T Nation

Lab Review Before My Appointment


Welcome coldstate,

When I started reading that your Total T was towards the higher end and Free T lower, I immediately started scanning for your SHBG levels, imagine my surprise.

Let me first say you sir hold the record for the most efficient SHBG I have ever seen, maybe a little too efficient for your own good. See there is a variability in the stickiness of a SHBG from person to person.

I’ve seen guys in the 70’s with good Free T levels and guys in the low 40’s with bottom end Free T levels, but yours takes the crown as the stickiest SHBG around at 33 and your Free T is almost bottomed out which leaves little doubt.

Total T is bound to SHBG and not bioavailable, it doesn’t influence anything in the body, Free T is bioavailable and is the portion of testosterone circulating in the blood and does all the amazing stuff, like build muscle, libido etc.

Your Free T percentage is 2.05 %, just barely within normal (2-3%), you wouldn’t be the first to complain of symptoms at the bottom percentile. This is what I call double confirmation testosterone is low.

What should be happening here is your pituitary gland should be increasing LH and therefore testosterone do to the low Free T, that’s not happening is lazy pituitary gland. Sometimes we see men with total T in the 2000’s, LH very higher and SHBG 246 is that once instance, Free T extremely low.

When I was diagnosed with low testosterone I had low Vit D, started TRT and Vit D corrected itself, however whenever I change dosages, it drops again for a couple of weeks until my testosterone become stable again which takes 6 weeks. Also note some people Vit D drops in the colder months and increases in summer time.

Considering all your levels twice weekly or an EOD protocol may be needed, T-cypionate causes spikes in estrogen, yours is already elevated near the top and Free T is low, when Free T gets to high normal estrogen will likely double. When that happens, not always, but most of the time it kills libido and erectile strength, bloating/water retention and causes mood problems.

I have issues with weight and therefore estrogen, for that reason I inject my small doses EOD, on a twice weekly protocol estrogen is very high and intolerable. There are some who really have trouble with estrogen, these guys do very well on daily dosing using insulin syringes of course which is what everyone should be using anyway.

More frequent dosing can also lower CBC labs across the board. You need to find out if there may be a cause for high CBC labs, or get used to donating blood on TRT. I wouldn’t donate too often or ferritin can be depleted. Normally we see high CBC labs in men who are injecting too much testosterone, yet your Free T is low.

Sleep apnea can cause high hematocrit as the body attempts to compensate for a lack oxygen throughout the body during sleep.



Thank you for such great insight systemlord. I initially was flattered by the SHBG record haha. I wonder if it has to do with a head injury I sustained when I was 13. I smashed the back of my head really hard on ice in a ski accident. I just want to be armed with as much background information so when I go in to see the TRT Doc that we can come up with a game plan together that I understand fully.


It all about genetics, being biochemically different. My SHBG isn’t so sticky (22) and at the other end of the spectrum. When my Total T is 500 ng/dL, Free T is 21 (ranges 6.8-21.5), other men with SHBG near 30 or higher require a higher Total T to equal the same Free T as I do.

The problem with sick care doctors is insurance companies restrict men to <800 ng/dL and treat every man exactly the same, except as you now know we are not the same. You’ll need supraphysiological levels whereas I would never need levels above midrange.

Forgot to mention, IGF-1 looks amazingly good, note sometimes TRT can increase it.


That makes sense. I actually have a pretty solid mesomorph body type and even though I haven’t worked out as much I’ve been able to maintain what muscle I have built. I’ve been just so tired that going to the gym sounds exhausting to me.

What did you mean by this?

You’ll need supraphysiological levels whereas I would never need levels above midrange.


Your SHBG is grabbing on hardnose to your androgens handcuffing your Free T, that’s why Free T is at the bottom end of the range. You need higher Total T to increase Free T to high normal.

My SHBG isn’t grabbing onto my androgens very strongly, therefore I have plenty of Free T to go around. When I scored a Total T of 677, my Free T was 29, supraphysiological all while Total T was in the normal ranges.

