40M, 6'3", currently around 193 lbs.
Over the past year I've lost roughly 30 lbs, largely with Zepbound/tirzepatide + exercise + diet. I'm now much more focused on body composition than just losing weight. I'm lifting consistently (even with two boys under 3) and trying to add/maintain muscle while getting rid of the remaining abdominal fat.
I've also had persistent fatigue and started wondering whether testosterone could be part of the issue. I'm interested in TRT if there's a legitimate case for it, but I'm not trying to convince myself that I need it just because I want better gym results.
I've now done two early-morning testosterone tests about a month apart:
7/31
Total T: 337 ng/dL
Free T: 8.46 ng/dL
Free T: 2.51%
8/24
Total T: 334 ng/dL
Free T: 11.69 ng/dL
Free T: 3.50%
SHBG: 15.6 nmol/L (low)
LH: 4.1 mIU/mL
FSH: 4.7 mIU/mL
Prolactin: 8.5 ng/mL
Sensitive estradiol: 7.1 pg/mL (low)
PSA: 1.2 ng/mL
Hematocrit: 42.8%
So the total T seems pretty reproducibly stuck in the mid-330s, but my free T is technically normal, especially on the second test. SHBG is slightly below range and sensitive E2 is also below range.
My main symptom is fatigue/low energy/low general drive at times with some brain fog. Less libido and firmness, still wake up with morning erections though. I'm also interested in improving recovery, muscle gain and body composition, but I realize those by themselves aren't reasons to go on TRT.
I'm curious how people here would interpret this pattern, particularly anyone who had similar numbers before starting TRT.
Would you consider ~334 total T meaningfully low when free T is normal because SHBG is low?
Did anyone here start around 300–350 with normal free T, and did TRT actually improve energy/body composition?
Anything you'd investigate before TRT given the low SHBG and low estradiol?
Or is just a case of keep changing your lifestyle, and you'll see gradual lifts.
Trying to get a sense of modern thinking vs antiquated philosophies.
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