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Low Test Confirmed, What More Blood Work Should I Do?

Total testosterone 12 nmol/L (normal range 10-28). SHBG 75 nmol/L (15-70). Bioavailable testosterone 3.2 nmol/L (4.4-14). TSH, free T3, free T4 all in normal range. Of course more tests are needed to pinpoint the problem, but it looks like I have a testosterone deficiency (or more accurately a problem with excessive SHBG). Please suggest what more blood work I should do. I want to be prepared in the discussion with my doctor, who probably doesn’t know anything about TRT.

Im a 52 year old male. I’ve had problems with dizziness, foggy brain, hard to make decisions, low sexual interest, etc, for several years. Was always very active in the gym all of my life, but had to stop a few years ago because no matter how easy I took it, it never felt like my body could recover enough afterwards. Constant muscle and joint pains. I have done blood work before and my testosterone was always in normal range, so I assumed I had some kind of depression. This time was the first time I tested SHBG to calculate bioavailable testosterone, and it gives a different picture.

SHBG really won’t change much in your case. We never try to lower SHBG. You need to start taking some testosterone to feel better.

Watch this podcast I did and it will give you some info you’ll need:

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TSH reference ranges are not normal and are compiled from sick people seeking treatment, the group that made up the reference ranges were later found to be suffering from thyroid dysfunction which increased to TSH range, later it was found people who were normal and not symptomatic have a TSH closer to 1.0 <2.5, yet doctors heads are still unaware.

Big difference between low normal and high normal Free T3, low normal would expect to see symptoms and high normal to support optimal thyroid function, like the difference between high and low testosterone.

You will need to seek private care for TRT since guidelines are strict not allowing levels above ranges, something you will require do to your insanely high SHBG, otherwise I expect to see high Total T and suboptimal Free T.

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Thanks Danny, that video was very informative, and gives me hope that I can get out of this hole I’m in. I applied to join the FB group, will be interesting to learn more.

You mentioned that you use Testosterone Enanthate. I am confused about why you inject as frequently as every day when the half life is 6 days. So are the esters not breaking down in the body the way people normally assume?

Thanks systemlord, interesting info. My values are: TSH 2.48 uIU/ml (0.35-5.55). Free T3 3.0 pg/ml (2.0-4.4). Free T4 0.93 ng/dl (0.71-1.85).

I am assuming your mentioned range of 1.0-2.5 is also measured in uIU/ml. In that case my TSH is at the extreme high end. Free T3 it looks like I am fairly close to the middle of the range. Tried to learn about the relationship between SHBG and TSH, if any, but could not find any good info.

If your Reverse T3 were elevated >15 ng/dL, it would negate a portion of your Free T3 and then midrange levels wouldn’t look so acceptable anymore.

Side note: There seems to be an inverse relation between SHBG levels and insulin levels.

Trust me when I say that, if I could, I would inject once a year. I don’t enjoy it. After having tried all methods, the unfortunate end result was every day gave me the best results. Everybody that I have spoken to that do daily also agreed. It is what it is.

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Very interesting to hear first hand experience, thanks Danny. Makes me a bit frustrated though, because Nebido (test undecanoate) monthly injections is the only thing they prescribe here in Sweden. If I decide to go on TRT, I would have to order the medicine from abroad, and deal with the whole thing on my own. But perhaps with the support on the FB TRT forum I could pull it off. Would have been good to have the backing of a local doctor though.

Are you in the Facebook group? There are lots of guys there from Europe. Most are using the cream because they are limited to undeconate.

I guess I could try the cream first, although I’d rather use injections. Feels more efficient, and Im not scared of needles. I’m in the FB group. I’ll try to look up some other guys in Europe to see how they’ve done it. I’ll contact you on FB so you know who I am.

Ask Steven about how he lived from injections to the cream :wink: