Low test/bloodwork help

[ashp]

Hi,

I'm turning 29 this month and for endless years now I've had problems of really low energy and exhaustion and recently my sex drive has been lower than it ever was. My progress at the gym is terrible and I struggle to make any gains at all. All of these symptoms combined lead a friend to suggest checking my test levels. I pestered and badgered my doctor into running some bloodwork and the results were:

Test Name Result Abnormal Reference Range
------------------------- --------------- -------- ---------------
TSH 1.98 0.40-4.50 mIU/L
Test Name Result Abnormal Reference Range
------------------------- --------------- -------- ---------------
TESTOSTERONE , TOTAL 283 250-1100 ng/dL
TESTOSTERONE, FREE PERCENT 1.89 1.50-2.20 %
FREE TESTOSTERONE 53.5 35.0-155.0 pg/mL

Because of the 'reference ranges' my doctor was unwilling to do anything further and maintains that 283 is totally fine for a 29 year old male who works out 4 times a week and is otherwise in perfect health.

From all my research it really does seem low for my age, I struggled to find out how realistic the reference range for free testosterone is. If you were 29 and got these results, would you insist on a referral to a specialist to discuss it further.

[Times Roman]

I'm pushing 49. for me:
Total test = 211
free test = 61

I would ask your doctor for a second opinion.
My doc is sending me to see an endo, as soon as he gets off his lazy duff and sets it up

[ashp]

Man, you got 20 years on me and my free test is lower than yours. I already emailed my doctor, cited a few facts and asked for a referral and said we can agree to disagree if you just send me elsewhere.

[Vettester]

Yes, I would be looking to see someone who knows what they're talking about.

Times Roman: It sounds like your journey with Kaiser is par for the course so far. Your age and your score should have been grounds for an immediate prescription. I've found their endos to be worse than the GP's.

[ashp]

I got more tests done and this is what my doctor sent me. I can barely understand this stuff so I don't know if the SHBG thing is a problem:

Here are all your results. Basically everything is normal. It is true, however, that your total testosterone is low for your age. It is not low enough that we would recommend treatment with testosterone. In addition, your SHBG (sex hormone binding globulin) level is low making your free level more in the normal range. It is the free level that really matters. The LH and FSH are not elevated and the other tests are also fine.


I'd like to repeat the testosterone and cortisol levels again just to see how they are. The cortisol is normal but often we do see it higher. So, I'm going to order these 2 again. Ideal time to have them is at 8am. Let me know if you have any questions.


Laboratory Report

36127 - TSH, 3RD GENERATION W/REFLEX TO FT4

No results available.

36170 - TESTOSTERONE, FREE AND TOTAL, LC/MS/MS

Test Name Result Flag(s) Reference Range Reported Date Footnote
TESTOSTERONE, TOTAL 398 250-1100 ng/dL 09/13/2010 09:00 AM AMD
TESTOSTERONE, FREE PERCENT 2.07 1.50-2.20 % 09/13/2010 09:00 AM AMD
FREE TESTOSTERONE 82.4 35.0-155.0 pg/mL 09/13/2010 09:00 AM AMD

4212 - CORTISOL, A.M.

Test Name Result Flag(s) Reference Range Reported Date Footnote
CORTISOL, A.M. 11.2 mcg/dL 09/13/2010 09:00 AM *

Reference Range
8 a.m. (7-9 a.m.) Specimen: 4.0-22.0

470 - FSH

Test Name Result Flag(s) Reference Range Reported Date Footnote
FSH 1.8 1.6-8.0 mIU/mL 09/13/2010 09:00 AM *

496 - HEMOGLOBIN A1c

Test Name Result Flag(s) Reference Range Reported Date Footnote
Hemoglobin A1c 5.4 <5.7 % of total Hgb 09/13/2010 09:00 AM *

Decreased risk of diabetes
<5.7 Decreased risk of diabetes
5.7-6.0 Increased risk of diabetes
6.1-6.4 Higher risk of diabetes
> or = 6.5 Consistent with diabetes

Standards of Medical Care in Diabetes-2010.
Diabetes Care, 33(Supp 1): S1-S61,2010.