I think it’s safe to say I was nowhere near 700 ng/dL naturally.


Usually higher SHBG guys need more dosing to achieve higher free t levels. Not always but it seems like a trend. Really the goals just to dose to where free to is at a good range and you feel good. Man cannot feel good if free t doesn’t ride with total T.S.

systems saying since your shbg is high you could probably save time and just get a bigger dose to increase freee t sooner than later.


Should I insist on T W/hcg or would Clomid or something else be a better idea?


Sorry thought this was another topic.

You need trt. Chlomid is temporary. Jsut trt no HCG.

Your systems not going to reboot from chlomid. At least that’s what I’m told. Can’t find anyone who says they tookchlomid and stayed normal. Most use chlomid to stop cycles. Like body builders. They also give it to super young guys so that they don’t shut off the system … there’s always hope they might fix the patient.

If t is low before starting it probably won’t come back online. So that’s why I suggest just getting in trt.

Jsut realizs it’s for life. Unless a miracle happens and they figure out how to fix us.

Tread carefully. Get every option out of your mind by trying it or debating it.


Also more importantly find s more capable provider. I can give you a few names to call and consult.


@coldstate well as I predicted lots of BS and bro-science.
An SHGB of 33 is right in the middle of the range and is consider very good. Not something to worry about.
Clomid is the number 1 T booster for guys in there 20 and 30’s It can be taken for many years.
If your balls are working it can turn 200 into 700 in less than a month.
Novadex is the number 1 drug used for cyclers needing a PCT to start their natural production.


Come on what’s bro science about what’s said.

Chlomid does not kick start a system to where you take it for a few months and then stop and your levels stay high. I said exactly what you said in different words. It’s a booster. Like I said they give it to young men to keep the system ticking. What’s the point. If my systems already not working what’s the point? I can see keeping it online and one day finding a solution.


The fact that his Free T is at the bottom of the range and SHBG can be the only cause since it binds androgens, I’d hardly call that bro science. Clomid will worsen his condition as it will increase his SHBG even higher sending his Free T into oblivion.

That’s not bro science, that’s a fact.


hrdlvn are you thinking that my levels are all normal?


No I am saying you need to research other methods of increasing your natural T lvl. Your numbers are not bad and can be improved without going to the extreme of inducing organ failure (your balls) with TRT.
Clomid and HCG are two very popular treatment right now. Novadex with diet and exersize might also be a possibility.

You have come to a forum where the first letter in its name is ((( T ))) which does not stand for tits. Of course you will fine several T junkies here and boys with the fetish of playing internet doctor. So all I’m saying is never trust any random person on the internet and that includes me. Just take notes and spend some time learning.


M[quote=“coldstate, post:17, topic:254222”]
my levels are all normal?

Try to avoid focusing entirely on the numbers and ranges. Sure, they are used as a guide and to measure results of therapy, but the bottom line is how you are feeling and is that acceptable to you.

Of course, there are plenty of opinions and options available to you. I would bet heavily that you would feel a lot better tripling your free testosterone. The symptoms you described are unacceptable, especially for a 29 y/o.

I think, ultimately, you’ll end up on TRT. Nothing wrong with trying other options. If you decide to go with testosterone, you do not need hCG unless currently trying to conceive or concerned with testicular atrophy.


Can low T cause mood swings? I swear some days I act like people closest to me could mean nothing. It is probably my most bothersome symptom besides fatigue.


Low T can cause mood swings, it happens when a man’s hormones are low or out of balance. Think of a grumpy old man who doesn’t care about anyone or anything and his sole existence is to complain about everything.

This is how I felt when testosterone was low.


Any idea how much of a role having low Vitamin D plays in all of the symptoms?


I’ve only seen one guy in years where supplementing ViT D fixed a guys symptoms, so it’s a long shot.

In other words it’s unlikely.