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question from a user

I’m 31, 6’2”, and 345lbs. I had back surgery last year and I was about 260 and athletic before I got injured 10 years ago. I’m fairly strong (I do some strong man work) but I’ve had issues with libido and mental health over the last 5 years or so. Here’s my blood work. I’ve done months of solid dieting until 2 months ago when I got hurt doing CrossFit and got pretty depressed and gave up on the dieting while recouping. Anything other suggestions to try before trt?

AlphaMD's Answer

Well, you have low total and free T. Technically, your FSH and LH should be higher in an effort to get your testicles to work harder. But FSH and LH are on the lower range of normal. This is consistent with mixed hypogonadism (both primary and secondary). Your pituitary is being lazy and not producing enough FSH/LH and your testicles are also not responding to what little FSH/LH is there. This means you are definitely not a candidate for clomid or hCG alternative therapies.

To be honest, I think the first thing you should do is consider TRT. At 345, you have plenty of weight to lose, and that will be even harder with a bad back.

TRT will help the mental health, help you lose weight, help your back heal, and help your libido.

In my experience, the best I have seen someone raise their T by making lifestyle changes was about 25%. In your case that would mean your level would go up to about 280. Still below the traditional 300 threshold to start therapy.

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