Height: 5’ 9"
Some background: For the past decade or so, I’ve been struggling with constant fatigue and tiredness. For a long time, I was told repeatedly by doctors that this was due to my depression (which I’ve been treated for). After hitting 30 and still having these symptoms despite my depression being managed, I started pushing my doctor to investigate other possibilities.
This led to my thyroid being thoroughly checked (they actually thought I had a tumor, but it turned out to be an error with the test…), a sleep study (ruled out apnea), my previous doctor even had me take iodine supplements for a while. I have also been tested multiple times for diabetes and saw a neurologist to rule out any neurological issues.
And then my doctor suggested in passing that she could check my testosterone levels, though quickly dismissed that as a possiblity. I started researching it myself and was amazed at how many boxes I checked off (I’ll list symptoms below). There were so many problems I’ve had that I never realized could be related, but mostly ignored due to thinking it was normal or because I was so focused on the struggle with fatigue. I was told there was no problem with my bloodwork, but I asked to have my results sent to me and decided to check my estradiol levels myself since I also had a lot of symptoms for high estradiol.
Turns out she did the bare minimum of testing, and this is what I got back:
Free Testosterone: 11.3 (8.7-25.1 pg/mL)
Testosterone (Total): 4.41 (3.48-11.9 ng/mL)
And my estradiol (sensitive) test: 45 (8-35 pg/mL)
Presented with my estradiol levels and the list of symptoms I made, my doctor agreed that while my testosterone levels aren’t low, they are sub-optimal for my age and could explain my issues. However, she doesn’t treat low T due to fears of infertility and suggested I go to find a low T center (saying that they’d take me more seriously and an endo would likely just rule it out based on the numbers alone).
Which brings me to today. I decided to have my testosterone levels retested, hoping I’d get levels a little lower to make it easier to get treatment. I got my results today:
Testosterone (Serum): 592 (264-916 mg/dL)
Free Testosterone: 14.1 (8.2-25.1 pg/mL)
And, obviously, these results indicate everything is normal and well within range. (The odd thing is the first test was taken within a a couple hours of waking up, while this one was taken after a night of no sleep.)
Describe Body and Facial Hair: I can grow a full beard and would actually say my body hair is above average.
Describe Body Fat: I’ve always had fat in my belly, lower back, butt, and thighs. I actually cut my weight down last year to 140 and still had fat in these areas despite being able to see my abs.
Health Conditions and Meds: Only thing of note is depression, which I manage with Wellbutrin. I also have a history of kidney stones which are prevented with daily potassium citrate supplements.
Diet: I believe I have a pretty well-rounded diet. I avoid processed food and track my calories very closely. I’ve currently been trying to bulk, so my calories are higher than normal.
Training: I do weight training 3-5 times a week dependent on energy levels.
Testes Ache: Very, very rarely do I have this happen. It usually lasts a couple days then goes back to normal. I’d estimate it doesn’t happen more than 2 or 3 times a year.
Morning Wood: I can’t remember the last time I woke up in the morning with an erection. If I wake up during the night to go to the bathroom, I’ll occasionally have one, but it’s not common and goes away quickly.
- Low libido
- Weak erections and difficulty keeping them
- Low semen volume
- Difficulty progressing in the gym and building muscle (been training for 3 years and have little to show for it)
- Gain fat easily
- Brain fog, difficulty concentrating
- Dull orgasms
Symptoms of High Estradiol:
(Taken from here, hard to find a credible source, so not sure how accurate this list is)
- Acne (primarily chest and back)
- Soft erections
- Enlarged prostate - I do have symptoms consistent with BPH: difficulty starting urination, frequent urination (up to 20 times a day), weak flow, bladder never feels completely empty, wake up multiple times during the night to go
- Gynecomastia (minor, I think, but diagnosed by an endo)
- I’ve always felt my testicles are a bit on the smaller side
I understand this is very limited information to go on, but my main question is whether or not I should let today’s test results discourage continuing down this path. Is there a reason my numbers would jump like this or is that to be expected? Could one of the tests just be an odd fluke? If not, would my estradiol be enough of a concern that a T specialist wouldn’t turn me away? Could more thorough bloodwork (LH, SHBG, etc.) provide a better indication of what’s going on despite seemingly normal T levels?
Any advice would be greatly appreciated.