T Nation

Help Interpreting Results, Before I Start TRT


#1

Hi everyone. I was hoping that I can get some help regarding my blood test results. A little about me I'm 38 yo 5'7" 155 lbs. Been working out most of my Life. Been really kind of depressed and low in energy along with almost no sex drive and also been getting cystic acne out of no where for over a year now . Also haven't gone to the gym in about 6 months. Just no will or energy to go so I went to an endo and had my blood test ran to see if my hormones were causing all these issues . When it came back I saw a few things like cholesterol was high so was estradiol and bioavailable testosterone was high. Dr sayid everything was fine maybe vit d was a little low so he perscribed 50,000 vit d once a week. And that was pretty much it. What bothered me was the estrogen. He wasn't concerned about it at all but I was thinking that that can contribute to the acne and other symptoms so I've read. About two weeks later I brought the results to my GP to see what he thought and when viewing them he said that something didn't look right so he took blood again. Went I went back the following week to go over the results my total testosterone was a lot lower and so was my estradiol. He also said that my free t was very low and that could be causing The low libido and no morning erection. So I was borderline but I could be a candidate for TRT to think about it.
1)My question is basically by looking at my blood test do I really need to be on TRT
2)How could the test and estrodiol levels be so different only 3 weeks apart
3)I see my LH is High is that affecting my testosterone?
4)what can you see wrong and what advice can you give me based on my blood results.
5) do I really need go on TRT

Any help is really appreciated. I have an appointment next week with dr to start TRT Just would like your advice.




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The first three pictures are from endo. They are not too clear as I had to snap pictures with my phone. They were giving me a hard time about making copies. The other pages are 3 weeks later.


New to TRT; Need Input on Lab Results and Plan
#3

No one will be able to read those labs. You need to do better - please...

Please read these stickies found here: https://forums.t-nation.com/t/about-the-t-replacement-category/38/2?u=ksman
* advice for new guys
* things that damage your hormones
* protocol for injections
* finding a TRT doc


#4

Thanks I just rescanned clearer pictures do you mind looking at them and tell me what you think is going on with me based on what you can see from blood results. thank you very much


#5

When labs vary that much, I have doubts about what is going on.

Had you been taking/stopping any medications?

Thyroids: Some levels looked really good.
Have you always used iodized salt?

HTC is getting high. If you increase T levels, will get worse. Can you be a blood doner?

Higher albumin helps with bio-T

Did you do anything to lower cholesterol?

LH/FSH suggest some degree of primary hypogonadism. You could test DHEA-S to see if that was low and rate limiting DHEA-->T.

Your bio-T is good enough that you should not be having low-T symptoms.

FT is released in pulses and perhaps first lab caught a peak and second a trough.

Essential fatty acids are just that, essential because your body cannot make these. Sources are fish oil, flax seed oil/meal, nuts.

Do you take any supplements?

Do you ever get leg cramps? That is typically a magnesium deficiency.


#6

Thanks for reading and responding to my post. To be completely honest I took about one or two Percocet for about 2 months straight last one was 3 days before the first blood test. Might of taken 5 or 6 more between first test and the second one. I hurt my shoulder a few months ago and decided to take for the pain. Shouldn't have since I was addicted to Vicodin for a Few years in the past. And I know how easy it is to get hooked on them. Not taking any now.
Do you think( we'll obviously you do since you asked about medication specifically) I guess I'm asking how much different and what specifically did the Percocet effect on my test? What about my TT and FT could that have made a major drop on my levels?

I Don't Get cramps on my legs but sometimes on my feet like I have to get out of bed and stand on my toes and stretch for a few seconds to stop the pain
I take fish oil maybe twice week. Eat almonds daily with breakfast. And flax seed seed maybe twice a week in shake
Vit d about 5000 in a day. Since it was low on test results
Are you suggesting to take more essentiall fatty acids based on something that you see in the results? Like you can tell I need more If so how much should I take?

Only supplement I take is pre workout. Pretty much daily use if I don't go to the gym I'll take it as an energy booster throughut the day.
Get most of my meals from the street being outside most of the day. And at home I've been using Rock salt. I see from reading ur stickys about iodine the resturants and most place Don't Use iodine salt. So unless there is another way to get iodine in my diet except for salt. I'm not sure that I get enough.
Are you saying I would need to donate blood.? If you are asking if I donete blood the answer in no. Never did
Are you saying that my albumin is a good level or do I need more if so how?
Didn't really do much about the cholesterol.
Please get back to me with your advice. Is there anything wrong with me? Do I need TRT. What should I do ? Please help


#7

Kind of strange that your E2 was high on the first set of labs and low on your second.

I'd try to stay off the opiates and alcohol for a while and get retested.


