T Nation

I Have Low T but Doctors Say I Am Fine


#1

Hi everyone great forum here has helped me allot to see other individuals situations.

Lets get straight to it. October last year I went to my GP and asked them to take some tests for my testosterone as i believed them to be low. I lift weights regularly and know what Im doing but the reults really have been minimum. My lifts are not shifting and we are not talking bout great lifts either. 220lb for 6 reps, squats 280lbs for 6. Ive been training on and off since I was 16 and I am 26 at the moment. Plus my bench has only gone up so slightly in the last 2 years.

I was on a cut and managed to loose like 20lb and this was watching my micronutrition being careful lifting heavy, sprinting yet I managed to loose allot of muscle. Any way this caused me to go to some tests.

The tests came back and my test is low

serum total testosterone 10.9 11.4 - 28 (average range)
serum shbg 14 18 - 54 (average)
serum free testosterone 277 243 - 571 (Average)

I then had another test months afterwards to see if the results would be similar and they were even worse with my free testosterone being 7.2!

I then got referred to a specialist which took months the whole process has taken close to a year and in the end the specialist told me my test was fine! He explained that because my sex hormone is so low I am actually producing more testosterone then is indicated. I felt he was fobbing me off and I expressed that neither the less the levels are still low but he just stated that numbers can be deceitful and said i look healthy and have a full beard. Although i tried to explain I am fatigued as fu*k and feel my muscle going.

I went back to my GP and he agreed with the specialist. I mean I am still confused how can my levels be ok when there indicated to be bad?

In addition I have the specialist letter in front of me and it says my free androgen index is 99 and the normal range is 25 plus this concerns me because he regards my 10.9 as the middle of the normal range when in fact thats under the border.

I am just looking for some advice I mean i feel tired constantly and i am thinking its due to that would do yall think i should do?


#2

Most doctors are focused on correcting disease states or frankly abnormal states, using drugs only when and as needed to do that.

By definition, your state is within the normal range, therefore on this philosophy many doctors will see no reason to treat.

He’s a general practitioner, not a specialist in optimizing hormonal health.

An individual endocrinologist may also work under the above philosophy and also see no need for treatment either. By his definition of health, you are healthy as is. If you were to bring in your gym results, to a given endocrinologist such a patient might be just another complainer, or just another person wanting to, in his view, get performance enhancement from drug administration rather than health improvement.

The only answer is a different doctor.


#3

To cut 20 lbs in a short amount of time you are probably going to lose a lot of muscle no matter what, and whatever you were doing to cut that much would likely also have interfered with testosterone and thyroid production in addition to causing the fatigue.

Low SHBG is usually a bad thing to have. There can be a number of reasons for it but among the more worrying conditions associated with low SHBG are insulin resistance, metabolic syndrome, (pre-)diabetes, and cardiovascular problems, as well as thyroid abnormalities. All these conditions will also make you fatigued and lose muscle mass. In other words, there may be something more fundamental you may have to treat before worrying about testosterone.


#4

Definitely want to post agreement with seekonk here.

My reply was limited only to the matter of, if prescription is needed, that some doctors will not do it in situations such as yours and why not, and that some doctors will.

It could also well be that you may recover natural testosterone production without any medical treatment or at least not requiring testosterone administration, for which there is a wealth of excellent advice here.


#5

How quickly did you cut all this weight and how exactly did you do it?


#6

Reiterating the work of others on the forums here, namely KSMan. Get a full lab done by your doc, reference the post on Lab Testing at the top of this forum

Also check the other stickies too, firstly being the Advice for New Guys sticky

Then move on to the other stickies at the top to dig deeper. Sadly, as others have said here as well… most docs prescribe to lab ranges and don’t look deeper. With you being 25 though, this definitely puts up some red flags.

How much do you get out? Low vitamin D can tank your Testosterone levels.
What medications do you take? Ritalin can tank your Testosterone levels.
How stressed are you?
Are you getting enough sleep?
Another favorite of KSMan, how’s your iodine levels, are you getting enough iodine?

These are all questions you should ask yourself before even looking into replacing Testosterone at your age.

It sounds like you’ve already been through alot already and I’m not saying that you shouldn’t keep looking, the completely opposite actually. I am advising caution however as hormone replacement therapy is not that is usually a start and then stop once it gets better, it’s a lifelong administration. Make sure you become as informed as possible on this subject and learn as much as you can. You are your #1 advocate, do not settle for less than you deserve in your treatment.


#7

You need to test LH/FSH to see whats going on with your testes or pituitary.

You need to be looking at a lot more than T levels - T tunnel vision, to find the root cause as low T is often the symptom of something else.

Are you young or old?

If you have a full beard then T levels drop, the beard never goes away.
Long term low T causes hair loss below the knee and perhaps shinny skin there too.
Loss of collagen can make the skin look aged/old, thin and inelastic.

Low SHBG is often seen with low T when there is a resultant low level of E2 estradiol.

Your TT was below normal and that is the criteria for natural guys.
Can’t look at low normal FT and say that things are OK because FT changes a lot through the day.
When on frequently injected T, FT levels can be quite steady and labs then reflect ones state of FT.
You are not in normal range.

In addition to the stickies suggested above, read “Finding a TRT doc” sticky.

Many here have thyroid and T problems and both have similar effects on mood, libido, sexual functio, energy and weight gain.
See the first paragraph in the advice for new guys sticky.
Hopefully, you have always used iodized salt and are not iodine deficient.