325 Total Test...What Next?

Been feeling like crapola for a while now. Sex drive down, tried/foggy, irritable and other stuff. Had full biometric done that came back and showed all normal. Then vitamin A/D/TSH all normal and test showed me at 325 total.

I go back in soon and believe that’s the issue. I know doc will want me to test again and all that but I am ready to get through this issue.
Any advice would be appreciated.

If you can post all of your labs and some general health history it might help.

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vit b12 516
vitamin D, 25 43
TSH with reflex 3.210

I don’t have my full biometric handy that I got 1-2 months ago but will get it and post this evening. Nothing was out of order.

Active PE teacher personal trainer that has started feeling like crap over the last year or so. No health issues to think of. My diet is based on whole foods and I train 3-4 times a week.

325 Total Test…What Next?

  1. Use alcohol swab to clean injection site and the rubber part of the 10ml vial
  2. Draw air into plunger equal to the amount of the desired dose.
  3. Stab needle into inverted vial, push the air in and draw out the necessary dose.
  4. Administer dose either intra muscular or subcutaneously.
  5. Repeat forever as needed.

You forgot:

  1. Grow big and strong
  2. Feel yourself rise from the ashes
  1. Bang bang bang.

TSH is too high and the sick care reference ranges are not the same thing as the optimal healthy ranges. Your doctors should be comparing you with healthy people and not those with thyroid dysfunction, but this is where we are in this moment in time.

It’s not as if any thyroid hormones testing were ordered, TSH is a stimulating hormone, if you want to see the results of thyroid stimulation to gotta check the free thyroid hormones, fT4, fT3, rT3, thyroglobulin antibody and thyroid peroxidase antibody.

Optimal VS Normal Thyroid Levels for all Lab Tests & Ages

Reference ranges for TSH and thyroid hormones

Though TSH remains the most commonly used endocrine test in clinical practice, the issue of an appropriate TSH, and to a lesser extent, free T4 and free T3 reference ranges is still under debate. First of all the distribution of TSH reference range is not normal, with median values (also depending on population iodine intake) usually between 1-1.5 mU/L.

There is also an argument that significant number of patients (up to 30%) with TSH above 3.0 mU/L have an occult autoimmune thyroid disease.

Testosterone levels aren’t normal, they may be within reference ranges for an 80 year old man, but they may not be normal for you. In fact your levels are on the bottom 5% and 10% meaning 90-95% of men on earth have higher testosterone across all age groups!

Your doctor didn’t test the free portion of testosterone, you know the stuff that’s bioavailable to all your tissues which you doctor failed to check because they don’t have enough education to be diagnosing you. At this point in time you’re not even being properly diagnosed and I don’t think your doctor is going to be much help.

You might have to seek private care for your hormonal issues because most doctors believe in range is normal, it is when you take into account their age, old men testosterone on the bottom of the ranges, young men at the top as you’ll see when taking from a sample of the population.

What’s a “Normal” Testosterone Level

25-34 years of age 45 subjects 617 ng/dL
35-44 years 22 subjects of age 669 ng/dL
45-54 years of age 23 subjects 606 ng/dL
55-64 years of age 43 subjects 562 ng/dL
65- 74 years of age 47 subjects 524 ng/dL
75-84 years of age 48 subjects 471 ng/dL
85-100 years of age 21 subjects 376 ng/dL

So will the doc not prescribe if you’re at 325? Confused by your situation. If that’s the case you have a few options.

  1. Doctor shop and find a normal PCP who will write
  2. Go to a “mens health/trt” clinic to get a script and pay 300-400 percent mark-up for a drug synthesized in 1933.
  3. Buy black market test and self administer
  4. Do nothing and keep feeling this way

Doc had me tested for other stuff and repeated total test and that number was 394 now up from 325 a few weeks ago.
Sex hormone binding 32
Test percent free 1.9
Free test 74

I have not researched the other numbers but on their given ranges they look low and immediately doctor says all numbers are normal.

Any advice or insight would be appreciated.

Most endos will say you are normal, but you are not. These levels are crap

You need to go to a clinic that specializes in TRT but most of them are also not very competent unfortunately. However there are some that are great

It would not be unusual at all for it to fluctuate that much in one day.

According to Dr. Abraham Morgentaler who is an expert in testosterone at Harvard and has proven TRT doesn’t cause prostate cancer, who is a leader in the field of TRT, your doctor is wrong, the medical community is wrong and men will show benefit when FT levels are above 15 pg/mL (10.8-26.6). Normal FT is 2-3%, you want it towards the higher end.

Our medical system doesn’t care for low hormone levels whether it’s low thyroid or low testosterone and isn’t seen as a life threatening condition. Another problem is the line is fuzzy regarding natural and abnormal testosterone decline do to aging, normally testosterone starts declining 1% every year beyond 30 and upon old age levels are somewhere on the bottom of the reference ranges or in some cases below the reference ranges.

The problem is normal is very blurry at the moment and no one can agree on normal status. If you look at Dr. Abraham Morgentaler recommendations, they are vastly different from the other institutions recommendations.

Doctors prescribe based off various guidelines and recommendations. The endocrine society recommends TRT <300, ISSM TT < 350 ng/dL ICSM in 2015 also recommends TRT <300.

However the guidelines does state that TRT can be prescribed TT levels up to 345 ng/dL. You’ll also notice the guidelines don’t focus on what constitutes normal FT levels, in reality no one knows, only the reference ranges where the populations are scoring, but that in no way constitutes normal “healthy levels” for you. It only means we have outliers (like me) who can get by with very little testosterone without symptoms.

Evolution of Guidelines for Testosterone Replacement Therapy

So you have two options.

(1) Do nothing and continue feeling like dogshit.
(2) Go private for your TRT treatment and pay out of pocket.
(3) Find a doctor not worried about getting in trouble for prescribing TRT to someone with normal testosterone levels.

This and posts #4, 5 and 6 are your answers.

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I was prescribed Clomid and stopped days in. That was probably the worst decision once I started to lean towards TRT. My Endo said it was better if we went that route. I stopped listening after he congratulated me for going from 270 to 318 in a 4 year span. So dont accept Clomid. I started therapy 4 weeks ago. Best decision ever. Im just starting to feel the change.

Whoa!!! This is another one for the “stupid things doctors say thread” possibly in the top ten. Buy the way, your levels fluctuate that much in 24 hours.

Whatever happened to the stupid things docs say thread?

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