T Nation

Just Received Lab Results, Are They Low?

I’ve been experiencing symptoms of low T for years. My previous doctor told me that the only labs I needed were total testosterone which she quickly said were in “normal” range. So here we are 2 years later still experiencing symptoms knowing something was wrong. I moved and had to get a new HMO doctor and on our first visit, I could tell this guy was different. Early thirties, progressive about medicine, and super cool. Anyways, he confirmed I should do comprehensive lab tests. I just received those results.

Estrone (E1) 9.6 (9.0-36.0)
Cortisol AM 13.4 (3.2-22.4)
DHEA-S 328.0 (80.0-560.0)
FSH 4.3 (0.7-11.1)
IGF-1 128 (41-246)
SHBG 29 (10-57)
Testosterone, Total 291 (160.0-726.0)
Testosterone, Free (Calculation)** 6.0 (9.0-30.0)
Androstenedione (AND) 1.0 (0.6-3.1)
Prolactin (PRL) 4.4 (2.5-17.0)
Progesterone (PRG) 0.29 (0.27-0.90)
Estradiol (E2) 44.7 (0.0-56.0)
LH 5.5 (0.8-7.6)
PSA 1.3 (<-4.0)

Any help or suggestions would be greatly appreciated!

(By the way I just showed these results to a non progressive doctor at work and even he said the levels were pretty bad)

We hear the “normal range” speech often like it’s rehearsed and gets old fast, it means I don’t care as I have other stuff to do, please go away because the medical community has a bias against TRT like it’s morally wrong for a young man in his 30’s to be on TRT.

Those levels are bad and you need to get Free T to the high normal ranges, 2-3x injections per week is optimal, once weekly can induce spikes in testosterone followed by lower levels by the end of the week.

Cardiovascular risk is associated with Total T levels <440, risk is higher in men with sexual dysfunction.

TRT may increase your IGF-1 which is low, you can try peptides to increase it naturally from an anti-aging or a sports medicine doctor.

Those total ranges are B.S. i dont get where they come up with the numbers. Do they just use the regional demographic and 160 was average low for that group of people? A measurement is a measurement. Its not like region As 160 = region B.s. 300. Just doesnt make sense to be hypo in one town but 140 above hypo in another when your measured T content is still the same number.

But yeah your levels suck. Get on TRT.

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I appreciate your responses. It seems TRT is in order. I have an appointment for Monday morning to see my doctor. Fingers crossed this all works out. I’m tired of feeling tired all the time. I’ve felt like this for years now.

Another note, your estrogen is already elevated, perhaps you would do better on an EOD protocol injecting smaller doses (25mg) which lowers estrogen the more frequent the injection.

Unfortunately, the doctor won’t allow me to do the injections at home yet. He said until we get everything in check, I have to come into the office to do the shots. He started me on 50mg a week (first shot was this past Thursday) which is a super low dose. I’m going to hit him with upping that dosage this week.

I feel bad for you, 50mg weekly is absurdly low. Obviously this doctor is anxious directing your TRT protocol, this always end up being bad for the patient. You’ll never find a knowledgeable TRT doctor with an HMO, HMO’s are only good for getting the script.

Clearly you doctor doesn’t understand that by day 7 you have cleared 50% of the hormone, you need to keep levels in the therapeutic range 24 hours a day, 7 days a week to see benefit.

You get it sooner or later, after the symptoms force your hand. You’ll be feeling like death at week #3.

In a couple weeks when shut down you will be lower than you are now. Find a new Dr. One that is going to treat you like an adult and not try to babysit you or torture you by dropping you lower than you already are.

Yeah HMO is definitely not the best. The problem with going through another doctor is one, I’d have to pay out of pocket. And two, I need a doctor who’d be open minded to putting me on it. You know how it goes. Unless you hit low 200’s, 9 times out of 10 the doc isn’t going to give it to you. Plus being 33 makes it even more difficult.

I can probably swing him into doing a different protocol. Maybe not necessarily doing the injections more then once a week initially, but upping the dose at least. Would you suggest no lower then 100mg per week? 75mg? I think he just wants to start off slow. I definitely cant afford a crash with how crazy work is right now.

I’m also a recovering addict. I’ve been sober almost 6 years. He’s worried about me having needles in the house and that I’ll overdo it. Which is ridiculous, but I do understand his logic. He said after a couple months and after he gets to know me a bit better, he’ll let me do it home.

What do you recommend brother? I have no problem advocating for myself. I do high end sales so I have experience talking people into doing things haha.

Honestly, what makes you feel best.

I’ve done 125mg, 250mg weekly, some trials of those dosages broken into shots 2x weekly, and have found the best results for me at 500mg taken 250mg 2x weekly.

My new doc might want to reduce this, but I’ve been on it a solid 2 years or so?

I’d much rather risk the negative sides, even though I have normal bloodwork ranges for everything except T, than go down in dose again so I might have to Dr shop again.

And it wasn’t hard finding my first Doc because


Hard close the Doc if you don’t feel good on 50mg to double it. Endocrine Society, I believe, says 200mg as a reference to throw out to advocate in your favor of 4xing it.

