T Nation

Can Anyone Help Me Interpret These Test Results?

Thanks for reading…

I recently got some blood test results through the post and am unsure how to read the results as this is all a bit new to me. As a little background I am 33 years old. Pretty active - play football (soccer) 3 times a week and lift weights 3 days a week. I weigh approx 71kg (156lbs) at a height of 6’.
I only started weight training about 18 months ago and have made some good strength gains but haven’t added much muscle.

Results 7th September;
Albumin 53 g/L (ref 34-50)
Luteinising Hormone 1.1 IU/L (ref 1.7-8.6)
Testosterone 7.7 nmol/L (ref 7.6 -31.4)
Free Testosterone 0.0649 nmol/L (ref 0.3-1.00)
Sex hormone binding glob 96 nmol/L (ref 16-55)
Prolactin 256 mIU/L (ref 86-324)
17-Beta Oestradiol <44 pmol/L (ref <192)

Results 3rd October
DHEA Sulphate 6.500 umol/L (ref. 0.44-13.4)
FSH 4.97 IU/L (ref. 1.5-12.4)
LH 1.61 IU/L (ref1.7-8.6)
Test 8.63 nmol/L (ref. 7.6-31.4)
SHBG 76.9 nmol/L (ref. 16.00-55…00)
Free Androgen Index 11.22 Ratio (ref. 24.00-104.00)

Any help appreciated. I have been experiencing what I believe are the effects of low test for the past few years ie. low sex drive, lack of morning wood etc.

Your SHBG is insanely high. But a reference value would be good. However, the highest normal limit ive seen for SHBG is 70. More than likely, your SHBG is choking off your free testosterone and giving you low testosterone symptoms.

  1. Meds? (any, past and present)
  2. Alcohol?
  3. Liver disease or other liver issue?

The reference level they give on the sheet is 16-55 so yeah 96 is quite a bit off that.
1 - Meds - Not taking anything, i take Vitamin d, creatine and omega 3 daily but i’m not on any meds.
2 - Not a big alcohol drinker, might have the equivalent of a few pints of beer a week.
3 - No known liver issues past or present

Your test is low for your age but just JUST within ‘normal values’. Considering they don’t take age into account I would say they are low. SHBG is high which will lead to further reduction in free test and make you feel like shit!

So SHBG is made by the liver usually as a result of high estrogen or medications, or anything that puts strain on your liver. There are some things in your diet too that can cause SHBG. Keto causes increase in SHBG, Fasting, low carb diets. Any of this you?

Really think about meds. Even OTC stuff. your SHBG is high for a reason, needs to be addressed.

I am meeting with my doctor in a couple of days to discuss some recent blood tests with him.
The particular result I have stated here were obtained via sending blood samples to an online lab. I got these myself as when I visited my go he only asked for a total testosterone test (7.1 result “normal”) and some general liver function tests. I will get the details of the liver tests on Wednesday.

I am not low carb, fasting or anything radical.
I am on 3000 cals a day. Approx 200g protein, 60g fat and 300 carbs. Not terribly strict on the macros but they average in and around those numbers.

In terms of sups or medicine it is only what I mention above, vit d, omega 3 and creatine. I also take homemade Kefir. Think that’s the only other unusual thing.

Doctors who only order TT clearly have no clue what they’re doing and have no business prescribing testosterone! My first endo only ordered TT multiply times which is why he was clearly unable to provide me with a solution to my symptoms I was presenting. He just didn’t know what to do, it was as if he took the driver’s test and passed without understanding any of the laws.

Our healthcare system is seriously broken!

In fairness to my particular gp, I think he knows enough to know how little he knows and I believe he is going to refer me to an endriconologist.
I have no idea how long the waiting list is though or how things are going to proceed from there.

Don’t be surprised if your endocrinologist is a complete moron too. I went in all prepared to have a grown up discussion with my endo, and he said “Wait, I have to stop you there, what is pregnenolone?” Instantly you realize you are talking with someone who may be a specialist, but is not a TRT specialist in any sense.

7.1 total test is not normal!!! That is low even for the ridiculous reference ranges they use.

I agree but the latest test I took give me a 7.7 which just about falls into the reference they use (7.6-31.4) so they could just fob me off with that.

Unfortunately I’m not terribly knowledgeable with what the various markers mean in order to argue my own case.

Ok so I saw my doctor today and he has referred me to an end but say the wait will be at least 4-6months. Mentioned the possibility of going private also…so that’s two options.

I’ve also send blood work to balancemyhormones.com who did tbe recent tests for me. They will have a doctor look at my labs and can offer a package of creams or injections depending on the doctors recommendations. Not sure what the pricing will be.

