31 Y/O Seeking Advice RE: Recent Lab Results

31 year old male. 6’2, 195lbs, 20-25% bf if I had to guess

As the title stated, I received my labs in the mail today and they were on the low side as far as I could tell based on my age. I’ll let you all be the judge.

Total Testosterone: 406 ng/dL (348-1197 ), low side of LabCorp’s range

Free Testosterone: 8.2 pg/mL (8.7-25), not even in an optimal range per LabCorp

All my other labs (CBC, CMP, TSH, Lipid Panel) with the exception of Vitamin D which was only 15.3 ng/ML were within normal parameters. I started taking 6000iu of Vitamin D3, and will continue to do this for a month and then drop it to 4000iu, and plan to spend about 20-45min a day in the sun.
For at least the last 5 years I’ve felt like I’m never well rested, and I have mental fog… this is what led me to getting my labs checked out. I’m a 31yr old healthy male… I work out 4-5 days a week doing a mixture of strength/hypertrophy workouts. I feel for the work I put into fitness… my results are kind of disappointing. I feel I could always do better, so I’m not blaming all of this on low test. I’m married and I wake up 3-4 days a week with morning wood… my sex drive is average. I have no issues keeping an erection. Just from a sexual side effects perspective, I’m a’ok. It’s the mild depression, mental fog, and less than optimal physique progress I’m wanting to improve.
Suggestions? I’ve already made an appointment for Tuesday to see my doctor re: these results. I want to make sure I do this the right way. Do these seem pretty damn low for my age?

Yes, FT is low. TT may be inflated by elevated SHBG creating more SHBG+T which is not bio-available and TT provides an inflated view of T status.

Vit-D3 gets stored in the body. Take 25,000 - 30,000iu for 5 days to build reserves. Do not take with high fiber or low fat meals.

“Normal” is a bad word.
With ranges please:
hematocrit [HTC]
TSH - should be near 1.0, the ranges are totally bogus

Your TT, FT suggest elevated SHBG, perhaps from elevated E2, but that then implies poor E2 clearance by the liver.

Need these labs - fill in the blanks - with ranges:
hematocrit [HTC]
fasting glucose
fasting cholesterol - can be too low

Training with low-T and/or low thyroid function can fatigue the adrenals, increasing T3. Younger guys tend to do this, overcoming with adrenalin.

Brain fog and low energy can easily be from low-T or low thyroid function. Please check that out via last paragraph in this post.

Please read the stickies found here: About the T Replacement Category - #2 by KSman

  • advice for new guys
  • things that damage your hormones
  • protocol for injections
  • finding a TRT doc

Evaluate your overall thyroid function by checking oral body temperatures as per the thyroid basics sticky. Thyroid hormone fT3 is what gets the job done and it regulates mitochondrial activity, the source of ATP which is the universal currency of cellular energy. This is part of the body’s temperature control loop. This can get messed up if you are iodine deficient. In many countries, you need to be using iodized salt. Other countries add iodine to dairy or bread.

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RBC: 5.07 x10E3/uL (3.4-10.8)
hematocrit [HTC]: 45.6% (37.5-51.0)
hemoglobin: 15.6 g/dL (12.6-17.7)
TSH - 3.370 uIu/mL (0.450-4.500)
**TSH is super high compared to the 1.0 you mentioned.

TT: 406 ng/dL (348-1197)
FT: 8.2 pg/mL (8.7-25.1)
E2, SHBG, LH/FSH, Prolactin (unavailable)
fasting glucose: 79 mg/dL ( 65-99)
fasting cholesterol total - 138 mg/dL (100-199)

I have an appointment with my PCP tomorrow at 9am. I’ll be fasting just in case they’re able to obtain labs. I’ve already planned to request a thyroid panel (ft3, ft4, reverse t3, thyroglobulin anti-body, thyroid peroxidase antibody), because I’m 99.9% sure I’ve got an under active thyroid (maternal grandmother has Hashimoto’s, mother has an autoimmune disease “MS”). I will continue to log my temps but here they are thus far:
Saturday 11pm: 97.6
Sunday: 7am 97.0, 4pm 97.3, 9pm 96.7
Monday 8am 97.5 …
***Had my wife check her temps to ensure the thermometer was functioning, and she registered ideal temps

Now I’ve looked into Iodine supplementation and it’s very interesting. I’m a little concerned until I rule out Hashimoto’s, because I’ve heard in can cause an autoimmune response with worsening symptoms… thoughts?

I’ve been supplementing with high doses of Vitamin D3 since Friday, and will plan on maintaining a therapeutic dose from here on out.

As from what I can tell in the stickies, I’ll need LH/FSH level to check for Primary vs Secondary Hypogonadism, what other essential labs do you recommend I request tomorrow (prolactin? E2?), SHGB?)

Thyroid auto-immune diseases are probably caused by elevated or high TSH in combination with selenium deficiency. I always suggest selenium use and multi-vits that list iodine+selenium. Please read the thyroid basics sticky. Note that higher amounts of iodine do increase TSH in a predicable and harmless manner, but that is often misunderstood. When taking higher amounts of iodine TSH lab results have no diagnostic value.

