33 years old, Should I start TRT?

[Clive]

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]

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! 

[Flyingfool]

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 don’t 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.

[ghce]

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.

[Clive]

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.

[Biceppeaks]

Honestly mate I was thinking of signing up to the forum instead of lurking but your post sealed it. I’m 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. I’ve been on compounded cream 10% for nearly a month now and the amount of positives are beyond what I thought I’d be getting 3-4 weeks in. You truly don’t know how bad you feel until you’ve got your test levels back to a decent level and wonder why you’ve 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 I’d 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 won’t know yourself.

[Clive]

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

[Biceppeaks]

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 wasn’t. I’d just be sore and irritable. I got used to it for a while like you and just thought that’s 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 didn’t just shave it hahaha) and even though I don’t 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, it’s made me want to get off my Effexor which I’ve 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 I’m in my early 20s or late teens energy wise. I’m still waiting for the full effect sexual wise but that has improved and as long as all my tests come back fine next week I’ll 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, it’s seriously been a life changer for me so far and I’m only into my 4th week!

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

[seppuku]

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]

Bicep - I know that feeling. I think we pretty much have the same story. Sleep wise if I don’t get at least 8 hours I’m done for .. Had a chat with the mrs and gana go for it. Worse case I’ll just try and get some gains in the gym lol best case I’ll be like ‘ok that’s how I’m supposed to feel’? Really appreciate you registering and telling your story, sounds like it’s benefiting you, whatever the numbers come back as. Interesting you mention anxiety, I’m pleased you’re doing better. I do have periods where I feel pretty flat, often accompanied with some anxiety (I hide it well). I’m hesitant to put it down to hormones but I’m really curious to see how it affects that and if I get a more of a drive about things .. I’ll 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]

Ok, thank you Clive

[Biceppeaks]

All good! Let us know how you go

[Forty2]

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]

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