T Nation

Low T Test Results Please Help


#1

First of all, I'd like to give a shout out to the guys here helping others out. I think you are very knowledgeable and probably more so than 90% of the doctors out there when it comes to T. I appreciate you taking your time to help and I'm sure others are grateful as well.

To make a long story short, since around 16 I've had what I consider to be signs of low T. Especially my difficulty to build muscle. At 19 I asked for a T test, it came back at 236 ng/dl.
Recently, now that I managed to get insurance again I was able to get another test. I wasn't able to get everything I wanted, like free T, SGHB, and, estradiol.

Age 20
Height 6'2
Weight 180
Body hair I have hairy legs, stomach, and, some chest hair. I can grow a beard fast I have to shave every 3 days. I have a very deep voice and have had pubic hair since age 11.
describe where you carry fat and how changed Most fat is around the gut area and doesn't really change its always about the same.
health conditions, symptoms none.
Rx and OTC drugs, any hair loss drugs or prostate drugs ever none
describe diet [some create substantial damage with starvation diets] Never diet, I have a fast metabolism.
describe training [some ruin there hormones by over training] 10 sets of 10 every 2 days for about 30 - 40 minutes focusing on a specific group. Not much cardio.
testes ache, ever, with a fever? 2 years ago I had an ache in my right testicle and it lasted about a day. I actually got an ultrasound for that, everything was fine.
This year during a flu fever a noticed some pain in that same area. Which is odd since if never had any injuries there. It also went away in a day.
how have morning wood and nocturnal erections changed? Inconsistent, morning wood only every other day and not at its max.

Here's my lab work:

Cholesterol total 167 (125-200)
HDL 38 low (> or = 40 mg/dl)
LDL 102 (<130 mg/dl)

Glucose 102 high (65-99)
Creatine 0.71 low (0.80-1.30)
Bilirubin 1.3 high (0.2-1.2)
TSH 3rd generation w/relex to ft4 1.01 (0.40-4.50 MIU/L)

FSH 1.5 low (1.6-8.0 mIU/l)
LH 4.4 (1.5-9.3 mIU/l)
Progesterone 0.8 (<1.4 ng/ml)
Prolactin 10.6 (2.0-18.0 ng/ml)
Testosterone 294 (241-827 ng/dl)

Thanks hope to hear from you guys soon.


#2

Nice opening post.

We are blind without E2 or FT.

FSH is the indicator of your gonadotropin output as FSH has a longer half live that averages things out. LH has a very short half life and the lab result is highly a random result of lab timing. So the LH lab value is not really very useful in terms of its specific value.

Your FSH and TT are consistent. So your testes may be willing and able, but you are not getting enough LH to make things work. With young men, such a situation raises the possibility of a pituitary problem. Damage from a blow to the head or whiplash. However, pituitary adinomas [benign tumors] are possible and radiology can detect these to some extent. An adinoma can grow and press on one or both optic nerves and cause a reduction of peripheral vision or create other visual field disturbances.

You should get treatment based on your age and symptoms. You should now be able to insist on these as a follow up to the low T:

Estradiol [E2]
free testosterone [FT]
DHEA-S

But one also needs to find the root causes and try to fix those. TRT can be needed, but you need to do more than treat the symptoms.

Fish oil flax seed nuts [EFAs], high potency B-complex multi-vits [with iodine] will help increase HDL. Eat healthy fats.

You do not want cholesterol lower, might be better a bit higher.

waist?

what signs of low ?
mood/depression
short tempered
apathy

describe diet in terms of what you eat, how much, what supplements

did you read this? http://tnation.T-Nation.com/free_online_forum/sports_training_performance_bodybuilding_trt/prototype_advice_for_new_guys


#3

Thanks for the response. I was wondering why the LH seemed normal yet the FSH low. I will try to get more testing by the next 2 weeks once I’m recovered I’ve been debilitated and on strong antibiotics thanks to pneumonia.

Waist is 35 1/2
Signs of low T are what I can summarize as feeling less manly, I don’t mean becoming feminized, but not having the same male edge I had. I feel it in sports where the competitiveness is low, in the way I take charge of situations, in energy levels, and the way I look at women. Its not like before when anything in a skirt was an automatic bone, now its more like looking as art.

