T Nation

Help Interpreting Results Before Doctor Appointment

Very grateful to benefit from the knowledge within this forum. I have an appointment with a Doctor to go over my bloods. Prior to this I would be interested to hear any comments from members of this forum.

My symptoms have progressively come on over 5 years, getting worse in the last 2 and becoming server in the last 6 months. I am 33 years old.

  • Greatly decreased sex drive
  • Testes feel uncomfortable / like they are being strangled / chemically block / suppressed from working normally / starved / blocked from working / not getting the things they need to function
  • Testes smaller and more retracted
  • Good mood, but mental drive has declined, ambition lower
  • Male pattern baldness at increasing rate
  • Increased belly fat
  • Losing strength and muscle
  • Limpoa
  • More fragile skin, skin easily irritated
  • Frequent urination (small volume)
  • Feel like 80 years old

HAEMOGLOBIN 142 g/L
HAEMATOCRIT 0.42 L/L
RED CELL COUNT 4.26 x10^12/L
MCV 98.4 fl
MCH 33.2 pg
MCHC 337 g/L
RDW 12.4 %
WHITE CELL COUNT 2.99 x10^9/L
NEUTROPHILS 0.99 x10^9/L
LYMPHOCYTES 1.54 x10^9/L
MONOCYTES 0.23 x10^9/L
EOSINOPHILS 0.16 x10^9/L
BASOPHILS 0.05 x10^9/L
PLATELET COUNT 201 x10^9/L
MPV 10.3 fl
UREA 6.3 mmol/L
CREATININE 93 umol/L
EGFR 81.17 ml/min/1.73m2
ALP 66 IU/L
ALT 17.2 IU/L
GGT 10 IU/L
TOTAL PROTEIN 75.5 g/L
ALBUMIN 42.2 g/L
GLOBULIN 33.3 g/L
SHBG 58.1 nmol/L
HBA1C 30.92 mmol/mol
TOTAL CHOLESTEROL 4.38 mmol/L
LDL CHOLESTEROL 2.25 mmol/L
NON HDL CHOLESTEROL 2.59 mmol/L
HDL CHOLESTEROL 1.79 mmol/L
TOTAL CHOLESTEROL : HDL 2.45 ratio
TRIGLYCERIDES 0.74 mmol/L
CREATINE KINASE 115 IU/L
FERRITIN 146 ug/L
TSH 2.54 mIU/L
FREE T3 4.65 pmol/L
FREE THYROXINE 14.9 pmol/L
FSH 2.43 IU/L
LH 2.71 IU/L
OESTRADIOL 96.2 pmol/L
TESTOSTERONE 14 nmol/L
FREE TESTOSTERONE - CALC. 0.195 nmol/L
PROLACTIN 107 mU/L
PSA - TOTAL 0.305 ug/L

Would any other information be helpful?

Ranges

A bit of advice for soliciting comment in the forum. When you post labs, always post the normal range for the lab. Normal ranges vary from lab to lab making it difficult to comment on labs with no ranges to compare. Likewise, for most tests, one should not compare labs from different vendors to each other.

I can comment on your symptoms, you seem to be missing the most commonly reported symptom for Low T, which is “brain fog” and lack of focus. Perhaps that wrapped up in your reported symptom of “mental drive decline”.

Your testosterone levels aren’t the best, Total T with where SHBG sits can’t bold well for ideal Free T levels with Total T hovering at 403. High SHBG can be a direct result of low-T. Your LH is low and the majority of the time men diagnosed with low-T on average have an LH value below 3.

Including ranges:

HAEMOGLOBIN 142 g/L 130 - 170
HAEMATOCRIT 0.42 L/L 0.38 - 0.5
RED CELL COUNT 4.26 x10^12/L 4.4 - 5.8
MCV 98.4 fl 81 - 98
MCH 33.2 pg 27 - 33
MCHC 337 g/L 300 - 350
RDW 12.4 % 11.5 - 14.4
WHITE CELL COUNT 2.99 x10^9/L 3 - 10
NEUTROPHILS 0.99 x10^9/L 2 - 7.5
LYMPHOCYTES 1.54 x10^9/L 1.2 - 3.65
MONOCYTES 0.23 x10^9/L 0.2 - 1
EOSINOPHILS 0.16 x10^9/L 0 - 0.4
BASOPHILS 0.05 x10^9/L 0 - 0.1
PLATELET COUNT 201 x10^9/L 150 - 400
MPV 10.3 fl 7 - 13
UREA 6.3 mmol/L 2.5 - 7.8
CREATININE 93 umol/L 59 - 104
EGFR 81.17 ml/min/1.73m2 ≥ 60
ALP 66 IU/L < 130
ALT 17.2 IU/L < 50
GGT 10 IU/L 10 - 71
TOTAL PROTEIN 75.5 g/L 60 - 80
ALBUMIN 42.2 g/L 35 - 50
GLOBULIN 33.3 g/L 19 - 35
SHBG 58.1 nmol/L 18.3 - 54.1
HBA1C 30.92 mmol/mol 20 - 42
TOTAL CHOLESTEROL 4.38 mmol/L 0 - 5
LDL CHOLESTEROL 2.25 mmol/L < 3
NON HDL CHOLESTEROL 2.59 mmol/L < 4
HDL CHOLESTEROL 1.79 mmol/L > 1.1
TOTAL CHOLESTEROL : HDL 2.45 ratio < 4
TRIGLYCERIDES 0.74 mmol/L < 1.7
CREATINE KINASE 115 IU/L 39 - 308
FERRITIN 146 ug/L 30 - 400
TSH 2.54 mIU/L 0.27 - 4.2
FREE T3 4.65 pmol/L 3.1 - 6.8
FREE THYROXINE 14.9 pmol/L 12 - 22
FSH 2.43 IU/L 1.5 - 12.4
LH 2.71 IU/L 1.7 - 8.6
OESTRADIOL 96.2 pmol/L 41 - 159
TESTOSTERONE 14 nmol/L 8.64 - 29
FREE TESTOSTERONE - CALC. 0.195 nmol/L 0.2 - 0.62
PROLACTIN 107 mU/L 86 - 324
PSA - TOTAL 0.305 ug/L < 1.4

Interesting, immediately after exercise I have a very clear head, but the day after intense exercise brain fog can be extreme.

