Blood results, low free t

[Joe87]

Hi everyone/

I live in the UK.

I recently got private blood test and the results are


TESTOSTERONE 14.01 nmol/L Lab range 7.60 - 31.40
FREE-TESTOSTERONE(CALCULATED)*0.251 nmol/L Lab range 0.30 - 1.00
17-BETA OESTRADIOL 35.17 pmol/L Lab range 0.00 - 191.99
SEX HORMONE BINDING GLOB 38.12 nmol/L Lab range 16.00 - 55.00

I'm 30, 6'2" 185lbs about 12-14%bf. Never done any AAS.

For the last 2 years I have had very low libido, no energy, mild depression, brain fog, irritability and generally don't want to go out and do anything anymore. I had thyroid checked by doc 6 months ago and he said everything is fine, I didn't see the numbers tho. Went to docs after private lab results and he said i need antidepressants because that needs to be sorted before he looks at anything else but I refused antidepressants, finally got him to do a testosterone test but he wouldn't do a free t test. Rang the docs Friday to make a appointment and the receptionist told me I didn't need to as the results are fine so I asked for a copy of my results and she said she would have to ask the doc and to ring back Monday to see if I can them.

The The doctor at the private lad said i should think about trt what do you guys think?

Thanks in advance.

[Youthful55guy]

TESTOSTERONE 14.01 nmol/L Lab range 7.60 - 31.40
FREE-TESTOSTERONE(CALCULATED)*0.251 nmol/L Lab range 0.30 - 1.00
17-BETA OESTRADIOL 35.17 pmol/L Lab range 0.00 - 191.99
SEX HORMONE BINDING GLOB 38.12 nmol/L Lab range 16.00 - 55.00

Antidepressants are a crutch for doctors to get you out of their face. I refused them twice too before I finally found someone that would do the proper labs and diagnose my condition. That was nearly 6 years ago and I have not had "depression" issues since. If your really need them for clinical depression, absolutely get them, but not as symptom control for another disorder. That's akin to taking an analgesic to control the headache that precedes a brain aneurism.

Regarding your labs:
Your total T is somewhat low, about the lower 30% of your age range. Not a red flag, but definitely a yellow flag

Your Free T is low. A major red flag.

Your the numbers for your E2 just look funky. Are you certain they used the sensitive (male) assay and not the standard assay they use for women? The lab should indicate they used the (LC/MS/MS) method. I realize they are in pmol/mL, but when I convert them to pg/mL (Which are the units my lab uses), the range is 0-52. My standard range is 8-35 pg/mL. regardless, it does not look like your are out of range. This does not surprise me because E2 is derived from T in the steroid hormone cascade, so if T is low, E2 will be low.

Your SHBG is not high, about mid-range. However, given your somewhat low Total T, would explain the low Free T. SHBG binds tightly to T to protect it from liver metabolism. It slowly releases the T to become "Free", and Free T is the active T. However Free T has a very short half line (3-4 hours). This is why we need SHBG, but not too much of it. It's really the ratio of Total T to SHBG that drives Free T levels and it's the Free T levels that make us feel "normal".

Bottom line is that in the USA, if your were older, you would probably be a candidate for TRT based on your Free T levels. I have no idea about how UK doctors view Free T. It's just now being recognized as an important male lab in the USA. However, you would want to rule out secondary hypogonadism with LH/FSH tests. If they are low, you would then want to rule out a pituitary tumor or benign adenoma with an MRI.