T Nation

Lab Results & Help with Next Steps

Hi All,

I’m currently scheduled in to see a specialist in the next few weeks but wanted to seek some guidance off of you guys if that’s alright.

I’ve been to the GP over the past few years due to depressive symptoms but only recently in the last year have had my levels checked. First reading came back very low which made me look into this more. I’ve had 2 additional blood work samples from then, which I’d love a bit of help in interpreting. I’m going to get some additional work done in the next couple of weeks including T3, T4 etc. Below are my stats & symptoms and have attached my blood work for you guys as well;

Age: 22 male

Height: 5ft10

Weight: 175lbs

Storing fat: Thighs & hips

Health conditions: All OK - not on any medication or any previous history.

Diet: Balanced diet with 4 litres of waters a day - rarely drink and never smoke.

Training: 3/4x week strength training (hard to progress in the gym - lose fat etc)

Symptoms: lack of motivation, energy, concentration/brain fog, work performance, ED, sex drive, performance in the bedroom, knee pain (isn’t healing - rehabbing but isn’t budging), depression (flat mood and lack of enjoyment), slow progress in the gym over the past 3 or so years.

Given my latest Testosterone reading I’m not sure where I’m at in terms of next steps, I wanted to address this over the year to see if my symptoms have improved but nothing has changed regardless of my nearly double Testosterone reading.

I’m seeing the specialist in April and wondered if there is anything I should be aware of before hand? Obviously TRT is my last choice in terms of what I want to do but I’m not sure if these symptoms could be the root course of anything else? Apart from getting the full thyroid pannel + t reading + full blood work is there anything else you’d recommend in doing?

Btw - appreciate the 3rd T reading has come back a lot higher, but the question is; is this an optimal level to be at for my age if I have EVERYTHING in check, sleep; diet; etc?

Thanks for your help! image image image

The word specialist gets thrown around quite a bit around here, the true specialist for TRT mostly exists outside your reach and most do not take insurance, so you will likely struggle to find a true specialist in TRT.

You need to educate yourself because your doctor won’t be, TRT has been ignored for the past 70 years by mainstream medicine, medical schools for decades have been teaching falsehoods to doctors that TRT causes prostate cancer and cardiovascular issues, only these studies have been shown seriously flawed and therefore debunked.

The damage is done, this is why so few doctors know how to do TRT well, TRT has existed outside of traditional medicine in preventive in anti-aging and sports medicine. This is where you should be looking for treatment. Just about every member here either figured out there own case while their doctor allowed it because they don’t know sh** or have seeked private care for their TRT.

You don’t need me to tell you your levels are as low as 90 year old men. TSH looks good, but isn’t a thyroid hormone. TSH doesn’t correlate well with symptoms, Free T3 is the main thyroid hormone that drives metabolism.

Don’t expect doctors to get to the root cause of low testosterone other than ordering an MRI, medical care in countries with socialized medicine are underfunded. Most never know why testosterone is low, no one understands what’s going on worldwide, only that by 2040 we likely won’t be unable to impregnate women the old fashioned way.

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Hey @systemlord thanks for your reply.

Appreciate self educating is important regarding TRT as not many docs fully understand, the guy I am seeing is a specialist in the field and has a strong track record in working with symptoms and knowing what to look for etc as I’m going private versus the NHS on this.

You say my levels are OK for a 90 year old man - what exact numbers are you referring too? My testosterone in particular, or what?

And yeah I’m going to get an MRI of my pituitary as well when I’m home to rule that one out.

Your total testosterone, 268 ng/dL (9.3 nmol/L) is seen in men with one foot in the grave. MRI’s most of the time never show any problems, yet testosterone remains low and the cause isn’t known. It’s going to be multifactor, chemicals in the environment, lifestyle, processed foods, working long hours especially at night time. Poor sleep is a huge factor in low testosterone, you get only 5-6 hours of sleep per night and years down the road your testosterone is low.

The NHS is a lost cause for bioidentical hormone treatment, if they gave everyone who needed TRT or thyroid treatment, funding would run dry and people with serious illnesses would keel over in record numbers.

@systemlord yeah my first reading was 268 ng/l, but 4 months on its climbed to 500 ng/l (3rd t reading) but symptoms have not changed. Would you say that’s still a low reading for 22 year old?

You should never be scoring in the 9.3 ranges at any time until your 90 years old, something is broken inside. Healthy young men scoring in the 28 nmol/L ranges see only a 13% reduction during the day.

Hell 17 nmol/L is low for your age, your testosterone should be at its peak in life, instead it’s low.

@systemlord cool, thanks for your insight, appreciate it. Apart getting the additional blood work done is there anything worth doing before I head down the TRT road at my age? Obviously fixing the diet, sleep gym etc but that’s all been done and has been for the past few years…


Guys - just bumping this. Been reading into Clomid and HCG further. Looks like my LH is on the lower side on things meaning HCG could be a good alternative before hopping onto TRT, correct?

Also - what would be the benefits of running HCG alone versus TRT & HCG (specialist likes to run these two together if he prescribes T.

Apart from the obvious of not shutting down my natural T levels if I ran HCG, anything else I should be aware of?

Also would be great to chat / input from guys who’ve run HCG alone and seen what the improvements have been.

Thank you.

Anything? :upside_down_face:

Tough to be dealing with these symptoms at any age, but at 22? Symptomlord made several good points.

I think we want to consider a “specialist” as someone who just does hormone optimization, restoration, anti-aging, rejuvenation, etc., therapy. This is not taught in medical school and there is no board certification for this.

