Help Interpreting Test Results, Should I Start TRT?

Here are my current levels at 23 years old. Would love some advice and feedback on if I should start trt and what would be a good protocol if so. Based on my own research it seems as tho I have the test levels of a 50 year old. Is this the case?

Testosterone, total 4.27 ng/ml

Testosterone, free 0.11ng/ml

Bioavailable 2.55 ng/ml

Shbg 21.90nmol/L

Here are the ref ranges as well

Test total ref range: 1.75-7.81 ng/ml

Test free ref range 0.043-0.213ng/ml

Bioavailable ref range 1.12-5.50ng/ml

Shbg ref range 13.3-89.5 nmol/l

Please describe physical appearance, weight, height and body fat percentage.

Your levels are underestimated, the US president scores in this range. Normally with SHBG this low you should see Free T higher which means you bind androgens well, not a bad thing is Total T is sufficiently elevated which yours isn’t.

Things like poor diet, poor sleep and even sleep apnea can cause testosterone to decline. Normally when a man comes to theses forums it’s out of curiosity or has symptoms of low testosterone.

Realistically you would need to increase testosterone to at least 600 or more to get sufficient Free T levels. A good protocol is difficult to recommend without pre-TRT estrogen measured, my advice would be drastically different if estrogen was sufficiently elevated versus being on the lower end.

SHBG being on the lower end and estrogen healthy, EOD injections is a good place to start. If estrogen is really low, then twice weekly could work.

@systemlord care to reply in my thread mate? sorry to chime in OP.

Oh and I still have gynecomastia /:

@systemlord physically I look every bit of 17 years old. I have an extreme baby face and when I go out with my girlfriend people think she’s my mom… we’re both 23 lol. I have been active all my life except for college. Up until college I played basketball and baseball and did strength and conditioning almost every day. Despite all of my training, I’ve never been lean. At my lowest of 160 lbs at 5’11 I still had lower belly fat as well as gynecomastia. Also, despite being fairly athletic and fairly strong, I’ve never looked like it. College is when I became very sedentary and I put on a LOT of weight FAST. In my 4 years of college I went from 160 to 290 almost 300 pounds! This is when all of the symptoms of low T became extremely apparent to me. I got tested and was diagnosed with Low T. I was hesitant to do trt therapy because of my age so I decided to adapt a healthy lifestyle to see if that would help. I’ve been dieting and working out for about 6 months now and im down 60 lbs and im currently 6’1 238. The labs posted are after my weight loss. I feel better but I sont think im operating at 100%. I still look 12 and despite working out for 6 months it still doesn’t look like I lift at all. Bf wise im currently sitting at around 25%

@systemlord also I’ve had low t symptoms since my teens. I’ve always been depressed and had extreme anxiety. I’ve always felt like I was behind in development compared to my peers and I still get random extreme headaches as well as mental fogginess. I also take ED medicine.

The gynecomastia statement suggests you have a hormonal imbalance at a very young age and is most likely not reversible, gynecomastia is a female characteristic as is moon face which you would expect to see in a women. With that said I expect estrogen to be elevated.

I would get IGF-1 tested, TRT will do nothing for you if IGF-1 is low. If you are expecting managed healthcare doctors to be knowledgeable in hormones, this is expecting too much. Sure they are doctors that do specialize in this area of medicine, they are too few of them in managed healthcare.

Im currently dealing with my urologist not a primary doctor. He suggested I start TRT, but I declined at the time. He seems to be pretty open and willing to work with me. I have an appointment with him tomorrow and wanted to discuss starting trt. I will get IGF-1 tested. If that’s low, then there’s nothing I can do? I would hate to have to live the rest of my life not living to my full potential. I just want to feel normal, especially since im in my 20s and these are years I’ll never get back. /:

Peptides can increase you natural IGF-1/HGH without shutting your natural production down. If that doesn’t work then HGH is needed, but very hard to get insurance to pay for it.

Based on a quick google search I dont think my lgf-1 is low. At 6’1 Im the tallest in my family and Im fairly strong. In my quick search low lgf is characterized as being short in stature and fairly weak, no?

Also if I did need peptides, would that solve all of my problems or would I still need to supplement with trt?

If IGF-1 were below average, then I would supplement with TRT. People can become deficient in IGF-1 later in life for various reasons in the same way you can have low testosterone.

I tried peptides and for some it does nothing, I had to inject SQ in the stomach every night an hour before bedtime.

My doctor believes elevated insulin was the reason why peptides didn’t work.

Gotcha. I guess the only way to know for sure is to get it tested. Other than IGF-1 and estrogen levels, what else should I get tested when I go in tomorrow?

Also, im pretty sure my estrogen levels are through the roof since I’ve had gynecomastia for forever, would trt make my estrogen levels worse theoretically speaking? Would my gynecomastia be even further enhanced? And would I need to start an AI right away?

Well usually you want a full set of lab testing included below before undertaking TRT, exclude the ones already tested. The first four are used to track progress while on TRT and to make protocol adjustments if needed.

  • Total T
  • Free T
  • SHBG
  • Estradiol Sensitive (E2)
  • LH-Luteinizing Hormone
  • FSH-Follicle stimulating hormone
  • Prolactin
  • Cortisol
  • Ferritin
  • Thyroid Panel
  • CBC-complete blood count
  • Comprehensive Metabolic Panel
  • Lipid profile/pane

I believe so, AI’s should be used when you have exhausted all other remedies like adjusting injection frequencies because AI’s can cause problems of their own and you don’t want to go down the AI road unless you have no other choice.

Saw my Urologist. Went over my results, he says Im much better and my numbers fall in the middle of normal. I tried making the argument that they’re low for my age range and he told me to not worry about that. Might be time to go to a trt clinic. Anyway, He gave me some other results from my bloodwork that they didnt include in the mail.

FSH: 9.22 mIU/ML Ref range 1.27-19.26mIU/mL

lh 8.93 ref range 1.24-8.62 mIU/mL

Prolactin 7.27 ng/ml ref range 2.64-13.13 ng/ml

What can be interpreted with this further info?

I fail to see how your doctor could know you do better in the mid normal ranges unless you told him so. Doctors are instructed to target mid normal ranges in the guidelines, so your doctors is blowing smoke up your…

The medical community is scared of the unknown and fear will guide decisions, by keeping you in the mid normal ranges, they may in fact be causing you to have less than optimal testosterone lessening the benefits of TRT.

Your best bet is to google anti-aging clinics and go based off reviews, be careful of the TRT clinics or Low T Centers are bad news forcing less optimal weekly office visits for your injections for profit treating you like an invalid.

Your testicles are damaged and are likely already infertile, you have primary hypogonadism.

Insane. My Urologist said everything was fine. I tried explaining to him that the symptoms were still there, they just aren’t as bad as before, but they are still there none the less. He said I may just have a thyroid issue. What should my next steps be? How did you come to the conclusion that I may be infertile already?

Your LH is abnormally high, we see this is men with testicular failure. The pituitary is basically pumping out LH in an attempt to stimulate the testicles, if you’re not infertile now you soon will be.

My advice is freeze sperm while you can if fertility is important to you.

Your urologist doesn’t give a damn about your symptoms, he only cares about the numbers and covering his own ass. Doctors who are unfamiliar with TRT will be guided by fear and will keep levels suboptimal to protect themselves.

Some doctors still believe what they were taught in medical school, that high testosterone (TRT) causes prostate cancer. It was a belief brought about by a 1941 report which has serious flaws and anecdotal evidence.

Your doctors sounds incompetent, you basically have the testosterone levels of a 50 year old at 23, I wouldn’t want this doctor in charge of my health.