T Nation

Blood Results. Advice?

Just got the following labs back:

T: 282 ng/dl
SHBG: 19.2 nmol/L
Free T: 6.8 ng/dl
E2 sensitive: 22 pg/ml
FSH: 0.8 mIU/ml
LH: 1.45 mIU/ml
Prolactin: 10.4 ng/ml
DHEA: 296 ug/dl

TSH: 2.47 uIU/ml
Free T3: 1.9 pg/ml
Free T4: 0.9 ng/dl

I am 33yo, 27% bodyfat.

Any thoughts or advice would be welcome!

How do you feel? Details.

Medications?

Honestly I don’t feel that bad. Pretty ‘normal’.

No medications at the moment.

Tried TRT in the form of Nebido last year. Had two injections but my E2 sky rocketed and I cleared the T very quickly. So spent a couple of months on clomid and nolva to clear any sides or potential gyno.

I live in a country with terrible doctors so they couldn’t give my anything else. But I’ve now found one who is more progressive and will prescribe enanthate.

My TSH has always been around 1.5. Surprised by the jump and hoping it was an error. I tested at 1.5 a week before this was taken!

I doubt you would have seeked a doctors help if you felt normal let alone go on clomid if everything is all fine and dandy.

Would like to see reference ranges since all labs have different ranges and units that doesn’t make it universal. Free testosterone is in the gutter and will cause you to gain weight in the mid-section simply for having low testosterone, your fat will accumulates is specific areas quite differently if your testosterone was optimal.

Testosterone sets your metabolic rates and very low LH confirms the diagnosis of low testosterone which at you age should be 600-800, not lower than President Trump who is 8 years away from being elderly.

Your E2 skyrocketed because of your high body fat percentage and dosing smartly is the only way to mitigate the symptom of high estrogen, of course if you were working with a hormone expert, he/she wouldn’t have given you Nebido in the first place, it’s TRT at its worst.

My SHBG is similar to yours and 20-25mg EOD would do nicely for you, if estrogen becomes a problem your may need daily 10mg injections which would lower estrogen. An AI may or may not be needed until weight is lost. If you were lean you could probably get away with two injection per week.

Once weekly injections would be asking for sky high estrogen I’ll make an educated guess twice weekly would do the very same. These are disease level states, cardiovascular disease, heart disease are common with levels below 440 ng/dL. Free testosterone needs to be at least high normal or higher especially in younger men.

Testosterone Threshold for Increased Cardiovascular Risk in Middle-Aged and Elderly Men:

Thanks very much for the info - I really appreciate it.

Do you think I should try getting lean and cleaning up diet and lifestyle for 6m and then retesting? I’m sure I could get up above 450. Right now my diet and lifestyle are terrible and training non existent. It seems a shame to resort to TRT at the ripe old age of 33.

Also, any thoughts on the thyroid numbers ?

Yes!!

If you don’t you will most likely regret not trying.

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Re: the study. Interesting but no guarantees that treatment with exogenous T would’ve improved outcomes, right ?

Right, associated with, not caused by.

“These data showed that a testosterone threshold of 440 ng/dL was associated with increased Framingham 10-year CVD risk in middle-aged and elderly men.”

There are sometimes other undiagnosed medical conditions that can prevent TRT from working, serious psychological (panic attacks) issues TRT can worsen by throwing other brain hormones out of whack. Sometimes there are people who just can handle androgens do to receptor abnormalities.

Low T is definitely a contributor to cardiovascular disease.

?

Did I say otherwise?

Hell ya dude you’ll feel great. Losing body fat and fixing diet will did you right up. Wait too long and you won’t have any energy to do shit. I did this at 27 and lost 20 lbs quick.

I want to make a suggestion: when you start working out find a pre workout for energy. Don’t eat allot after your workouts. Just enough and eat slow. Slowly cut the nasty sugars and carbs out of your diet. Eventually you’ll enjoy less salty foods and stuff won’t taste bland.

Don’t go to the gym with bros and try to learn from them. Unless they are a trainer. I did this and it held me back a year or two. Find proper technique and find a fat burning routine. Do that for a few weeks and switch it up. Switch it up so that your body doesn’t get used to the workout. otherwise it prolongs fat burning and adaptation.

I also always telll people to eat less . Don’t worry too much about what you eat. Worry more about the caloric intake… if one avoids sugar overload, and processed carbs there moving in the right direction.

Don’t forget. Muscle burns fat. The more muscle you gain. the more fat you burn when resting… the fat is your muscles food. So muscle up… Cardio can only get you so far.