Confirmed Low Testosterone - Does He 'Need' TRT?

[@jamie.777]

I am 50, lost 75 lbs. I am thin,but "skinny fat", i quit boozing for a year. I am thinking of trt,i have the fatigue, fog symptoms. My liver amd blood work is all good

[@sharpshooter3309]

I’m really liking the case based discussion Doc, thank you! I just wanted to ask your opinion on HRT and neurosteroids. Will hcg alongside TRT be enough to produce an adequate amount of allopregnanalone and DHEA or do you have patients supplement with these?

[@themenshealthclinic]

Thank you and yes, there’s rarely a need for pregnenolone & DHEA 👍

[@JoesLife89]

Hi. Im 35. My total T is 486, and my free test is much lower and the clinic recommended I get on. Ive worked out for 5 years and barely see progress. I have struggled with obesity all my life but lost signifcant weight 10 years ago and kept it off, however my body is still in the overweight range, and its like im stuck there. I also never get erections anymore... unless i manually stimulate myself. My bloodwork is pretty much next to perfect and im healthy, just lowish DHEA levels and free testosterone. I already paid for my prescription and ill get my trt in the mail in a week or so. I thought about this for a year, its not like i jumped on. I did a blood test last year and my levels were better a year ago. I may not "need" it but i certainly am interested in optimizing my life, having the body I struggle for and having my libido back. Im taking a chance... i think i made a good decision, we will see. Its not like i live an unhealthy lifestyle, and i put the effort in for a decade and still feel like shit. I dont drink or smoke. Anyway, ill stop rambling. Fingers crossed.

[@pault3705]

Just a segway...like your skull and bones hoodie. What brand is it ..nice video!

[@themenshealthclinic]

Thrudark 🖤

[@pault3705]

Thanks

[@davekosztan4641]

I'll be in clinic 23rd April, looking forward to it👍

[@themenshealthclinic]

Good man 👊

[@bogse]

Why give a guy TRT if he is a boozer. Makes him recover faster and booze even more. I would almost at least request liver levels before and his "reward" is TRT if he stops excess drinking. Of course he may start to booze later after initial TRT which makes things harder.

[@themenshealthclinic]

It’s not my place to be judge and jury, just try and act in the best interests of the patient 👍

[@stevebeary8043]

Dr Steven's. DO you treat patients in the US with telehealth. Love your content.

[@winstonbrown1516]

Hi Dr. Stevens. Have you ever come across Test in the, "normal", range but still suffering from all the usual symptoms? Constant low mood, feeling of muscle weakness, brain fog, emotional, irritability.., etc. Watched some vids that says what I believe, which is, one size does not fit all. 6'2", 16.5st Brummie, just feeling like shite!

[@anthony55964]

Hi Doc, is there a particular brand of Vitamin D supplement that actually works?

[@johnmorgan7989]

Great video. On a slightly different topic what would regularly working night shifts do to t levels? Night time and while your sleeping is when most of your t is made so what if you never sleep at night? Good long term night shifts screw up your bodys ability to make t?

[@themenshealthclinic]

Of course, your anabolic processes predominate at night when you are sleeping 💤

[@jamiejones162]

Another great video! I've heard you reference individuals having a free T between 0.5 to 0.8 is typically optimal for most. I have a total T of 22 and free T of 0.3, and I am feeling most of the symptoms of low T, but I can't get prescribed TRT. My SHBG is 54, but is making efforts to lower this going to even make a substantial effort?

[@themenshealthclinic]

Only time will tell obviously 🤷‍♂️ TRT, SHBG & Health - Facts, Questions and Evolution themenshealthclinic.co.uk/trt-shbg-and-health-facts-questions-and-evolution/

[@jamiejones162]

@themenshealthclinic Thank you, keep the videos coming! 💪

[@pault3705]

Im 51 year old male, had vasectomy and not on trt...had bloods and fsh was 2.6iu/l ?? Is this normal ?

[@Dwpinvestigation]

I’m on trt. My fasting bloods are high. Like 9-13. But my ac1 is normal. Could the trt be making my blood’s sugar go up

[@ALANVTHOMAS-fx7ur]

My Total T is above normal and I have High LH & FSH. Do I need to take TRT ?

[@softfeet750]

Do you check patients with low testosterone for prolactinomas? With an MRI scan? Do you check patients with low testosterone for testicle problems, such as cysts and tumours? A testicular ultrasound is a fairly routine test.

[@themenshealthclinic]

Everyone has a physical examination which includes a testicular examination. MRI scans and USS are only indicated when deemed clinically necessary 👍

[@softfeet750]

@@themenshealthclinic Thanks, that is helpful

[@germain9074]

The hypothalamus releases gonadotrophin releasing hormone (GnRH) which signals the pituitary gland to release luteinising hormone (LH). LH signals the testes to produce testosterone. As I understand the blood tests your clinic performs measure testosterone and free testosterone as a marker for potential TRT administration, but what test do you perform that actually shows if the signal itself to the testes is functioning properly. Measuring the testosterone levels themselves cannot be a fullproof way in and of itself to be sure signalling is functioning correctly? Thanks.

