T Nation

Blood Results, Need Help Reading Them


age: 35
height: 5’90’’
waist: 32
weight: 176/ ± 11% BF
describe body and facial hair: average on body, not a lot of facial hair on cheeks
describe where you carry fat and how changed: Mostly on abdomen and lower back. Noticed last year when cutting down to 9 or 10% bf my abdomen and lower back stayed fatter compared to several years back. Losing bf takes more effort now. I have to go as low as 1800 or 1900 kcal to get the same results as before at 2400. Nothing has changed much in terms of exercise frequency or intensity between then and now.
health conditions: psoriassis on elbows
Rx and OTC drugs:
any hair loss drugs or prostate drugs ever: no, used paxil in the past but now off. Got it for anxiety when i was 26. Still a bit anxiety now and then but have a good handle on that.

Since nov/dec 2015:

a.) not able to maintain my 4 day upper body/ lower body routine. Took some time off and gradually reintroduced training but still only 3 days and lower intensity.
b.) Lack of motivation to workout, work or pursue things. Typically I’m very driven. Now kind of flat.
c.) Brain fog, difficulty finding words, difficulty thinking fast or concentrate. This hinders me at work and is not good for confidence.
d.) I feel kind of like an old man. After training hard, muscle soreness remains longer and I tend to be more susceptible to injuries and straining muscles.
e.) Difficulty cutting down to lower bf.
f.) Difficulty to put on muscle when bulking.
g.) Really low libido with 1 or 2 occasions a year when it spikes really high which seems odd. Its day and night.

lab results with ranges: Lab test from 6/22/2016
WBC: 5.2 k/ul (4.2 – 9.1 k/ul)
RBC: 4.9 m/ul (4.6 – 6.1 m/ul)
HGB: 14.5 gm/dl (13.7 – 17.56)
HCT: 43% (41 – 52%)
MCV: 87.7 fl (82-98)
MCHC: 33.7 gm/dl (31 – 36 gm/dl)
Platelets: 230 k/ul (150 – 400 k/ul)

Chol: 187 mg/dl ( < 250 mg/dl)
HDL: 56 mg/dl ( > 35 mg/dl)
LDL: 127 mg/dl ( < 130 mg/dl)
Chol/HDL: 3.3
Triglyceride: 88.5 mg/dl ( < 200 mg/dl)
Glucose fasting: 88mg/dl ( < 100 mg/dl)
Creatinine: 1.06 mg/dl ( < 1,4 mg/dl)
25-hydroxy-vitD: 28,17 ng/dl (> 30 ng/dl)
HoloTC Active B12: 99.4 pmol/l ( > 60 pmol/l)

Albumine: 4.86 g/dl (3.5 – 5.2 g/dl)
SHGB: 44.5 nmol/l (18.3 – 54.1 nmol/l)
Test Total: 369 ng/dl ( 249 – 835 ng/dl)
Test Free: 5,86 ng/dl ( > 3,61 ng/dl) (1,58%)
Bioavailable T: 154 ng/dl (41,7%)
LH: 4.5 IU/L (1.7 -8.6 IU/L)
FSH: 9.3 IU/L (1.5 - 12.4 IU/L)
E2: 24 pg/ml (27-52 pg/ml)
Prolactine: 8.1 ng/ml (4.1 – 15.2 ng/ml)

TSH: 1.66 mU/l (0.27 – 4.2 mU/l)
FT4: 1.49 ng/dl (0.9 – 1.7 ng/dl)
FT3: 322 pg/dl ( 200 – 440 pg/dl)

+/- 1800 a 2000 calories.
+/- 80 gr fats; fish, nuts, eggs, olive oil, lean meat, omega 3
± 160 gr protein; fish, eggs, lean meat, diary, whey
± 135 gr carbs; oatmeal, potato’s, whole wheat bread, vegetables, pasta, brown rice, some fruit
+/- 2500 calories.
+/- 100 gr fats; fish, nuts, eggs, olive oil, lean meat, omega 3
± 180 gr protein; fish, eggs, lean meat, diary, whey
± 220 gr carbs; oatmeal, potato’s, whole wheat bread, vegetables, pasta, brown rice, some fruit

If I go above 2500 calories I gain fat and no muscle although I feel a bit more energetic.

describe training [some ruin there hormones by over training
Upper body / lower body 4 day split. A lot of compound exercises. Minimal 2 days rest between same muscle groups. I try to deload every 6 or 8 weeks but not good at that.
1 day soccer training and 1 day soccer match a week.

testes ache, ever, with a fever?
No fever but lately a dull ache mostly left.

how have morning wood and nocturnal erections changed; Almost not there. Sometimes when libido suddenly spikes it seems there is some action during the night or in the morning. But nothing compared to as before. Libido is really low.