My mood is off, I’m not always down, but I’m down a lot more than I was before I suspect the low T started, which I feel happened in progression not as a sudden crash. I would say I have become very apathetic.

My temper is not as bad as it used to be, but now I’m easily annoyed, its not an aggressive temper, its more an annoyed temper. I would say I sometimes act like a woman on PMS. Which makes me wonder if estrogen is taking over.

My diet is fairly healthy I rarely eat in the street. The only fast food I occasionally eat is IN and Out. I eat lots of salmon, meat, rice, and beans. I do need to work on eating salads and fruits. I like mango, kiwi, pears, plums, and grapes. I drink lots of cranberry and orange juice. I don’t drink much soda.

Supplement wise, I take centrum silver (I didn’t realize that was for people over 50 lol) but its good nonetheless. I take omega 369. Regarding the low HDL and LDL. I was trying plant stenols for a month before that test because high cholesterol and heart attacks run in my family. I’ve read stenols can also lower HDL.

Thanks for the reply, I will post more info when I can get those tests.


#4

Your cholesterol levels are not a risk factor!!! There are many things that affect endothelial dysfunction. You will need to know what that means and many other things.

In general: -others are reading this too.

Lovastatin is dirt cheap. Get 90 day supply at Walmart for $12. Get larger than you will need and take 1/2 tabs to get a 180 day supply. You need Co-Q10 with that and perhaps any herbal that is tweaking the same liver enzyme pathways. You can get lovastatin in red rice yeast concentrates, but the Rx is way way less expensive. Plant stenols are mostly ineffective and expensive. Statin drugs do not normally lower HDL.

TRT often lowers cholesterol significantly. One can easily say that low hormones increase cholesterol. In a clinical setting, we know that driving E2 low in females leads to high cholesterol levels and we have similar reports from body builders who take E2 very.

You need DHEA to make T and you need pregnenolone to make DHEA and you need LH to get the testes to make a significant amount of your pregnenolone. So low LH is a bit of a trap.

We really need more data, CBC and fasting glucose.

Sometimes T production is rate limited by low DHEA levels, but often not. At your age, DHEA levels should be high.


#5

I’ll try lovastatin, thanks for the advice. The reason I’m so weary of my cholesterol levels is because I’ve had people in my family die in their 30’s from heart attacks caused by clogged arteries from high cholesterol.

The numbers I first posted were during fasting.

glucose is 102 (65-99)

CBC:

WBC 5.5 (3.8-10.8 Thousand/UL)
RBC 4.61 (4.20-5.80 Million/UL)
Hemoglobin 14.8 (13.2-17.1 g/dl)
Hematrotic 43.8 (38.5-50.0 %)
MCV 94.9 (80.0-100.0 fl)
MCH 32.1 (27.0-33.0 pg)
MCHC 33.9 (32.0-36.0 g/dl)
RDW 12.5 (11.0-15.0 %)
Platelet count 198 (140-400 Thousand/UL)
Absolute neutrophils 3080 (1500-7800 cells/UL)
Absolute lymphoytes 1738 (850-3900 cells/UL)
Absolute monocytes 462 (200-950 cells/UL)
Absolute bosinophils 198 (15-500 cells/UL)
Absolute basophils 22 (0-200 cells/UL)
Neutrophils 56.0 (%)
Lymphocytes 31.6 (%)
Monocytes 8.4 (%)
Eosinophils 3.6 (%)
Basophils 0.4 (%)


#6

Cholesterol levels below 160 increase all-cause death rates.

You are been too hasty and are misinformed.

You should be checking vit-D25, CRP and homocysteine levels, taking a good B-vit complex, getting enough EFAs. Just looking at cholesterol is dumb. You need anti-oxidants too.

