T Nation

Low Test 31 yr old, Doc Says I'm Fine


#1


Hi

Vitals 6'1, 187lbs bf less then 20 i think.

Symptoms
Gyno since age 13
late facial hair development
fatigue
poor concentration
week erections

I went to the Endocrinologist today and he said that my Total test number of 215, isn't important and that the only important number is my bio avail. I was a bit confused after reading thousands of articles stating that under 300 is horrible and I should be in the 500 plus range. Apparently he disagrees. I asked if TRT would raise my total and make me feel better, he said no. At that point I called bullshit.

He did another blood draw today and will call me in a few days. We are testing more hormones etc, that weren't caught in the first test. Can someone send me some reference data that states total testosterone at that level is 'bad' combined with all my symptoms? I thought I was a prime candidate for TRT and hypogonadism..am I wrong?


#2

are you a prime candidate? signs point to yes, but you need a lot more tests first before you start on any treatment plans.

have you checked out any of the sticky threads at the top of this forum? especially the blood test sticky and how to find a good HRT Doctor.

I think Dr. Chrysler may have a paper, but for the most part it is just common knowledge. Lab Ranges themselves are horribly too large, and you are even outside of that too large of a range.

what does your endo consider bad?

also do you have any other blood work?


#3

Thanks. Yes we performed another blood test today and I'll post results when i get them in a few days. As to what he considers 'bad' is a good question. He literally just focused on telling me all that mattered was the Bio Avail number, not the free or total.

I guess my point is this. I've never read a forum where someone was considered healthy and virile at 215 total test regardless of the free. There has to be something weird going on. Maybe the next lab results which shed more light.


#4

Purechance, sorry forgot to answer your question on HRT doctors. I'm saving that as a 'next step' if needed. I have excellent medical coverage through my hospital right now and I think out of network is like 80%. I live in MN so I need to prepare and do some investigations. If you get a scrip for TRT from a HRT doctor..is that covered by insurance in most cases as well?


#5

yes, any licensed doctor can write a script and as long as you go to an in-network pharmacy, it should be covered (unless your state or insurance plan has some very weird rule). I'm in HR so I have some experience talking about insurance plan details.

plus some good HRT actually take insurance. You don't always have to go out of network to find them.

good luck.

what are you getting tested? did you read the blood test sticky and make any requests?


#6

Thanks for replying.

I just seen my lab results online tonight and here are the results

FSH = 4.5
SHBG = 13 normal range (10-60)

My doctor is a 65 yr old Endo that is making me question his competence. He will call me I believe tomorrow to tell me what he 'thinks' the numbers mean.

I still haven't found one piece of evidence online that shows a 30 yr old grown man is healthy at 215 total test levels...doesn't exist.


#7

Hey Hydrojoe

I'm facing a similar problem. Since your SHBG is quite low, your bio avail / free T will be in the "Normal" range, even if your total T is very low. I think the key element here would be to find the source of your low SHBG. Have your Insulin and Cortisol checked, they are closely related to low SHBG and low total T.


#8

Thanks for the comments of others. My endo stated since my bioavailable test is in normal range my abnormal total test meant nothing. I then contacted BodyLogicMD in MN and signed up for their program and just performed my blood testing at Quest Diagnostics in Edina. My salivia test is in the mail and should be here next week. I've been in communication with the doctor in the cities and passed along my test results and his response is completely different.

He states that he hears this everyday how the endos say everything is 'normal'. I'm extremely excited to have my first consultation in the next few weeks. I'll keep everyone posted.


#9

Here are my full test results from Quest Diagnostics. Any feedback ideas is greatly appreciated!!!

Test Name In Range Out Of Range Reference Range Lab
ESTRADIOL, ULTRASENSITIVE EZ
LC/MS/MS 19 < OR = 29 pg/mL

LIPID PANEL
CHOLESTEROL, TOTAL 188 125-200 mg/dL CB
HDL CHOLESTEROL 38 L > OR = 40 mg/dL CB
TRIGLYCERIDES 303 H <150 mg/dL CB
LDL-CHOLESTEROL 89 <130 mg/dL (calc) CB

