T Nation

Decades Old Varicocele and Low T Lab Results


Hey guys,

I was diagnosed with a Grade 3 varicocele on the left side when I was in high school, and I’m 34 now. At the time, it didn’t hurt and the doctor said to come back if it gets worse and he’d take care of it with surgery. It never really hurt, so I never went back.

For as long as I can remember I’ve been a low energy kind of guy, and I guess I thought that was normal for me. On a whim, 6 months ago I had my total T and free T tested and was surprised by the results:

Date Tested 9/2017 (11 am)

  • Total T (LC/MS/MS): 344 ng/dL (250 - 1100)
  • Free T (dialysis): 76.3 pg/mL (35 - 155)

Started reading online about low T and found out that cholesterol is needed for T production. Starting eating whole eggs at breakfast. Got tested again 2 months later.

Date Tested 11/2017 (2 pm)

  • Total T: 227 ng/dL (250 - 1100)
  • Free T: 51 pg/mL (35 - 155)

Eggs apparently didn’t do much. Continued reading and found out that Vitamin D3 is needed for T production. Started taking 500IU Vitamin D3 daily (though didn’t get a Vitamin D blood test yet). Did some more research and decided to get a Thyroid panel, Iron panel, Lipid panel, and blood test for T again month and half later after taking Vitamin D.

Date Tested 12/2017 (8 am)

  • Total T: 319 ng/dL (250 - 1100)

  • Free T: 85.6 pg/mL (35 - 155)

  • Vitamin D, 25-OH, Total: 26 ng/mL (30 - 100)

Thyroid panel

  • T3 uptake: 30% (22 - 35)
  • Total T4: 7.5 mcg/dL (4.5 - 12.0)
  • Free T4 index: 2.3 (1.4 - 3.8)
  • TSH: 1.68 mIU/L (0.40 - 4.50)
  • Free T4: 1.2 ng/dL (0.8 - 1.8)
  • Free T3: 3.8 pg/mL (2.3 - 4.2)
  • Reverse T3: 15 ng/dL (8 - 25)
  • Thyroglobulin antibodies: <1 IU/mL (< or = 1)
  • Thyroid peroxidase antibodies: 1 IU/mL (< 9)

Iron panel

  • Hemoglobin: 16.1 g/dL (13.2 - 17.1)
  • Total Iron: 138 mcg/dL (50 - 180)
  • Iron binding capacity: 362 mcg/dL (250 - 425)
  • Saturation: 38% (15 - 60)
  • Ferritin: 117 ng/dL (20 - 345)
  • Transferrin: 275 mg/dL (188 - 341)

Lipid panel

  • Total Cholesterol: 249 mg/dL (< 200)
  • HDL: 43 mg/dL (> 40)
  • LDL: 172 mg/dL (< 100)
  • Triglycerides: 183 mg/dL (< 150)
  • Cholest/HDL: 5.8 (< 5.0)
  • Non-HDL cholest: 206 mg/dL (< 130)

Started taking 10,000 IU of Vitamin D3 daily, as well as Vitamin E with Selenium. At the time I thought that my low Vitamin D3 might be the cause of the low T. Got tested again 2 months later.

Date Tested 2/2018 (10 am)

  • Total T: 339 ng/dL (250 - 1100)

  • Free T: 82.9 pg/mL (35 - 155)

  • Vitamin D, 25-OH, Total: 38 ng/mL (30 - 100)

About a month ago I first read about the relation between varicoceles and low T. I read somewhere that Rutin and Horse Chestnut helped some guys naturally minimize a varicocele. Started taking those daily, in addition to the Vitamin D3 and Vitamin E.
Also read about a guy who had Chronic Pelvic Pain Syndrome (tight muscles in the pelvis cutting off circulation to the testicles that can cause a varicocele). Started doing some stretches and pressure point release as best I could, and found out I was really tense down there.

Finally, I found this forum a couple of weeks ago, and got FSH, LH, E2 tested.

Date Tested 3/2018 (10 am)

  • FSH: 4.1 mIU/mL (1.6 - 8.0)
  • LH: 3.4 mIU/mL (1.5 - 9.3)
  • E2: 35 pg/mL (< or = 39)

Looks like E2 is high, but FSH and LH are about normal? Based on the Thyroid panel results, I thought I could rule out anything wrong there, but from what I’ve read on this forum a high FSH and LH indicates the issue is with the testicles. Looks like I haven’t pinpointed the issue yet.

I’m probably missing something here, could you guys take a look and let me know what you think?


Varicocele def causes low t. You can get a testicular ultra sound to get an update.

You LH fsh are just normal. You can raise your fsh and Lh by taking clomid just to see if you are primary or secondary hypogonadism. Raising those should tell your balls to make more t.

Btw i love all this things you did to rule out other causes.


Thanks charlie12, I’m trying to be as systematic as possible and make one small change at a time until something works.
I must have been living under a rock - had no idea a varicocele can cause low T. No doctor ever mentioned that to me, and I found out by reading people’s stories on the internet. Crazy!

Unfortunately, not sure how to proceed at this point. My plan is to continue with the supplements and stretching/pressure point release and get tested again in late April or early May.

I am cautious about taking any medication until it’s my last option. Long story short, weird side effects run in my family with certain drugs - codeine has no effect for example.

Forgot to mention in my first post, have ED pretty bad and had it for years - pretty embarrassing. I’ve been in several relationships where my low energy and ED have created problems that eventually end in a breakup. It sucks big time.


Ok. You are suffering. Just have a plan when your done trying this to jump on TRT.

You say you rather not do drugs. But you should consider Viagra or Cialis to get your dick working. It’s temporary while you figure things out.


You should get an ultra sound with Doppler of testes to see if surgery on the varicocele will help. If that does the trick then maybe you don’t need trt.


You appear to be either or combo:

  • poor absorption of Vit-D3
  • poor conversion of Vit-D3–>Vit-D25 [actually many very complex processes]
  • hyper metabolizer of Vit-D3 or Vit-D25
  • spilling Vit-D through kidneys
  • and no way to really know

Vit-D25 is the active form and is actually a vital steroid hormone that effects/enables many gene expression processes. Keep taking it and try 20,000iu for a while to see if you notice anything.

FT moves a lot hour by hour and day by day. So its diagnostic value is limited. In your case, TT is your best indication of T status.

Thyroid is very important for energy, mood, libido etc.

  • TSH suggests that you are not getting enough iodine.
  • T4 and fT4 suggest that your thyroid is compensating decently.
  • fT3 is strong above mid-range so body temperature and energy should be OK
  • rT3 looks good relative to range, but some publisher ranges are low and then perhaps an issue
  • eval end result via oral body temperatures - see below

Iron status seems OK

Cholesterol might improve with TRT.

If you lowered E2 with .25mg anastrozole twice a week, LH/FSH and T might improve. With your low T, you are very estrogen dominant.

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 numbers 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.