Where are you located? Affects diagnostic and therapeutic options.
Labs:
Can you get FT [free testosterone] tested?
Kidney function labs?
Better to test LH and FSH. But with TRT, both should be near zero and are not needed. So I have to wonder about a doc who ordered LH while on TRT. One exception would be testing on TRT one time to detect a FSH secreting testicular cancer.
SHBG is elevated by higher E2 levels and lower FT. E2 is not remarkable, makes me wonder where FT is.
LH=3.0 on TRT suggests that free and bio-T are very low.
Thus I ask this:
- How much T, in mg’s do you inject and how often?
- Are you self injecting?
- When were labs done relative to prior injection?
With TRT, both LH and FSH are expected to go to zero, not LH=3.0
With SHBG=55, FT may be low and there will be more SHBG+T, that is not bio-available that is inflating the TT number.
You seem to have too much iron.
You need to avoid iron fortified foods: bread, pasta, cereals vitamins
Iron overload can cause low-T and can harm vascular organs: liver, kidneys …
MCV:
- What B vitamins are you taking as supplements?
- Is your diet weird?
- What medical conditions and what medications?
Your T levels have never been high.
Prolactin can lower LH/FSH and thus T.
Prolactin can be elevated by some meds as well as recent orgasms or cuddling babies or puppies etc.
Prolactin can be elevated by a prolactin secreting pituitary adinoma, more something that happens at a younger age, but maybe it has been lurking there. Prolactin is easily managed with 0.5mg/week Dostinex/cabergoline. The problem with the adinomas is that they can get large enough to press on the optic nerves. Is you peripheral vision less that 180 degrees?
TSH:
Should be nearer to 1.0, there is a problem from a lack of iodine or a thyroid issue. What is your history of using iodized salt? The thyroid lab ranges are insane and most docs will not see a problem. Pleases eval your overall thyroid function - see 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.
That is a lot to cover. Try to respond to all issues. The first sticky listed will help with terminology etc.