GLUCOSE 78 65-99 mg/dL
UREA NITROGEN (BUN) 10 7-25 mg/dL
CREATININE 1.12 0.79-1.33 mg/dL
eGFR NON-AFR. AMERICAN >60 > OR = 60 mL/min/1.73m2
eGFR AFRICAN AMERICAN >60 > OR = 60 mL/min/1.73m2
BUN/CREATININE RATIO NOT APPLICABLE 6-22 (calc)
SODIUM 138 135-146 mmol/L
POTASSIUM 4.3 3.5-5.3 mmol/L
CHLORIDE 101 98-110 mmol/L
CARBON DIOXIDE 26 21-33 mmol/L
CALCIUM 9.9 8.6-10.2 mg/dL
PROTEIN, TOTAL 7.6 6.2-8.3 g/dL
ALBUMIN 4.8 3.6-5.1 g/dL
GLOBULIN 2.8 2.1-3.7 g/dL (calc)
ALBUMIN/GLOBULIN RATIO 1.7 1.0-2.1 (calc)
BILIRUBIN, TOTAL 0.7 0.2-1.2 mg/dL
ALKALINE PHOSPHATASE 81 40-115 U/L
VITAMIN D, 25-OH, TOTAL 18 L 30-100 ng/mL

TSH, 3RD GENERATION 0.03 L 0.40-4.50 mIU/L CB
T4, FREE 1.0 0.8-1.8 ng/dL CB
T3, FREE 3.7 2.3-4.2 pg/mL CB
DIHYDROTESTOSTERONE 26 25-75 ng/dL EZ
TESTOSTERONE, FREE,BIO EZ
AND TOTAL, LC/MS/MS
TESTOSTERONE, TOTAL,
LC/MS/MS 271 250-1100 ng/dL
TESTOSTERONE, FREE 58.4 46.0-224.0 pg/mL
TESTOSTERONE,BIOAVAILABLE 125.2 110.0-575.0 ng/dL
SHBG 15 8-48 nmol/L
ALBUMIN,SERUM 4.7 3.6-5.1 g/dL
CBC (INCLUDES DIFF/PLT) CB
WHITE BLOOD CELL COUNT 6.6 3.8-10.8 Thousand/uL
RED BLOOD CELL COUNT 4.98 4.20-5.80 Million/uL
HEMOGLOBIN 16.3 13.2-17.1 g/dL
HEMATOCRIT 46.9 38.5-50.0 %
MCV 94.2 80.0-100.0 fL
MCH 32.7 27.0-33.0 pg
MCHC 34.8 32.0-36.0 g/dL
RDW 12.2 11.0-15.0 %
PLATELET COUNT 213 140-400 Thousand/uL
ABSOLUTE NEUTROPHILS 4066 1500-7800 cells/uL
ABSOLUTE LYMPHOCYTES 1789 850-3900 cells/uL
ABSOLUTE MONOCYTES 568 200-950 cells/uL
ABSOLUTE EOSINOPHILS 152 15-500 cells/uL
ABSOLUTE BASOPHILS 26 0-200 cells/uL
NEUTROPHILS 61.6 %
LYMPHOCYTES 27.1 %
MONOCYTES 8.6 %

EOSINOPHILS 2.3 %
BASOPHILS 0.4 %
DHEA SULFATE 380 H 110-370 mcg/dL CB
INSULIN <2 <17 uIU/mL CB
LH 3.9 1.5-9.3 mIU/mL CB
PROLACTIN 8.0 2.0-18.0 ng/mL CB
PSA, TOTAL 0.6 <


#10

well somthing is going on with your thyroid. No idea what, but you need more tests like thyroid antibodies and something else. Your free t3 looks great, but a TSH of 0.03 is very troubling.

Vit D3 is extremely low. You may want to start 6,000iu D3 daily.

you should also test for 8am Cortisol and possibly free cortisol.

what did your doctor say/recommend?


#11

What med conditions do you have and what Rx/OTC meds?

What supplements for the labs and what planned now?


#12

Thanks for your continued questions/support. My cortisol levels (i don't have them with me) where crazy off the chart between 10-2 but then actually went down below normal after 5 pm. My doctor indicated that my body was doing well at regulating itself, but I just needed to understand stress triggers at work (corp finance).

Other meds, take celexa 30mg daily.

I met with the doc from Bodylogic this last friday (2 hour consult) and he prescribed me with Testosterone 200mg and I inject E3D 0.2ml. My first injection was saturday and I already noticed a huge difference in my energy levels and mental clarity. It may sound weird, but my memory, thinking quickly, speaking on my feet has gone up noticeably already. I'm not sure if this could be one of the first benefits to occur but it's great. The needle I use is a 27gauge I believe. It's extremely short and doesn't hurt either.


#13

You may have had a doc address hypogonadism symptoms with the SSRI. That can make T go lower and the sexual side effects are depressing too.