T Nation

29 y/o, Total and Free Testosterone?

I’m new here, and someone told me that you guys know a lot about testosterone, so I thought I’d post my question here.

I’ve been feeling awful for about 6 months, and my Dr just recently wanted to check my T levels. He sent me to get the work done, and wanted me to bring the results back to him. I have them but I’m a little confused by them. I don’t understand any of the levels.

My total testosterone was 498 ng/dL
Free Testosterone was 11.0 pg/mL

My total looks like it’s within ranges (the ranges are 280-800), and the free t looks like it’s within range but a little low (9.3 - 26.5).

I’m not sure how to interpret them. Do these look good for someone who is 29?

Thanks for any advice.

Don’t let them tell you that your in range so nothing will be done. I was in the low 300 for TT for years and nobody would help because i was in the ranges I felt like crap and did not have the sex drive that i should have. Well I what took shit into my own hands met with numerous Dr.s until I found one with knowledge and an oped mind and today i should be in the 800’s for TT not sure blood gets drawn today and I’m starting to feel great again.

Now we just have to get the adrenals and thyroid figured out. Two posters on her to pay attention to are KSMAN and Hardasnails. They are full of information and it aint bullshit.
READ THE POST UP TOP OF THE FORUM MOST QUESTIONS CAN BE ANSWERED OUT OF THEM

The borderline low free T would most likely be “low” if the range was age dependent since free T levels fall off markedly with increasing age. I have seen countless people (on the forums) with a free T value such as yours who have all the signs and symptoms of hypogonadism. However, trying to get a regular doctor to treat you will be VERY difficult. Most regular docs (endos included) place more importance on total T levels than on free T levels and of course borderline low levels are considered “normal” regardless of your age.

There is a need to look for and fix causes, not just mask the symptoms with TRT. T can be reduced by drugs that interfere with liver function, blows to the head, pituitary adinomas etc. You need to read the stickies to start understanding things. Pay attention to thyroid and adrenal problems. Evaluate your dietary intake of iodine, fish oil & other EFAs [essential fatty acids] and vit-D3. Low cholesterol is a problem and statin drugs create problems too.

Always post ranges with lab work. Always get and retain copies of all lab work.

Your levels are poor for your age.

You need to be testing serum E2 [estradiol]. T levels need to be evaluated in the context of E2 levels.

What happened six months ago? High fever? Testes were injured or painful? Car accident or blow to the head? Medication episode or started/continuing a new drug? Stressful event?

Provide:
age
height
weight
waist size
body temperature when you first wake before getting out of bed
where do you carry fat, how changed
any signs of gyno and history
mood changes
how do you sleep and how changed
any loss in peripheral vision, check each eye
other visual field disturbances
feeling hotter or colder
how are you affected by stress, how changed
stress events ever leave you feeling physically unwell
brain fog [if you have it, you do not need a definition]
word finding
key board skills declined
short tempered
changes in emotional reactions
social avoidance
changes in activities
loss of morning wood
loss of nocturnal wood
great looking women are interesting as art objects VS objects of lust
any foreign travel prior to the changes 6 months ago
any testicular pain or ache and time line
changes to sweating
bloating
changes to urination or urine flow
list drugs, OTC and Rx, supplements, alcohol, tobacco and changes re 6 months ago

Where are you located? Affects your options.
Do you have medical insurance?
Can you budget some out-of-pocked money if needed?

This can affect your relationship with wife/GF which does add another motivation to get things done.

KSman, correct me if I’m wrong but I think the AACE uses this symptom in place of blood serum tests, correct?

Got me on that one! Over the years of my T decline, my hands were in a race condition over what hand would type it’s next letter first. Which could yield: My Hadns were in a race condition voer … TRT eliminated that problem that had been getting worse for years. I don’t know that others have pointed this out as T related problem.

Haha no I was being a smartass! I am sorry. I do agree that testosterone levels probably affect everyone differently. One thing I notice when I’m low on T is I tend to like talking to girls more…as a friend…but when I’m higher, I can’t stand their whining, indecisiveness, and their mere inability to accomplish any task and instead insist on talking about their feelings. That’s what I’ve noticed.

You need T to repress those empathy and connection circuits in your brain.

[quote]What happened six months ago? High fever? Testes were injured or painful? Car accident or blow to the head? Medication episode or started/continuing a new drug? Stressful event?

Provide:
age
height
weight
waist size
body temperature when you first wake before getting out of bed
where do you carry fat, how changed
any signs of gyno and history
mood changes
how do you sleep and how changed
any loss in peripheral vision, check each eye
other visual field disturbances
feeling hotter or colder
how are you affected by stress, how changed
stress events ever leave you feeling physically unwell
brain fog [if you have it, you do not need a definition]
word finding
key board skills declined
short tempered
changes in emotional reactions
social avoidance
changes in activities
loss of morning wood
loss of nocturnal wood
great looking women are interesting as art objects VS objects of lust
any foreign travel prior to the changes 6 months ago
any testicular pain or ache and time line
changes to sweating
bloating
changes to urination or urine flow
list drugs, OTC and Rx, supplements, alcohol, tobacco and changes re 6 months ago

Where are you located? Affects your options.
Do you have medical insurance?
Can you budget some out-of-pocked money if needed?

