Nice forum! I have been researching this stuff for a while now and would like some input on some bloodwork I have done.
I have an Engineering background & quite like to treat the body as a "system" so a lot of these blood tests results are fascinating for me and I love researching possible causes and solutions. I'm very into healthy eating generally & have tried quite a few supplements over the years. Mostly eat paleo-ish with some junk and alcohol and have done for 5+ years.
Exercise wise at the moment I walk to work during the week (25 mins each way) and try to do some kettlebell work 2-3x per week. I used to do Stronglifts 5x5 in the past but really messed up my knees (patellofemoral syndrome) so haven't done any serious weight lifting in the last 2 years. Trying to work on my flexibility at the moment so hopefully I can get back to weight lifting eventually but some knee pain still persists over 2 years later.
I'm not overweight according to BMI but I do carry excess fat around my midsection. I likely fit the skinny-fat category. I have a reasonable amount of muscle, especially in my legs but I don't seem to respond particularly quickly to weight lifting in terms of hypertrophy. I have quite a lot of body hair , chest hair etc. So lots of those things don't particularly point to traditional "Low-T". I have previously suffered from low energy/anxiety/depression at times but have mostly got past all that with healthy eating and some supplements. Strangely at the moment I am finding Spirulina in particular to be very helpful for energy levels. Have done the basics of Vit-D/K2/Magnesium for years now. Recently took a break from vitamin-D and noticed a huge decrease in energy levels so definitely going to be keeping that up.
Basically the point of this post is that I concluded recently that I have zero libido / sex drive and pretty much never had one. It's strange, I kind of always assumed it was normal but I spent some time reading posts on asexuality.org and identified with lots of the posts there but then decided to check hormone levels to rule that out as a cause. Asexuality as a concept doesn't really make sense to me from an evolutionary perspective or otherwise. Some of the common posts on here also mention the concept of seeing women as art more than lust and I can also strongly agree that this is how I feel generally.
In terms of investigation I have decided to mostly do as much as I can myself as I don't really fancy my chances at finding a knowledgeable enough doctor and nobody will care about my health more than myself at the end of the day. Hence I have been doing private blood tests using medichecks in the UK.
Anyway onto some blood results:
First tests I did in May 2016 (I know, ages ago. I kind of started looking into it a year ago but didn't really take it seriously, I recently read a book Man Made: A Memoir of My Body - Ken Baker and it kind of inspired me to try and do something about this as I resonated with a lot of what he said)
This basic hormone panel was my first step. Obviously total testosterone is very low compared to age-referenced bands.
Then I learned about prolactin so had that tested on its own:
Okay so that's quite elevated which is interesting. However it's only double the top of the range and most of my search suggests that prolactinomos could often cause levels 10's or 100's of times above the norm. So definitely elevated and probably causing problems
Interesting point here, it turns out that my sister has also had prolactin tested for other reasons and also has a similarly raised level (around 2x the range but not insanely high). She went as far as having an MRI to check for prolactinoma but nothing was found. Additionally my brother has some gynecomastia despite significant exercise and good diet but has not had any tests. So it's possible that there may be some genetic component here or at the very least it's possible that my high prolactin will be idiopathic.
Next thing I did was December 2016: T,E2 & Thyroid
T a bit higher here but still not ideal and no indication of free T. E2 is pretty high but still "in range". Thyroid mostly looks okay I think, TSH is a bit high but fT3 and fT4 look okay to me based on guidelines I have seen on this site (middle - upper inside range).
Okay so finally I just had a big blood panel done a short while ago (May 2017), This blood panel is intended for people interested in TRT and covers a large range of things.
So I think most of the blood count stuff looks okay, nothing bad really with liver, kidneys etc. Cholesterol isn't ideal but I'm not too concerned especially as most of the links between raised cholesterol and heart disease have proven to be pretty tenuous recently.
fT3 is quite low this time. Total T is quite low. Calculated free-T is very low and below lab range.
Prolactin is still elevated. I had been taking some P5P for a while before this test to try and control prolactin but I stopped taking it 5 or 6 days before the test so hopefully should not have had much of an effect on the result. Can't say I particularly noticed much from P5P (was doing 100mg a day).
Would appreciate comments & suggestions. I'm guessing that the way forward if I managed to get a competent doctor/endo would be a pituitary MRI to search for a prolactinoma followed by a trial of a dopamine agonist like cabergoline. Thing that annoys me here is that I can logically conclude that a macroprolactinoma is very unlikely given the prolactin levels so I'm not in danger of occlusion on the optical nerve or similar. So the next step either way after an MRI would just be a trial of a dopamine agonist rendering the MRI kind of pointless. I'm not really sure what the best way to go about all this is within the NHS (UK). Even getting an appointment at a normal GP has a 2 week waiting list and no guarantees I will even be able to convince them to refer me to an endo. Even if I can that's probably a month+ long wait too. I'm a little tempted to try get my hands on some caber myself and give it a go but not sure if that's risky without medical supervision.
Edit: Just adding some more info. I do suffer from some brain fog from time to time and do struggle a bit with motivation to get things done / get out of the house, but not really depression anymore. I'm also quite sensitive generally to certain foods, some things can give me brain fog quite quickly. Also just reviewing my logs from November time I was taking Shilajit mineral pitch for a few weeks up to the December Testosterone test (where level was pretty good). I was taking Ashwagandha KSM-66 for a few days before the test too. IIRC I stopped taking Shilajit because it led to bad brain fog eventually & Ashwagandha eventually leads to complete apathy for me so I also no longer take that regularly. I wonder which (if either) of these things contributed to a decent Testosterone reading that time. Hard to say. While taking Shilajit I also had very good morning wood a few times (something that I have not experienced much of recently)