T Nation

24 Y/O, Blood Tests


#1

Hi all,

I am 24 years old. I do bodybuilding and did general health check few months ago at sports doc but they did not do any hormone checks therefore I decided I will do those separately now. What stroked my attention was the level of testosterone. I would NEVER tell I could be testosterone deficient. I am 5’10", 202lbs and ~10% body-fat. Pretty strong in gym as well.

Truth is I noticed do not have libido as I used to have and my tendons ache at places where it never did. But I have been treated for anxiety and depression since 16 so it’s hard to tell what affects my current level of anxiety.

These are results I got:

10-Sep-2018
DHEA… 5.05 umol/l
LH… 6.34 IU/l
FSH… 6.5 IU/l
TST… 10.4 nmol/l
Free TST(calculated)… 0.186 nmol/l
SHBG… 36.6 nmol/l
FAI… 28.42
Estradiol… 29.6 pmol/l

Morning sample at 7 AM

I went with these results to a GP and expressed my concerns about low T. She decided to redo blood tests but this time TST only, Thyroid and Prolactine.

TSH… 1.88 mU/l
Free T4… 15.3 pmol/l
TST… 10.0 nmol/l
Prolactin… 126 mU/l

Blood sample was taken at 2 PM this time

I was told everything is in order and no further action need to be taken. I am the only one who thinks such TST levels are unacceptable for 24 yo guy or is something wrong with doc?

Anyways I pulled some strings and circumvented GP and I have an appointment at urologist. I know many of you guys are more knowledgeable about male hormones than the most of GPs out there so I wanted to know second opinion from you. Thanks!


#2

You have a problem, doctors in your country do not care about your symptoms, they only care about references ranges, if you are in range you’re normal even if you have all the classic signs of an androgen deficiency.

This is how managed care works. You are low in testosterone without a doubt, these ranges don’t account for age. It’s not alright for a 24 year old to have the same testosterone as a 90 year old man because you will lose 1% of your testosterone every year after 30 and eventually end up in the range you are scoring now when you reach an elderly age.

So you see it’s not normal for you to be this low so early in life. Most doctors don’t use common sense, they use reference ranges.

I suggest you go private and avoid the NHS like the plague. Almost none of these doctors know what they are doing when it comes to sex hormones. GP’s have no business treating you for an androgen deficiency since they have zero knowledge, endocrinologists and urologists typically have little to no zero knowledge as well.

It’s the same everywhere in the world, endocrinologists and urologists typically just aren’t taught or trained in sex hormone replacement therapy.

The only doctors that know what they are doing are those into sports medicine and anti-aging, this is where the testosterone world has existed for several decades.


#3

Yea that is what I though. That level of TST is definitely not sufficient for guy my age. Even though I am bodybuilder and bombarding my body often during caloric deficit, that low test is not normal I think. Truth is during my earlier sport career I abused steroids since 18. I have been off now for more than 3 years. I guess there is a good chance I did this to me. I acknowledge the responsibility. I accepted the risk then and I do so now. But if I am hypogonadal I want to be treated properly so I can carry on normally.

The urologist I am visiting shortly has a website saying he also specializes in andropause which is tstcurrently deficiency. Overall he is very well known doctor here. I hope he knows what he is doing and will take me seriously


#4

I visited urologist on Monday. He did semen analysis + testicles check + blood tests.

My semen is in great condition, testicles are all right. Have a look at bloods.

S-SHBG : 22.2 nmol/l [14.55-94.64]
S-Testosterón : 9.64 nmol/l [7.0-26.0]

Doctor says everything is in order. What the hell??


#5

Anabolic Steroid induced hypogonadism is likely the culprit of you’re problems, you could try a HTPA restart or go on TRT. How do you feel? If you feel great, then the numbers don’t matter, if you feel like shit and have these numbers, a diagnosis of androgen deficiency can be made, some people naturally have very low levels of testosterone and it isn’t an issue.