Dude find another dr. Go telemedical. Also I just turned 31 if you need it age should not be a factor. Your free test is below the bottom of the range with a shitty TT any Dr who says you dont need T gets a hand shake and you ask if they want their door closed on the way out. You dont even finish rhe conversation, just leave instead of wasting more time. A younger guy needs it more. My first Dr knew i was on methadone (10yrs) and said that’s great I can give you the injectables and you will be fine with them. He just assumed i was IV. Althought I had never touched needles prior to test. He started me at 100mg a week and didnt want me dosing more frequently because “it was unnecessary” he also wouldn’t give me an anwser about what kind of levels he would be happy with which meant 500 most likely so i went to defy. They agreed with eod minimum based on shbg and raised by dose by 40 mg. They want you optimal at the top of the range+

They took the top 5% and called them high. They took the bottom 5% and called them low. The 90% in between are “normal”. As far as I know, there is no research as to the ideal or optimal healthy level. It is doubtful there will be any, unless the NIH funds it, as a pharmaceutical company won’t pay for it since they cannot get a patent on testosterone.

As noted, various labs have different ranges, in part due to varying testing methodology. However, a few years ago Quest dropped the bottom range number from 350ng/dL to 250, meaning anyone 345 to 250 no longer qualified for insurance reimbursement. That change was negotiated between Quest and ……………Blue Cross/Blue Shield, who likely agreed to pay Quest a little more for the test since they could save on the other end and come out ahead.

No one is more corupt then pharmaceutical companies. Im actually working on a new construction pharmaceutical plant right now. I was at one last year that they knew they were going to be closing and laying off like 300 of their employees but they still went ahead and started construction on a brand new facility. We got like 1/2 way through with the mechanical piping and pharmaceutical piping when they just told us to wrap it up. The CEO had been defrauding stock holders and didnt want to arouse suspicion so they just went ahead with a project that was probably 50 million + so they could all cash out and do whatever they needed to do before pulling the plug.

I think health insurance companies are right up there with them.

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Oh yea deffinitly. Someone is up top deciding to let kids die because the treatment is bad for their bottom line. With the money they make they shouldnt be able to refuse treatments to anyone. It should be a non profit industry

You’ve gotten good advice so far, how long you want to draw this out and suffer needlessly because you don’t want to pay out if pocket is up to you.

Sooner or later you’ll realize there is no other option, we see it everyday and we try to warn guys and the ones who don’t listen are coming back here creating multiple threads complaining that TRT isn’t working.

I don’t know of anyone currently on 75mg weekly, it’s just not enough to be optimal which managed healthcare doctor do not care do to, optimizing your levels so you feel your best. Once you are in range regardless of how you feel, they consider your protocol a success.

I hear you brotha. Definitely not my plan to not take your guys advice. I trust the vets on here more then I trust the doctors to be honest. I sent a long email to the Dr this morning telling him about my concerns and the suggestions you guys have given. I’ll be back in on Thursday for another shot and he says we’ll talk about it then. If he’s not willing to do it, theres a place called the Man Clinic literally 2 blocks away that specializes in TRT. The only difference is they do not take insurance. I figured I would try to do it with my HMO doctor and see if I can get everything covered. I have no problem switching over to the other place if need be though.

By the way jimmy401, I was on Methadone for years too. That stuff is a nightmare. I got off of it almost 6 years ago now.

It saved me. Im on a split 72/73 i go twice a month and it turned my life around. It obviously sucks to be dependant on a drug like that but it keeps my messed up back pretty much pain free and just gives me the piece of mind that I could never do something stupid and ruin my life again. With the yearly callback I know i could be tested any time so I can’t smoke pot or drink, the little habits that will still consume am addict. Someday ill probably get off it but it doesnt negatively effect me so im not worried. I have a good career making 6 figures. More than anyone i know or grew up with, I’m not nodding out or anything like some people would expect. I see the same guys every year same routine " this stuff is shit, this place just wants my money, im getting off for good" 3 months later all skiny and looking like shit back for an intake appointment.

If You do go somewhere else i would suggest defy medical. You could get the ball rolling now with out commiting then when the time comes pull the pin. It will be much cheaper than any tmill/clinic/concierge medicine. They know their shit and your insurance can still cover all the labs which basically equate to almost half the bill.

This is great advice and while face to face doctor visits are probably best, when in an area lacking access to good TRT doctors, it’s the only path forward. If you work late hours and have little time to drive to appointments, Defy is open early and late for phone consultations.

Defy will also provides advice only consultants and even work with your doctor if he is willing, maybe he/she will learn a thing or two. Insurance doctors will skip on necessary testing to not upset the insurance companies and get blacklisted which can hurt careers.

Defy Medical is cheaper than any walk-in clinic, $100-$150 yearly, you won’t find anything cheaper locally. Defy specializes in TRT, it’s most of what they do on a daily basis and are good at it. If not interested in fertility, you could skip HCG which will only lower the cost.

Deficient in growth hormone, they can prescribe growth hormone releasing peptides normal doctors can’t.