T Nation

Low Total T (465), High DHEA-S (596)

Have a friend who recently started on TRT and has been amazed at the transformation. That was the push I needed to finally go and get some blood work done that I had been putting off for years.

Have been dealing with some extreme fatigue periodically as well as what felt like a slow recovery time. Aside from that, it seems to be particularly hard for me to get off, most of the time. At times this becomes full blown anorgasmia where I can’t cum at all. Erections tend to be pretty good. But will sometimes lose steam part way through.

Tend to be more anxious / withdrawn in social situations than I’d like.

Ideally I’d like to increase recovery rates, increase energy, and have more confidence in my ability to obtain an erection and orgasm during sex.

Age: 26
Height: 6’ / 183cm
Weight: 187lbs / 84.8kg
Facial hair: Beard. Not particularly thick or course
Body hair: High coverage, low density. Few stray back hairs. Less thick and dense than facial hair. Quite soft
Carry fat: seems to be fairly equal. chest, arms, hips, stomach, legs. Seems to have been this way for as far as I can remember
Health History:

  • Gynocomastia as a teen (went away on it’s own. started lifting)
  • Blood pressure always “normal” / “good”
  • Self-diagnosed variocele in one testicle
  • Tonsil stones since I’ve been young (KSMan has asked this in other threads, couldn’t find out what he was driving at though)
  • Some periods of minor depression and anxiety
  • Allergies to grass and mold
  • Testicular trauma around age 13. Some asshole thought it’d be funny to hit me in the nuts

Symptoms:

  • fatigue / slow recovery (feeling like I need a nap every day)
  • high refractory period (2x a day can be challenging)
  • bouts of anorgasmia (especially when going for 2nd time in a day)
  • occasional issues with ED in the past (especially with new partners), but seems to have largely gone away in the past year or so
  • low sex drive (2-3x / wk on average)
  • periods of low drive
  • high appetite, high metabolism. feeling of needing to drink more water than most

Diet: Relatively low on veggies and fruit. Lots of meat, butter, pasta, eggs, nuts. Little sugar / junk.
Morning wood: inconsistent. Ranging from nothing to plump to can’t lay on my stomach. A soft erection most mornings.
Training: 2-3 days a week in the gym. 2-3 days a week rock climbing
RX / OTC Drugs:

  • No TRT
  • No medications
  • No hair loss / prostate drugs ever
  • D3 semi-regularly (5-10k IU / day, when I take it)
  • Fish oil when I have it around
  • Magnesium / Zinc / B6 when available

Misc:

  • Some periods of relatively high stress, but low overall
  • Never been particularly strong (hoping for a 1RM 225lb bench within the next month)
  • No testicle aches, even when sick
  • More dribble and less shooting on ejaculation over the past few years

Bloodwork
Taken 9:00am, ~1 hour after waking up. 3 hours behind “normal” time zone. Was in the area for ~3 days before draw.
No orgasm for about 3 days prior.

Item                 Results  Units    Range
--------------------------------------------
Triglycerides             63  mg/dL   50-150
Cholesterol              143  mg/dL  100-200
HDL                       55  mg/dL      >40
LDL (calculated)          75  mg/dL     <100


Item                 Results  Units    Range
--------------------------------------------
FSH                    4.800 mIU/mL 1.4-18.1
LH                       4.7 mIU/mL  1.5-9.3
E2 (non sensitive)        30  pg/mL     2-54
Cortisol (random)       14.1  ug/dL 4.8-19.5
DHEA-S                   596  ug/dL  240-549
Total T                  465  ug/dL 250-1100
Free T                  91.7  pg/mL   35-155
Prolactin                6.9  ng/mL     2-18


Item                 Results  Units    Range
--------------------------------------------
D25 OH                    54  ng/mL   30-100
B12                      582  pg/mL  200-950
Folic Acid              12.7   ug/L    >=6.0

The high DHEA-S levels immediately stuck out to me. No thyroid or other markers at this time. Total T is also quite a bit lower than I had expected.

You shouldn’t listen to doctors who say you’re normal simply for being in the normal ranges, we don’t know what normal is for you only everyone else. Most men start to experience low testosterone when Free T drops below midrange, Total T is bound to SHBG and is the single most important test for evaluating sex hormone deficiencies. SHBG binds testosterone, estrogen, thyroid hormone and insulin. So if these tests are doctor ordered, your doctor clearly doesn’t specialize in this area of medicine.

This is a classic sign of all low T suffers, not severely depressed but withdrawn socially, lacking motivation. Your dribble and ejaculation issue is from being sub-optimal Free T, the penis needs healthy testosterone/nitric oxide to stay strong and healthy.

