29 year old male...first time bloodworm - am I a candidate for HRT?

[1luv]

Hello All,

29 year old male. Lab tests below:

I am wondering if anyone can give any sort of reaction to these results. My PCP is not the most knowledgable when it comes to HRT...so I want to see if it is something I would benefit from pursuing.

Testosterone, Serum - 749
Free Test (Direct) - 10.2
Estradiol, Serum, Ms - 22
Free Estradiol, Percent - 1.8
Free Estradiol, Serum - 0.40
LH - 5.3
DHEA - 238

I am not sure what else to post...i tried posting entire results but it is too large...

[Chauffeur]

Posting the reference ranges for those labs would be very helpful.

Total testosterone looks awesome though.

[1luv]

Testosterone,Free And Total

Test Low Normal High Reference Range Units Testosterone, Serum 749 348-1197 ng/dL Comment: Adult male reference interval is based on a population of lean males up to 40 years old. Free Testosterone(Direct) 10.2 9.3-26.5 pg/mL

[1luv]

Estradiol, Free Serum

Test Low Normal High Reference Range Units Estradiol, Serum, Ms 22 pg/mL Free Estradiol, Percent 1.8 % Free Estradiol, Serum 0.40 pg/mL

[1luv]

Luteinizing Hormone(Lh), S

Test Low Normal High Reference Range Units Lh 5.3 1.7-8.6 mIU/mL

[2Sox]

I agree with Chauffeur says. Without knowing anything else about you and your medical history, your Total T number looks good as does your Free T- even though it's on the low side of the range. Why do you want to pursue TRT??

[1luv]

I started looking into it not based off of bloodwork, but based off how how i felt. I recently had some traumatic brain/spinal cord injury which i was lucky enough to get out of basically unscathed (after a surgery and year recovery) but have never felt quite the same since. I then read a few articles that linked traumatic brain injury to drops in test levels...

My energy level has gone down, my mood has declined, my libido suffers...which is why i began down the path of bloodwork.

[Chauffeur]

Free T is definitely far from optimal and could certainly be why you don't feel well. Did you happen to have your SHBG or FSH values measured?

[1luv]

I looked through my results and found no tests for SHBG or FSH...could they be called something different?

[1luv]

These were the tests I had done:

Comprehensive Metabolic Panel
CBC
Lipid Panel
Testosterone Free and Total
Estradiol
DHEA-S
TSH
PSA
LH

[Chauffeur]

I looked through my results and found no tests for SHBG or FSH...could they be called something different?

No, they'd be labeled as such. They'd be nice to have for sure, but it doesn't really change the fact that your free T kinda sucks.

What was your TSH value? Many consider it to be a poor indicator of thyroid function, but it's all you've got right now.

Based on your history, it seems likely that your accident played a role in how you're feeling now. Were/are you taking a lot of pain meds for a long period of time?

[1luv]

TSH - 1.060 (.45 - 4.5 reference interval)

yes, I was on fairly high doses of narcotic pain medication for an extended period of time. I am currently completely off of medication now and have been cleared to get back in the gym.

[Chauffeur]

TSH - 1.060 (.45 - 4.5 reference interval)

yes, I was on fairly high doses of narcotic pain medication for an extended period of time. I am currently completely off of medication now and have been cleared to get back in the gym.

I'd say it's pretty likely that the injury you sustained has something to do with this, and the opiate use probably played a role as well.

You may want to give it some time once you get back in the gym and have your diet in check. Your body might be able to recover from this. If you retest and your free T is still low then some type of treatment could be an option.

It's likely going to be difficult finding a competent doctor if treatment is necessary. Many doctors will have a hard time looking past your total testosterone value, which is VERY good. There aren't many who understand the importance of free testosterone.

[1luv]

Thank you very much for your time and thoughtful insight, Chauffeur!

[kelkel]

I'd say it's pretty likely that the injury you sustained has something to do with this, and the opiate use probably played a role as well.

You may want to give it some time once you get back in the gym and have your diet in check. Your body might be able to recover from this. If you retest and your free T is still low then some type of treatment could be an option.

It's likely going to be difficult finding a competent doctor if treatment is necessary. Many doctors will have a hard time looking past your total testosterone value, which is VERY good. There aren't many who understand the importance of free testosterone.

Solid advice above. Be sure to test your SHBG as well as Vit D levels next time. If SHBG is through the roof and binding all your T Vit D can help to some extent, but know your D level before you supplement with it. It's a fat soluble hormone and high levels for extended periods can be toxic. Other items such as stinging nettle root and/or avenacosides can help reduce shbg. If all that fails speak to your doc (or a new one) about danazol.

[1luv]

What is the best way to proceed with additional testing? My doc is exhausting me as he just simply has no clue...

[kelkel]

What is the best way to proceed with additional testing? My doc is exhausting me as he just simply has no clue...

Best way to proceed would be to find a better doctor first. Don't feel obligated to stick with a doctor just because you've been with them for years. I see my GP for regular doc stuff and a Uro for all my TRT needs. Do some research in your area or even post up the area you live in and maybe someone here can guide you. Finding the right doctor is imperative.