Cholesterol is essential for life. What you are concerned with is endothelial dysfunction and how that is treated or avoided. Cholesterol does not plug up arteries, that is the result of endothelial dysfunction. Some have very high cholesterol and do not have arterial disease. Some have low cholesterol and do have arterial disease. The endothelium is a one cell layer thick lining that keeps some blood components from penetrating the blood vessel walls. Those blood components cause the problem, but the root cause is the endothelial dysfunction. Some familial problems are genetic, however many are diet, life style issues that are learned by the children from parents.

For those with endothelial dysfunction, lower cholesterol may slow down the progress if the disease.

Low testosterone contribute to endothelial dysfunction in men. Estrogen dominance does that in women, which is really fro declining progesterone levels. Oral birth control does this because of the progestins [fake progesterone].


#7

I do try to get as much antioxidants as I can. I know I sound ignorant on the subject and I admit I am. All my life when I mention history to doctors, its always cholesterol they tell me to look out for. That’s no excuse though, I should have done more research. I will research endothelial dysfunction.

I will set up an appointment soon, I picked the most experienced endo I could find around my area, hopefully he’s a good one since I’ve read its hard to find a good endo for T.


#8

Big pharma has made huge profits with statin drugs, and they spend a lot of money convincing the public and doctors that cholesterol is evil. We have had a few here with very low cholesterol and their hormones were a mess, not unexpected.

Do not expect to find agreement in what you read.
http://www.google.com/search?hl=&q=causes+of+endothelial+dysfunction

And a collection here:
http://www.google.com/search?q=site:www.lef.org+endothelial+dysfunction

Maybe you can help your other family members too.


#9

Just got back from the doc. I wasn’t able to get a referral to a specialist because according to them the numbers are normal. I guess if your 80 its normal. They also claim FSH is normally low in men. The only option I got left is to find an endo that is wiling to give me an appointment with those lab numbers.


#10

The ranges for FSH are for men. How low relative to women is meaningless.

How is this not malpractice? The behavior does cause harm.

“referral to a specialist” -where are you located? -why is your doctor a gate keeper?

There is a thread from another guy around your age.


#11

I’m in Socal. I tried going straight to a specialist, but they said they didn’t want to see me until I went to the regular doc and got more recent tests. The ones I had were 1 year old. It sounded bizarre to me, so much bureaucracy. I’ll call a few different places. It makes no sense, since I would think specialists would love to have more clients to charge.

The thread you mentioned is in here in TRT right? I’ll look for it. Is it this one? http://tnation.T-Nation.com/free_online_forum/sports_training_performance_bodybuilding_trt/just_started_trt_1


#12

I got an appointment next week. I’m not too excited since I’ve read how frustrating it is to deal with these people.

I want to attempt a clomid restart. The only thing that worries me is that I’ve read that it is very liver toxic and my liver has a tendency to act up when stressed.

I will also try to get better tests. So far I got these as the critical ones from the sticky.

TT
FT
Bio T
E2
Dhea-s
Vit D2
LH/FSH

Should I try to get both FT and Bio T or is that redundant? Or which is best of the two?

I’ve read the stickys and the consensus is that most docs are idiots. Is there any suggestions in how to deal with them?


#13

[quote]KSman wrote:
Nice opening post.

We are blind without E2 or FT.

FSH is the indicator of your gonadotropin output as FSH has a longer half live that averages things out. LH has a very short half life and the lab result is highly a random result of lab timing. So the LH lab value is not really very useful in terms of its specific value.

Your FSH and TT are consistent. So your testes may be willing and able, but you are not getting enough LH to make things work. With young men, such a situation raises the possibility of a pituitary problem. Damage from a blow to the head or whiplash. However, pituitary adinomas [benign tumors] are possible and radiology can detect these to some extent. An adinoma can grow and press on one or both optic nerves and cause a reduction of peripheral vision or create other visual field disturbances.

You should get treatment based on your age and symptoms. You should now be able to insist on these as a follow up to the low T:

Estradiol [E2]
free testosterone [FT]
DHEA-S

But one also needs to find the root causes and try to fix those. TRT can be needed, but you need to do more than treat the symptoms.

Fish oil flax seed nuts [EFAs], high potency B-complex multi-vits [with iodine] will help increase HDL. Eat healthy fats.