Normal T4 production creates a lot of free radicals that can cause damage if not cleaned up by specific enzymes that must have selenium in their structure. If that is not working, the immune system when cleaning up damaged cells and inflamed tissues can misread the cellular debris as foreign, then its an autoimmune state.

When iodized salt was introduced to populations, Hashi’s shows up, partly because no-one was looking for it before in a sea full of goiters, lethargy and mental retardation. And the cases were probably there all ready, but the process was muted by not enough iodine for T4 production to generate free radicals.

Your maternal grandmother was on a salt restricted diet for high blood pressure that denied her of iodine [common]. Women have a greater need for iodine than men and also are more prone to hyperthyroidism and Hashi’s etc.

Need AM temps [low] and mid-afternoon body temperatures.

Cholesterol is way too low. <160 is associated with increased all-cause mortality. Cholesterol is base for making sex hormones, DHEA, cortisol as well as Vit-D3.

If you have not been using iodized salt, doing thyroid labs may produce some interesting results, but the results will probably all be normal. If you get those labs done now, doc may easily refuse to do them again later.

Please see my prior list of labs.

Ok, would you recommend I wait on getting Thyroid labs until I’ve had some Iodine & Selenium supplementation? And If so, how long should I wait? I’ve got all the classic symptoms of Hypothyroidism (trouble staying awake, feel cold all the time- especially hands & feet, constipation, dry skin, low body temperature). I’m trying to determine in what order I should treat my low T and Hypothyroid.

Yes, wait. See what you can do with iodine+selenium. The do labs later if temperatures are still low. Some feel changes in a few days. Increased energy and clarity of thought are good indicators. results can vary…

It’s been a year since my last set of labs, and in that time I’ve started supplementing with a multi, fish oil, vitamin D3 5000iu daily. I still feel mild depression, and I’m rather moody… but I wonder how much of this is hormonal, and how much is just personality. Some situational depression, as I’ve been out of the gym for 9mo d/t disc bulge and sciatica. KSMAN or anyone care to chime in on these results? I’m 32, and I’d rather not be tethered to TRT this early in the game, but I also want to be the most optimal version of myself.

T. Test: 517 ng/dL (264-916) (previously 406)
Free Testosterone 9.3 pg/mL(8.7-25.1)prev:8.6
LH: 2.8 mIU/mL (1.7-8.6)
FSH: 4.4 mIU/mL (1.5-12.4)
Estradiol (ECLIA Methodology) 10.9 pg/mL (7.6-42.6)

TSH: 2.030 uIU/mL (0.450-4.500)(prev. 3.370)
T4 Free: 1.50 ng/dL (0.82-1.77)
T3 Free: 3.3 pg/mL (2.0-4.4)
Vitamin D, 25-Hydroxy: 42.3 (30.0-100.0)(prev.15)

Low estrogen is bad for joints, bone and your genneral health, the brain loves estrogen so much it produces its own. How do your joints and bones feel?

We see high SHBG men in here all the time with high Total T, low FT and low E2, high SHBG inflates Total T and make you’re testosterone status look better than actually is creating low FT and low E2 do to lower free hormones.

You’re never going to be optimal as long as you have low free hormones. Your E2 labs are the incorrect method typically used for females in menopause and children, you need the LC/MS/MS sensitive method designed for men.

Would like to see RT3., thyroid looks alright. Still closer to 1.0 is optimal. Don’t let your Total T fool you, FT is what matters and yours is at the bottom.

Probably can’t get labs right away, but maybe in a few months. My libido is fairly good. I just feel a little depressed, I’ve had social anxiety for years, and I’m easily pissed off and moody. I don’t think any of it’s debilitating, but who knows… maybe this is just what I’m used to. How’s my LH and FSH? Is there anything I can do realistically outside of TRT? Yeah… TSH isn’t amazing, but I’m happy with the improvement.

When my testosterone was low I was very moody, had social anxiety. Went on TRT and all that went away in just 2 months, my family saw a massive personality change. LH is low and typically indicates low testosterone, high SHBG is deceiving by making a you’re testosterone levels look good when in fact testosterone production is much worse.

TRT is the only thing that will save you from the moodiness and social anxiety. The cause is low T and there is no other solution other than to replace what’s causing the issues. Most guys are scripted SSRIs is a Band-Aid to cover up the symptoms without ever addressing the cause.

@KSman you were insightful the last time I posted a year ago. Was hoping you could chime in. As you can see, I’ve seen improvements in all my labs… some to a smaller degree than others. I’m left wondering if I should get on TRT or just continue what I’m doing in terms of supplementation and living a healthy lifestyle. Monitoring this year to year. Any labs you think I should get sooner than later? I’d say absolutely no sexual side effects other than I rarely initiate sex with the wife… but if she mentions it, I’m always game (no ED). As I think I’ve previously stated, irritability and moodiness are my main concerns. I’ve considered trying Wellbutrin to combat my irritability and mild depression.