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I am 38 years old and have been experiencing some fatigue, difficulties recovering from workouts, decreased libido and mild depression. Lab results:
Total Testosterone: 533 (reference: 280-800)
Free Testosterone: 7.1 (reference: 8.8-27.00)
Not sure what the free testosterone is so low. Doctor is considering treatment.
Free testosterone is what's important here. It's what works for you. You can have all the total test you can handle but if free is low it doesn't matter. Do you have further BW you can post? SHBG by chance? Anything else, cortisol, prolactin, thyroid, etc.
Tell us a little more about yourself please. Height, weight, estimated BF%? Lifestyle?
And welcome to the forum!
Glad to see you over here on the forums.
Let me collect the lab work and I will forward you all the information, including height, weight and life style. I am new and glad to be here. I hope you guys can assist. I have been feeling awful for a long time now..
If he is considering treatment he had better damn well check your LH and FSH before treatment and don't let him tell you otherwise. (unless he already checked it and you haven't posted it). Don't let him treat the symptoms until he knows the cause, because there may be more at play than primary hypogonadism such as any number of pituitary problems.
And check TSH as well... thyroid levels are necessary for normal testosterone production. Hypothyroidism would also fit the clinical picture you have given us, and if this were the case you would still have symptoms despite being given testosterone as it is the wrong treatment.
Erhm.... maybe post all your blood work results before I type out my entire undergrad haha.
Hello Gentlemen:
Following are my lab works. I am still missing a few (vitamin D) and a few others. But I think the following information can give you an indicator of what is actually going on.
I am 38 years old and weight 150 founds. I consider myself fit although I have always been skinny. I am not sure what my body fat percentage is. But I have little fat in my body. I workout 4 times per week but do little cardio when I go to the gym (bad on my part).
I hope this information helps!
(SHBG) 32,60nmol/L (reference: 13,0 - 71,0)
Thyroid-stimulating hormone 1,51mcUI/ml. (reference: 0,27 - 4,20)
thyroid hormones 1,42ng/dl. (Reference: 1,00 - 1,70)
Aspartate transaminase (AST) 27,3U/L (Reference: 0,0 - 40,0)
Creatine 1,04mg/dl. (Reference 0,67 - 1,17)
Dehydroepiandrosterone (DHEA) 135,42ug/dl.(Reference: 80,0 - 560,0)
Triglyceride 45,2mg/dl. (Reference 0,0 - 150,0)
Glucose 81,5mg/dl. (Reference 70 – 100)
Cholesterol Total 142,1mg/dl. (Reference 0 – 200)
Cholesterol (HDL) 34,29mg/dl. Abnormal (Reference 40,0 - 60,0)
Cholesterol (LDL) 98,77mg/dl. (Reference 0,0 - 100,0)
Total Testosterone 5,33ng/mL (Reference 280-800)
Free Testosterone 7.1 ng/ml (Reference 8.8-27.00)
You're thyroid appears quite good.
You need an LH and FSH test.
Can you tell me what LH and FSH stand for? I think those are the ones we're waiting for.
Assuming that everything is normal, what would explain low free testosterone and would I benefit from therapy if everything else is normal?
Lieutenizing Hormone-stimulates test production
Follicle Stimulating Hormone-stimulates spermatogenesis
Both critical to determine pituitary function.
TSH is fine but is a weak indicator for overall thyroid function. You would need at a minimum FT3, FT4, RT3, Antibodies.
Thanks for the response. I will get those to you as soon as i get them.
assuming all is normal, what would explain low free testosterone? stress, medications? I read somewhere that receptors can go bad?
Stress, bad diet, lack of exercise, and the list goes on.
Lifestyle changes in some people can treat mildly lowered test such as yours... it's worth a shot before jumping on trt. Just don't waste your time with "test boosters" from supplement shops.
And don't fret about receptors until the LH comes back.
Thanks, bro. They had to put me on lexapro (antidepressant) because I was feeling like grap. Hopefully, all this is short lived.
I was tested for vitamin D2 and D3 and was wondering if this could be the origin of my low free testosterone:
Vitamin D2 - - I tested 3dl (normal range is above 30dl)
Vitamin D3 - - I tested 23dl (normal range is above 30dl)
Total vitamin D results: 23dl.
I welcome your opinions.
This is a concern as it can lead to poor bone mineralization, etc. However, correcting vitD levels will not help your testosterone. (Except for the generalization that proper nutrition supports healthy test levels.)
Did your doctor order this? If so ask why, because there could be a great number of disorders he was investigating (not testosterone related). If you ordered it yourself out of curiosity then don't get overly excited about it. You can solve this by supplementing vitamin D. A lot of cows milk has this added.
