question from a user

TLDR: high output / high stress life. Physically and mentally. Last 2 years feeling sluggish, burned out, and find doing challenging things extremely difficult and draining. Considering HRT to maintain quality of life because I haven't been feeling great for too long now. Bloods below... I live a relatively high output and stressful life. I own my own business, which I opened just a year ago. I manage every aspect of the business currently from providing the services, office management, network & marketing, etc. I also work 2 days a week in another office for supplemental income as my office grows. I exercise 5x a week. Right now it's full body 3x per week and 2 days that are much lower intensity focused on mobility, basically active recovery days. Things for the last year have plateaued and I'm not seeing the progress that I'd like. Both in terms of strength gains and fat loss. I play softball during the summer and ski during the winter. I enjoy living an active life and want to maintain this and participate at high levels for as long as I can. I also hunt pretty hard for a few months out of the year. Energy levels get drained pretty hard during this time when I'm putting in a lot of miles in cold wet conditions. In the last 1-2 years I've just noticed stagnation and slight declines in my ability to push hard, my energy levels, and ability to manipulate my body composition like I previously could. Perhaps the things that is most noticeable is my motivation to do challenging things, physical and mental challenges, has dropped a lot. My diet is clean. I get a minimum of 165g protein everyday, sometimes up to 200. Carbs and fats fluctuate by the day. Been eating about 3100 calories a day on average for the last year. 90% whole foods. This is very consistent. Up until last year I was between 15-17% BF. Once I opened my office stress levels went up and things started to change with how I was progressing in the gym and ability to burn fat. Sleep is on point. 9 hours of sleep consistently. I go to bed and wake up at the same time every day. I don't party or drink. Used to smoke weed but don't anymore. No issues with ED, always solid morning wood. Libido fluctuates at times but I don't recognize this as any sort of issue or a change from previous years. I'm 33M, 5'7", 190lbs. My BF% is 22-23%. Bloodwork on November 7 is as follows: Total Test: 514 ng/dL Free Test - EQ: 13.74 ng/dL HbA1c: 5.4% FSH: 2.6 ulU/mL LH: 2.5 mlU/mL SHBG: 39.8 mol/L Estradiol 26.8 pg/mL DHEA-S: 290 ug/dL Vit D: 62. 8 ng/mL

AlphaMD's Answer

We very often here "I have been feeling like shit for 6 months for 2 years, I have symptoms of low T" for all patients seeking if TRT is right for them. It sounds like you're doing it right, and based off what you said I don't see any other major concerns. You would likely be between primary/secondary & relative, leaning on relative hypogonadism for now. Given a decade more of aging, you would probably just be low. It's perfectly fine to pursue TRT at this point as it sounds like it would help with many of your issues. If it does not help & you cycle off, then you know something else is up, but I'm betting it would help.

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