T Nation

Low T or Not Low T, That is The Question (UK Based)

I went to the doctors about 18 months ago feeling the typical effects of low t, bloods were taken and tests taken…you should see the results below.

As you can see the test level is very low. But with it being done the estrogen wasn’t taken.
I asked the doctor about trt and he laughed…but agreed to a second blood test as we wondered if the results while in the “normal” range were an anomaly. The bloods were taken, and came back “normal and nothing to worry about” but I never did see or get told the numbers.
I went away a unhappy…but plodded on with life. I always wanted another test to be done but I couldn’t afford a private test until a few weeks ago. I “hummed and ahhhed” over if it was worth doing. But decided to go with it last week. Ordered the kit monday…and arrived Wednesday.

I took the test as soon as I work up. It was packed and sealed to be posted by 7am. The results came back on Tuesday afternoon. I was happy with a majority of it. However, the testosterone levels were better than I expected, but at a level of a 70 year old (I’m only 36). The biggies were the super high SHBG and cortisol levels, I’m addition to the super low free test (which will be caused by the shbg) my estrogen was low but what I consider healthy low. I’ll post the results up of the most recent test below.

Control of the shbg and cortisol should be my first concerns. But this is where I’m at a loss to start. Proviron should help with shbg, but cortisol…not a clue.

There are two things that you might look into.

The first is that a calculated free testosterone level below 0.225 nmol/L, which is what you’ve got, is associated with hypogonadism. I posted a thread with details a while back. This paper suggests TRT for anyone below 0.250 nmol/L.

The second is that you’ve got high levels of LH and FSH, with low-normal (in your second test) testosterone. That’s characteristic of compensated or subclinical hypogonadism.

Your numbers for testosterone, SHBG, LH and FSH aren’t dissimilar to what mine were. I’m on TRT for the second reason, though I’d have possibly fallen under the first too.

Give me a few hours to have a read and I’ll get back to you. But from the initial glance over…trt is looking more likely.

Kit? Blood draw?

TSH is way to high. Should be nearer to 1.0
Lab ranges are bogus.
In UK, iodine deficiency highly suspected [by me].
Please explain your history of:
iodized salt
commercial bread
milk, cheese and other dairy
sea food

You may be feeling cold easier now?
Outer eyebrows sparse?
Generalized hair thinning? - not male pattern baldness

See last paragraph for further evaluation of thyroid status.

Please read the stickies found here: About the T Replacement Category

  • advice for new guys - need more info about you
  • things that damage your hormones
  • protocol for injections
  • finding a TRT doc

Evaluate your overall thyroid function by checking oral body temperatures as per the thyroid basics sticky. Thyroid hormone fT3 is what gets the job done and it regulates mitochondrial activity, the source of ATP which is the universal currency of cellular energy. This is part of the body’s temperature control loop. This can get messed up if you are iodine deficient. In many countries, you need to be using iodized salt. Other countries add iodine to dairy or bread.

The blood test was 3 vials around 1.5ml in total, they recommended a blood draw, but I was doing it at home, so i used a finger prick kit, but the vials were filled as recommend, so I didn’t see the problem.
I’ve had a look at the iodine issue. I have 3 or 4 eggs a day for breakfast, with some spinach, often have 200-300g of broccoli for my food in the day (my meals are typically breakfast, pot of food around 1100-1130, another pot 1400-1500, dinner around 1800-1900, and maybe a skyr style yoghurt an hour or so before bed), also when I wake up in the morning I have a 1/4 tsp of pink salt with a shot of lime juice in a small glass of water. Any salt I add to food is Himalayan pink salt. Bread I rarely eat, but when I do its rye bread and its with some poached eggs.
I love milk, but again don’t drink that much any more (had loads as a kid), I have some cheese every now and then as a treat, but not often. Sea food, one or two portions a week, its generally white fish, but I have been taking mackerel to work a little more recently.
I’m sat outside in the British “summer” at the moment, its probably 10degC and I’m wearing shorts, feeling the cold isn’t an issue. Eyebrows are as they have always been, I’ve a good thick head of hair (although my hair is fine, but always has been), Im not a hairy person, legs/body are relatively hairless.
I don’t have an oral thermometer, so I will pick one up today and evaluate tomorrow.

You are iodine deficient.

There is no useful amount of iodine in that salt. You can get iodized salt, not in all shops, but it is there.

Others in your home will be deficient too. Very important for children and women do need more iodine than males as there is a need to store iodine in breast tissues. Low iodine can also lead to fibrotic breast disease/condition in women, although elimination of coffee does help, coffee is not the primary cause, but doctors are not generally aware of such distinctions.

Try to address all of my points, or they may get missed entirely.
You may be feeling cold easier now?
Outer eyebrows sparse?
Generalized hair thinning? - not male pattern baldness

Getting hold of a thermometer was trickier than I was expecting.
Mid afternoon temp was 36.5degC which (if my maths is right) makes it 97.7degF. I’ll let you know my morning temp…tomorrow.

Iodine is tricky to get too. But I’ve managed to get selenium without an issue, and some kelp tablets (I know they are like pissing into a sieve, but every little helps)

I messed up a little. I forgot to take my temp first thing. The Manchester bombing had my mind elsewhere. So it slipped my mind. However, after a moderate workout at the gym (I know, not ideal) my body temp was 95degF

96.08 degF my eyes were open for 3 min. That’s about as first thing as I could manage.

And 97.03 mid afternoon.

Got some lugols iodine on order

You are off to a good start.
Must be using that selenium!

Lugols 12% turned up later than expected. Been on it 5 days now. Taking one drop (which equates to 5mg) going to give it 10 days or so to kick in…then drop down to 5mg eod.

Managed to get a referral from the doctors to see an endocrinologist. However non of the 7 local nhs hospitals have any appointments free. So I need to wait for a space to open up…or go back to the doctors in 6 months then get another referral.

Don’t be surprised if the NHS denies you outright, they do it all the time to those that are below the ranges. If it happens private is the only option.