[@VincentSPICER]

The question is curious, naive and obvious. One would assume that the doctors at the clinic would test for primary vs secondary hypogonadism, checking the levels of all the hormones, finding out where in the pathway the shutdown/signalling might be failing. If you have a high level of LH & FSH and are still suffering hypogonadism (considering symptoms, of course, not just numbers), then the testicles would become suspect (i.e. primary). Or maybe the failure is even further back up - in the hypothalamus (GnRH). All these steps could be checked. It's complicated - what about the androgen & estrogen receptor sites being blocked by something - that is something else to check. When you ask "what test do you perform that actually shows if the signal itself to the testes is functioning properly" ... are you suggesting testing the levels of LH & FSH? When you mention about testing testosterone and free testosterone as a marker for potential TRT administration - I think that is just the quick & easy first step. I'm not trying to answer your question on behalf of the doctor - but even with my "lay knowledge" of the subject, I would think of the assumptions that I have just mentioned.

[@VincentSPICER]

Anyway... just curious, have you listened to many of Dr Robert Stevens videos? I have - and I have fact-checked a lot of what he says (good to check the scientific papers of Dr Abraham Morgentaler, Harvard - foremost researcher) - and Dr Stevens is very detailed and thorough - I have total confidence & faith in him and the knowledge that he shares.

[@germain9074]

@@VincentSPICER I've met the Doctor in-person. Have you? His mentality appears to be that no question is too stupid, or "naive" as you put it.

[@VincentSPICER]

@@germain9074 How lucky you are to have met him. And yes, his attitude is perfect. And I apologise by my comment, but your question just seemed like it was already answered in the video - I should watch the video again, I likely missed something. I usually try to watch his videos a few times because they are so jam-packed loaded with an incredible amount of information - it's like replaying the lesson over & over, until I get it. And, yes, generally, I agree, no question is too stupid - everything should be asked so as to leave nothing to chance. Again, my apologies, and I didn't mean to come across disrespectful (to you or to anyone). I am an appreciative member of the audience here.

[@jwwilliams]

I would have gone ahead and put him on. Use that honeymoon faze to get him motivated to pursue healthier choices. Let's be honest, he's probably going to need trt either way. Might as well go ahead and get him started. You can't really go by feelings. These guys have felt like s*** for years. They think it's normal. I feel fine lol. How many times have you heard i thought I felt fine before but now after TRT I realize I was wrong.

[@themenshealthclinic]

He needs a second test to confirm the diagnosis. I’m confident he will start TRT. However, it’s a chance to sow the seed that he needs to make some changes to his lifestyle, nutrition and training so that when he starts TRT, the improvements will be sustainable. The patients that do best are the ones that appreciate testosterone only allows you to earn your reward through effort. The patients that do worst are the ones that don’t feel they need to change as the testosterone has made them feel ‘better’.

[@jwwilliams]

Yeah that's the other possibility. Some are motivated to do something once in and others use it as an excuse not to. I see your point. At the end of the day they have to understand it's not a miracle worker and they still have to put in the work.

[@haeloglobal5725]

Hi I have a question , can you provide enclomaphine as an alternative to hcg as I had to stoop trt as the hcg not only raised my estrogen it also makes me lethargic and groggy . I tried test on its own and was great but end up stopping for few reasons .

[@themenshealthclinic]

No, it’s not an alternative. You simply need to be under the care and supervision of someone who knows what they are doing.

[@haeloglobal5725]

@@themenshealthclinic ok , it seems to be favoured in the state so I assumed it was a better option . If I take hcg alone it makes me on a total downer . Test on its own is great . But it all got too hard with company I was using never replying ever . I’ll have to make a trip down to your company

[@gussstavo]

I was on 100 every 5 days and now im on 75 split in m/w/f cause i got suprafisiological with that and i feel like shit now but i have to wait till next analitics

[@tomknowles7811]

This is the disappointing thing. In the UK, even with private clinics, we're still way behind the curve, with clinicians shitting themselves about numbers rather than symptom resolution

[@gussstavo]

@@tomknowles7811 im in Argentina, i can assure you its way worst, youre basically on your own, drs here dont have a clue about trt, the usual philosophy is, if youre not going to die from it then we better not do anything

[@mattlofty5884]

Can folate cause fatigue ? How were his RBC ?

[@themenshealthclinic]

Yes, RBC was normal 👍

[@NYGuy2000]

Did he have any hypothyroid issues, too?

[@themenshealthclinic]

No, upcoming thyroid case study 👍

[@lorrangee9083]

First

[@themenshealthclinic]

Boom! 💥