This can affect your relationship with wife/GF which does add another motivation to get things done.
[/quote]

I hadn’t had any injury or anything prior to feeling this way. Honestly, the only thing I did was start eating healthier, quit smoking, and started drinking A LOT of soy milk. As far as stress, I have a relatively stress-free life.

I take no medication whatsoever. Matter of fact when everything first started, it started with a pretty bad headache that lasted for about 4 days. I took a tylenol the first day, which didn’t help at all. Second day, aspirin, which didn’t help. The next two days, I just dealt with it.

After the headaches, I got to where I couldn’t make my eyes focus on anything. It felt like it took WAY too much energy to make my eyes focus on stuff, so I’d kind of go “cross-eyed” in a way. Been happening ever since.

age - 29
height - 6’3"
weight - between 140 - 150
waist size - 33
body temperature when you first wake before getting out of bed - Low. When I wake up, usually around 96-97.5

where do you carry fat, how changed - It’s kind of fluctuated, even though I’m thin. Mostly under my chin (just a little) and lovehandles, although they’re not big at all.
any signs of gyno and history - Nah, not really. My left “breast” has always been just a LITTLE bigger, but I attributed that to me being right handed and using my right arm more.
mood changes - Mostly just kind of numb. I’ve been getting irritated easily, but that comes and goes.

how do you sleep and how changed - When it first started 6 months ago, I couldn’t sleep more than 2 hours, but I was EXHAUSTED. Now, even if I sleep for 10 hours, it’s not enough.
any loss in peripheral vision, check each eye - Not “loss”, but my vision got a lot more blurry since it started.

other visual field disturbances - None. Other than a lot of floaters, lol.
feeling hotter or colder - Colder. Feet almost always stay cold. I get cold chills a lot.
how are you affected by stress, how changed - Stress makes it seem worse. When I get stressed, my head will “tingle”, especially in the back of the head. Weird feeling.
stress events ever leave you feeling physically unwell - Any physical stress makes me exhausted. Emotional stress makes me pretty tired, too.

brain fog [if you have it, you do not need a definition] - YES. It’s awful.
word finding - Been much more difficult. I was a programmer, but I can’t concentrate enough to do it anymore. I’m forgetting everything.
key board skills declined - Absolutely. I’m having to hunt for keys most times. Also mistyping everything a lot more lately. Re-arranging letters a lot.
short tempered - Off and on, yeah.
changes in emotional reactions - Not horribly. Mostly I just have lost interest in everything.

social avoidance - I WANT to be around people, but I don’t feel like doing anything.
changes in activities - Just lost interest in a lot of things.
loss of morning wood - YES. Even if I do get it, it’s smaller and not as firm.
loss of nocturnal wood - Yes. Libido has basically disappeared.
great looking women are interesting as art objects VS objects of lust - YES. It sucks.
any foreign travel prior to the changes 6 months ago - About a year before, but felt fine for a year.

any testicular pain or ache and time line - Once or twice… kind of sharp pain, particularly in the left testicle.
changes to sweating - For a while, I couldn’t sweat at all. Now, I sweat a little more normally, but only when it’s REALLY hot out.
bloating - Every day. Wake up bloated, go to bed bloated.
changes to urination or urine flow - When it first started, I was peeing A LOT. Waking up having to go, etc… Interrupted my sleep a lot. Now, it’s a little more “normal”.
list drugs, OTC and Rx, supplements, alcohol, tobacco and changes re 6 months ago - None at all. Quit smoking 4 months before the symptoms started. No alcohol since 21, no drugs. Nothing.

Sorry for the lengthy reply, and thank you for your help!

Get a Thyroid Panel ASAP:

TSH
Free T4
Free T3
Those are the main tests so you can get an idea of where your thyroid levels are at.
If your doctor won’t do it, get it through LEF.org OR Private Labs MD.

The things that make me wonder if this is a thyroid problem:
-started drinking A LOT of soy milk.
-Now, even if I sleep for 10 hours, it’s not enough.
-I don’t feel like doing anything.
-Colder. Feet almost always stay cold. I get cold chills a lot.
-Every day. Wake up bloated, go to bed bloated.
-For a while, I couldn’t sweat at all. Now, I sweat a little more normally, but only when it’s REALLY hot out.

I have the same problems when my thyroid is underactive as well. How are your bowel movements??

