New Blood Work- Need help sorting this out

[jakesonyou]

The last four months I have been in the process of seeking TRT treatments. I have minimal sex drive, can't build muscle or strength, and I feel sluggish all the time.
My most recent blood test came back (haven't used anything or done anything different) and my testosterone has doubled since two months ago!
How can it fluctuate that much and why then do I still have the symptoms of someone with a testosterone deficiency?
I am actually quite a bit discouraged by this because now I feel like there is nothing out there that can help me.

[Novice489]

How old are you? Hormone levels fluctuate depending on many factors in your environment. How are your stress levels? Do you get consistent sleep?

[jakesonyou]

How old are you? Hormone levels fluctuate depending on many factors in your environment. How are your stress levels? Do you get consistent sleep?

24. I stress out very easily. My sleep is consistent, 8-9.5 hours every night.

[kelkel]

Levels can range based on many factors. You show elevated cortisol and prolactin which can both reduce testosterone levels. Your TSH is also elevated. TSH is a weak thyroid indicator but in your case it shows you need further investigation with a full thyroid panel. Know that hypothyroidism causes hypogonadism as well.
And stress raises cortisol levels. Vit C can help a bit there.

[jomamma007]

well elevated cortisol and stress is going to put a beating on your adrenals.
I'd point your issue to something mental. Depression and anxiety perhaps. But as Kel stated, you need a more thorough thyroid panel to rule out any issues there first.

[jakesonyou]

I'd like to have my free testosterone checked . Maybe my body just isn't able to use the TT at it's disposal?

Also is there anyway this could just be a one off/ false reading? Or if I was truly hypogondal, would this not even be a possibility?

[kelkel]

Your free test is what's useful. Total doesn't really matter. Look at the BW list in the Finding A Doc Sticky and fill in the blanks with what you need.

[jakesonyou]

Your free test is what's useful. Total doesn't really matter. Look at the BW list in the Finding A Doc Sticky and fill in the blanks with what you need.

Will do, Thanks! Is there any difference in the way they treat someone with low free test vs. just low total test?

[kelkel]

A knowledgeable doc will treat you based on free Test. You can have a 1500 total test level but if your free is shit it doesn't matter. Free is what does the work for us.

[jakesonyou]

A knowledgeable doc will treat you based on free Test. You can have a 1500 total test level but if your free is shit it doesn't matter. Free is what does the work for us.

Got ya. So would you treat low free test with traditional means (exogenous testosterone, hcg, etc)?

[jakesonyou]

Bump. Still wondering how a doctor would go about treating someone with low free test vs. low total test.

[kelkel]

You can't separate the two. Best look at your SHBG level and see if it's too high. If so, that's what's binding your free test. Lowering it will allow more free test to do it's job. T and E both circulate in your blood bound to SHBG and partially to albumin. It's what breaks free and hits your receptors (AR & ER) that work for us.

Test your Vit D level as well. Optimum D levels can/will help to reduce SHBG thus allowing more free T.

[jakesonyou]

Most recent tests. I visit with the doc in 2 weeks to discuss everything. Thoughts?

[Rusty11]

I have no real answers. But, your tsh has come down nicely. Your FT is pretty low. Your estradiol is quite low, as well. Like elevated e2, very low e2 can give you all of the symptoms you mentioned in your first post. Just my uneducated thoughts.

[jakesonyou]

I have no real answers. But, your tsh has come down nicely. Your FT is pretty low. Your estradiol is quite low, as well. Like elevated e2, very low e2 can give you all of the symptoms you mentioned in your first post. Just my uneducated thoughts.

Thanks. I feel like I'm in a weird spot. SHBG is high, E2 is low, and Test is low. I know the doc was considering a clomid restart, but doesn't clomid raise SHBG? In for more thoughts.

[kcwebguy]

You might try letting your estradiol come up a bit and see how that helps you. As Jake said, the symptoms you are experiencing can be caused by too little e.