Blood work help - Low T

[gnosis]

I finally got some blood work done after a few years of feeling very tired, super low libido, ed, and gaining weight no matter what I did.

I've been reading up on trt for a little while, but it would be great if someone could comment on these results and offer some guidance.

I'll be starting self trt soon, then when I get back to the states I'll go to my doctor for an rx.

35 years old
Caucasian
5'11"
275 lbs
Bf% high (probably 20%+)

Only taking cabergoline at 0.5 2x week to increase sensitivity

Test 151 (264-916) LOW (I've never tested above 350)
Free Test 5.4 (8.7-25.1) LOW
E2 12.4 (8.0-35.0)

LH 6.7 (1.7-8.6)
FSH 2.7 (1.5-12.4)
SHBG 18.7 (16.5-55.9)
Prolactin 5.1 (4.0-15.2)

IGF-1 169 (88-246)
TSH 1.7 (0.450-4.500)
Thyroxine (T4) 8.1 (4.5-12.0)
Free Thyroxine Index 2.0 (1.2-4.9)

Thanks very much!

[Youthful55guy]

You are definitely low on T and especially Free T. E2 is also on the low side, but that is to be expected with low T (T is the precursor molecule to E2).

Your SHBG is also on the low side and I suspect this could either be the root of the problem or a result of low E2 (E2 tends to drive SHBG up and T tends to drive it down). You need normal levels of SHBG binds T and protects it from rapid metabolism in the liver. On the other hand, if SHBG is too high (like mine), it can excessively bind T and drive down Free T. You need normal levels of Free T because SHBG-bound T cannot cross the blood-brain barrier for you to feel "normal".

Your LH is in the normal range, but a bit high. Your FSH is in the normal range. From the surface, it does not appear that you have primary hypogonadism (testicles not working properly) but we can't rule it out either. On the other hand, with normal gonadotropins (LH & FSH) it does not appear to be secondary either (problem with the brain/pituitary axis). We need to know more about when during the day the LH/FSH test was run. It is very important that it be FIRST THING IN THE MORNING (as soon as the lab opens). LH & FSH (especially LH) are highly episodic (released in pulses) and have a relatively short half-life (20 minutes for LH and a little longer for FHS). So, if you miss a pulse, you could get a false "low" reading. About 50% of your daily LH/FSH is released during the last 4 hours of sleep, REM sleep to be specific. So, that is why they establish the normal ranges on waking LH/FSH levels.

It's your low SHBG that leads me to think that may bee the root of your problem. It would also point to the importance of frequent dosing once you do go on a TRT protocol. Guys with low SHBG burn up T faster, so you need to feed it into the system more frequently. If you inject large amounts (of T-cyp or T-eth) just once a week (as some still do), you will burn it off rapidly and not be able to maintain T levels over the week. It also puts stress on the liver. From what I've read, guys with low SHBG tend to do better with daily subcutaneous injections, but that is only anecdotal "bro science". There is also some logic to using a longer-lasting T ester (e.g. Nibido = Testosterone Undecanoate). It's slower release kinetics might feed T into your body at a more steady daily rate. HOWEVER, this is still a relatively new treatment and I've read very mixed reports on the satisfaction of users.

Last piece of advice is to read the first post in the sticky string on the first page of the forum called "Best Practices in TRT". There I discuss many of the important elements of TRT in more detail.

[gnosis]

You are definitely low on T and especially Free T. E2 is also on the low side, but that is to be expected with low T (T is the precursor molecule to E2).

Your SHBG is also on the low side and I suspect this could either be the root of the problem or a result of low E2 (E2 tends to drive SHBG up and T tends to drive it down). You need normal levels of SHBG binds T and protects it from rapid metabolism in the liver. On the other hand, if SHBG is too high (like mine), it can excessively bind T and drive down Free T. You need normal levels of Free T because SHBG-bound T cannot cross the blood-brain barrier for you to feel "normal".

Your LH is in the normal range, but a bit high. Your FSH is in the normal range. From the surface, it does not appear that you have primary hypogonadism (testicles not working properly) but we can't rule it out either. On the other hand, with normal gonadotropins (LH & FSH) it does not appear to be secondary either (problem with the brain/pituitary axis). We need to know more about when during the day the LH/FSH test was run. It is very important that it be FIRST THING IN THE MORNING (as soon as the lab opens). LH & FSH (especially LH) are highly episodic (released in pulses) and have a relatively short half-life (20 minutes for LH and a little longer for FHS). So, if you miss a pulse, you could get a false "low" reading. About 50% of your daily LH/FSH is released during the last 4 hours of sleep, REM sleep to be specific. So, that is why they establish the normal ranges on waking LH/FSH levels.

It's your low SHBG that leads me to think that may bee the root of your problem. It would also point to the importance of frequent dosing once you do go on a TRT protocol. Guys with low SHBG burn up T faster, so you need to feed it into the system more frequently. If you inject large amounts (of T-cyp or T-eth) just once a week (as some still do), you will burn it off rapidly and not be able to maintain T levels over the week. It also puts stress on the liver. From what I've read, guys with low SHBG tend to do better with daily subcutaneous injections, but that is only anecdotal "bro science". There is also some logic to using a longer-lasting T ester (e.g. Nibido = Testosterone Undecanoate). It's slower release kinetics might feed T into your body at a more steady daily rate. HOWEVER, this is still a relatively new treatment and I've read very mixed reports on the satisfaction of users.

Last piece of advice is to read the first post in the sticky string on the first page of the forum called "Best Practices in TRT". There I discuss many of the important elements of TRT in more detail.

Great reply. Thanks so much Youthful55guy. I've read many of your posts, as well as the best practices sticky, and plan to use that to self trt.

My blood work was taken at 11 am, roughly 2.5 hours after waking up. Hopefully I didn't get a false low reading on the lh or fsh.

I will get more blood work done 6 weeks into self trt:

Cyp - 14-15 mg ed / 100 mg wk
Hcg - 70iu ed / 500 wk

Thanks again

[kelkel]

Agree with YG55. Only thing I see a little different is that with the relatively upper range LH and still low T the issue very well may be primary. At least it surely leans that way at first glance. Re your caber, I'd reduce it to .25 x 2 per week. It's all you need and you won't feel a difference. Plus, you'll save money or at least stock up some extra caber for future use.

[gnosis]

Agree with YG55. Only thing I see a little different is that with the relatively upper range LH and still low T the issue very well may be primary. At least it surely leans that way at first glance. Re your caber, I'd reduce it to .25 x 2 per week. It's all you need and you won't feel a difference. Plus, you'll save money or at least stock up some extra caber for future use.

Thanks very much for the reply Kelkel.

I'll reduce that caber for sure.

[kelkel]

Thanks very much for the reply Kelkel.

I'll reduce that caber for sure.

No worries. Re Caber I'm a big fan so I'm not telling you that out of any form of disdain. Just that it will give you the results you want at a lesser dose.

[gnosis]

No worries. Re Caber I'm a big fan so I'm not telling you that out of any form of disdain. Just that it will give you the results you want at a lesser dose.

Sure, no problem. Thanks for clarifying.

I'm a big caber fan too. The best for sensitivity and explosive finishes.