You do not want cholesterol lower, might be better a bit higher.

waist?

what signs of low ?
mood/depression
short tempered
apathy

describe diet in terms of what you eat, how much, what supplements

did you read this? http://tnation.T-Nation.com/free_online_forum/sports_training_performance_bodybuilding_trt/prototype_advice_for_new_guys
[/quote]
KSman this idea of a “blow to the head” damaging the pituitary gland is quite scaryto to me as someone who plays sports. Is this a common occurrence or would it take a major trauma to cause such damage?


#14

[quote]CircaThursday wrote:

[quote]KSman wrote:
Nice opening post.

We are blind without E2 or FT.

FSH is the indicator of your gonadotropin output as FSH has a longer half live that averages things out. LH has a very short half life and the lab result is highly a random result of lab timing. So the LH lab value is not really very useful in terms of its specific value.

Your FSH and TT are consistent. So your testes may be willing and able, but you are not getting enough LH to make things work. With young men, such a situation raises the possibility of a pituitary problem. Damage from a blow to the head or whiplash. However, pituitary adinomas [benign tumors] are possible and radiology can detect these to some extent. An adinoma can grow and press on one or both optic nerves and cause a reduction of peripheral vision or create other visual field disturbances.

You should get treatment based on your age and symptoms. You should now be able to insist on these as a follow up to the low T:

Estradiol [E2]
free testosterone [FT]
DHEA-S

But one also needs to find the root causes and try to fix those. TRT can be needed, but you need to do more than treat the symptoms.

Fish oil flax seed nuts [EFAs], high potency B-complex multi-vits [with iodine] will help increase HDL. Eat healthy fats.

You do not want cholesterol lower, might be better a bit higher.

waist?

what signs of low ?
mood/depression
short tempered
apathy

describe diet in terms of what you eat, how much, what supplements

did you read this? http://tnation.T-Nation.com/free_online_forum/sports_training_performance_bodybuilding_trt/prototype_advice_for_new_guys
[/quote]
KSman this idea of a “blow to the head” damaging the pituitary gland is quite scaryto to me as someone who plays sports. Is this a common occurrence or would it take a major trauma to cause such damage?[/quote]

Yeah it sounds scary if you play sports. I’ve never had any blows to the head or trauma.

I’m guessing, by common sense that any blow is a risk an it may or may not cause damage.


#15

Just got back from the endo. Unfortunately, I wasn’t able to get e2 or dhea-s. He mentioned Dhea is to check for adrenals.

He wants to check free T, cortisol, full thyroid panel, tsh,t3,t4 etc, and all the 6 hormones produced by the pituitary, including growth hormone.

Probably have to get a pituitary MRI as well.

Does it sound like I’m on the right path so far? what do you think KS?


#16

Endo is an idiot. If E2 is high, it is HPTA repressive.

you can do your own out-of-pocket labs at LEF.org


#17

I finally got my results. Endo says my free T is normal even though total T is low. He thinks the T is binding to something, probably SBHG and that the liver is producing too much of it. Basically since my free T appears ok he feels that its not worth it to mess with my system and inject me with testosterone. Since I was not tested for sex binding hormone I don’t think we should just assume, I believe it could also be binding to E2.

HGBA1C 5.7 % 4.0-6.0
Adrenotopic hormone 26 6-46 pg/ml
Cortisol 27.8 a.m range 8.7-22.4 it was taken a.m
TSH 3rd generation 0.946 mIU/mL 0.340-5.600
Free T4 1.4 ng/dl 0.8-1.9
PSA 0.80 ng/ml 0.003-4.0
FSH 4.5 mIu/mL 0.70-11.3
LH 6.7 0.8-7.6
Prolactin 14.4 ng/ml 2.5-17.0
Testosterone free 15.98 8.8-27.0
Growth Hormone 7.3 ng/ml <10.1
IGF-1 401 127-424


#18

^^

What do you guys think?


#19

Since I’m out of insurance in a few weeks, can anyone chime in on the numbers? What do you think KS should I live with it since I’m too young?


#20

Hate to bug people, but I just need some feedback on what I was told and the new lab numbers.

What are some tips to lower SBHG.