I think TT an FT is low and LH vs FSH seems strange. I hope you guys can point in some direction based on the results.


Seems like primary hypogonadism. Your free T is very Low and causing your symptoms most likely. Dull ache could be from Varicoceles, they can be detected physically or an ultrasound.


Ok, could it be that if there are any varicoceles and they get corrected the primary hypogonadism clears up?

What about the difference in lh fsh level? I thought these are normaly aprox. the same. SHGB seems high also.


Can you find a range for that? 41.7% does not mean anything to me.

Have you seem these stickies found here: About the T Replacement Category
advice for new guys
things that damage your hormones
protocol for injections
finding a TRT doc

Thyroid seems quite decent. Noting that fT4 is above midrange.
Using iodized salt supports thyroid and its good to have a supplement that also contains selenium. To double check, see that your oral body temperatures hit 98.6 in the afternoon.

Labs and symptoms are very consistent.

Note that starvation diets are harmful. Low T and low thyroid function can drive fat gain, in your case it appears to be strictly a testosterone problem.

Primary hypogonadism can be caused by vascular abnormalities in the testes. Doc can check that out.

Your SHBG is quite high relative to E2. But SHBG could be that way from low T.
HTC is low from low T as expected.

You should take 5,000iu vit-D3. Find 5000-6000iu tiny oil capsules. Take 25,000/day for first 5 days and 5,000 thereafter.

Is stress a major factor in your life?


Ksman thanks for replying,

I ran my lab numbers through the issam calculator to check them. The calculator came up with the bioavailable number and percentage. So i added it. It wasn’t on the lab report.

I read some of the stickies but not the protocol for injections and finding a trt doc. I’m in Europe and they are pretty conservative when it comes to T. I went to the doc in Januari this year because of my symptoms, The only thing he wanted to add to the bloodwork besides basic stuff was TT (also 369 then) and Vitamine D. I noticed they ordered the 1 25 dihydroxyvitamin D test and from what i understand that is not the test (25 hydroxy) you want to do with the symptoms at hand. Basically i don’t have much faith in my current doc.

Recently after not getting any better i went to a private lab and got the numbers mentioned here. I didn’t want to beg my doc. for it and getting the hypochondriac treatment in return.

I will check temp. in afternoon. Do you think Ft4 is subobtimal?
The last 2 weeks i’m supplementing 5000IU liquid D3 from Solgar. I’ll bump that up. Also added 600mg magnesium citrate per day and was thinking of adding 50mg zinc pic. EOD.

I have to admit i have a job that is pretty stressfull. But in the past i could handle it better because i felt different. I had less experience and track record but more confidence and lower perceived stress. Gradually i gained experience and trackrecord but my confidence declined and perceived stress rose. I feel it has to do with the cognitive issues, increased selfdoubt and generally not feeling on top of my game. So what came first? The low T could be from stress, but low T could also make me more susceptible to stress.

Is it possible to remain fertile on TRT? We do not have children currently but want to try within comming years.


Read protocol for injections, then you will understand fertility issues. You would need T+hCG or T+SERM to safeguard fertility.

Stress is relative when your hormones are not right, stresses become more stressful.

Do not over do zinc, you can reduce absorption of some other minerals. Look for zinc in other supplements.

fT3 and fT4 are good. But body temperatures then might still be low if stress has caused rT3 to become elevated. Body temperatures are very informative. But most guys ignore body temperatures as they thing its trivial and unrelated to their issues.

Vit-D3 status: you simply want to have an optimal level, effects of low levels are small and will not be noted.