question from a user

Thanks to glp1's, I have lost 28% bodyweight in 11 months. Taken my BMI from over 50 to 39. I am 6'3 and 54 years old. 30 years ago I was a hyper responder to resistance training. Not so much anymore. Latest scan showed me at 208 lbs lean body mass so I still have much of my younger mass. My PCP is amazing and got me started on the glp1's. My quality of life has improved significantly. More energy, more libido et al. But, it still ebbs and flows significantly. I have asked my doc about checking for hormone levels and he is old school enough that he wants to wait until I have moderated my BMI to a healthier level and then check. His idea is get healthier and then we will check and see if you need any help. He knows just enough about TRT that he has concerns with side effects with my still high BMI. Knowing that higher BMI may have additional risks associated with TRT than men with healthier BMI. The glp1's have saved my life. I am back doing 2+ hours of cardio per week and lifting again and my diet is much better. Sorry for the long background, but the question is, should I pursue the TRT route now or should I wait until I am healthier. I like where I am now, but am seeking that next level of energy, libido, focus and overall well-being. My Dr has been right so far, but I am trying to figure out the chicken and the egg which came first scenario. Do I need to get healthier first and then check for TRT candidacy or start it now to help me get healthier faster?

AlphaMD's Answer

I would say it would be wise to check your T levels. There is no harm in knowing, and this conversation may be moot if your T levels are normal.

As you say, your doctor is old school, so he may not be up to date on the latest studies regarding TRT. It is very safe regardless of body weight.

I will say that you will lose weight faster and feel better quicker if you are hypogonadal and start TRT. Hypogonadism itself is an independent risk factor for heart disease and stroke. Literally you are less likely to die if you fix hypogonadism.

So you should consider getting checked. It sounds like you trust your doctor, so you should maybe approach him first and revisit the idea of getting tested.

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