#8

I've been reading that the opiates can in increase estrogen in the body. So yes won't use them again. As far as alcohol haven't drank in about a year now. What about the rest off results. Free test seemed low on both test. My GP said its on the very low side. And that's could be causing the symptoms ( no sex drive, no motivation, alway tired, social depersonalization. Thayts why he offerd to try TRT to see if it would help with symptoms. Honestly hate needles and a little scared of being on it for the rest of my life if I Don't Have to be. But at the same time I Don't feel like myself for the past two years. Don't want to be around people. Haven't been with any girls, and my sex drive is almost non existent. Where before I'd bang anything in site.


#9

Pay attention to ksman's response. I'm just a noob.

He said you have "some level of primary hypogonadism". That means your testicles aren't functioning as they should in the presence of LH / FSH.

That said, if your E2 comes back high again, I'd suggest starting with an AI. If not, you could try a SERM, but that may fail due to your "some level of primary hypogonadism". Otherwise, you should inject. Topical T does not perform as well and should be avoided. I don't like needles either, but if that's my destiny, I shall grow to like them just fine.

Don't discount testing DHEA-S. If you are low on DHEA, then your body doesn't have the materials to make T, which could explain the primary. Of course, you could just supplement DHEA 25mg / day and see if that helps your numbers any.


#10

My concern was that you might have had low EFA's. With what you describe that is not a concern. EFA's have some anti-inflammatory properties.

Try a magnesium supplement. A good one is sold in the store here.
Foot cramps probably will go away with that. I take a single capsule.
https://biotest.t-nation.com/products/zma

Your oral body temperatures are your best indicator of overall thyroid function:
* when you wake up, should be 97.7-97,8, higher is OK, 93.3 is a problem
* also check for 98.6 mid-afternoon

Get a high potency B-complex multi-vit with trace elements that also lists iodine+selenium
Find a 500mcg, 0.5mg iodine supplement.

While we have doubts about what the labs are indicating, your symptoms indicate a problem that has been been there for years. While low-T is the obvious problem, you can't feel right if thyroid is also holding you down. Report you temperatures. Get iodized salt at home for when you do use salt.

Getting TRT would change your life a lot and you would find the burden worthwhile. TRT may improve your cholesterol too.


#11

Thanks for responding. I will be going to the store in a few to buy thermometer to check my temperature as you said. Along with b complex vitamins and increase iodine intake. Im going crazy deciding what to do about my appointment this week for starting TRT. My whole thing is I really want to make sure this is something that I sincerly need. Obviously it crossed my mind as I'm sure a lot of other people to do it for a little while because it's something done legally by a dr. But after reserching about it for months and reading other people's experience. You realize that this is not something to play with.

I guess what I need help figuring out more is if I take the b vitamins, more iodine, consume fatty acids daily , take vit d to raise because it was low. Is it possible that by adding these I can raise my testoserone results and help my testicals producing more since I'm primary?
Not sure how to ask the question exactly , I guess im just hoping that being low in any of those above would fix my low testosterone problem. And have a significant jump up in numbers not having to go on TRT. For example after taking the above vitamins and minerals Is it possible that by supplying with them I would raise my test to 500 or FT to 10 or something like that ?(Wishful Thinking).
Or can you already tell by my results that I need TRT since I show signs of primary.? BtW I have a varicocele on my left testical. I have had it since 15 . Read that this could effect test production. Is that my problem? And another thing is that both tests were in the afternoon. First test around 1 pm and 2nd test about 3 pm. In both cases I asked the dr if it would effect my results that it was so late in the day seeing as best time to check is early morning but both said it wouldn't make a noticeable difference. How much could that have effected my test results? I really appreciate the help and advice I have appointment to start TRT this week. But would really appreciate your guys input first. Thank you


#12

Sorry but I want to know how bio T is good here. The range is bad but I had higher bio T(his is 190), the first range is 110-575, other max out at 190 but results are same.


#13

Could really use your advice.


#14

Because you T levels were not so low and with your symptoms I suggested some supplements that may help your vitality. I am sorry if you had the impression that this could resolve T issues.

LH is released in pulses, lab could have detected a peak. Typically, FSH is a better indicator of overall LH status than LH itself.

Because your labs were contradictory, you need to do labs again.


#15

Your bio T is not high, the range is weird. FT and Bio-T are low. One test has ranges from 110-575 and the other 50-190. That's why it's flagged high! Unbelievable ranges though, would make a person with 100ng/dl TT look normal. Get LH/FSH done. Varicocele CAN lower T, i also have bilateral varicocele and LH/FSH high-normal indicating some degree of primary hypogonadism. If FSH/LH is low, SERM can be given a shot before TRT.