[quote]JLWilson wrote:
Get a Thyroid Panel ASAP:

TSH
Free T4
Free T3
Those are the main tests so you can get an idea of where your thyroid levels are at.
If your doctor won’t do it, get it through LEF.org OR Private Labs MD.

The things that make me wonder if this is a thyroid problem:
-started drinking A LOT of soy milk.
-Now, even if I sleep for 10 hours, it’s not enough.
-I don’t feel like doing anything.
-Colder. Feet almost always stay cold. I get cold chills a lot.
-Every day. Wake up bloated, go to bed bloated.
-For a while, I couldn’t sweat at all. Now, I sweat a little more normally, but only when it’s REALLY hot out.

I have the same problems when my thyroid is underactive as well. How are your bowel movements??
[/quote]

I’ve had 3 thyroid panels, and every doctor has said they were normal, except for once. The first time it was taken, my TSH was 2.76. Doctor said it was fine. Second time, it was 4.3, and FT4 was “normal”. I can’t remember the number, but it was in the middle of the ranges. So they doctor got a little concerned and retested it. During the retest, TSH was 2.6, FT4 was “high” at 23.3 (range: 11 - 23), and FT3 was 4.6 (range: 3.5 - 6.5). Doctor said I was fine and moved on.

Just got a new doctor, and he wanted it tested AGAIN. This time, TSH was 1.55, FT4 was 1.59 (range: 0.82 - 1.77), FT3 was 3.0 (range: 2.0 - 4.4).

I’m not sure if stress could affect the test at all, though. That last thyrodi test was tested along with a sed rate and the testosterone (the results I posted earlier). The day before I went to have it tested, my best friend of 20 years had just passed away. I slept for all of about 4 hours, got up and within 2 hours of waking, went to get tested. During the testing, I was actually making/getting calls letting people know about my friend’s funeral and such. Pretty stressful period…

The thyroid numbers look decent. See if you can get rT3 tested. You really seem to have estrogen problems [bloat]. Adrenals may be a mess too. Fixing T alone might create a mess.

[I am having trouble imagining a 150# 6’3" guy with bloat.]

That foreign travel: What if you had a lingering parasitic disease? That can wear down your adrenals. Was that a tropical destination?

[quote]KSman wrote:
The thyroid numbers look decent. See if you can get rT3 tested. You really seem to have estrogen problems [bloat]. Adrenals may be a mess too. Fixing T alone might create a mess.

[I am having trouble imagining a 150# 6’3" guy with bloat.]

That foreign travel: What if you had a lingering parasitic disease? That can wear down your adrenals. Was that a tropical destination?[/quote]

Nah, nothing tropical. Matter of fact, it’s a really cold area, and I usually go during the winter. I was tested for h. pylori which came back negative. About two years ago, I started getting bad indigestion and such, so they tested me for that and diagnosed me with “IBS”, which has since disappeared.

A couple of things that may not be worth mentioning, but I’ll mention them anyway. I get these weird chills/tingling feelings all over my body, but it seems mostly around my head. My muscles will twitch A LOT, at random places. For instance, if I lay down on my side, whichever side I’m lying on, the muscle right above my ear will twitch to the point of being annoying and sometimes keeping me awake.

I’m wondering about the fluctuating thyroid numbers though. I’ve always kind of thought it might be a thyroid problem, but you said something about estrogen problems. I’ve read (whether it’s true or not) that having too much soy can raise estrogen levels in men, and I had TONS before I started feeling awful.

[quote]KSman wrote:

I am having trouble imagining a 150# 6’3" guy with bloat.

[/quote]

I’m having trouble picturing a 6’3 150lb guy.

[quote]rtr13 wrote:

[quote]KSman wrote:
The thyroid numbers look decent. See if you can get rT3 tested. You really seem to have estrogen problems [bloat]. Adrenals may be a mess too. Fixing T alone might create a mess.

[I am having trouble imagining a 150# 6’3" guy with bloat.]

That foreign travel: What if you had a lingering parasitic disease? That can wear down your adrenals. Was that a tropical destination?[/quote]

Nah, nothing tropical. Matter of fact, it’s a really cold area, and I usually go during the winter. I was tested for h. pylori which came back negative. About two years ago, I started getting bad indigestion and such, so they tested me for that and diagnosed me with “IBS”, which has since disappeared.

A couple of things that may not be worth mentioning, but I’ll mention them anyway. I get these weird chills/tingling feelings all over my body, but it seems mostly around my head. My muscles will twitch A LOT, at random places. For instance, if I lay down on my side, whichever side I’m lying on, the muscle right above my ear will twitch to the point of being annoying and sometimes keeping me awake.

I’m wondering about the fluctuating thyroid numbers though. I’ve always kind of thought it might be a thyroid problem, but you said something about estrogen problems. I’ve read (whether it’s true or not) that having too much soy can raise estrogen levels in men, and I had TONS before I started feeling awful.[/quote]

Literally, everything you say reminds me of my thyroid problems. The labs look decent, but they may not be correct for YOU. Soy also interferes with your thyroid as well. rT3 can interfere with your T3 and still cause hypothyroid symptoms.

