Normal T? 25yo, 12 nmol/l (346 ng/dl)

Hello everyone.
Two months ago I decided to make a doctor’s appointment because of the symptoms that had been bothering me for some time. Mainly tiredness, lack of drive, concentration and motivation, decreased libido and EQ, and an overall lack of real emotion. I just feel that nothing really excites nor upsets me anymore. I can tell if women are pretty but I rarely get that “extra” drive.

These are my stats:
-age: 25/26

-height: 180cm/ ~5’11"

-waist: 81cm/32"

-weight: 74kg/163lbs

-describe body and facial hair: Apart from armpit and pubic hair, very little body hair. I’ve got a little hair on my lower arms, and quite a bit on my lower legs. My chest is completely smooth save for some lone strands of hair. My facial hair is both slow growing and has little coverage. I basically only grow hair above the upper lip and on the chin.

-describe where you carry fat and how changed: I’ve never had much fat, but the fat I have seem to accumulate by waist, chest and face. No changes in this as far as I know.

-health conditions, symptoms [history]: No obvious physical problems. I think I was depressed for maybe a year or two, but never got an official diagnosis of it. I have not been severely depressed for the last 12 months, only feelings of apathy.

-Rx and OTC drugs, any hair loss drugs or prostate drugs ever: Recently started my annual pollen allergy medication, but for the better part of the year I don’t. I doubt this affects me. It can bring some fatigue, but I can feel the difference of what comes from the allergy and what doesn’t.

-lab results with ranges: I hadn’t really done much research beforehand. All I knew was that I wanted to test my testosterone. I trusted the details to the doctor. Thus, I did a standard test (What I assume to be the Swedish standard test), plus a test of total testosterone. I’m not sure which results are relevant so I’ll just include them all. Because of the high Ca and B12, I did a follow-up test after not taking multivitamin pills and not drinking milk for a week. Turned out the pills didn’t contain any calcium, so any change there would be from avoiding the milk. He also wanted to test my renal function again because of the serum creatinine. But he told me that it’s probably high just because of my muscle mass. The follow-up test included Ca again, Ca2+, PTH and serum creatinine. This is how my results were listed, with English translations where I felt confident to make them:

S-K 4.2 mmol/l (3.6-4.6)
S-Creatinine 114 µmol/l (60-105) (follow-up test: 110 µmol/l (60-105))
S-ALP 0.70 µkat/l (0.60-1.8)
S-ALAT 0.32 µkat/l (0.15-1.1)
S-Na 140 mmol/l (137-145)
S-Ca 2.55 mmol/l (2.15-2.50) (follow-up test: 2.49 mmol/l (2.15-2.50))
S-Ca ionized (follow-up test: 1.23 mmol/l (1.18-1.31))
B-Hb 154 g/l (134-170)
B-EPK 5.210^12 (4.2-5.7)
S-B12 830 pmol/l (140-500)
Erc-MCV 88 fl (82-98)
Erc-MCH 30 pg (27-33)
Erc-MCHC 337 g/l (317-357)
B-LPK 4.7
10^9/l (3.5-8.8)
S-Free T4 17 pmol/l (12-22)
S-TSH 1.6 mIU/l (0.30-4.2)
S-Testosterone 12 nmol/l (9.9-30)
S-Parathormone (follow-up test: 2.58 pmol/l (1.6-6.9))

-describe diet [some create substantial damage with starvation diets]: Three or four meals a day, much protein, much dairy, especially milk, little processed food or soda. I can’t really say how much of it comes from protein, fat or carbs, but would say I have a balanced diet.

-describe training [some ruin there hormones by over training]: Weightlifting three times a week, about 1.5 hours per session including rest, chatting etc. I’m mostly doing the Stronglifts or Madcow routines, so it’s quite a lot of squatting in particular. These last five months I’ve been cutting down a lot on the weights though. Very rarely do I run or do any other cardio.

-testes ache, ever, with a fever?: Sometimes I feel a dull ache just above the pubic area, don’t know if that’s related.

-how have morning wood and nocturnal erections changed: Morning erections have decreased in frequency, and are also (along with the regular ones) weaker when they do occur. I think the nocturnal erections are even rarer.

I’m not sure how long I’ve felt this way. Maybe as long as 5 years or more. Previously I just thought it as part of my personality or maybe because of a depression. I’ve been under a lot of stress and not doing well at university, and I guess that could make anyone feel bad. But it never crossed my mind that it might be something physiological wrong with me.

Then I happened to read a description of the symptoms of low testosterone on the web. I felt it described me exactly, so I made the aforementioned appointment. I never seek medical attention unless I think it’s really necessary.

