Waist Circumference and testosterone

GiffMeReta

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Since my lab results came back on the low side, I've been watching for anything relevant. For now, my approach is to bring BMI down below 30, then repeat the bloodwork to check whether my testosterone numbers shift. TRT isn't something I want to start right now.

Earlier today I came across this study, and it made me feel optimistic about managing this without TRT. Briefly (WC = Waist Circumference):

Visceral adiposity, rather than BMI- or WC-defined obesity, is the primary adiposity correlate of low testosterone in US men. Testosterone deficiency in some men appears to be a phenotype of visceral fat biology rather than obesity per se.

Click to expand...
 
Adipose tissue contains aromatase, which converts your testosterone into estrogen. Estrone is the primary form of estrogen produced in this process. Estrone promotes weight gain. This creates a self-perpetuating cycle.
 
Before starting GLP1, my total test was pretty low (<250). Then, 9 months into tirz, my latest bloodwork showed BMI had fallen to roughly 25, and my test had recovered into the average range. For anyone dealing with this, I strongly suggest getting BMI to a normal level and building a good base with exercise and sleep first. That's not just because your T might recover by itself—beginning TRT while carrying a lot of body fat also leaves you more prone to problems with aromatase conversion.
 
fatjacked said:

Before starting GLP1, my total test was pretty low (<250). Then, 9 months into tirz, my latest bloodwork showed BMI had fallen to roughly 25, and my test had recovered into the average range. For anyone dealing with this, I strongly suggest getting BMI to a normal level and building a good base with exercise and sleep first. That's not just because your T might recover by itself—beginning TRT while carrying a lot of body fat also leaves you more prone to problems with aromatase conversion.
That's really fascinating. I've had the same hunch — that TRT aromatizes when body fat is high — and that's exactly why I'm holding off on testing my levels again until I've lost more weight.

Did the higher T change anything for you? Are you finding it easier to put on muscle at the gym? As of now, I can't say my current weight loss has even improved my sleep, but I'm looking forward to reaching the stage where my forearms can grow.
 
GiffMeReta said:

fatjacked said:

Before starting GLP1, my total test was pretty low (<250). Then, 9 months into tirz, my latest bloodwork showed BMI had fallen to roughly 25, and my test had recovered into the average range. For anyone dealing with this, I strongly suggest getting BMI to a normal level and building a good base with exercise and sleep first. That's not just because your T might recover by itself—beginning TRT while carrying a lot of body fat also leaves you more prone to problems with aromatase conversion.
That's really fascinating. I've had the same hunch — that TRT aromatizes when body fat is high — and that's exactly why I'm holding off on testing my levels again until I've lost more weight.

Did the higher T change anything for you? Are you finding it easier to put on muscle at the gym? As of now, I can't say my current weight loss has even improved my sleep, but I'm looking forward to reaching the stage where my forearms can grow.

To be honest, it's tough to pin down. Back when I was heavy, I didn't really have a bunch of the classic low T signs, and separating any improvements from the broader metabolic shifts of GLP-1 is tricky. For instance, brain fog and that mid-afternoon crash were things I dealt with before dropping weight, but I'd chalk those up more to insulin resistance and awful eating habits than to testosterone. Plus, I was still putting on muscle while fat because I ate massive amounts and lifted heavy—I was just packing on fat at the same time, and I decided that had to end. Even with a gradual approach to weight loss, I did shed some lean mass, and since I'm still in a calorie deficit, building muscle is a struggle now, even with T back to normal.

So basically, I feel better these days, but I wouldn't call the testosterone shift the main driver behind any of it. I doubt I'd have given it much thought if others hadn't kept mentioning it or if I hadn't gotten flooded with ads after I started looking into it. Now that I'm sort of moving into recomp and aiming to get some lean mass back, I'm really curious to see how that plays out.
 
TRT ranks as the single best choice I've ever made. That said, I'm with you that carrying more body fat brings estrogen problems along with it. These days I figure I'm sitting around 11-12% body fat, and honestly the results have caught me off guard: stacking trt with Reta and dropping from 278.8lbs down to 244 since June 16th. Not a bit of muscle gone, and my strength is way up.
 
Looking back, the link should have been obvious to me much sooner. The period when I was battling obesity and diabetes lined up with the point where low T symptoms first appeared.

Until I turned 50, diet and exercise had always been enough to take weight off. Then a high blood sugar scare pushed me to overhaul my lifestyle so I wouldn't slide further toward diabetes.

Despite eating properly and running regularly, progress became far harder than it used to be, and I realized I needed outside help. Even so, both my A1c and my weight kept climbing.

Tirzepatide got me moving in the right direction, yet I continued to feel terrible. Testing showed my testosterone was low while I was at a higher weight. I expected it to rise once I lost weight, but the numbers were a letdown: total testosterone went from below the average range to only just inside it.

That led me to try enclomiphene, which produced a 100% increase within a couple of months. Even then, I didn't feel the way I had a few years earlier. So I chose to start TRT, and my only regret is not doing it sooner.

For me, the metabolic problems appear to have stemmed from low testosterone, setting up a vicious cycle: weight gain lowered testosterone further, which in turn drove still more weight gain.

The mental health upside has been the largest one. Negative self-talk and depression are now uncommon for me. I feel optimistic about what lies ahead, and my metabolism is recovering in a manner I doubted diet, exercise and tirzepatide could ever manage on their own.
 
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