If you’re currently in a hefty caloric deficit (cutting intensely) you’re testosterone will plummet, if this is the case, 9-10nmol or even lower is normal, I’ve seen bloods of guys pre-comp that have TT’s lower than 100ng/dl (4nmol) hence why many natural bodybuilders during competitions look very flat and lack the muscle fullness you see enhanced guys with, they have little to no androgen production at the time of competition. I can link a piece of literature that documented an individual (natural) prepping for a competition, prior to the competition his testosterone was 900ng/dl, during it was 200ng/dl and afterwards it rose back up to nearly 1000ng/dl. So if you’re cutting and feel like shit… stop eating in such a deficit, you don’t need TRT.

May I ask exactly what you used, how long you were on for and what doses?

There is a universal disliking of doctors on this board, the doctor bashing is unwarrented, endcrinologists know about sex hormones, the notion that they don’t is bullshit, they may not be up to date on testosterone replacement protocals because they have bigger things to worry about. What’s more serious, an old, obese male who doesn’t do any form of exercise, eats badly and has a poor sleep schedule with a TT of 300ng/dl or an individual with addisons disease suffering from an episode of adrenal crisis? When you think of the medical issues these doctors see daily, subclinical hypogonadism is not on the top of their checklists, too add to it, many people (like the example I gave above) can potentialy normalize their testosterone and eliminate symptoms of low T by sleeping better, choosing better dietary options and loosing weight. While some can say “oh but @unreal24278, I’m too tired with low T to go to gym therefore I can’t lose weight”. Who said anything about going to gym? Eat under you’re maintenance caloric intake and you’ll drop some pounds. That being said, you’re young, fit and exercise regularly, I’m just pointing out that many people who are on TRT probably don’t need to be (not that that’s a problem, just pointing it out)

Even the least intelligent of endocrinologists know more about hormones in general than you or I. Doctors who are into sports medicine and anti aging may be the best bet to get hormones prescribed to you, however they’re also more likely to prescribe you higher doses (YESSSSSSSSSSSS, HUGE PLUS), and they’re more expensive, they make tons of bank from you being their patients, and that’s not a bad thing, however you need to know sometimes these doctos will have more then you’re health on their agenda, there are a few clinics in Florida that’ll prescribe you 200mg test, 200mg deca, 50mg winny or anavar, they are prime examples of clinics that will treat you but are more focused on making money than their patients. It’s probably something I’ll do when I’m older as in literally next year or even as early as later this year if I have the time as I’d feel comfortable taking high doses if it was monitered via bloods and whatnot.

I’ll say this now, on this board there’s a notion that SHBG dictates injection frequency. NOWHERE does ANY literature exist saying this is the case, SHBG is a transport protein that a large portion of testosterone (and estradiol and dihydrotestosterone) Whatever testosterone isn’t bound to SHBG or Albumin is free testosterone, having more free testosterone doesn’t mean you go through testosterone at a faster rate, how fast you burn through testosterone is up to individual metabolism and elimination of the drug. Want to prove me wrong? Post some literature on it, if you feel better on more frequent shots it isn’t due to SHBG, it’s due to you’re individual metabolism of the drug and how you react to fluctuations in hormonal status, some are very sensitive to even minor hormonal fluctuations, others can feel the same at 1500ng/dl and at 500ng/dl

How’s you’re cardiovascular health?

Also I should say even if a doctor doesn’t have you’re health at heart, that’s not exactly a bad thing, if you have a supportive doctor that’ll prescribe and whatnot and you’re aware of the risks, it can be a dream come true, and both you and the doctor will get along very nicely lolololol. Many people believe in a strict code of ethics, I believe if the patient is aware of the risks, and the doctor is willing to prescribe, there’s no wrongdoing being done, that being said I do have a problem if these hormones are being prescribed too like… naieve people who just want to lose a couple of pounds


#6
  • Low libido the most of the time deteriorating during years.

  • Less semen that I used to have.