615 - LH

Test Name Result Flag(s) Reference Range Reported Date Footnote
LH 1.8 1.5-9.3 mIU/mL 09/13/2010 09:00 AM *

746 - PROLACTIN

Test Name Result Flag(s) Reference Range Reported Date Footnote
PROLACTIN 8.7 2.0-18.0 ng/mL 09/13/2010 09:00 AM *

822 - AST

Test Name Result Flag(s) Reference Range Reported Date Footnote
AST 15 10-40 U/L 09/13/2010 09:00 AM *

823 - ALT

Test Name Result Flag(s) Reference Range Reported Date Footnote
ALT 14 9-60 U/L 09/13/2010 09:00 AM *

866 - T4, FREE

Test Name Result Flag(s) Reference Range Reported Date Footnote
FREE THYROXINE 1.2 0.8-1.8 ng/dL 09/13/2010 09:00 AM *

899 - TSH, 3RD GENERATION

Test Name Result Flag(s) Reference Range Reported Date Footnote
TSH 2.22 0.40-4.50 mIU/L 09/13/2010 09:00 AM *

[frawnz]

Your original results were very similar to mine (I'm 30), and my endo agreed that it was pretty low for my age group. You need to ditch the GP and go see an endo or hit up an anti-aging clinic if you can't get any help from that front.

[ashp]

This was an endo! She wants to redo the test and cortisol results again, I asked her why if they were normal. I'm not sure what she's looking for now.

[frawnz]

The "normal ranges" for testosterone don't take age into consideration, so they are simply normal ranges for all males, which obviously varies a great deal based on age. This is a much better range table based on age:

[Vettester]

That will be the response with most of your GP's these days. I've worked with a female GP in the past and she is the same way. They will usually treat the score before they treat the patient.

As Frawnz mentioned, you can check for another endo referral or go rogue and find a clinic that will treat the patient's symptoms. I'm actually surprised your score wasn't in the 200's with the amount of LH you're producing, but everyone is different.

She mentioned the SHBG being low. I didn't see the score, do you know what it was?

[ashp]

I emailed her about the SHBG because I don't even remember us ordering that test, so I'm kinda confused. I hate dealing with this stuff!

[ashp]

She replied, fast and said: "I was inferring it from the free level."

She also wrote:

"The SHBG level is affected by many things, but it is not a problem for it to be on the low side. The body regulates the free level so low SHBG will cause low total testo but not necessarily low level of hormone that the body cares about.


To define the cortisol level as clearly normal, we like to see it >18-20. However, it is not abnormal to have it be lower and it is often lower. If you are still feeling very fatigued and the test comes back at a similar level, there is another test we can do which involves giving you an injection of a hormone (ACTH) to stimulate the adrenal to see if the cortisol increases appropriately. This is a more involved test, so just repeating the cortisol may be much easier for you. If you could stress yourself in some way that could increase the cortisol level naturally. Seriously, don't overdo it but this is one of the major stress hormones and it should increase in response to stress. If this seems impossible or weird, just come on in and we can just repeat it to see what it is again. Also, I don't think the lab is open before 8, around 8 should be great."

[zaggahamma]

did u tell her she's stressing you enough

[chuckt12345]

mine came in about 260 and i was prescriped T. Depends on your doctor, a good doctor views you by your symptoms and not just on the numbers. If your having prbs with your sex drive tell him that.

[frawnz]

Yep. I kind of have my symptoms list ready every time I go, and I make sure I emphasize them:

low libido
low energy
unnatural muscle fatigue, especially when working out
testicle shrinkage
etc

[ashp]

I haven't done anything since getting this results, wasn't sure what to do. If you had my bloodwork above at age 29 would you continue to pursue this as a potential issue? I still have a low sex drive, problem building muscle at the gym and fatigue. Other people have suggested sleep studies but it just seems like some kind of attempt to boost up my test levels for a month would be a real easy way to see if it helps rather than constantly wanting me to repeat the tests.

I don't have any other endos in network so I would have to keep trying to persuade her to try something. :/

[zaggahamma]

I haven't done anything since getting this results, wasn't sure what to do. If you had my bloodwork above at age 29 would you continue to pursue this as a potential issue? I still have a low sex drive, problem building muscle at the gym and fatigue. Other people have suggested sleep studies but it just seems like some kind of attempt to boost up my test levels for a month would be a real easy way to see if it helps rather than constantly wanting me to repeat the tests.

I don't have any other endos in network so I would have to keep trying to persuade her to try something. :/

yes why not pursue it...and its never a bad idea to check your sleep especially if you suspect something....also urologists prescribe test as well as GP/FAMILY DOCTORS....you're not healthy now stick to this bro..u can thank me later