I’ve talked with a lot of guys in forums over the past 8+ years I’ve been on TRT, and brain fog (lack of focus) seems to be one of the most common symptoms. For me it was extreme. I could not focus at work and I had a constant “buzzing” in my head. All of that cleared up within the first week of TRT. Many do not respond that quickly, but I did.

Regarding your labs, thanks for posting the ranges. You seem to have a similar problem as I do, which is that your Total T is respectable, but your Free T is abysmal. Free T is the more important of the two labs. This is because SHBG-bound T cannot pass through the blood-brain barrier where guys need it to feel normal and have a healthy libido. So with high SHBG, your Total T is good, but your brain is starving for T.

Your SHBG is high and out of range, and will probably continue to climb with age. There are good studies that demonstrate this. This is also why SHBG and Free T are often reported by labs with age-adjusted numbers. The medical community has somehow concluded that just because it’s normal for SHBG to increase with range, that we should accept these age-adjusted ranges as guidelines for TRT dosing. As you probably guess, I believe this is a bunch of BS.

I did a lot of searching on the internet and found the normal Free T ranges for all age groups. I use this information to adjust my dosing so that I have the Free T of a 20-30 year old man, which is around 27 pg/ML. You’ll have to do the unit calculations yourself. However, keep in mind that (per my prior post) comparing one lab to another is difficult due to differences in methodologies. The numbers that I found were for the lab in the USA that I mostly use, which is LabCorp.

Thank you for the comments. I understand that the only way to bring down SHBG is by increasing androgens, which would come via TRT. This would shut down my own T creation, which is a shame as on its own it is near where it needs to be. Are there any other approaches to tackling high SHBG?

Not that have worked for me. When you are genetically programmed to produce more SHBG, you are left with few options.

My experience with using higher doses of T to suppress SHBG have not been all that successful. Some here say that it works, but that was not my experience.

The ONLY approach I’ve been successful with is the use of low doses of (illegal) synthetic anabolic hormones, namely stanozolol (2.5mg 2X per day) and Oxandrolone 5mg 2X per day). They are both very effective, even at these low doses, but stanozolol is your best bet because it requires half the dose and is 4X less expensive. It is also commercially available in the EU unlike the USA, which requires importation. However, without a prescription, both are illegal to possess.

I do not use this approach anymore, I much prefer to saturate the SHBG protein so that enough T spills over to keep my Free T in the desired range. As the graph below shows, that is between 120-125mg/week of T-cyp in an every 3 day protocol.

Yes, this must be frustrating, however, you have low testosterone, it’s low free testosterone and that is what matters. Sure, if your total test is low, free test will be as well. Your total test isn’t terrible, but your SHBG is what makes you have low testosterone signs and symptoms.

I see it all the time, total testosterone 800-900 (250-1100ng/dL range) and free testosterone 30-40 (35-155pg/mL range). SHBG of 70-110! (10-50) Guys feel like crap, PCP checked total testosterone and they are fine. Anti-depressant time.

Your’s is a little high, 58, but enough to drive free testosterone to the basement in your case. Easy fix is TRT. With the above scenarios, 160-200mg a week puts their total test at 800-1100 at trough, free test at 150-200, brings SHBG down to 40-50. For you, I would expect to increase total to the top of the range, bring SHBG down into the 30s, tripling your free testosterone. If you have three times as much free testosterone working for you, you’ll feel better.

You will likely need a TRT practitioner though, small chance a GP or endo will address this given your total number. Good luck going forward.

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You can look up causes for high shbg and see if there’s a fix for that before trt.

Here just one cause
Patients with anorexia nervosa have high SHBG levels. With successful treatment, levels start to fall as nutritional status improves.

That’s EXACTLY what happened to me! Fortunately, I said not to the antidepressant and did my own research and found the right provider.

Just to be clear from my prior post, if you were to chose the path of low dose synthetic anabolic steroids (I don’t recommend it), you must also start TRT. These synthetic steroids will suppress endogenous T production when taken alone and will probably just make the problem worse.

What’s the craziest combo of high total t / low free T you’ve ever seen?

I had one test with total T of 1077 [264 - 916] and free T of 6.5 [8.7 - 25.1]. Didn’t test shbg then but had to be over 150.

I’ll have to look, don’t think I’ve seen 150, at least not in a guy, 130s though. I’ve seen women at 250. FreeT 0.1. Not good for their spouse or significant other, or them…

Damn that’s pretty crazy, I’ve never heard of free T being that low. Yeah it’s not good, numb d isn’t exactly great for relationships.

Second set of labs for me a few months later was 862 total, 6.3 free shbg 151. Wish I had tested shbg the first time but I didn’t know what I was doing

I had been on fin and then dut for years right before this, I always thought it was related but who knows if it really is or not.

Those were women. Their range 0.1-6.4 pg/mL.

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