Edit (post replies):
Basically, (as suspected), test levels are decent, lose some weight fatty, use a GLP1 of some sort to help, then reasses when you are 20kg (at least) lighter.
I thought this was the case, but simetimes you just need a bit of a sounding board.
Glad I dug out the results themselves BTW. Bit of a worry GP said all was "fine", especially the insulin score......
Thanks everyone!
Hi all,
Been poking about on this sub for a while, finally sticking my head above the parapet.
45M. Been symptomatic with “low T” type symptoms for around 18 months now, gradually getting worse. Constantly feel in a funk, brain fog etc. Over the last 9 months it’s become noticeably worse. I’m a VERY mediocre powerlifter, and my deadlift PB has completely tanked by around 25%, which has almost driven me off a cliff to be honest. Admittedly this wasn’t helped by getting shingles last year either, but we’re well past any post-viral phase now and the spiral of doom continues.
Yes, I am a fatty. Fluctuate between 115–120 kg. On CPAP for about 3 years (was 130 kg when I started CPAP and powerlifting). Definitely helps – I feel even worse if I miss a night.
Currently doing about an hour a week on the indoor bike as well as 3–4 weight sessions. Honestly, if I DON’T do these, my symptoms are even worse, so I can’t be doing everything wrong.
Finally convinced my GP to run some endo/metabolic bloods. She said they were “fine”, but I managed to get hold of the results and I’m not convinced. She does, however, want me to get a calcium CT to check the ticker.
Bloods were as follows:
Total Testosterone: 19.1 nmol/L
SHBG: 34 nmol/L (10–45)
Missing: Free testosterone, LH/FSH, E2, prolactin
Glucose (fasting): 7.2 mmol/L
Fasting insulin: 20.1 mU/L
HbA1c: 5.6%
Total cholesterol: 5.9 mmol/L
LDL: 4.1 mmol/L
HDL: 1.3 mmol/L
Triglycerides: 1.1 mmol/L
ALT: 50 u/L
AST: 37 u/L
GGT: 48 u/L
CRP: 5.7 mg/L (0–8)
Creatinine: 97 µmol/L
eGFR: 80
Hb: 145 g/L
Hct: 0.43
PSA: 2.97 µg/L
So looking at these, although I’m missing a few hormone labs, this looks more like insulin resistance rather than low testosterone.
Initial thoughts/questions:
- An endo probably won’t touch me, but what about a TRT clinic? Do any of the bigger TRT clinics also manage metabolic/weight loss issues?
- Given I don’t want to tip over into full diabetes, if TRT isn’t appropriate I probably need to go back to the GP and push for metformin. I know I can get GLP-1s privately, but they seem even more expensive than TRT. If the GP doesnt play ball - has anyone tried berberine?
- Weight loss will obviously help everything, but is it worth trying TRT to improve symptoms/recovery and potentially assist with weight loss?
TLDR: Suspected low T, but labs suggest insulin resistance instead. Worth treating that first rather than pursuing TRT? And do TRT clinics also handle metabolic issues/weight loss?
Sorry for the ramble, just trying to get my thoughts clear. Any guidance would be much appreciated, thanks.