T Nation

Help Me Analyze My Blood Test Results


#1

An off the cuff google search led me to the fantastic “Estradiol: Why You Should Care” thread on
this forum and convinced me I should be getting my E2 levels checked in addition to my test.
So, I got them checked and of course all of the results came back as “normal”. However, as this and
many other forums know, what the medical profession deems normal is skewed by the elderly being included in the reference ranges, amongst other things.

So, with that in mind, I’d be very grateful if those with more knowledge than me on the matter would comment on the results of my bloodwork and let me know if everything is approximately as it should be.

The vital statistics are as follows:

Age: 31

Serum testosterone level 18.1 nmol/L (523 ng/dl)

Serum oestradiol level < 73 pmol/L (Note the result had the “<” before the 73)

Serum prolactin level 219 mu/L

Serum LH level 3.1 iu/L

Do the ratios look correct for a man of my age? Many thanks to whoever can offer any insight.


#2

What are the ranges? No free T tested, why? If your TT is fine and FT is low that’s no good since FT is the active hormone. There’s no way to tell where you land in the ranges. Those numbers are nothing to brag about, bordering on acceptable. On average though 523 ng/dL is on the low end for someone in their 30’s, normally we see healthy 30 years olds in the 800 ranges. It will be difficult to get TRT above the 500 range. You mention NO symptoms whatsoever. Do you lift weights or workout and eat right?


#3

What was tested for estrogen and as it relates to TRT is the incorrect test. You are looking for Estradiol Sensitive (E2) with through LC/MS (Liquid chromatography / with tandem mass-spectrometry) as the analytical method. This method is needed as in males the level should be rather low so LC/MS is needed to accurately get those ranges.

As for your total test being at 521.28 ng/dl, it would depend on your protocol, and when the test was collected as it relates to your last injection to determine if there are any potential issues with your protocol.


#4

I seriously doubt he can get the sensitive E2 test since he’s clearly outside the USA.


#5

Appreciate the quick replies here.

What are the ranges? No free T tested, why? If your TT is fine and FT is low that’s no good since FT is the active hormone. There’s no way to tell where you land in the ranges. Those numbers are nothing to brag about, bordering on acceptable. On average though 523 ng/dL is on the low end for someone in their 30’s, normally we see healthy 30 years olds in the 800 ranges. It will be difficult to get TRT above the 500 range. You mention NO symptoms whatsoever. Do you lift weights or workout and eat right?

I did request a free T test but unfortunately the NHS does not provide them. I agree that the total test number being 523 is borderline acceptable for my age when judged by several “testosterone by age” charts I can find online.

I’ll provide more information in regards to symptoms:

Had depression intermittently throughout my life, most notably between 16-19 and 29 to present day. Oftentimes have difficulty focusing and lack a drive in life in general.

Lowish sex drive. Seem to never have morning erections anymore though getting and maintaining an erection is no problem. Strangely, I don’t often feel spontaneously horny anymore, more when I focus on becoming aroused or watch porn (infrequent user).

Been lifting weights for years and eating relatively clean. Extremely modest results considering, I sometimes wonder whether it’s been worth the time investment. I’m 6’3 with long limbs and fairly small wrists/ankles; adding what muscle I have has definitely filled me out somewhat and made me look better in clothes but I’ve basically stalled and maintained for years now.

Here’s the thing: I’m considering using an ssri that I had very good results with in my early 20s but I wanted to be sure the symptoms of depression weren’t being caused by low test/estro levels. Note, I’m natty, never used gear of any sort before.


#6

It’s a losing battle to get TRT through the NHS, another issue is your doctors didn’t test for SHBG, if it’s high that would explain your symptoms. Yet another issue is even if your do have high SHBG the doctors in the UK are useless and fail to understand much of anything regarding male hormones and the relationship SHBG has on sex hormones. Depression can definitely cause low libido and the added stress can affect erections. I think an SHBG test is at least should be done, guys from the UK have been routinely sharing their FT labs results.

How is your ability to gain muscle right now, any gains lately?


#7

Good point, they should have a proper E2 test of some sort as it is baseline for female infertility and menopause confirmation.

Often when looking at academic studies, this si the sort of reference chart you get:

image

This is more what you are looking for. I have scene this floating around, I did find the original source but I do not have the time this morning to confirm the data aggregation used to make the chart.


(Dominique Simon, Marie-Aline Charles, Khalil Nahoul, Genevieve Orssaud, Jacqueline Kremski, Veronique Hully, Evelyne Joubert, Laure Papoz, Eveline Eschwege; Association between Plasma Total Testosterone and Cardiovascular Risk Factors in Healthy Adult Men: The Telecom Study, The Journal of Clinical Endocrinology & Metabolism, Volume 82, Issue 2, 1 February 1997, Pages 682–685, https://doi.org/10.1210/jcem.82.2.3766)

Low hormones can be a cause of depression and anxiety based disorders. For this I will refer to the below study:

"Our results show that in a large population of hypogonadal
men, 92.4% of patients demonstrated depression symptoms
as measured by the PHQ-9, ranging from minimal to severe.
The percentage of patients with moderately severe to severe
depression symptoms was 17.3% in the overall population,
and when analyzed by subcohort, the percentage of patients
with moderately severe to severe depression symptoms was
significantly greater in subcohorts defined by medication usage,
age (<60 years), and TT levels. After 12 months of TRT,
the percentage of patients with moderately severe to severe
depression symptoms significantly decreased from 17.3%
to 2.1% and PHQ-9 scores significantly improved. Overall,
the mean drop in PHQ-9 score after 12 months of TRT was
5.62±6.24, which represents a clinically meaningful improvement
[18] in depression symptoms. "
Khera, M., Bhattacharya, R. K., Blick, G., Kushner, H., Nguyen, D., & Miner, M. M. (2012). The effect of testosterone supplementation on depression symptoms in hypogonadal men from the Testim Registry in the US (TRiUS). Aging Male, 15(1), 14-21. doi:10.3109/13685538.2011.606513

All references to studies are accessed and verified by EBSCO. Selection was made for peer reviewed journals


#8

https://www.bloodtestsdirect.co.uk/index.php?route=product/product&product_id=274

Do you think this would be sufficient for testing SHBG? I was under the impression that a blood test proper was more accurate than sending saliva/finger prick.

I haven’t actually gained any muscle for many years now, I don’t think. Impossible to say for sure as I haven’t been documenting weight and BF%. I’ll be honest, I started in the gym with the best of intentions doing starting strength/strong lifts routine. Got to one and half plate squat, two and half plate dead, 70kg flat bench and 50kg ohp then stalled. That was eating 4000 cals a day, weighing food, tracking macros etc. No way I could consistently eat more than that a day whilst being healthy/not having horrid skin on face. The lack of progress became demoralising, particularly when others (who were probably on test et al) were blowing up with nowhere near as much scrutiny to diet.

These days I just do a routine based around machines, pullup bar and dumbbell work. Plus hiit on the elliptical. As you can imagine, this doesn’t produce any appreciable gains but keeps my body relatively in shape. When I used to try to bulk, I just looked approximately the same but with a big gut.


Where to Get a SHBH Test in the UK?
#9

The analytical method determines what is more accurate. Silva testing has come a long way, but if older methods or devices are used it can be less accurate.


#10

Hey, thanks for the reply. It isn’t stated on their site what method they use. I’m going to email them to ask; what analytical method should I be looking for?