Help with Blood Work - TRT Necessary?

For the last year or two I have had low libido generally, bad erection quality and almost never waking up with a boner. I have also noticed reduced/slowed facial hair growth and increased balding. Although I will say that I don’t often get a full 8 hours of sleep and I do not exercise much (if at all).

Here are my test results from a couple of days ago (blood taken at 10am on a fasted stomach). I am 33 years old.


  • Total Testosterone: 97 ng/dl (range: 250 - 840)
  • Free Testosterone: 27 pg/ml (lab range: 15 - 50 - although when googling it says that normal reference range is 50-200 pg/ml!)
  • LH: 4.12 (range: 1.7 - 8.6)
  • FSH: 1.8 (range: 1.5 - 12.4)

Thyroid and Prostate:

  • PSA: 1.04 (range: <1.4)
  • TSH: 1.9 (range: 0.27 - 4.2)
  • T3 Total: 1.23 (range: 0.8 - 2.0)
  • T3 Free: 3.36 (range: 2.0 - 4.4)
  • T4 Total: 12.1 (range: 4.5 - 12.0)
  • T4 Free: 1.77 (range: 0.93 - 1.7)

Seems like the lab forgot to include SHBG and Estradiol (E2). Do I need to check these as well? What should my next step be here? Do another test to confirm the low numbers and then get on injections?

No way do you have normal FT with TT at 97! You most likely have combined hypogonadism, a mixture of both secondary and primary hypogonadism. It’s very rare anyone fixes hormones levels this low naturally.

As it stands now, your testes aren’t functioning very well at all, even with LH almost midrange. Any increases in LH whether through lifestyle changes or medical intervention, set any expectations low.

My labs were identical to yours 5 years ago, TT 91, FT below range, LH 4.6 and SHBG 11. I got a low-T and type 2 diabetes diagnosis.

It wouldn’t hurt to test estrogen, as for your SHBG, it’s very low if your TT has anything to say about it, because low SHBG men have lower TT levels. You may also have metabolic syndrome, and at the very least a fasting glucose and A1C should be ordered.

To get insurance to pay for treatment, yes you do need two separate tests showing low-T. Will a second test be much different than the first one, most probably not.

You can get off your butt and try to fix this naturally, or you can go on TRT. If you think you can go on TRT and continue this piss poor lifestyle and avert other heath problems from your sedentary lifestyle, think again.

TRT isn’t a cure all, it’s a tool and should you choose to use it, it can improve your health tremendously!

Thank you, systemlord.

I am actually surprised how badly I did on this test. The last time I checked my levels (which was about 2.5 years ago) my total testosterone was close to 800 ng/dl. I still lead the same sedentary lifestyle back then. The lowest result I’d ever had previously was 350 ng/dl which was when I was taking SSRIs (this was 10 years ago). But the symptoms I have currently definitely checks out with having low testosterone.

Are you saying that even with testosterone injections/TRT, I should not expect my test levels to get into optimal levels? Or perhaps you meant other types of medical interventions?


Glad I could help!

I was referring to medical interventions that raise LH which would stimulate the testes, like clomid. TRT will absolutely raise your testosterone, estrogen and DHT. If you have type 2 diabetes and/or metabolic syndrome, TRT can increase SHBG.

If you’re considering TRT, please be aware some doctors follow outdated guidelines and prescribe protocols that prevent recovery and prolong suffering. When using enanthate or cypionate, dosing is at a minimum once weekly.

There are topicals and orals, the latter two are more expensive and insurance may not cover them.

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Now you have a credible reason why your testosterone levels are so low.

Results:** The results showed that 21 days consumption of maximum doses of Tranylcypromine , significantly increases concentrations of LH and FSH hormones and significantly reduce testosterone concentration in maximum doses and leydig cells in all three experimental groups (P≥0.05). In addition, no significant effect was observed in the body weight, testicular weight as well as Sertoli cells. Moreover, testicular tissue study indicates that 21 days of Tranylcypromine consumption significantly reduces spermatogony,spermatid , spermatocyte and thus, affects spermatogenesis.

I see. Thank you for the clarification and the tips about doctors. What kind of dosing regiment are you on yourself? Would you suggest IM injections or are sub-q injections fine too? I have some experience with both (although never testosterone) and of course greatly prefer subcutaneous injections. Although I realize they’d have to be daily.

I’m on a very expensive oral T gel capsule, Jatenzo taken twice daily. My doctor gave me a medical exception due to treatment failure for four years and my health was going down the toilet fast!

A member on Excelmale recently inquired about it with his insurance company, $220 per month co-pay! Injections is about a few dollars for 12 weeks.

I think SQ is best for lean guys, not high body fat guys, but not a fan of SQ myself. IM was better. You can use insulin syringes in the deltoids.

@leonardlevino You got the units wrong, in your excelamle post, your lab report shows 9.7 ng/mL or 970 ng/dL. That’s TT over the range, however your FT is about mid-range.

I feel horrible at these FT levels and since I have low SHBG, my TT was only 428 ng/dL, still subpar.

You most likely have high SHBG. You won’t get TRT with these levels unless you seek private.