Need Help with My Bloodwork

Hi guys
I’m 26 years old and suffer from fatigue and panic disorder. So I decided to test my T Levels because I also don’t build muscle that well and gained weight the last years without changing my lifestyle.
My results

FT 3: 3.1 pg/ml (2.0-4.4)
FT 4: 13.4 ng/ml (9.3-17.0)
TSH: 1.63 microgram/dl ( 0.27-4.20)

Androstenedione: 1.45 ng/ml (0.50-3.50)
Dhea-sulfate: 614.70 microgram/dl (50.00-560.00) +
SHGB: 23.0 nmol/l (18.3-54.1)
FSH: 5.1 mlE/ml ( <6.0)
LH: 4.8 mlE/ml (1.7-8.6)

Test. Total 3.68 ng/ml (2.49-8.36)
Free androgen Index 55.52 (15.00-95.00)

This test was done by an endocrinologist. I’m from and live in Germany by the way. I see they haven’t tested the free testosterone and bioavailable testosterone. Should I do more bloodwork tests or would a TRT don’t make sense for me if you look at the results?

Greetings from Germany

Good luck finding a doctor in Germany knowledgeable in sex hormones, most just follow the reference ranges like they were taught, in range is normal except this is not true with sexc hormones because there are other factors of considered like receptor sensitivity, SHBG levels and the rate at which T is metabolized.

You have countless guys in these forums and their doctors are telling them their normal, only they don’t feel normal. This is a common theme and tells you our medical systems has a blind spot for sex hormone knowledge. Most guys that find these forums show improvements after starting TRT, which just goes to show you western medicine is getting it wrong.

The studies are clear, levels <480 is associated with cardiovascular disease. A 26 year old at these levels should sound the alarm that something is wrong and any doctor not testing the free portion of testosterone lacks basic understanding.

None of the experienced doctors are using free androgen index, they are testing the free portion of testosterone.

Testosterone Threshold for Increased Cardiovascular Risk in Middle-Aged and Elderly Men:

The locally weighted regression showed that total testosterone levels of 440 and 480 ng/dL were associated with increased Framingham CVD risk and an increased probability of increased hsCRP, respectively. Men with sexual dysfunction (poor sexual performance, decreased morning erection, and loss of libido) had significantly greater CVD risk.

Definitly low for your age. For me symptoms start below 450 ng/dl and my sweet spot appears to be around 550 to 650, but of course everybody is different.
LH is mid range which implies the problem is rather the Tests and not the pituitary.
Was blood drawn in the morning after overnight fasting? Any relevant childhood sickness, mumps?
You could try clomid or hCG, but if the testis are underperforming you might not get good results.

Thanks for the reply
The blood was not taken in the morning and not in a fasted state. More in a semi fasted.
There is no childhood disease. But I have PKD (Polycystic kidney disease). Which wouldn’t be a problem for a TRT because there are studies that have shown people with chronic kidney failure reach the terminal state much faster than people with high testosterone. I can’t find the study at moment.

What do you mean by <450 ng/dl? Total testosterone ?


Thank you for the information.

So there is going to be a lot of trial and error with doctors. On the other hand I would like do a "self prescribed " TRT. But it’s not that safe for me because there is no doctor who can help me.

Maybe a younger doctor would be more open minded to do a TRT ?

Fasting is important for diagnosis, but you seem to be lo anyway.
And yes total T.
Any indications for diabetes or pre diabetes state that could explain the low SHGB?

Just for reference

Has anybody ever checked for the presence of varicoceles in your scrotum?

If you happen to live in the Munich area i can recommend

This is besides the point, LH is about midrange and testosterone is lower than mid range hinting a poor testicles response to stimulation. I had the same problem, LH is 3.6 and Total T 97 ng/ml.

The fatigue and panic you speak of are all common symptoms of low estrogen which indicates Free T must also be low.

You have other problems besides low testosterone, your adrenal glands are also working overtime, high DHEA also comes with symptoms.

Doctors are taught in medical school TRT causes prostate cancer which is based off anecdotal evidence, newer studies are showing low T is not prostate cancer friendly as doctors once thought. This is one of the reasons it’s so difficult to get TRT, plus TRT is low cost, low profit and is not good business.

These are the reasons why so many doctors are so clueless.

I was once at a urologist 6 years ago. There was and I hope everything is alright down there.
I also checked once my blood glucose via a blood sugar device. I work at a hospital. 2-3 hours after a meal I had blood sugar amount of 83 mg/dl. So that’s the normal range. I also tend to get hypoglycemic if my breakfast consists only of sugar. E.g cereals which I eat very rarely.

Thanks for the recommendation but I live in south western Germany which would be a pretty long way to drive :grin:

just as a future reference, there are various free and bioavailable T calculators online if you have total and shbg. I have no reason to think they’re inaccurate.

A lot of them are inaccurate, they were created before current testing method were even finalized.

They can be off by as much as 40%.

Thanks for the recommendation
I now have tried one of the calculators and it says that my free testosterone is 9 ng/dl and Bioavailable testosterone 211 ng/dl .

After trying 2 more calculators the results differ a little bit from each other.

Well, calculators take some assumptions, for example that the binding between T and SHGB is the same in every individual. We know that we are all different, also in minor differences in the sequence of SHGB (these small differences are called Single Nucleotide Polymorphism or short SNPs and they make us unique) which cause different binding affinities to T in different individuals. But studies have shown that the calculators are sufficiently accurate for most people.

Check out these if you are interested in the science :slight_smile:

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