T Nation

First Test / Lab Results - Guidance Needed


#1

Hi All,

I've been browsing these forums for a little while and found a lot of great information on here - and I thank the active userbase of knowledgeable individuals for that.

I'm 29 years old, and recently suspected I had low T Levels due to some symptoms I've experiences for a long time (high difficulty gaining muscle mass, trouble sleeping, abdominal fat, trouble concentrating, semi-low sex drive, shyness, anxiety & depression, low motivation). I exercise 3x per week, typically compound/heavy lifts and light cardio, and have a generally balanced & protein-heavy / lowish carb diet w/ a multivitamin, fish oil and D supplement.

Anyway, I decided to have my T level checked with my GP, along with an overall health checkup as I hadn't been to the doctor in quite some time.

All of my normal levels came back fine, but my T level was on the low end - T=246 (range of 250-1100 ng/dL). My doctor noted that it was low, however we tested in the afternoon, so he recommended I come back in the morning (9am) for another test.

The second test, T = 341. He prescribed me a month's supply of Testim to see how I would react to it. I chose not to use it, as upon further reading, I realized that we hadn't determined the reason for my low T level.

I went in for further early morning testing, this time measuring TSH, T, Free T, FSH, LH, and Estradiol. I read a thread on a forum from several years back that indicated these were important levels to know. My results, delivered today, are as follows:

Age = 29
TSH = 2.04 (0.04-4.50 mIU/L)
Total T = 365 (250-1100 ng/dL)
Free T = 82.0 (35.0-155.0 pg/mL)
FSH = 1.8 (1.6-8.0 mIU/mL)
LH = 1.9 (1.5-9.3 mIU/mL)
Estradiol = 27 (< or = 39 pg/mL)

Based on my limited knowledge here, it seems that my T levels aren't horrendous, but definitely are on the low range of normal (and I believe very low for my age), and my FSH and LH are on the extreme low end, which would indicate some form of secondary hypogonadism.

My GP mentioned that any further testing would probably be best through an Endo, however I don't know of any in the Chicago area that are specialists in this sort of thing; nor do I know the extent of the treatment that is necessary (if at all).

Based on my test results above, would any users out there have any suggestions / info to share about my situation? Or what further tests / doctor (type) I should seek?

Any help is greatly appreciated.

Best regards,
-Dirk


#2

welcome Dirk

1st stay away from Endos... I haven't heard any good success stories from anyone ever going to an Endo (including my own story).

have you read the stickies like Finding A TRT doc? some good advice there. call compounding pharmacies and ask for an open minded HRT doc.

your high TSH results warrant more thyroid testing. FT4, FT3, RT3, 8am Cortisol, ferritin. more info on thyroid issues at stopthethyroidmadness.com/things-we-have-learned (man.... I really need to find a way to share on ad profits from that site, the amount I pimp them).

yes, your low FSH/LH indicate secondary hypogondasim and warrant a pituitary MRI to rule out a tumor.

the estradiol looks possible like the wrong test was run. typically you want to the test with the range of 4 to 40 (or something close to that). The test doesn't look too far out of range, but it's reliability is unknown.

testing for D25-OH is pretty standard now as most people are finding they are deficient in vitamin D3, or like most you can simply assume you are low and start taking 6,000iu D3 daily.


#3

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#4

Hi PC,

Yes, it took me 6 months to reply to this. Sorry! Moving right along...

I just recently scheduled an appointment with a supposedly TRT-friendly doc in the Chicago area. Did some searching and managed to find one. The appointment isn't until mid-September though. His specialty is urology / male reproductive medicine.

In the meantime, I think I should look into your suggestion of getting my Thyroid levels tested.

Do you think I should see a different doc to look into thyroid testing? Or perform the test myself via online labwork (i.e. www.privatemdlabs.com/ - my issue with this is I have a high-deductible health insurance plan and this would be out-of-pocket, but it's probably cheaper than going through a doc)?

In doing more reading it seems that hypothyroidism can have a role in hypogonadism, but the reverse appears to be true as well. So I'm not exactly sure if I should look into Thyroid stuff while I wait for my September appt with the TRT doc, or just talk about it with him in September. And if I see another doc in the meantime, it seems like many docs that focus on thyroid issues have a mostly female patient base. Not sure if that matters.

Thoughts?

Best regards,
-Dirk