterone cream 100mg daily

Sept 2016
Testosterone   8.2 nmol/l   9-38
Free Testosterone   239 pmol/l   L   250-800
SHBG:  14    nmol/L   9-60
Free Androgen index   586   >400
Oestradiol    112   pmol/L    <190
LH    2.6 IU/L Adult male   2 - 9 IU/L
FSH  1.4 IU/L Adult male L2 - 12 IU/L

22 November
T 6.8  nmol/L ( 9-38 ) L

March 2017
Testosterone:   45.0  nmol/L ( 9-38 ) H ( 1,323 ng/dl )
Free Testosterone:   1512  pmol/L ( 250-800 ) H
SHBG:   17  nmol/L ( 9-60 )
Plasma IGF-1:   227 ug/L ( 55-198 ) H
Plasma cortisol:   434 nmol/L ( 0600-1000 hrs 170-500 nmol/L )
HbA1c:   36 mmol/mol ( 20-40 )
LH:   <0.1 IU/L
FSH:   0.1 IU/L
DHT Plasma Dihydrotestosterone:   7455   pmol/L ( 223 ng/dl ) 
Reference Range Adult males  1000-6000 pmol/L

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Re: 33 years old, Should I start TRT?
« Reply #3 on: July 01, 2019, 09:22:58 pm »


Clive

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Re: 33 years old, Should I start TRT?
« Reply #4 on: July 01, 2019, 10:00:18 pm »
Thanks so much for the replies.

Pretty much sums up how I’m feeling. If I don’t try it I think I’ll always be thinking about it and attributing everything to ‘low T’.. getting the results does kind of make everything click into place, I do think I’m probably symptomatic, although I was ‘getting by’

Yea, we calculated free T and it was impressively low..

In terms of protocol. It’s NHS so Nebido or gels. Went for the Nebido (10-12 week injections). No clomid or HCG unless I go private. Which I might do if I see some benefits on nebido but think protocol could be better +/- fertility. I know Nebido has a long half life and can take time to reach steady state, hopefully if I am going to see benefits I should see signs on it? Trial is for 6 months.

« Last Edit: July 01, 2019, 10:06:30 pm by Clive »

Biceppeaks

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Re: 33 years old, Should I start TRT?
« Reply #5 on: July 02, 2019, 02:09:26 pm »
Honestly mate I was thinking of signing up to the forum instead of lurking but your post sealed it. Iím also 33, levels were 280 and I felt like utter trash for the good part of 6-9 months before I even got looked at treatment wise. Iíve been on compounded cream 10% for nearly a month now and the amount of positives are beyond what I thought Iíd be getting 3-4 weeks in. You truly donít know how bad you feel until youíve got your test levels back to a decent level and wonder why youíve waited so long to treat it. The first thing that went for me was the need to have naps 3 hours after waking up, the fatigue has just vanished and at its worst Iíd be sleeping 8-10 hours a night and then needing a 3-4 hour nap a few hours upon waking, especially if I managed to be active the day before, IE - Playing basketball or even coaching would render me incapacitated for a good 3 days haha.

If you respond well to treatment you wonít know yourself.
« Last Edit: July 02, 2019, 02:15:58 pm by Biceppeaks »

Clive

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Re: 33 years old, Should I start TRT?
« Reply #6 on: July 02, 2019, 07:37:33 pm »
Hey man! Ok so we’re very similar then!!  Do you know the cause for yours? What symptoms did you have before and how do you feel now?

Mate tell me about the naps!! Hahaha I can really relate to being wiped out after any sport as well, but just explained it away as getting older. that’s why I think I’ve got to try it, cus I can’t stop thinking how I might feel with normal hormones ..  one really confusing thing is I’ve pretty much always felt like this as an adult and have always just thought this is how I am. So it’s pretty confusing and kind of crazy to think about. I’m going to give it a try I think tho .. thanks for the reply mate great to hear your story
« Last Edit: July 02, 2019, 07:43:16 pm by Clive »

Biceppeaks

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Re: 33 years old, Should I start TRT?
« Reply #7 on: July 03, 2019, 02:10:26 am »
Yeh I originally put it down to getting older but it was a bit ridiculous been cooked for 3 days or so after 1 hour of exercise and etc, the mind was willing but the body wasnít. Iíd just be sore and irritable. I got used to it for a while like you and just thought thatís how I was and then it got worse and decided to demand a doctor to give me a full hormone panel. I took finasteride when I was younger for hair loss (I have a nice shaped head no idea why I didnít just shave it hahaha) and even though I donít put it all down to that I think there was a number of factors that caused it. When I was 27 my levels were 400 which is low for a 27 year old so I probably could have got treatment then but I had other things going on as well.