As for you, your FSH and LH are low. You may never find out why. Systemlord threw out some reasons. Have you had concussions? Short of an obvious and treatable cause, what do you do?

I do not think it is unreasonable to try hCG or clomiphene first, if for no other reason than your response will give you some clues regarding the cause. Both of those are generally not considered to be long term solutions, but still worthwhile to try. Yes, there are downsides to both and some do not react well, keep in mind that some respond differently to the same or similar protocols that work well for others. Given your age, you’ll want to preserve fertility so hCG will be part of the picture down the road anyway.

If I am you, I am looking further into thyroid function. Test free T4, free T3 and reverse T3. Check IGF-1 and DHEA-S. Try Clomid and cleaning up any lifestyle issues. See what happens and go from there. My guess is you will end up on TRT eventually.

Good for you for taking some initiative and addressing this. Most do not. Good luck.

Hey Highpull thanks for the response. Nothing like that, no concussions etc. Completely fine with any head injuries so far in my life, fortunately enough.

Yeah getting some additional blood work done next week, following that I’ll probably assess which route to go. Appreciate the heads up regarding Clomid. Could I even run HCG on its own to see if it has an effect? I know it sounds bad, growing a bit impatient now as I’ve been waiting nearly a year with all the relevant checks and of course sorted everything (sleep, diet etc) but that’s been sound for the past 3/4 years so nothing too worry about there.

I’ll see how the apt goes thank you

You could. I was thinking Clomid since it “tricks” the hypothalamus into thinking estrogen is low and therefore produce LHRH to get the pituitary to increase LH and FSH. Just curious to see how you would respond.

However, Clomid is a drug. Hormones are a more natural approach, though hCG for guys not so much but it doesn’t screw with your brain. Nothing wrong with running hCG. I certainly understand your impatience.

Thanks again for the response mate, highly appreciated.

Given the length of time this has been going on and how long I’ve been waiting for this appointment/follow up. Would it be stupid to just follow the TRT route straight off the bat if the doc agrees? I feel Clomid/HCG will prolong the process?

Or would I feel the same effects pretty quickly if Clomid/HCG reacts well for me?


I don’t think it would necessarily be stupid, though I would be surprised if the doctor would start with it. Clomid and hCG are typically used in men for fertility and only until conception occurs, so long term use is questionable.

You should feel the benefits pretty quickly regardless.

Mm the clinic I’m going through only offers HCG & T, no Clomid unfortunately. See what the doc suggests as he doesn’t offer Clomid:. Another clinic which isn’t too far afield offers this as an option within therapy treatments but the level of service isn’t as good. Thanks for your help, I’ll wait to see how the first apt goes and go from there.

I would contact defy or a specialist that does provide Chlomid and understands why you would want to use it for a younger man.

Trust me when I say this current clinic is not the best choice for you. I say this because it’s obvious they do not investigate or customize based on client age or situation. @highpull is right.

Usually prescription drugs, supplements and usage of T boosters cause this low T situation in men. Diet can also do it. So without those it’s either environmental (pollution, technology, and etc)… I can’t think of many other factors.

What did you do different to increase your levels? It’s going back up so that’s great. You want to be st the high end for your age … I’d keep on the track and re-test in a couple months if there’s something you did between tests differently and you feel it helped. Who knows maybe you’ll keep moving up to natural levels for your age.

If anyone can recover it’s a 22 year old. Don’t give up. I don’t believe your doomed and will end up on trt. Not until you’ve tried to fix this issue with all the energy you can muster. Get after it and stay positive. Negativity will only make things worse. Believe your getting healthier and keep asking questions.

Hey @enackers Thanks for the reply. Yeah I’m pretty tied at the moment with the amount of options which is available to me (I’m in the U.K.) so we’ve got ‘two’ specialist/,clinics who are more versed on this topic in comparison to the NHS or Endo’s. One of which I mentioned offers HCG & T within their treatment plan and the other which does offer Clomid alongside HCG and T but isn’t as recommended as #1. Appreciate Clomid could be a great option given my age and I’m going to discuss as to why this isn’t within their treatment plan and ask if this could be a solid route to go down to.

Mmm - things that changed was mainly me ramping up my calories and taking a 6 week vacation between the first and 3rd result. Bear in mind those levels have not changed my symptoms in the slightest. I’m retesting as you said next week as it’s been 4/5 months since my last blood work so I want to see how my levels have held up after my last result. Which is also interesting to see, yeah my T went from 280 to 500, but my LH definitely has stayed/dropped on the 2/3rd Test. Surely it potentially shows that my putiarity function is on the lower end of the spectrum?

Everything is down to a T with external factors - I’m gymming regularly, diet is in check, sunlight, water, limited drinking, no smoking not overweight. There isn’t much I can do to ‘naturally’ boost my levels - I’ve been doing this for the past 4 or so years. Losing weight/progressing in the gym is a struggle - got to a 150KG squat, 180kg Deadlift for 3 reps and 100kg bench but progression hasn’t moved in a good 3 years. I shit you not.

Appreciate the words - definitely frustrating when you been busting your balls for a good amount of time and seeing little to no progress alongside other symptoms.

Quick q - is Clomid short term/long term? I.e if it is successful can I stay on indefinitely or would I sooner or later have to switch over?

Same as above with HCG?

Thank you

Ok so you have done allot. I totally understand bro.

I know it’s a pain and you don’t have many options but use the other clinic with Chlomid. At least it keeps your system moving… I wouldn’t care if there not rated as long as I get what I need. Don’t let that cloud your judgment. Choose what’s best.

Yeah - long term though there isn’t any studies, no? (Clomid)