T Nation

Lab Results Help

Hello everybody!

I am 50 yro, lifting weights for the last 20 years. Did a couple light cycles over the years, my last cycle were in 2011. and were almost as T replacement, bit higher - 250 test depot a week for 12 weeks. I didn’t took test since then but did few oral cycles almost not worth to mention by today standards ( 3 weeks of Anavar 30 mg a day or 4 weeks D-bol 20 mg a day)
In recent years I became bit low on my libido, recuperance from lifting and everyday life, so naturally, especially being into T nation, youtube TRT stories, I suspected low T.
Couple days ago I finally, for the first time in my life, went and did blood work done.
The results came and it surprised me at some results, some other’s not.
Thing worth mention is that I did labs in a pretty bad period (that’s why I actually went to see it, I thought my stats gonna be terrible) and after that, I start to feel good, in these recent days.
So, here they are. Note that the references and results in my country ( I am not english native speaker at all) ain’t coming in ng/DL but in nmol/L but I guess you will know how to transcribe them.
And finally, here are the results:
TT: 18.06 nmol/L ref. 4.47 - 26.60 (which is higher normal, right?)
Free T: 11.20 pg/ml ref. 6.30 - 17.80 again, not bad
SHGB: 30 nmol/L ref: 13 - 71
E2: 34.2 pg/ml ref less than 87.0
FSH: 4.0 mlU/ml ref: 1.5 - 11.8
LH: 2.94 mlU/ml ref: 1.1 - 25.0
DHT: 147.3 pg/ml ref: 250.0 - 990.0

LH and DHT especially seems pretty low, could that be my low libido and sometimes weak erections?
as for my blood count, everything is in range except these which are on higher side:
HGB: 173 g/L ref: 138 - 175
RBC 5.21x10 /L ref: 4.34 -5.72
MCH: 33.2 pg ref. 27 - 34
PDW: 15.9 ref: 9 - 17.0

I would appreciate your experience and help about the results and possible solutions.

Thank you!

You think it is high normal, but in fact it is not. I started TRT with 19.64 of these units. I had higher SHBG so my free t was low.
The free T also does not look more than average. Dr Abraham Morganteler says most men with free t under 15g/ml may benefit from TRT but again it is all very relative. It depends on the sensitivity of receptors and many other things we dont yet know.

The best clinical practice shows that for people with average values like yours symptoms should be the guideline whether to start TRT or other testosterone optimization treatment. This is the main thing most endocrinologists do not understand

Tnx for your reply, Vonko. My main concern, after reading my labs and researching, is a low DHT.
I never study DHT much, but now I see my symptoms are a lot and mainly associated with my low DHT which are:depression, low libido, not much of strength and lack of “healthy male agression”, so to speak.
I wait for others to wake up due to time zone difference and hopefully, chime in.
Cheers

I see the DHT, but there is no other way to optimize it than rising the testosterone levels. DHT is derived fro your testosterone. And the free test is borderline low.

Have you ever taken anything against hair balding like finasteride?

No finasteride and yes, I am losing my hair and very fast :slight_smile:

Basically with the low t symptoms and test values you have you have these options:

  1. Fix your lifestyle as much as possible to attempt to naturally optimize testosterone and or symtoms
  2. Try clomid monotherapy
  3. Try HCG monotherapy
  4. Start TRT

Usually best tried in this consequence

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LH is the stimulating hormone that drives the testicles to make testosterone which is then converted to estrogen and DHT of all things, so it would be a domino effect for everything that follows if the primary stimulating hormone is low.

DHT is needed for libido and you lack sufficient amounts. The majority of cases of men diagnosed with low-T have an LH between 1-3. Your levels may be normal, but might not be normal for you.

If you are going to make the point that your Total T isn’t that bad, consider two different lab tests can show a 200 ng/dL-+ difference on the same day.

No, I am not making point, I meant by the way I am feeling, and felt that very day, I was expecting my T levels would be MUCH worse. I’m trying to get help here, not argue. I am aware of what the LH and DHT are about.
Currently I am thinking about TRT for life or maybe start with Proviron… not sure what should I do in fact. Tnx

Bump! what are your thoughts on Proviron, I suppose it may help with low DHT levels

This misleading and completely out of the context.

In the particular study you are referring, Morgentaler demonstrated a benefit od TRT independent of total T levels if freeT was below 15 pg/ml. 15 pg/ml converts into 1.5 ng/dl and its been measured with a different method than @hanktt freeT measurement having a different ref range.

The 15 pg/ml (1.5 ng/dl) is therefore by no means related to the 11.2 pg/ml freeT result.

In addition the study by Morgentaler used a direct assay with a T analogue, an assay which has been demonstrated to be of no value for the determination of freeT levels.

Please stop giving advice like this, it’s doing more harm than good.

@hanktt TT and calc FreeT levels are above average for a 50 year old and there is no scientific reason whatsoever to believe that he would benefit from TRT.

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There is a lot of clinical reason to believe it, so I think your advice is misleading. I started TRT with similar values and it is night and day difference for me. Even if his levels are above average they are far from optimal and symptoms should be the guideline in such case and he seems to have enough of them

Tnx for your advice. My thoughts on my t levels were pretty close, like being 50 and having decent total and free T. So I am hesitate to jump on trt and face possible side effects,( raised e2, cholesterol etc. )my goal for now, as it seems - to me - but I’m not an expert so seeking for advices, would be to somehow raise my dht because I feel the symptoms and obviously my lab stats showing them too.

I would not overinterpret the DHT results, especially If it has been measured with an immunoassay. These assay have rather low accuracy and precision in measuring DHT. The LC-MS method would be the method of choice.
The only recommendation would be to re do labs in a month using LC-MS technology for T and DHT before starting any treatment whatsoever.

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I was referencing from a book of Dr. Abraham Morgentaler which was interpreted wrong because there was no context regarding lab data.

Yes I know Ive read the same book but he puts more emphasis on symptoms