T Nation

Blood Test Results - Low T Symptoms

At first sorry for my english. I’m 38 years old 5’11 ft, 178 lb. Problems with libido and erection for the last 2 years. In march 2018 I got back to gym after 15 years gap and felt a bit better. My blood test taken in may 2018:

total testosterone 6,72 ng/ml (ref range 2,49-8,36)
free testosterone 18 pg/ml (ref range 1-28,28)
shbg 78,48 nmol/l (ref range 18-54)
lh - 8,18 (ref range 1,7-8,60)
DHEA- 7,80 (ref range 1,70-6,1)
Estriadol- 35 pg/ml (ref range 7,63-42)
Prolactin- 9,74 (ref range 4-15)

I can feel that it is hard for me to gain muscle mass although lifting weights (2-3 times a week) led me to manage doing 6 reps squat of 245 lb and 15 pullups.
I started suplementing with vitamin D, fish oil, boron and stinging nettle. I also noticed that after my leg training my knees hurt and my recovery is very long. Should I consider trt? What diet and supplements shuld I try?

It’s hard to tell from your blood work posted with all the commas, but It looks like you’re numbers are decent. SHBG is pretty high.

Personally I’d look to natural ways to increase test and erection. Once you start trt, things could get worse for libido and erection. I’d only start TRT as a last resort if you’re bloods are super low.

That’s quite high SHBG you have there, SHBG scanvanges sex hormones and binds them up and when elevated gets a little greedy and grabs ahold of more and more bioavailable testosterone until you’re symptomatic. Your bioavailable or free testosterone is the hormone your body responds to, not the bound hormone -> total testosterone which is like a reservoir.

Your only option is TRT at this point. I would stop consuming foods that increase SHBG or put stress on the liver, alcohol, some medications are a few things that will increase SHBG. I had a vit D deficiency when diagnosed with low testosterone, I started TRT and Vit D when up on it’s own.

You want free testosterone to be 3/4 or higher, I feel dead with free testosterone at midrange. These ranges are BS and doesn’t account for those natural well above the normal ranges. Over the last 40+ years hormone across the population have been on a steady decline since the industrial revolution, these chemicals are messing with our hormones.

Your parents hormone damaging birth control is another big one.

DHEA is a tad high suggesting the possibility of slightly overactive adrenals glands which can have symptoms of its own.

Thanks to your advice. I started supplementing Vitamin D a few months ago. I also went to urologist who said that my blood tests are ok and there must be more of the psychological background of my state which is bullshit. My my libido and semen count 5 years ago were on quite high level although I didnt lift weight at that time and I drank heavier. For a long time I dont have breakfasts having my first meal at noon. What diet shuld I apply? What foods increases SHBG? Its strange bec

Your doctors just hormone ignorant, he joins the majority. All my doctors don’t care about TRT, every single one is disinterested in learning how to do TRT.

Sounds like you could do a lot by dialing in your diet. There are plenty of resources on the forum for info in regards to that. Basically you need to eat clean protein sources (omega 3 rich fish, lean beef, etc), low GI carbs (except for around workouts where you would want the down and dirty simple sugar types for quick energy) and healthy fats. You should try a zinc supplement, and maybe throw in a magnesium supplement at night to help lower SHBG.

Also, breakfast is a must. You would be better served by eating at least 6 small meals a day beginning shortly after waking.

Your numbers aren’t great but they aren’t terrible either. You have a lot of room for improvement naturally, before, or at least until you seek treatment.

I started supplementation with fish oil and vitamin complex adding vitamin d and zinc a couple of weeks ago. I also started having more eggs and beef steaks. In 2016 and 2017 I used to do a lot of cardio (trail running) having mainly vegetable diet what could ruin my hormonal system plus I had some stresfull moments at work. I almost dont have facial hair (never had). I dont feel like a men anymore, have no energy, everything seems to me dull. I was so desperate that I even tried no fap for a month having regular exercise and then I felt a bit better. But it shouldnt be like that that I have to abstain with semen retention and train 3-4 days a week to function on poor level (dont have energy to do anything else in life except working out and work). I forgot about women- didnt have sex for 4 years.

I have to add that I used to smoke a lot( 1-1,5 pack of malboro a day) till May when I switched to IQOS which isnt healthy either but I can feel the diffrence. Im looking forward for days off -will try to give up this shit then.

Little update. I introduced some changes in my life since I got the last labtest at may. As I mention above I started supplementing with vit D, fish oil, eat more eggs and red meat ( also took boron and stingging nettle for two months in july-august). Actually I havent been working out for over a month (feel weak and creepy) as I had a nose surgery. Having time off work I took another blood test.

Total T = 18,25 nmol/L which is 519 ng/dl (ref range 4.94 - 32.01)
Free T = not come yet
SHBG = 50,30 nmol/L
Estriadol = 15 pg/ml
TSH 4gen. (uIU/ml) = 1.1686 (ref range 0.3500 - 4.9400)
fT3 (pg/ml)= 2.415 (ref range 1.710 - 3.710)
fT4 (ng/dl) = 1.216 (ref range 0.700 - 1.480)
FSH (mIU/ml) = 4.63 ( ref range 0.95 - 11.95)
LH (mIU/ml)= 6.03 (ref range 0.57 - 12,07)
Prolactin (ng/ml) = 10.02 (ref range 5.18 - 26.53)

These results show that I managed to reduce SHBG from 78 to 50 which is great. I’m worried about lower TT level (I hope it is a cause of recent surgery and literally laying in bed for the last 3 weeks and not working out for over a month) and dont really understand the drop of estriadol (from 35 to 15). I feel very week although I dont have problems with erections now. My semen volume is very low and I feel very exhausted after masturbation (in my case it seems that better is abstaining from it). Using Nebido Calculator my free test is very low. I’m still thinking of TRT but in the place where I live doctors dont prescrbibe it to patients with my results. At summertime when lifting 2-3 times a week I had some days of good feeling (nothing special but after years manage to experience morning wood a few times and feel quite energetic). In spite of above circumstances I still had problems with joint pain (especialy knees after squats) and recovery time after workout. And I’m literally like zombie when not working out- hardly wake up from bed, had no motivation and energy to do anything.

In your case Total T should be ignored, Free T is what matters. Sometimes when we see low estrogen we also see low Free T since estrogen is converted from Free T.

You more than likely have low Free T, your knee pain is from low estrogen and sooner or later osteoporosis. Ejaculation is difficult when estrogen is low. Also low energy is from low estrogen and low Free T.

as you can see in my earlier posts my estrogen in May was at normal level (35) so i guess I can return to this level without medications.

I just got my free testosterone result which is 22, 50 pg/ml (ref range 1-28). It means that from May by lowering shbg I managed to rise up my free testosterone from 18 to 22 pg/ml despite the fact the blood test was actually took over a month from my last workout and 3 weeks after the nose surgery which I spent lying in bed.a As a 38 year male Im happy with this result seeing other younger guys in this forum who have to cope with hormonal imbalances. Hence it is now obvious for me that every symptoms I mentioned here are rather stress, depresion and diet related. Is it possible to have quite high free test like mine with elevated SHBG? Are free testosterone tests relible?