The causes for high DHEA could be many things, adrenal hyperplasia is an inherited condition caused by mutations in genes that code for enzymes involved in making steroid hormones in the adrenal glands. It could also be adrenal cancer or tumors.

Beware of sick care doctors, most are quacks in their field of medicine and have zero knowledge in male sex hormones since medical school doesn’t really cover it for more than 20 minutes, not joking. That’s where doctors overly focus on lab numbers is becauses they have no knowledge and are only managing a number, in range is normal and below range isn’t, only it’s not that simple.

Suggest seeking a private specialists, this is where knowledgeable TRT doctor practice medicine in anti-aging and sports medicine for the past 70 years. There’s no standard of care for TRT in sick care and that makes it more likely that you’ll not find good care under insurance base sick care.

Your levels are mid range for your age. You should be in the top range not a range of a 40-50 yr old man.

There’s something in the water, food , air, that is causing this issue in men and woman. I highly suggest trying to fix this naturally and after that’s exhausted get on trt.

Don’t take boosters or vitamins that mess with estrogen and etc. they are temporary and can cause long term damage:

Research what lowers T in men and see if you can find why your is low.

Throwing this out there because it’s not talked about enough. Some are jsut too ignorant to realize our bodies aren’t made to masturbate and have sex daily for weeks and months on end…At your age I had Ed and my T was low . I fixed that by abstaining from sex for 45 days. No stimulation nothing and I was healed. It took about 3 years or so to realize the solution. Until then doc had me on T and viagra.

At your age the body is resilient. If anyone can recover and heal hormonall it’s a 20 something.

And system makes a good point. Take it from us men who have been there and seen many men deal with sick care docs. They are a waste of time. They create more harm and want to give you cialis, anti depressants and such

Thanks for chiming in @systemlord

Not doctor ordered. Picked these out myself and tried to get all the ones I could remember. What big ones did I miss? SHBG and thyroid factors?

Can SHBG be inferred when Total T and Free T levels are known?

Yep! This fits me EXACTLY.

Thanks for the heads up. Been a stern skeptic of doctors for health related things for a long time. The lack of an optimal range for things that is age adjusted is crazy in my eyes.

My conclusion as well. From what I’ve read, I’m too high for most to diagnose as “low”, but still much lower than targeted TRT levels.

Agreed. Fixing the root cause seems like smart approach. Something is not working correctly, somewhere in the chain.

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I would estimate your SHBG levels are above midrange (30), for comparison a Total T of 496 would see my Free T 20.8 (range 6.8-21.5) high normal. My SHBG is 22 nmol/L together with these Total T and Free T numbers.

If your pituitary was functioning properly, you would see LH at the top end of the ranges and Total T and Free T higher and you wouldn’t need TRT. TRT will kill two birds with one stone, lower SHBG a little and increase Free T.

The higher testosterone, the healthier your cardiovascular system and heart health, doctors should be recommending TRT for those who aren’t optimal. TRT can prevent and or treat obesity, metabolic syndrome, cardiovascular disease, heart disease, erectile dysfunction and diabetes to name only a few.

The problem with sick care by definition do not prevent disease, they wait for disease to strike and then they profit from your disease. When you are diagnosed with a disease, it opens billing codes doctors can then bill to insurance.

The docs won’t help you because there working with insurance companies and have become brain dead. They treat ranges because they realize insurance companies will cover treatment if your blood work shows your below a range the insurance calls low t. Your going to get nowhere with most of these sick care docs. System calls them that and I agree.

You might get lucky and find a provider but pay out of pocket. They won’t know how to help though.

That’s why it’s important to go private without insurance and get some real help.

Docs are about 1500/2k a year and then u pay for meds. Ends up being around 2 to 3500 with meds. Depending on what your given.

Clinics are 2k to 3k a year but that includes meds and u pay monthly. You pay for blood work out of pocket as well. Year 1 500-600 on bloods. After that it’s chraper I think.

Yes put your research hat on and start looking for answers. Don’t be surprised if you can’t fix your issue. You just want to make sure there are zero options left before starting trt. Because TRT is for life…

The environment (corps; tech, food; health) is at war with men and woman. Everything from cell towers; pollution and food has been reported as a cause of this. They neglect the populations health for profit and share holders.

I think more often than not it’s life style and medications that causes these long term sides. Your young and I am just surprised your already effected. Unless it started when you were very young.

Hang in there and run any ideas you have with the group here. There are guys here who have spent much time researching this topic and could tell you what they think.

Good luck man.