So, I told the doctor everything that’s been bothering me and that I suspected that it could be due to low testosterone. He said he was very doubtful of it because of my muscle mass and relatively deep voice, and seemed reluctant to even do the test. I insisted though and he agreed to it. (Is it impossible to build or maintain muscle mass with low T? Would a developed voice suddenly get high if T levels sunk?)

Well, he called me the week after and told me my testosterone was fine. 12 nmol/l (346 ng/dl), which was within the range. It felt reassuring and I assumed it was the same as the mean value of free T for 25 year old men which I’d read was ~12(ng/dl). At the time I didn’t know about the differences between American and European units. He then went on to talk about the calcium which was high, as mentioned above.

A couple of weeks later, in our second phone conversation, he told me my values were within the ranges, so nothing to worry about. I was a bit sceptical about the calcium being just one decimal below the upper limit and that was with no milk, something I normally drink everyday. But he told me not to worry, so I don’t know.

Since I’d made some research of my own since the first test, I also questioned the lab ranges of the testosterone. “So, this 9.9-30, is that for my age group?”, I asked.
“It’s for all men”, he said. I said 12 seemed quite low, considering my age. He gave me some explanation on how it’s based on a normal curve, and some men just naturally have lower testosterone and their bodies are adapted to those levels. Well, I told him I still didn’t feel well. He told me it wasn’t possible to know if this was low for me, unless I’d taken a test before and it showed a higher value. That would indicate that my testosterone had decreased from their normal levels.

I then explained how my test value might even had been unusually high for two reasons. I’d taken zinc and magnesium supplements before the test, something that’s supposed to raise your T. He didn’t know of any such connection. I also told him that at the time of the test, I hadn’t ejaculated in 7 days, something shown by a study to increase T by 45%. He hadn’t heard of such a study and doubted that ejaculations and T levels would correlate. Regardless, he offered me to take another test in late May, so this is where I stand now.

(Fun fact: I called the Swedish medical hotline just to see if I could learn something before my next contact with the doctor. I was told their lower limit for normal T levels was 5.5! For ages <50… I said that sounded outrageously low. She asked me if I had any medical education which I don’t and sounded a bit irritated.)

It seems the doctor now sees my case as closed, even though my symptoms remain. I can still think of more things to test for, like cortisol, vitamin D, FSH and LH, but haven’t asked for that. I was thinking of trying to get a referral to an endocrinologist, but according to this forum they often seem to be less than satisfactory…

Maybe it’s worth mentioning that I’ve got a left sided varicocele. Not sure how it would be graded.

So, what do you guys think?
Personally, I thought it was obvious. Because of my symptoms I wanted to test for low T, and it turned out that I had just that. But based on the doctor’s answers, friends who are in medical school and people on other forums, I’m a borderline hypochondriac and it’s not low T that is my problem, but rather depression or something else. I try to keep an open mind about what ails me and I’m not obsessed about testosterone being the culprit. It just seems likely, all things considered. Regardless, I just want to solve this and get my energy back, whatever it takes.

Thank you for taking the time to read my post.

Serum total testosterone concentration represents the sum of unbound and protein-bound testosterone in circulation. Most of the circulating testosterone is bound to SHBG and to albumin; only 0.5% of circulating testosterone is unbound or free. The term bioavailable testosterone refers to unbound testosterone plus testosterone bound loosely to albumin; this term reflects the hypothesis that in addi-tion to the unbound testosterone, albumin-bound testosterone is readily dissociable and thus bioavail-able.

Free or bioavailable testosterone concentrations should be measured when total testosterone concen-trations are close to the lower limit of the normal range and when altered SHBG levels are suspected e.g., in older men and in men with obesity, diabetes mellitus, chronic illness, or thyroid disease. The T loosely bound to albumin vastly overpowers the influcence of Free T in determining androgen status even though it’s the Free T separated from albumin we are measuring. That’s is why Bioavailable (aka “Free/Weakly Bound”) T is the gold standard for testing. Free T normally correlates with Bioavailable testosterone so they are normally comparable.

I will ask to get my SHBG levels tested then. Would you say this is warranted, considering my total testosterone?
The doctor will probably not be too enthusiastic about it since my TT was within lab ranges, and I’m not elderly, obese etc.
It’s always good to have some leverage.

I am a 25 year old male who usually gives levels of 390 - 450 ng/dL. My symptoms are very similar to yours. You are most certainly experiencing symptoms of low testosterone. Its sucks, I know, you’ll get better.

[quote]futbolplayer wrote:
I am a 25 year old male who usually gives levels of 390 - 450 ng/dL. My symptoms are very similar to yours. You are most certainly experiencing symptoms of low testosterone. Its sucks, I know, you’ll get better.[/quote]

Are you on TRT now?
I recently started taking Vitamin D supplements, figured it can’t hurt. No obvious gains yet though.