T Nation

Doctor Testing for TRT. Are These Blood Tests Enough?

I recently went to the doctor on suspicion of testosterone deficiency. The blood results have just come back, and apparently they show values within range. However, I am not sure if this test can be taken as sufficient to rule out a deficiency. I have read a fair amount both on here and from other sources, so am aware that it is a pretty complex topic.

There are no tests for LH or FSH - maybe these are not needed unless the previous ones indicate it? Anyone?

I have not discussed the results with the doctor yet, would like to be prepared with some information before hand. Hope someone here can chime in.

I am male, 44 years old, 176 cm, 73 kilos (I think that’s equivalent to 69.2 inches / 5.7 foot height and 161 pounds).

These are the relevant part of the blood test results:

Testosteron;P
nmol/L
14,0
Reference range 10,3 - 27,4

Sexual hormone binding globulin;P
nmol/L
38,1
Reference range 15,8 - 55,5

Testosteron free;P
nmol/L
0,3170
Reference range 0,2400 - 0,6900

Thyrotropin [TSH]:stuck_out_tongue_winking_eye:
E-3 IU/L
2,79
Reference range 0,40 - 4,80

Hemoglobin A1c (IFCC);Hb(B)
mmol/mol
33
Reference range < 48

Hemoglobin [MCHC];Erc(B)
mmol/L
20,6
Reference range 19,7 - 22,2

Hemoglobin;B
mmol/L
9,0
Reference range 8,3 - 10,5

Hemoglobin content [MCH];Erc(B)
fmol
1,9
Reference range 1,7 - 2,1

17-Hydroxyprogesteron;P
nmol/L
3,29
Reference range < 8,00

Albumin;P
g/L
39
Reference range 36 - 45

Androstendion;P
nmol/L
3,08
Reference range 1,70 - 6,90

Glucose, medium (from HbA1c):stuck_out_tongue_winking_eye:
mmol/L
5,4
Reference range < 7,7

FSH and LH are used to determine primary or secondary in a scenario where you have low T. You don’t have low T by medical standards but it sure is sub-par. If you want to go the TRT route you would likely be stuck using an off-insurance mens clinic where they would treat your symptoms versus your numbers.

Very possible.

This will depend on your doctor and if going by reference lab ranges, they will not prescribe TRT because you are “within normal”. You’re going to have to make the case for treating symptoms over numbers. Thyroid should include fT3 and fT4. It would be interesting to get E2 checked, VitD, DHEA, PSA should be checked.

It’s doubtful any sick care doc will prescribe TRT with these numbers, the cut off points to be considered for TRT are set too low. There are studies showing men with hypogonadal symptoms between 300 - 400 ng/dL or 10.41 - 13.88 nmol/L.

Free T measurement outside the US are notoriously inaccurate because other countries don’t have access to the more accurate testing methods. You can however calculate the Free T percentage using the Total T and SHBG measurements.

Your Free T percentage when calculated shows a Free T percentage of 1.87 % which is below what is considered normal which is between 2-3 percent.

I don’t see estradiol (E2) tested.

It was not tested.

Thanks. I will try asking the doctor to test for estrogen. What would change if for example estrogen was abnormally high? Would this indicate that TRT is still a possibility, in spite of testosterone testing ‘normal’?

Or do doctors treat this separately like with Arimidex or something like that?

It would be a reference point for when you start TRT.

Difficult to say. I hope not.