Most people who live in the top half of North America can't physically get enough sun to promote healthy vitD levels... and it is winter too. Everyone in Canada and most of the states should be making an effort to get more vitd in their diets.
Ahem... LH and FSH tests? stop trying to find new and obscure causes! haha
...adding to my above... D2 is converted to D3 in the body in order to be useful. Your test suggests your body is converting D2 just fine but is not getting enough of it.
Like I said, is your doctor treating or investigating Crohn's? Celiac? Liver problems? Etc.? Such disorders affect vitD absorption from your diet.
If not, just supplement.
Vit D can improve free testosterone levels by virtue of decreasing shbg levels, but not to a large degree. And yes to directly above!Quote:
Originally Posted by MODO
Thanks MODO for your input. I asked her to order the test out of curiosity. She also order liver function (liver enzymes) as she is considering testosterone replacement therapy in case the origin for low testosterone cannot be found.
I am still waiting on the LH and FSH test. I was told they would be ready on Monday.
If I end you getting T replacement, I have no clue what kind to take or whether the gel is better than the shots. If I get it, why not take advantage to build some muscles? I have a lot to learn. But I think this site is a good resource.
Hopefully the doctor can restore your normal function and you won't have to worry about this.Quote:
Originally Posted by jump100
YES! And start with mastering diet and training before taking advantage of anything else.Quote:
Originally Posted by jump100
By the way, on an unrelated topic, I am trying to edit my profile (add a picture) but I am being directed to page saying I don't have sufficient privilege to do so. What am I having this issue?
If you are on a computer, click on the "settings". The profile and notifications links don't work for me either, but you can access your picture via settings. If it still doesn't let you, you may need to make more posts first.Quote:
Originally Posted by jump100
Folks - Following are the rest of my lab results:
Prolactin (PRL) - 8.19 ng/ml (Reference 4.0-15.2)
LH - 7mUl/mL (Reference 1.7-8.6 mlU/mL)
FSH - 3.64mUl/ml (Reference 1.5-12.4 mUl/ml)
Estradiol 15.85 pg/mL (Reference 7.63-42.6)
Free T. (test was repeated) - 10.18pg/ml (Reference 8.80-27.00) -
Free T is still below average and may be the orgin of all my maladies. I welcome your input (should I lobby my doctor for T replacement or is it still too early?)
Even though this LH is in the reference range, it is very high. And your testosterone being bare minimum...Quote:
Originally Posted by jump100
Best thing to do is to make some lifestyle changes and give it some time. If your levels don't improve within a few months I would definitely be asking for TRT and/or HCG. You could benefit. Just don't jump straight to it just yet because your hypogonadism may be transient, and recovering your natural test production is comparatively better for long term health.
ps - your doctor may want to run another test or two, or he may be happy with the biochemistry to say this is age-associated primary hypogonadism... although it might be iartogenic depending on your cycle history... or both. I figured I'd mention this in case you wanted to google more info on it. Treatment is the same either way: horomone replacement.
Remember: low normal T is only a problem if you remain symptomatic. Being in the low half of the reference range when symptoms aren't present is still comparatively healthier than being on TRT. I know you have symptoms now, hopefully that changes! But if you are below reference range then TRT is indicated.
I edited that like 8 times... done now, promise.
Thank you, MODO. I think that the most prudent approach would be to wait a few months after my life style changes are able to make a difference. I was inactive for 6 months so this may have had an impact on my overall health.
I have eliminated all sugars from my diet and increased fat consumption. I have also been lifting heavier (deadlifts, bench press and shoulder press). I need to sleep more and work on reducing stress. I work for the U.S. Government and I am posted overseas so I have a very stressful job.
It’s amazing how damaging to your health is the lack of physical inactivity.
Sounds like you've got the right idea! Be careful with the fats of course, other than that keep at it and hopefully you will be feeling better soon.
Great answer.Quote:
Originally Posted by MODO
I'll add one thing without re-reading the whole thread. Have Varicoceles been ruled out?
I will meet with the doctor on the 10th to discuss the lab results. She examined the testicles the first time I saw her and she said the testicles were normal. But I have noticed that one is slightly larger than the other one.
It looks like he's been through a physical so hopefully the doc was on the ball... so to speak...Quote:
Originally Posted by kelkel
jump100 you may want to ask your doc if she wants to image for varicoceles, and her answer will tell you whether or not she's ruled it out yet.
ha ha ha.....Quote:
Originally Posted by MODO
And if she looks good have her check every visit.
ha, hell yeahQuote:
Originally Posted by kelkel
Ha, yes, she is on the ball. By the way, I work for the US Government and I am posted in Bogota, Colombia. The Dr. is a Colombian female and very good looking too.
Don't hate now....
Have your phone's camera ready next time you see her. ;-)Quote:
Originally Posted by jump100
By the way guys. Great discussion.