T Nation

47 -T Labs Total Low, Free In Range


#1

48
6’0/240 lbs
Waist 38
Bald since 18yoa, can get a way with shaving every other day, otherwise normal body hair.
Always carried fat in stomach, slight man boobs.
No health conditions or medications

Testosterone, Total = 274 (Range 291-739 ng/dL)
Free Testosterone = 7.3 (Range 4.3-304 pg/mL)

Diet is Low Carb/High Fat-Modest Protein
Crossfit 4x a week
-testes ache, etc - Never
Slightly less morning wood, no noticeable change in nocturnal erections.

I didn’t have any clue that low testosterone was a thing until recent physical. Described that something just seemed off, what I see people are calling ‘brain fog’ here, and trouble loosing weight or making gains in the gyms despite keeping a close watch on diet and keeping track of gym gains.

He ordered a T test with the above results. None of the other tests that I see mentioned in the sticky were ordered. I have now done a lot of reading and identify with all of the symptoms except I haven’t noticed any loss of libido or the ability to maintain an erection. The only thing identify with in this area is very low semen volume or even orgasm with no ejaculation.

My doctor wants to do a trial to see if TRT works. He did not mention whether it would be injections or other and I didn’t know to ask. Should I ask for more initial testing? Is there any long term harm in trying TRT for three months and stopping if it doesn’t seem to be working?

Thanks.


#2

In the 2nd post of the 1st topic in this forum; follow these links:

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

In the thyroid basics explained link, check you oral body temperatures as suggested.

You should not go after T shots without more diagnostics and having a game plan for TRT that includes hCG and anastrozole [as needed].

You need these labs. The issue is your health and vitality and your doc has T tunnel vision.

TT
FT
E2
LH/FSH - cannot be done after T injection(s)
CBC with hematocrit
fasting glucose
fasting cholesterol
A1C
AM cortisol [at 8AM please]
DHEA-S
AST/ALT
TSH -this and next two, if body temperatures are low
fT3
fT4 [please not T3, T4]
PSA - need to know if a problem and get a benchmark before TRT
CRP
homocysteine
have you had a DRE prostate exam?

Do you get cold easily?
Outer eyebrows sparse?
Always used iodize salt?
Vitamins that list iodine+selenium

Do you take any supplements?

Did problems evolve slowly or an abrupt onset.

If you get T and E2 right and have good thyroid function, you should be able to loose fat and gain muscle.

Blood pressure and pulse?

TRT will work if done right. But you could easily not feel the benefits if there are problems with thyroid function or cortisol, rT3.


#3

Thanks - here are my labs. The only thing that stood out to me was the really low DHEA with the Low T. I just started teh idoine+selenium, no other supps. Temperature OK. BP averages a little high 130/90.

Testosterone, Total 274 L 291 - 739 ng/dL
Free Testosterone 7.3 4.3 - 30.4 pg/mL
Estradiol, Ultra LC/MS/MS 16 0 - 29 pg/mL
LH 3.2 1.5- 9.3 mIU/mL
FSH 3.9 1.6 - 8 mIU/mL
%A1c 5.2 4.3-6.5 %
DHEA Sulfate 31 70- 495 mcg/dL
AST (SGOT) 24 4 - 41 u/L
ALT ( SGPT) 29 4 - 51 u/L
TSH 1.66 0.4-4.5 mIU/L
T4, FREE 1.5 0.8-1.8 ng/dl
T3, FREE 3.2 2.3-4.2 pg/mL
PSA 0.8 0-4 ng/mL
Hematocrit 44 35.9-47.1 %
DRE - neg

I just realized I didn’t get CRP, homocysteine, or cortisol…
Back to the lab?

Thanks,


#4

Do you get cold easily?
Outer eyebrows sparse?
Always used iodize salt?
Vitamins that list iodine+selenium

Are body temperatures low?
Check body temps as suggested in the thyroid basics explained link.
If body temperatures are good, thyroid function is excellent.
TSH should get lower with iodine+selenium if you have been deficient.

Your fT4 and fT3 should support good body temperatures. If not, elevated rT3 is suspected to be blocking fT3 and we need to know the role of stress in your life, including accidents, illnesses and infections.

Pregnenolone–>DHEA happens in the adrenals. We do not know if pregnenolone is low or if there is something not right with the adrenals. Cortisol is important for your energy level. Cortisol is also an adrenal hormone. So AM cortisol would be good to have.

Cholesterol–>pregnenolone happens in the mitochondria inside your cells and a lot of that happens inside the testes. Mitochondria make ATP, the universal currency of energy in your cells. Mitochondrial metabolic rate is regulated by fT3 [if not impeded by rT3] and that is how your overall basic metabolic rate and body temperature is regulated.

Get 25mg DHEA tabs and take 25mg ED with meals that are less fiber and more fats/oils. Take 5,000iu Vit-D3 the same way.