T Nation

Confused With My Lab Results

Tell that to @dextermorgan

TRT is not birth control. Does it reduce the chances? Sure. But don’t plan on it being 100% effective.

Now if you are TRYING for a baby, then sure, add HCG/FSH as needed.

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True. The chances of having a child are lessened when you are on TRT. Not everyone can be as lucky as Dexter, but you’re right.

I vaguely remember reading a study that stated 71% of men on TRT become infertile.

Here are my recent labs that were tested in early March. My endo never tested fT3.
TSH 2.550 uIU/mL 0.450 - 4.500 uIU/mL
T4,Free(Direct) 1.60 ng/dL 0.82 - 1.77 ng/dL
What tests should i get tested every time when someone is having low T. My endo is an idiot , he don’t seems to be much concerned about my symptoms at all.

This is typical of an endo with his head in the sand. The fT3 is the end result and is how you determine thyroid performance.

Yeah mostly they only care about getting you numbers in range, after that they are done. This is no way to treat a patient, what an underachiever!

There are some people with thyroid problems that don’t covert enough fT4 → fT3 and your doctor is shooting in the dark not testing fT3.

I find most doctors really suck, a few are exceptional.

Could you please educate me what tests should i get tested next time? May be i should order by myself through a private clinic with out my insurance.

I believe Total T, Free T, SHBG, LH and FSH, E2 ,Prolactin,TSH ,fT4,ft3 and lipid panel. Am i missing anything?

That’s pretty much standard testing for someone wanting a testosterone/thyroid panel. Make sure the Free T testing is either the Equilibrium Dialysis or Ultrafiltration method.

You could add a CBC if you wanted.

You’re not on TRT but have a very low SHBG. That could be a sign of insulin resistance; how’s your diet look?

Dosing anastrozole daily usually always ends badly for me (I am on TRT). It’s got a 48 hours HL, and I’ve made the mistake of taking a little bit each day until I feel better, but then will overshoot the mark and drive e2 too low. If I take it EOD and feel good in about 4-8 days, then I know I’ve found the dose that works for me. If I feel good in 1-2 days, then I know I took too much

My diet is normal. I don’t eat very excessively but due to genetics i always have high triglycerides. I don’t eat red meat. Even after trying with 1400 calorie diet per day 4 times workout a week , i couldn’t reduce triglycerides less than 220. (range 0-150). I started taking Fenofibrates this months to reduce triglycerides . My endo said even my SHBG is low i shouldn’t get worried since T F+W% is normal. That idiot never tested free T though.

I can only imagine what would happen if you went on TRT with your SHBG already at 10, clearly you have a low metabolic rate if the high triglycerides and low SHBG are any indication.

Your doctor is a idiot, your Free T levels probably aren’t optimised to where you can fully benefit. Sex hormones aren’t taught in medical school, so in range is normal is the default thought process.

If you attempt to use your brain and understand that testosterone increases metabolic rates, then you would come to the conclusion that low normal testosterone (Free T) gives you a lower metabolic rate when compared with testosterone near the top of the ranges gives you a higher metabolic rate.

So while Free T levels are normal, it my not be the best or healthy for every individual, especially those with metabolic syndrome who need to push things even harder to to achieve a healthy state.

Are you saying that i can’t get benefit from TRT.

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The only instance SHBG would increase on TRT is those with metabolic syndrome and/or diabetes where TRT would improve insulin resistance which is already suppressing SHBG. I have diabetes and was diagnosed with low-T (91 ng/dL) and pre-TRT my SHBG was 12 and within 4 weeks on TRT it went to 24.

So if you’re not insulin resistant SHBG is more than likely going to decline unless you are treating an undermining condition that is suppressing SHBG. A lot of low SHBG men tend to struggle on the TRT, but not in every case.

Keeping TRT aside for now, but is there a way to optimize the Free T levels based on my current labs and conditions. It seems like i am not getting any benefits with Clomid therapy. Should i try with HCG monotherapy before i consider TRT ? Does reducing triglycerides boosts SHBG ,Total T and Free T?

Increased SHBG levels may be seen in:

Liver disease
Overactive thyroid (hyperthyroidism)
Eating disorders (anorexia nervosa)
Estrogen use (hormone replacement therapy and oral contraceptives)
Decreased sex hormone production in men (hypogonadism)

Decreases in SHBG are seen with:

Obesity, type 2 diabetes or the metabolic syndrome
Polycystic ovary syndrome
Underactive thyroid (hypothyroidism)
Androgen (“anabolic steroid”) use
Cushing syndrome or excessive use of glucocorticoids (such as prednisone or dexamethasone)

I was on TRT for years and my left testicle had all kinds of shit going on with it since I was a kid. Got my GF pregnant by month 3 and was actually on 350mg T and 150mg Mast for months at the time on conception.

Left Testicle:
*Epididymis: There are 2 epididymal head cysts measuring 2 mm and 3 mm.
*Hydrocele: Small.
*Varicocele: Present.


Left-sided varicocele.

Left-sided epididymal head cysts.

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Good show! Congrats on the seed that your girl is growing for you guys! Its gonna be fun.
Im sure Im shooting blanks at this point but It would be crazy if I suddenly had one take.

I’m only like 4-5 weeks behind you, pretty crazy to think about.