  • Moodiness

  • Less quality of sleep

None of these were acknowledge before because I related them to heavy training, dieting, etc…

  • The first tst level was checked during dieting (~1800 kcal) - 10.4 nmol/l

  • I have been eating above maintenance for 2 months now (~2800+ kcal) - 9.64 nmol/l

I ran approx 6 cycles during ages 18-21. Average cycle duration was 10 weeks. I used no more than 2 substances at the same time - usually it was some testosterone ester 500mg/w max with another substance in moderate dosage.
Something like

  • tst+dbol
  • tst+stan
  • tst+nandroP
  • tst+superdrol
  • etc…

it’s well, I have regular checks


#7

At least it seems like you knew what you were doing (dose wise, duration and compunds), so props for that I guess. Do you have bloods prior to AAS use? I can only give advice however I’ve seen similar situations before, it isn’t so much about age, it’s about whether you bounce back or not, it’s comparable to russian roulette, you never know if you’ll be the one who doesn’t bounce back afterwards. I’d assume it’s related to prolonged use abuse of anabolic steroids, however I’ll ask a few more questions

  • How’s you’re lifestyle (stress, sleep schedule, anxiety)
  • Do you take any prescription meds, if so, what are they?
  • How’d you react to superdrol (unrelated, but it’s known for being notioriously harsh so I’m curious as to how you handled it), I’ve heard stories of people having hypertensive crisis level blood pressure readings from it.

#8

I am stressed easily and sometimes chronic worrier I would say. I have been treated for anxiety since 16. Now I am much better because of psychological treatment
However the anxiety is double edged sword - what comes first? anxiety or low T? Chicken or egg?

Yes, sertraline for the before mentioned anxiety. But I feel it is not helping much in terms of anxiety. However I keep taking it just in case, I consider tapering down in future.

One of my favourite compounds. Zero sides except painful pumps especially lower back. I usually took 30mg. Tried 40mg for couple of days but I did not see much difference.


#9

Low testosterone can cause or exacerbate an existing anxiety disorder, definitely a double edged sword. A 276 total testosterone isn’t subclinical in the sense that it’s a disease state level, the studies show a total testosterone level below 440 is associated with cardiovascular disease over a 10 year period, other studies show the cutoff point to be higher in men with higher SHBG since free testosterone is affected to a greater degree.

CONCLUSION:

These data showed that a testosterone threshold of 440 ng/dL was associated with increased Framingham 10-year CVD risk in middle-aged and elderly men. Poor sexual performance, decreased morning erection, and loss of libido had an impact on the testosterone threshold for CVD risk. The threshold level was higher in men with sexual dysfunction. Further study is required to evaluate the validity of these testosterone thresholds for CVD risk.


#10

may i ask something. i have low t but im underweight and maintain/lose weight because it seems i dont eat wnough (im eating 3k daily) im 6’2” weight 154 should i bulk up to 180 and re think of trt then? i do have low t low lh fsh igf1 but high shbg. you also talk about cardiovascular health. i do have low pulse and im not an athlete. pulse at 38.
@systemlord what do you think also?

i forgot to mention i have e2 of 10

sorry for highjacking thread. since talking about weight i just wanted to know this


#11

When I was low testosterone my appetite was suppressed, when I get my testosterone levels elevated, my appetite is insane and I want eat everything in sight. When my estrogen is high in relation to my testosterone, my appetite decreases regardless of testosterone levels.

Your estrogen is high in relation to your testosterone, so it’s no surprise your appetite is suppressed. So for you it’s a double edged sword, low testosterone and high estrogen.


#12

It’s already been quite while since I had proper morning wood. My libido is definitely decreased. I am going to visit another doctor for second opinion.


#13

My advice is to seek a private clinic that specialises in hormones, a garden variety GP, endocrinologists or urologists are typically TRT ignorant.


#14

Yes I am going to private clinic that specializes in andrology. I already got a reply from their doctor that from his experience men under 12 mmol/l usually experience problems. Considering my age the treatment might by difficult because exogenous testosterone will affect my fertility he said. But I would rather be infertile than being frigid for the rest of my life :slight_smile:. And since my fertility is over the roof right now, I will consider frozing some boys before (if) I start TRT


#15

again, he could recover t if he ups calories?