Also got one other blood test back and it’s awful…
Free test 0.0648 nmol/L
(Reference range 0.3-1.0)

In UK?

Please directly edit opening post to add reference ranges or repost with reference ranges. You do not memorize these in different unit systems and we do not either. Ranges are actually not universal and are specific to each testing lab.

The normal values for prolactin are:

Males: less than 20 ng/dL (425 mIU/L ) -but vary by testing lab

Prolactin is fine.

You have secondary hypogonadism. As a rule, FSH should be tested as well. Your secondary is not caused by high prolactin, so cause is not a prolactin secreting pituitary adinoma. However, your pituitary could be damaged by heading balls and other blows to the head or concussions which can sometimes show up on a MRI.

Please read the stickies found here: About the T Replacement Category

  • advice for new guys - need more info about you
  • things that damage your hormones
  • protocol for injections
  • finding a TRT doc

Evaluate your overall thyroid function by checking oral body temperatures as per the thyroid basics sticky. Thyroid hormone fT3 is what gets the job done and it regulates mitochondrial activity, the source of ATP which is the universal currency of cellular energy. This is part of the body’s temperature control loop. This can get messed up if you are iodine deficient. In many countries, you need to be using iodized salt. Other countries add iodine to dairy or bread.

KSman is simply a regular member on this site. Nothing more other than highly active.

I can be a bit abrupt in my replies and recommendations. I have a lot of ground to cover as this forum has become much more active in the last two years. I can’t follow threads that go deep over time. You need to respond to all of my points and requests as soon as possible before you fall off of my radar. The worse problems are guys who ignore issues re thyroid, body temperatures, history of iodized salt. Please do not piss people off saying that lab results are normal, we need lab number and ranges.

The value that you get out of this process and forum depends on your effort and performance. The bulk of your learning is reading/studying the suggested stickies.

Over training can also cause some secondary.

SHBG is not causing secondary but increases SHBG+T that lowers FT. SHBG+T is not bioavailable and it inflates TT so TT is actually overstating your T status. Liver panel labs are useful, AST/ALT at a minimum.

Hi KSman,

Yes I am in the UK. Northern Ireland to be precise. I could pursue treatment either within the UK/NHS or in the Repuclic of Ireland.

I have edited the original post with the reference values I was provided. I will also post below.

Albumin 53 g/L (ref 34-50)
Luteinising Hormone 1.1 IU/L (ref 1.7-8.6)
Testosterone 7.7 nmol/L (ref 7.6 -31.4)
Free Testosterone 0.0649 nmol/L (ref 0.3-1.00)
Sex hormone binding glob 96 nmol/L (ref 16-55)
Prolactin 256 mIU/L (ref 86-324)
17-Beta Oestradiol <44 pmol/L (ref <192)

While I do play football, I tend to avoid heading the ball too often so hopefully concussions shouldn’t be a factor.
I’ll read up on the sticky posts you mentioned to get a fuller understanding of everything re. thyroid etc.

Hopefully TRT with high-normal TT can start to push down SHBG.

TRT can increase E2 which is not good for SHBG. Like to see a target of E2=80 pmol/L and that often need anastrozole. Getting E2 managed within those heath care systems is a problem.

Your problem is definitely with the pituitary aka secondary hypogonadism.

I have gotten through an invoice from an online doctor here for the attached items.
Would you agree with this protocol?
I am told the proviron will be temporary until the SHBG is under control and that the anastrozole is only to have onhand in case of itchy nipples etc but is not to be taken unless I feel symptoms.
They have also mentioned that the HCG can be used 3 months on, one month off and still be effective, do you agree with this? I would like to keep alive the chance of having children sometime in the next few years.

Why stop hCG? Too save money?
Any advantage to have a natural guy take a drug to stop LH?

Above supply list does not describe dosing.
Supplies bundle seems too expensive.

hCG protects fertility

Yeah I was a little worried about the cost commitment and they suggested hcg would still be effective done 3 weeks on, one off or 3 months on and one off. Do you agree with this or is it not worth it?

Sorry I don’t really understand this. Is this in relation to the proviron?

I’ve bought it the supply bundle to get me started but will look at sourcing things myself next time when I know a little better what I am doing.

I’ve gone with it for my first time to simplify things but I’ll look into sourcing these elsewhere next time when I am a bit more knowledgeable.

Any advantage to have a natural guy take a drug to stop LH?
Sorry I don’t really understand this. Is this in relation to the proviron?
I believe he’s referring to hcg, saying the body doesn’t produce LH for 3 weeks and then takes a week off so why should you.

Ok. Yeah that makes sense. Thanks.

I had just raised some issues with the provider about the costs involved and they suggested that hcg could be done 3 on and 1 off to save costs. Not sure if that is factual or not though.