T Nation

Help Interpreting Lab Results?


#1

Good afternoon all,

I would really appreciate some help in interpreting my recent lab results. Discussed my low sex drive, difficulty losing fat at a reasonable rate, being tired and finding myself really irritated at things that shouldn’t bother me with my doc. He got a bunch of labs worked up - and he marked them all as “normal”.

As you will see my total test is what one would expect of a 80 year old man I believe based on what I have researched on the web.

I sure would appreciate a educated review of my numbers. Not sure what to do or where to turn given that the doc just said “ok, normal”.

I’m 38, been lifting for most of my life, was a D1 athlete, recently got back into lifting/bodybuilding after 5 years off. Results below:

Total test = 324 ng/dL; ref value 240-950
Free test = 11.7 ng/dL; ref value 4.65-18.1
Bio avail test = 149 ng/dL; ref value 72-235
Estradiol = 22.60 pg/mL; ref value 0-66
T3 total = 1.14 ng/mL; ref value 0.97-1.69
T4 free = 1.05 ng/dL; ref value 0.78-2.19
Cortisol free and total = 19 mcg/dL; ref value 5-25, 0.807 mcg/dL; ref value 0.121-1.065
Dehydroepiandrosterone = 5.3 ng/mL; ref value <10
Ferritin = 169.0 ng/mL; ref value 18-464
Follicle stimulating hormone = 4.77 mIU/mL; ref value 1.6-9.7
Luteinizing hormone = 5.20 mIU/mL; ref value 0.8-7.6
TSH reflex FT4 = 2.79 uIU/mL; ref value 0.47-4.68
PSA = 0.38 ng/mL; ref value 0-2.59

Much appreciated,


#2

Edit your post to ad lab range


#3

Thanks, just updated


#4

You, my friend, have just joined the fastest growing men’s club around…the low T club.

Before proceeding, you need to read all of the stickies on this forum. Found here:

just keep scrolling down for each new sticky. Most of the stuff we will tell you is in these stickies. After you’ve read them, come back with questions.


#5

thanks bud


#6

Your doctor has missed a couple of important tests, SHBG is the gold standard for sex hormone evaluation, it tell us how well you hold onto your testosterone. I’d say you’re dealing with an inexperienced GP, most insurance doctors will get TRT wrong and don’t know how to properly diagnose low T. Prolactin is also missing.

They don’t teach hormones in medical school, the only way they gain experience is trial and error, usually that means turning away men who are suffering symptoms of low T. For now your doctor will fixate on labs ranges not understanding age related testosterone levels and that you score lower than president Trumps who is 71 years old.

If your doctor missed SHBG most certainly ordered the wrong E2 labs, is it LS/MS/MS method? If not then you got the female E2 labs. Your better than midrange LH stands out as you testosterone levels should be higher, this is something we see on men whose testicles are on their way out or damaged.

Are you overtraining? This can lower testosterone levels especially if hard dieting.

Are you on any medications, SSRIs?

Thyroid labs incomplete, there are no free thyroid hormone testing, fT3 is the only active thyroid hormone and is where the rubber meets the road and is not tested. Do you consume iodized salt, thyroid requires iodine to function properly and going without it can damage your thyroid.

See our thyroid sticky and check oral body temps, body temps are connected to fT3 thyroid hormone, if body temp is 98.6 in the afternoon fT3 is expected to be alright.


#7

thank you for the note. sounds like I need a new doctor or one that specializes in this. I am probably not overtraining - although admittedly I am out of shape and need to strip off about 35 lbs. of fat to get to approx. 10% body fat. Given my over abundance of fat, I was not super surprised to see the low total T reading, although I didn’t expect it would be as low as it came in.

Regarding SHBG, I hear you. Not sure why the doc didn’t do that one. My guess is he probably thought he had that indirectly covered by measuring the free and bio available.

The testosterone test that was run was Liquid Chromatography - Tandem Mass Spectrometry for the free t. It was Equilibrium Dialysis for the bioavailable t. And, the lab notes that the test was performed by Differential Precipitation. So, I’m not sure what all that is, but that is what the lab notes read.

My body temp is 98.6 in the afternoon.

I do consume iodized salt - not sure if it is enough or too much?

Thanks again for the response.


#8

Not sure if you are aware or not, but you can order your own bloodwork in most states. I personally use Private MD Labs. They have a huge range of tests. There are other similar sites, I just haven’t used them.

My point is that, dont let your Dr. keep you from getting the info you need to make an educated decision. There are a ton of guys on this board that have been down this road before you. You pretty much have to accept the fact that you are going to have to take control over your treatment if you want to feel better.


#9

Roger that and thanks for the message. I went through the doc I did because it was covered under insurance, and probably partly out of my own laziness. Appreciate the recommendation.


#10

What test do you order from them?


#11

Alot depends on how much you want to spend. My HRA account pays for mine.

The number of tests is huge and you can order them a-la-cart or as packages.

There’s this one:

And this one: