T Nation

Help with Lab Results

Been experiencing low-T like symptoms for a long time, finally bit the bullet and contacted a clinic, and went and got bloodwork yesterday. And now I am perplexed, as my total T level came back at 627.

I am 45 years old, 6’1" and 200lbs. I am experiencing all of these issues to some extent;

  • Lack of physical endurance, despite regular exercise
  • Difficulty building muscle and retaining strength, despite lifting 4 or 5 days a week. Strength disappears quickly if I miss a few gym days.
  • Getting more skinny-fat: man-boobs and mid-section, even though I watch what I eat and I’m in the gym most days.
  • Never had much facial hair
  • Leg hair thinned out
  • Decreased libido, has affected my marriage for a long time
  • Morning wood is rare
  • General fatigue, malaise, lack of vitality and drive
  • Experiencing more joint pain, aches, etc
  • More frequent “brain fog”

Here are some of my other lab numbers;
Creatinine 1.24
TSH 1.61
Total Testosterone 627
Estradiol 19
PSA 2.0
I don’t see any test numbers for SHBG or Free T on my labwork.

I understand that clinics want to treat symptoms and not necessarily a suggested range. but I really don’t want to pursue starting TRT injections if I don’t need it. What are your thoughts on my numbers?

I think your total testosterone looks pretty good, but your free testosterone could be low.

How does your diet look like? Stress level? Any medications?

My diet is pretty decent… I know that is vague. I only drink coffee and water (and a couple beers or some liquor a few times a week). I rarely drink soda. I try to eat fairly clean, and I really don’t over-eat.

Stress level is so-so… life is pretty good overall.

No medications, never have.

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Ranges would be nice. Your E2 looks low, depending on the range, which would point towards low free T.

Sorry, I’ve been reading a lot, but I am still new to this. Is this the range you are asking for?

ESTRADIOL 19 < OR = 39 pg/mL

Yes, that’s the one for E2. We like to see all of them with your lab values because they vary from lab to lab. 19 with one lab isn’t 19 with another if you get my drift, so we need ranges to establish relative levels, And I would call it low, and not helping s number of things - including libido.

Thank you for explaining. Here are the others that I left out;

CREATININE 1.24, 0.60-1.35 mg/dL
TSH 1.61, 0.40-4.50 mIU/L
TESTOSTERONE, TOTAL, CB MALES (ADULT), IA 627, 250-827 ng/dL
ESTRADIOL 19, < OR = 39 pg/mL
PSA, TOTAL 2.0, < OR = 4.0 ng/mL

Your labs look middle of the road, nothing obvious to point at. It would probably pay to lay out your actual training and eating. There could easily be some things in there that could help. It also could simply be something else affecting you. Some guys want to force a diagnosis in spite of the labs, Personally I prefer that labs assist the diagnosis.

Yes, I do not want to force getting on TRT. I’ve never been on anything, and if my body is functioning as it should, I don’t want to screw anything up. My levels all came back “in range”, other than my blood sugar came back slightly low.
GLUCOSE 63 L, 65-139 mg/dL

However - if I can optimize myself to feel 20 years younger and get rid of some of the symptoms that I have been experiencing, and do it without screwing myself up, I am open to it.

Prolactin test would’ve been good.

Like roscoe88 said, getting prolactin numbers would be good. It’s also worth getting shbg, lh, and the tested too. I felt very similar. Doc has me on clomiphene and anastrozole and it has been a game changer.

If your SHBG is high then your free T might be low, E2 is decent but approaching a deficiency. There have been members diagnosed with osteoporosis a couple of points lower. It’s common for those with low estrogen to have joint problems, estrogen is needed for joint and bone health.

If you aren’t eating enough and you are in the gym a lot, I would expect SHBG to be elevated. I’m willing to bet your SHBG is on the higher end.

Your glucose is low, the body needs glucose for energy.

Interesting. I do experience joint pain, which has been increasing in the last couple of years.
So, if I were to start TRT and increase my T levels, this would then increase my estradiol levels as well? Or, since my T level is decent is there something else that I should do to bring my estradiol up a bit, instead of TRT?

I don’t know why the clinic didn’t have my free T, prolactin, LH, and SHBG tested.

This is entirely likely, but better to try and fix other things before making the leap to taking hormones.

When I first did my blood work before TRT, my levels were at 450 and I felt terrible. I went to see a doctor about testosterone pellets and he did another round of blood work and my levels were at 625 and I still felt terrible… tired, depressed, anxious, moody, plus a lot of those other symptoms you mentioned. Once I got on TRT all of the symptoms went away. I did pellets first and now I’m on injections. I think sometimes people need to be above 800 to feel good… 1100-1200 would be even better.