T Nation

Confusing Lab Results


Been on TRT a little over a year, 175/mg wk of Test Enathate. (Originally started me out at 125mg/wk, but bumped it up).

Latest blood work came in, and basically I was back to where I started Pre-TRT!

Total T: 578 (scale 250-1100)
Free T: 66 (scale 46-224)
Bioavailable T: 138 (scale 110-575)
SHBG 41 (scale 8-48)
IGF 293 (scale 64-334)
Estradiol 19 (scale 13-54)

Prior blood work had all T-levels much higher, in fact, even when I was on 125mg/wk, all levels were much higher. Any ideas as to what could cause these crappy numbers? I'm scratching my head, because I always thought the body produces 5-10mg/day...which means even with my natural test production completely shut down, I should still test higher at 175mg/wk?

My biggest concern is that I've gone through the trouble of a TRT program, doctor's prescription, exorbitant prices...etc. And now I'm wondering if my test Enathate is even real. But let's say it's legit...what could change in my body to cause this? (all my other CBC results are within accepted ranges...nothing's jumping out)

Thanks in advance


A little more information: I'll be getting another blood draw shortly, and if the results are still shitty, will switch to some Test I procured from...shall we say...someone who is not affiliated with a doctor. Will then re-test after a month and see where my levels are. If I ascertain my "legit" source scammed me, I'll probably have an anuerysm, but I'll least I'll know my body's not screwed up.

Interestingly enough, when they saw my IGF numbers, they asked if I was already on GH (I'm in my late 30's). I was at the high end of scale, and have never used the stuff.

Maybe this next round of blood work will turn out fine, but I don't think it will. While I feel "ok", I do notice muscle quality down a bit and bodyfat is sticking pretty good, even though I've upped the cardio and cleaned up the diet after the holidays. Strength is still good, but honestly, it pretty much always is. I find that TRT seems to help physique moreso than strength, and found (via Bodpod testing) that it gave me about 8-10lbs lean muscle. This may not sound like very much, but it's a small dose, and it's not like I was a pile of crap before TRT. Just felt myself losing my edge and decided I was going to fight it all the way.


If you where at mid 500's before TRT then it was not needed in the first place. I do see there is high shbg which can creep up on people even on TRT. In your case i would look into potential adrenal issues. These can be tested by 24 hour saliva cortisol testing. With 175 mgs a week then you are not getting it deep enough into the muscle, If you are going through a "antianging clinic" they are ripping you off and under dosing you and just taking your money.
Elevated SHBG can be from starvation, malabsorption, liver imbalance, silent inflammation with in the body, low dhea (which TRT can deplete), low gh levels, low progesterone, low dht I would look into your gut issues if there are food intolerance , and other areas which are mentioned above. IF you are thyroid meds or any other meds this can cause it as well. Hope this helps.


Sorry, original Total T was 381, and Free was 44, and bio was 100. Just checked my records, so I was certainly a candidate for TRT (at least I think so).

Thanks for your reply...many things I can cross off your list (starvation...not a problem!), low gh, etc.

Not sure about Liver imbalance...under the Hepatic section, everything is within range EXCEPT for ALT, which is at 63 (range 9-60). Honestly don't even know what that is...if it's enzymes I'm a bit wary of that number. I do considerable amount of strength training, and I've heard it can keep those numbers elevated.


ditto HANS.

what are your 'other' test results like TSH, 8am Cortisol, Free T4, Free T3, Ferritin, D25OH, B12, Magnesium, etc.?


Yes, I would suspect that there was something wrong with the injectable. However, a few[rare] guys are hyper metabolizers of T and they need 300mg T ester per week to achieve high normal levels. The are hypo-metabolizers. Nothing more about that is known.

You should be in HPTA shutdown, with LH/FSH close to zero. One would expect that your testes would be softer and smaller and your scrotum might be pulled up tight to your body as a result.

Low E2 and high SHBG is unexpected. The high SHBG is lowering your FT. More T is SHBG-T which makes your TT high. Note that SHBG-T does not transport T, it permanently binds it. The things that you find to read concerning SHBG and T are mostly very wrong. It is bio-T that creates benefit. TT is somewhat a measure of your SHBG generation. More SHBG leads to more SHBT-T that increases TT.

If you inject once a week and do labs at the end of that week, your levels will be low. Your lab results are a matter of timing. You should inject at least twice a week. Note that T eth peaks faster than T cyp, which means that it also drops sooner and deaper than T cyp. That would make you feel worse at the end of the week VS T cyp.


Thanks for the replies. Unfortunately, I don't have any of the other lab results at this time, nor am I on any thyroid meds. Last time T3 was checked, it was 339 (scale 230-420). LH was 3.1 (sacle 1.5 - 9.3), and DHEA was in the middle of the range as well.

I can say that I inject twice/wk, and had blood drawn before I injected for that day (so about 3.5 days since last injection). This is consistent with how I've timed my other blood draws.

Further, if I'm a hyper metabolizer...it must have just happened (if that's even possible). All previous results indicated increases in FT, TT, etc. on as little as 125mg/wk.

Seems the path of least resistance may be determining if the injectable is legit. I'll switch to another product and re-test and take it from there. The second alternative is that it's physiological- and from the varied responses, that looks like a bit of a hornet's nest to figure out.

Thanks guys, it's been helpful.