T Nation

Need Help with Labs


I am looking for help interpreting my labs-
I am a 37 y/o male I have been working out doing HIIT for quite a while and before that doing body building. Lately I have had trouble with joint soreness, muscle soreness and recovery and wanted to get a hormone panel since my blood-work has come back normal. I decided to order my own labs thru labcorp since my Dr declined to order tests for me. He stated that if i did not have trouble attaining erections there is no reason to believe I have Low T My results are as follows:
Total test 357 ng/dl (348-1197)
LH 8.7mIU/ml (1.7-8.6)
FSH 5.6mIU/ml (1.5-12.4)
Estradiol 10.7pg/ml (7.6-42.6)
I presented the results to him and he brushed them of- stating that I was in range and there was no need for TRT… The risks outweigh any positives blah blah blah… But he did order another set of labs- to satisfy me. This time I went to Quest diagnostics my results are as follows:

SHBG 22 nmol/L (10 - 50)
Testosterone Total 534 ng/dL (250 - 1,100)
Testosterone Bioavail 213.3 ng/dL (110.0 - 575.0)
Testosterone Free 97.5 pg/mL (46.0 - 224.0)

How could there be such a difference between tests when they were taken less than a week apart? Am I a candidate for for TRT based on my first set of labs? Also I am curious why my LH is so high and my FSH is normal in range.

Any help interepting these labs would be great help. I understand that if i go the TRT route at my age it is likely a long term commitment (rest of life). I also understand that my Dr. isn’t willing to help, I will just have to do this on my own (which I am fine with).
Thanks In Advance!


Our bodies aren’t machines that run the same all day everyday. Its likely that the second test caught you on a good day or the first test on a bad one.

Based on the first test your e2 is low which could be responsible for the aches and pains.

Your T isn’t clinically low on test #2 but it certainly isn’t optimal either.


Thanks for the response, Ok- I think I understand- This may be a dumb question… How can i raise e2? By raising T correct?


Yes or put on some fat. Are you very lean? Those are the only two ways I know of and putting on some fat obviously isn’t a great option.


Hostile is correct and you LH number signify your body is working properly. Your E is low but I bet it would have been different on the next test and that’s also not clinically low. Still, low E does cause joint pain. What is your diet like?


I’m not lean or fat-but putting on fat definitely isn’t in my game plan either.


Yeah I wouldn’t. I would retest E. I drove mine down below measurable once when I started TRT and had joint aches plus felt awful. But your levels are not that low so it’s questionable if that’s the problem. Certainly don’t get fatter LOL. If you want treatment a men’s clinic would probably treat you as a cash patient. You’re not ideal right now and though not clinical you would probably achieve a lot of benefits. I wouldn’t tell you that it’s a need and only you can decide if it’s worth the risk of side affects and long term dependency.


I don’t exactly diet, but eat quality food. Occasionally (one or two times a week) I eat junk food (chips/wings/burgers), but never soda or sweets. I would guess I’m prob around 15%bf. Typical day- 1.5 cups of oatmeal and a protein shake for bf- after the gym another shake then I eat 2 lunches usually 6-8oz of meat and a carb (potato/rice). Dinner is usually the same as lunch but add a salad. I’ve got a pretty good metabolism- height 6’1" weight 190


Alcohol is like 2-3 light beers prob 4 times a week.


I heard the same from my Dr before one of my lowest reading at 190 total t. I was able get erections just fine as well. Most doctors are ignorant idiots on the topic.


This is a degree of secondary hypogonadism.

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

  • advice for new guys
  • things that damage your hormones
  • protocol for injections
  • finding a TRT doc

LH is release in pulses and has a short half-life. Timing of the labs can catch a high or a low. FSH levels are steadier and a better indicator of LH status that LH most of the time.

So your energy levels are OK?
You can eval overall thyroid function by checking oral body temps as per the thyroid basics sticky. Make sure that you are getting iodine from iodized salt and vitamins listing iodine+selenium. Thyroid function can affect T levels. Do not expect to get iodine in prepared food or at restaurants. We have a pattern here with younger guys who blast through training with low T and/or thyroid on sheer will power and adrenalin, but that can end very un-well.


My energy is ok, could I use more energy? Sure! Ill read the articles.
Most of my issues revolve around my inability to recover. I will stay sore a long time after workouts mostly in my traps and shoulders. The inflammation persists and eventually turns into muscle strain… this is my best guess as to what is happening, I end up not working out due to injury more than I work out.
If I’m kneeling down I grunt to get up… knees and hips are not what they used to be… I’m 37- not quite an old man yet.
I use salt with iodine and don’t eat out much anyway.
I don’t know if I have thyroid issues, I believe my levels came back normal. I will go ahead and monitor my temperature anyway. However I have been known to get really hot when sleeping and wake up sweating. I had always attributed this to a high metabolism.


I reviewed my labs from last year with regard to thyroid. See below:
Tsh 2.330uIU/ml (.45-4.50)
T4 free 1.48ng/dL (.82-1.77)


TSH should be nearer t0 1.0, something was wrong.
fT4 should be midrange or better and that level is good.
fT3 is unknown.

T4 is a reservoir for T4–>T3
There are only T3 receptors, no T4 receptors.

T3 regulated mitochondrial metabolic rates. Mitochondria make ATP, the universal currency of cellular energy and regulates body temperature by that pathway.

Low mitochondrial function leads to sore muscles. So might be something going on there.

Over training is not an absolute kind of thing, it is relative to you metabolic abilities and limitations.


Forgive my ignorance, but what does this mean? What could be the cause? What is a possible solution?


It’s hard to know without more data. It again shows your Dr’s lack of knowledge by only testing tsh and t4; they should have also tested ft3 and Rt3.

To get a better sense of your thyroid, take your oral temperature for at least 3 days in a row, twice per day.

Once in the morning before you get up, drink anything or shower etc. Once again in the afternoon around 3pm with the same criteria (shouldn’t have eaten or drank anything recently).

Post those 6 numbers here. They serve as a good litmus test to your thyroid health.


I am trying to get you to take the above seriously.


Ok- I’ll post the temps in a couple days


Took a short vacation but finally got my temps…
Day 1 Morning97.4 evening 99.0
Day2 Morning 97.7 evening 98.6
Day3 morning 97.4 evening 98.6


Temps look good in my opinion.