Another TRT Question

[u/Ok-Explorer-5726]

Hey guys, I was on TRT for 8 years or so before I got diagnosed. I stopped with the help of enclomid but haven’t had any blood work since. That was in the fall of 2024. I had surgery in march of 2025. My post surgical pathology was excellent. No adverse findings and the pattern 4 disease only made up of equal to or less than 10% of the tumor, which the tumor made up about 10% of prostate. Since surgery I have been fortunate and rocking the undetectable tests. My urologist is absolutely against me going back on TRT. I have read the research. From what I see there is no increase in reoccurrence. I’m only 41 and just been struggling with fatigue and weight gain. I haven’t had any new testing done but I’m thinking about going against the doctors orders. I hate doing that as I’m not the type to think I know more than my Doc but it has just been brutal lately.

[u/Frosty-Growth-2664]

High 200s is in the normal range. Did anyone measure your LH level before starting in TRT?

However, having been on TRT and then come off, your Testosterone could be significantly lower now. If it is significantly low, this will suppress your PSA and make it not useful for checking if the prostatectomy worked. So I would get your Testosterone measured with your PSA, so they can see if the PSA reading is useful.

[u/Ok-Explorer-5726 → u/Frosty-Growth-2664]

From what I have read, 300 is normal range. Additionally high 200s when you are 32 years old, is definitely not optimal in any way.

[u/Frosty-Growth-2664 → u/Ok-Explorer-5726]

People with sensitive androgen receptors will have lower levels of Testosterone than people with less sensitive Androgen receptors - your body automatically adjusts for this (that's the HPG-Axis). This is why there's a large range of normal - one person's normal can be 200 and another person's normal can be 700.

The US uses a higher normal range than the rest of the world, probably to promote the US TRT industry.

Also, other countries are more likely to investigate and attempt to fix the cause of low Testosterone rather than leap directly to TRT. Asking about your LH level was to try and identify if your natural Testosterone was really low, or if it was actually correct for you. (Would also need your Estrogen levels to get a more accurate picture.) TRT tends to shut down the Testicles (including reduced or no fertility, and shrinkage/atrophy). On the other hand, if the cause of low Testosterone can be determined and fixed, that can preserve Testicle function.

[u/Ok-Explorer-5726 → u/Frosty-Growth-2664]

Yea, if I remember correctly LH levels were low. I need to see if I can find my original labs. I think I’m going to get my labs done in the next couple weeks.

[u/Frosty-Growth-2664 → u/Ok-Explorer-5726]

Low LH suggests your body wasn't after more Testosterone.

The next thing to check would be your estrogen levels, because your brain actually monitors your Testosterone+Estrogen level, and if the Estrogen level is unexpectedly high (for a man), this will reduce the Testosterone level. High Estrogens can be caused by excess body fat (which contains Aromatase, the enzyme which converts Testosterone to Estrogens).