T Nation

Lab Results: Low Free T and IGF-1

Hey guys,

Here are my results:

Age 30
6’3" 205- used ti be 195 but added 10 pounds of fat which cant seem to lose.
Waist 32-34
Facial hair: cannot grow full beard but have to shave every other day
I started to grow fast at 14 well until I was 18.
Very active ~10~12 % BF
Lately been gaining fat around waist, always aching, sore joints, less energy/weak so I got myself tested.
Hot flashes at night and interrupted sleep patterns. Erections are strong but sdrive lower than before.
Total T: 508.48 ng/ml
Free T: 10.43 pg/ml
Estradiol: 25.23 pg/ml
IGF-1(SM-C): 160.9 ng/ml
Albumin: 4.64 g/dL
Free T3: 3.11 pg/ml
Free T4: 1.32 ng/ml
Also said I was vitamin D deficient.

Based on my results and age,

  1. do you think I would be prime candidate for TRT.
  2. Doctor offers, Nebido, T-enthanate, patch, and gel…Which would fit my case?
  3. Is it worthwhile to take doctor prescribed IGF-1 injections at my age/current level?

Im going in for my follow-up tomorrow but would like advice before I get my doctor’s recommendation.

Thanks in advance.

One typically evaluates GH status with IGF-1, then injects GH as needed. IGF-1=160 is low for your age.

Edit your post above with the [edit] function in the lower RH corner, add lab ranges!

Read the advice for new guys sticky. CAREFULLY! be open minded to other conditions. We need a lot more info.

You need to understand why T is low. Get LH/FSH tested before you start TRT, too late after that.

Your condition also describes Lyme disease.

At your age, low T is more often a symptom of some other problem. You need to do more home work. Sounds like your doc is trigger happy.

Other labs:
LH/FSH
TSH
DHEA-S
AM cortisol
iron
ferritin
fasting cholesterol
fasting glucose


Ksman, thanks for the info. Im reading the beginners sticky thread now

Im attaching the full readout of my test results. Hope you can get a better idea.

Remainder of my results. Btw, the day i took my test, I hadnt exactly fasted (veggie fruit smooth/protein shake/ coconut oil)

I edited first post for more details

Glucose is very low for fasting, hard to believe for non-fasting.

Can’t see what might be suppressing your HPTA, might be good idea to test prolactin as well, to see if that is the problem.

Can you get body temps and iodine intake history?

Okay, I went to my follow-up,

Like it shows, vitamin d low, glucose low, free-t lower end of range, igf-1 low.

The low glucose didn’t concern him much as he said I would get light-headed, crave food, shakes, when hungry. He recommended chromium to regulate glucose and 5000 iu’s of vitamin d-3.

Regarding the free-t, he didnt suspect a serious pituitary problem as I am still in the normal range, albeit the lower end.

If I chose to go with the TRT, he would want me in the upper end of the normal range with options in Nebido(once every 3 months), t-enthanate, gel, or patch.

Regarding my igf-1, he recommended bio-available GH, 1.5 iu’s per day for 6 days/week = 9 iu’s per week. A once per week 9 iu injection is also offered, but slightly more expensive.

Any insight greatly appreciated :slight_smile:

And the GH costs what? It takes around 6 weeks to realize the benefits of GH when one has had low levels. The benefits are of course greatest for those who have lower levels. The first part of the dose that replaces your natural production is a waste. Example: If your natural production was .6iu/day, if you took .6iu/day, that would tend to simply replace what you were making and your serum IGF-1 levels would not change much.

Usually I need to ask three times: Can you get body temps and iodine intake history?

With higher TT and lower FT, we know that SHBG is high. But your E2 is decent and not an obvious reason why your liver is making more SHBG. “SHBG levels increase with estrogenic states (oral contraceptives), pregnancy, hyperthyroidism, cirrhosis, anorexia nervosa, and certain drugs. Long-term calorie restriction of more than 50 percent increases SHBG, while lowering free and total testosterone and estradiol. DHEA-S, which lacks affinity for SHBG, is not affected by calorie restriction.[7]”. Your liver is playing an active role in this and that suggests that you should look at other pathologies. Did I mention Lyme disease?

When did your problems start? Any tick bites or illnesses preceding that? Had you traveled to any tropical countries?

Get those other labs. LH/FSH is essential.

As with GH, TRT replaces your baseline T production. TRT may result in the same problems with low FT:TT ratio.

Ok, The GH(caretropin) costs $350 per month and the nebido is $300 for 3 months.

Sorry, regarding iodine, I was taking 1 to 2 ON Optimen Multi’s that contains 50 mcg of iodine(kelp) per pill. I have now upped that to 3 pills per day (150 mcg). How would I take body temp’s?

I asked my doctor about the LH/FSH and it is not covered by my insurance so I decided not to do it since I already paid 250 for the first t/hormone test…

I did travel to Thailand for 1 week only but had no tick bites then or ever. My body temp issue started in august I would say.

Free T is not a meaningful diagnostic marker. Do not go on TRT based on that. The tests are inaccurate and even if they were accurate, the biologically relevant number would be “Bioavailable T”, also called “Free and weakly bound T”, which you were not tested for.

No way is your vitamin D status responsible for any symptoms you may have. Your vitamin D is not low - above 20 is fine according to the recent meta-analysis by the Institute of Medicine. Above 30 there are indications that your risk for certain diseases starts to increase (prostate cancer and pancreatic cancer, for example - you can google the IoM study for more information).

LH/FSH would identify if the problem is with the testes or the hypothalamus&pituitary.
Also need prolactin to rule in/out a prolactin secreting adinoma.

Can you get body temps and iodine intake history?

  • advice for new guys sticky
  • thyroid basics sticky
  • oral, deep under your tongue, no eating, drinking talking for 1/2 hour prior
  • when you wake and at mid afternoon