T Nation

Bloodwork Advice?

Hey Tnation, big fan of the site, first post on this forum. Got my bloods done, could anyone give me advise on these levels are they ok or do I need some kind of intervention.

Feel like shit last year, libido down, erections are mild, no morning glories, mild depression, no drive, fatigued.

Natural lifting last 8yrs or so. (Was a boxer in my 20’s)
35 years old
90kg
BF 16%
Height 185cm

Supplements:
Curcumin - 500mg/day
Vit D3 - 2000iu/day
Omega 3 - 4000mg/day
Magnesium glycinate - 300mg/day
Zinc chelate - 15mg/day

Eat free range grass fed,red meat,eggs,chicken,raw milk.

Balanced diet of healthy carbs/fats/proteins around 2800/3000cals per day.

E2 (sensitive assay) <48pmol/L
Total test - 11.5nmol/L
SHBG - 35.20nmol/L
Free testosterone - 220pmol/L

I know I’m missing a few tests but is this enough to get a basic picture of what’s going on regarding hormones. Also did a full FBC and PSA which all looks normal.

Thanks for any feedback.

Can you give ranges here :arrow_up: and yeah if you can put up all of your blood work that is always helpful. Do you take vitD3 because you are deficient?

These are disease state levels, estrogen is low and osteoporosis is common among people with low estrogen if left with low estrogen for long periods of time, in your case estrogen is low because testosterone is low. TT is low and SHBG not low, meaning most of your hormones are bound to SHBG and deactivated.

TT = deactivated, FT is the stuff that matters, but no reference ranges provided to see where you measure up against other healthy men. You qualify for TRT in the UK with these numbers, <12 nmol/L is needed to get TRT, <15 nmol/L and a 6 months trial of TRT is allowed.

11.5 nmol/L converts to 331 ng/dL.

Testosterone Threshold for Increased Cardiovascular Risk in Middle-Aged and Elderly Men: A Locally Weighted Regression Analysis.

The locally weighted regression showed that total testosterone levels of 440 and 480 ng/dL were associated with increased Framingham CVD risk and an increased probability of increased hsCRP, respectively. Men with sexual dysfunction (poor sexual performance, decreased morning erection, and loss of libido) had significantly greater CVD risk.

Cost of hormone-disrupting chemical exposure in Europe in billions

EDCs interfere with the body’s hormones. Found in food and food containers, plastics, furniture, toys, carpeting, building materials, and cosmetics, they contain chemicals such as bisphenol A, flame retardants, and pesticides such as chlorpyrifos. They are often released from such products and enter the bodies of humans through ingestion, dermal contact or inhalation.

“Costs in the U.S. would likely be quite similar, as exposures to EDCs are fairly similar to those occurring in the EU, although levels of flame retardants are much higher in the U.S.

Thanks for the reply @NH_Watts

Actually had Vit D tested few months back and wasn’t deficient, do you think it’s still necessary to take it ?

Sorry I’m new to bloodwork , what do you mean by ranges ?

So what was the result? And was this prior to supplementing or after you already were?

Any result always has a corresponding high and low associated with it. For total T it is usually 300-900. For vitamin D it is usually 30-100, and so on.

@NH_Watts

S-PSA - 0.83ng/ml (Ranges 0.0-4.0)

E2 result: <48pmol/L - Ranges : 40-161
SHBG result: 35.5nm/L - Ranges: 11.1 - 78.1
Free test result: 220pmol/L - Ranges: 180-739

FBC results in picture below it’s just in different language don’t know if you’ll understand but give it a shot. First column is results , second is ranges.

TT ranges: >12nmol/L (probably doesn’t need therapy)
<8nmol (test therapy usually would benefit)
8-13nmol (if symptomatic and supported by lower free testosterone level, test therapy may be beneficial)

@systemlord

Thanks for the reply.

I posted all the ranges and FBC results now.

So by what you saying is trt would be something to look into ? A 6month trail.

This is grossly inaccurate, what this is saying is that you have to have the equivalent testosterone levels of a 90 year old man to experience low testosterone. The fact is no one can say for certain with 100% accuracy whether or not you are experiencing low testosterone symptoms simply by looking at lab values.

In a world where the average doctor is utterly clueless regarding TRT and the fact that this is a new area of medicine. The experienced TRT doctors are seeing men complain of low testosterone symptoms long before reaching the levels your lab report is saying.

The studies are showing something completely different, cardiovascular problems at double those numbers. So please disregard it entirely and assume the person who wrote it doesn’t have a clue what their talking about.

If you want to live a long full life, it’s looking like you do need TRT. Most men who go on TRT don’t feel good with FT midrange, yours is lower and most men need their FT at the top of the ranges to feel good.

You are looking at osteoporosis and cardiovascular problems and a poor quality of life at the levels you’re seeing. Finding a knowledgeable doctor who will prescribe TRT, another matter entirely.

This may in fact be your biggest struggle because the majority of doctors knowledge is quite poor and if all they have to go on are these guidelines writing on the lab report, God help you!

1 Like

Given this and your labs, TRT is a logical choice.

Concussions? Dumb question…….I know, but pituitary function may be part of the equation. Were FSH, LH and prolactin levels checked.

@highpull

Thanks for your reply.

Have had concussions many years ago, didn’t test FSH,LH and prolactin. Should I try get this done ?

Problem in my country I have get a referral from a doctor for the tests or the medical insurance doesn’t pay or it’s very expensive, and the doctor is a retard when it comes to the topic of trt.

@systemlord

Yeah that’s why I posted it here, the ranges the lab proposed seemed like a very broad spectrum.

Reason I went for those tests is that I’m displaying all the symptoms of low E2 and low test , that I’ve read on tnation articles and have tried to correct them over last say two years (naturally through supplements) but these are my results still.

Like you said finding a doc to deal with is will be a problem in my country. It will have to be a DIY mission.

@systemlord

Could stress mess up my hormones this bad? Would it be logically to try out an adrenal support supplement?

Last two years I’ve been consistent at eating healthy, training, sleeping, anti plastic, grass fed free range food and taking the supplements proposed by tnation to increase free test. But these are the results I’m producing. Seems like trt only option left ?

The door swings both ways, low testosterone can make normal every day stress amplified ten fold, stress can wrech hormones, but what came first, the stress or the low hormones…

It’s more likely the low testosterone came first, because we are in a low testosterone epidemic and it’s happening across the globe to people who previously didn’t have psychological problems or problems at all.

Not for a lack of trying, you failed to see improvements because the problem more than likely isn’t correctable.

Given the history of concussions, I wondered if pituitary damage could be part of the problem. I suppose it does not really matter, as long term you’ll need TRT. I would be nice to know that prolactin is not high as that can cause low test symptoms.

I think I would move on to TRT if I am you.

@highpull

Thanks man, and how would someone go about reducing the level of prolactin ?

@systemlord

Thanks for the feedback, does feel like stress has been amplified. Will have to look into getting on to a trt protocol. Just for interests sake something like this:

100mg test depot - 50mg Monday 50mg Thursday
Sub Q injection
Re-test levels after 3 months
Maintain Hemocrit levels by donating blood

Cheers mate

This is a solid plan, but if you find that you have symptoms after 6 weeks it wouldn’t hurt to do labs. Often times men are aromatasing a lot and either need a dosage reduction or need smaller more frequent dosing.

First, attempt to determine the cause, which is often not possible. There are medications, cabergoline and bromocriptine, which are standard. Optimizing thyroid, or correcting hypothyroidism, may help. Sometimes, psychological stress can increase it.