Something else that occurs is euthyroid sick syndrome or subclinical hypothyroidism. You may feel the symptoms now despite normal T4/T3, but a slightly elevated TSH indicates that all is not well inside your body. Here’s a link:

[quote]JLWilson wrote:

[quote]KSman wrote:

I am having trouble imagining a 150# 6’3" guy with bloat.

[/quote]

I’m having trouble picturing a 6’3 150lb guy.
[/quote]

Trust me, I hate it. I’ve been thin my whole life. No matter how much I’ve eaten or worked out, I just can’t gain any muscle. I’m “strong”, but I have no obvious muscle. It sucks. I think the most I’ve ever weighed was around 170. Man I wish I could get back to that weight…

[quote]JLWilson wrote:

[quote]rtr13 wrote:

[quote]KSman wrote:
The thyroid numbers look decent. See if you can get rT3 tested. You really seem to have estrogen problems [bloat]. Adrenals may be a mess too. Fixing T alone might create a mess.

[I am having trouble imagining a 150# 6’3" guy with bloat.]

That foreign travel: What if you had a lingering parasitic disease? That can wear down your adrenals. Was that a tropical destination?[/quote]

Nah, nothing tropical. Matter of fact, it’s a really cold area, and I usually go during the winter. I was tested for h. pylori which came back negative. About two years ago, I started getting bad indigestion and such, so they tested me for that and diagnosed me with “IBS”, which has since disappeared.

A couple of things that may not be worth mentioning, but I’ll mention them anyway. I get these weird chills/tingling feelings all over my body, but it seems mostly around my head. My muscles will twitch A LOT, at random places. For instance, if I lay down on my side, whichever side I’m lying on, the muscle right above my ear will twitch to the point of being annoying and sometimes keeping me awake.

I’m wondering about the fluctuating thyroid numbers though. I’ve always kind of thought it might be a thyroid problem, but you said something about estrogen problems. I’ve read (whether it’s true or not) that having too much soy can raise estrogen levels in men, and I had TONS before I started feeling awful.[/quote]

Literally, everything you say reminds me of my thyroid problems. The labs look decent, but they may not be correct for YOU. Soy also interferes with your thyroid as well. rT3 can interfere with your T3 and still cause hypothyroid symptoms.

Something else that occurs is euthyroid sick syndrome or subclinical hypothyroidism. You may feel the symptoms now despite normal T4/T3, but a slightly elevated TSH indicates that all is not well inside your body. Here’s a link:


[/quote]

So you have a thyroid problem? I have to ask; did you have problems with muscle twitching and dry mouth?

Definitely with muscle twitching. My eyelids would twitch, my biceps would twitch. I don’t notice it nearly as much now. I wonder if it has something to do with fibromyalgia, another common symptom of hypothyroidism.

A lot of the things I’ll notice when I’m hypo:
-cold feet/cold hands
-Cold skin (even in 100 degree heat)
-Infrequent bowel movements
-Lump in my throat or just “presence” of something in my neck area
-Extremely sleepy (10+ hours a night)

I have tertiary hypothyroidism—>my hypothalamus doesn’t secrete TRH to my pituitary to release TSH.

P.S. I have to wonder if you have an adrenal problem considering your difficulty in putting on weight which may rule out a thyroid problem.

[quote]JLWilson wrote:
Definitely with muscle twitching. My eyelids would twitch, my biceps would twitch. I don’t notice it nearly as much now. I wonder if it has something to do with fibromyalgia, another common symptom of hypothyroidism.

A lot of the things I’ll notice when I’m hypo:
-cold feet/cold hands
-Cold skin (even in 100 degree heat)
-Infrequent bowel movements
-Lump in my throat or just “presence” of something in my neck area
-Extremely sleepy (10+ hours a night)

I have tertiary hypothyroidism—>my hypothalamus doesn’t secrete TRH to my pituitary to release TSH.

[/quote]

I also have this feeling in the bottom of my throat… almost like someone is sticking their finger on it pressing it in. It has kind of a dull ache, and comes and goes throughout the day. Some days, more than others.

I had an MRI done a while back, and the dr said that something would have shown up on it if there was a tumor or something. So at least I’m clear there.

My BMs used to only come about once a week or so. When they did, it was horribly dry and small, like pellets. Then lately, most days when I wake up, I have a semi-loose BM as soon as I wake up, but that’s about it. I rarely ever have “normal” BMs.

Man, even right now, my shoulders are killing me. They’re aching badly and feel really weak. This crap’s been going on for so many months, and I’m tired of it. I’m so physically tired I can barely function today, and I slept for around 9 hours.