Speaking of, itís made me want to get off my Effexor which Iíve taken for years for anxiety and panic disorder. Any residue anxiety I had has vanished upon treatment and can probably put the most of my anxiety issues down to low test (and probably my lifestyle when I was younger)

I feel like Iím in my early 20s or late teens energy wise. Iím still waiting for the full effect sexual wise but that has improved and as long as all my tests come back fine next week Iíll continue on. Find a doctor who knows what they are doing and actually cares about youngers not feeling like geriatricis. I only need 6 hours sleep not and can run fine on less if I need to be up early for any reason, not needing to nap has been great, not sleeping half the day away and can actually study and do more part time work, itís seriously been a life changer for me so far and Iím only into my 4th week!

Let us know how you go, always happy for a chat as Iím still a newbie at this myself.

seppuku

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Re: 33 years old, Should I start TRT?
« Reply #8 on: July 03, 2019, 05:05:34 pm »
Clive - just curious, what are the current testosterone ranges on the NHS?  I'm from the UK, but haven't had any NHS blood tests for years, i'm guessing the lower end cut off point has gone up since I last was tested (latest Medichecks draw, months off clomid was 9.7nmol/l)

Clive

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Re: 33 years old, Should I start TRT?
« Reply #9 on: July 03, 2019, 05:48:35 pm »
Bicep - I know that feeling. I think we pretty much have the same story. Sleep wise if I donít get at least 8 hours Iím done for .. Had a chat with the mrs and gana go for it. Worse case Iíll just try and get some gains in the gym lol best case Iíll be like Ďok thatís how Iím supposed to feelí? Really appreciate you registering and telling your story, sounds like itís benefiting you, whatever the numbers come back as. Interesting you mention anxiety, Iím pleased youíre doing better. I do have periods where I feel pretty flat, often accompanied with some anxiety (I hide it well). Iím hesitant to put it down to hormones but Iím really curious to see how it affects that and if I get a more of a drive about things .. Iíll keep this thread updated and let you know what happens

Sepp - my levels ranged between 7.8 and just under 10 nnmol/L over a couple of years. GP referred to Endo who offered a trial - I think guidelines are under 8 treat, 8-12, with symptoms, offer a 6 month trial. Endo suggested it in my case really.

seppuku

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Re: 33 years old, Should I start TRT?
« Reply #10 on: July 03, 2019, 08:35:31 pm »
Ok, thank you Clive

Biceppeaks

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Re: 33 years old, Should I start TRT?
« Reply #11 on: July 07, 2019, 10:00:59 am »
All good! Let us know how you go

Forty2

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Re: 33 years old, Should I start TRT?
« Reply #12 on: July 16, 2019, 09:50:37 pm »
First time poster here, have been reading lots of great info on the forum.

So about three years ago I had some bloods run for the fertility clinic, and total T came back at ~250. I've had three repeat tests since then, ranging from 220 to 270 ng/dL which is 8-10 nmol/L (normal range >350 or >10). Each time my LH and FSH has been middle of the range (when they should have been elevated really). SHBG ranging from 39-45 (relatively high normal). Prolactin has come back once about 10% higher than normal but nothing exciting. TFTs, IgF1, FBC, U&E and LFT all normal. GP referred me to NHS endo who has offered a trial of TRT plus MRI as reckons I have secondary hypogonadism.

My conundrum is whether to trial TRT or not... I've got two kids now with no immediate plans to add to this (partner only wants 2, tho I would be partial to completing the hatrick). In terms of symptoms, well I must admit my libido has always been low, I am pretty tired most of the time and facial hair is spectacularly sparse. But I have always felt like this. I'm in good shape and pretty active. Never taken steroids. At these levels, do you guys think I may benefit from giving it a go? I'm kind of interested to see what would happen to have normal levels of hormones and wonder if I've bene putting up with low T for years... What do you think? thought it would be useful to ask guys who presumably have started TRT at these kind of levels.. Thanks for any replies

Clive, have you ever taken Roaccutane?

Clive

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Re: 33 years old, Should I start TRT?
« Reply #13 on: July 21, 2019, 03:49:50 pm »
Hi mate, no never taken any meds really.

Update

So had my first nebido shot 10 days ago

Not sure if placebo or what, but have had so much more energy and mood just feels a lot better. Careful not to read too much into it as probably too early to be experiencing these things but really have felt good. Libido has increased a little bit too ... will update again in a few weeks


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Re: 33 years old, Should I start TRT?
« Reply #13 on: July 21, 2019, 03:49:50 pm »