T Nation

Surprising Low T Test Results. Next Step?


#1

I decided to get a total and free testosterone test done and ended up with unexpected low results. Total T was 231 and free was 39.

I am 47 years old, low daily stress. Married. Sexually active and interested. Been getting stronger in the gym near my peak levels approaching 1300 powerlifting total. Get strong from just a few work sets with low reps, 3-6 sets of 2-3 exercises a day sets of 1-6 with 1-4 reps in the tank on all sets. Big exercises only.

I am 5-9 210 which is pretty much where I have been for the last 20 years. Never got lean but I look like I lift.

Never had T test before. If anything I would have assumed that I had normal to higher T since I am still regularly sexually active and interested, married for 20 years, also never had a problem gaining muscle or strength, but tended to have some fat on hips and chest which I would have guessed was slightly elevated estrogen (not consistent with low T as I understand).

I eat a saturated/monounsatured fat based diet with plenty of protein and I eat starches but virtually no sugar.

I quite using tobacco 5 years ago, and quit drinking alcohol in my 20s. I tend to overcaffeinate and will wake up at night a couple of times, but I get plenty of sleep in terms of hours. Maybe I have poor sleep quality. My son has type I diabetes and so I tend to be a little alert at night and may check his glucose monitor.

Also, have not been able to lose abdominal fat with calorie restriction like I used to. Even a few years ago, I could bring down my waist size fast in 6-8 weeks of cutting calories.

A1C is 4.9. (I do have relatives with type II diabetes). Also, could have sleep apnea. Dad and both brothers had it. I was negative 8 years ago.

Anyway, its one test, so I am wondering if I should wait and retest in a certain time frame? Should I try anything nutritionally or in terms of exercise?


#2

I think you need to spend some time in the TRT Forum. Lots of good info there and guys in the same boat.


#3

I’d look at time of day that the test was taken before going too far. Also bear in mind that test levels are just a single piece of a much bigger puzzle. If all other health markers are in a good range, enjoyment of life is reasonable, and recovery is good then the only difference between this week and last week is that now you know that number.


#4

It seems you may be more sensitive to androgens than almost everyone here, most at that levels would feel as though we are dying. Most of us go by labcorps ranges as they are the 800 pound gorilla when it comes to labs testing and we normally go by their Free T ranges (6.8-21.5), so a Free T of 39 doesn’t compute.

A 231 Total T may be near optimal for you in the absence of symptoms. SHBG plays a big part in Free T levels and if low would explain why you have no symptoms, low SHBG men have a lot of free testosterone, free estrogen and lower Total T.

When my Total T is 500 I have Free T at the top of the ranges, a guy with high SHBG would need very high Total T to equal the same Free T since Total T binds SHBG (Total T+SHBG) and becomes bio-unavailable.

Free T is bioavailable.

If you did labs after 10am, your results are misleading.


#5

Thanks. My free T of 39 shows near the bottom of the reference range, but in range. what units do you get your 6.8-21.5 range from?

Anyway, I did a walk in test at 2:00 pm. Should I retest it in the morning? Fasted? After working out or before? (does it matter)?


#6

I don’t fast for hormone tests (certainly not required like a lipid panel) and I usually just go first thing in the morning after having eaten.


#7

I’ve never fasted for any of my bloodwork. I have tested testosterone at 2pm and 7am and there was little difference between the two. At 2pm I had tt 293 and at 7am I had tt 300. At tt 293 i had better ft that was mid range. I was still symptomatic at that point. One thing i will say, and I’m not saying this is necessarily what you would experience, is that i fought trt for a while and when I finally started I didnt realize how much my condition had been affecting me. I thought it was just age catching up with me and never associated it with low t or low e. My joint pain. My sexual issues. Lack of morning wood for years and years. All of it was positively affected by trt.


#8

Labcorps Free T range is in pg/mL, but I’ve seen pg/mL before on other lab companies and the ranges are all different. You can’t compare one lab companies results with another, there’s no standard of testing and one lab company to the next could show 100-200 difference in levels from the same sample of blood.

This is why insurance company require two morning blood tests to confirm low T.

Your tests are no good, testosterone levels peak in the earlier morning, by midday that are halved and by night time they are low.

You need earlier morning testing and no doctor or insurance company would use those labs for determining low T status.

You don’t have to fast for hormones testing.


#9

Do you have any links or anything to back up the claim that testosterone levels “halve” by the afternoon? I have done bloodwork and have never seen my levels “halve”. Should that lead me to believe that naturally produced testosterone has a half life of 24 hours?


#10

I have found sources that show up to a 50% drop between morning and low levels for the day. https://www.google.com/url?sa=i&source=images&cd=&ved=2ahUKEwiB2e2ZpvXeAhXq5IMKHcZFAJ0QjRx6BAgBEAU&url=%2Furl%3Fsa%3Di%26source%3Dimages%26cd%3D%26ved%3D2ahUKEwiB2e2ZpvXeAhXq5IMKHcZFAJ0QjRx6BAgBEAU%26url%3Dhttps%3A%2F%2Fwww.quora.com%2FWhy-is-the-testosterone-level-high-early-in-the-morning%26psig%3DAOvVaw2shjYTx_bdn8rHOIALnIIy%26ust%3D1543432741523435&psig=AOvVaw2shjYTx_bdn8rHOIALnIIy&ust=1543432741523435

but the curve tends to smooth out for older individuals. I suspect though that since I have moved to morning training consistently over the last few years that my levels might be higher in the morning even though I’m 47.


#11

I’ve been doing some research and just read in the journal of urology that men over 40 do not have the same variations in testosterone levels as younger men and any readings done from 2pm or earlier can be considered accurate. I saw the chart you linked to and it doesn’t seem very accurate. I saw it on another page as well and it said they believe it may be salivary testosterone testing. Either or it doesn’t matter. I’ve never seen that much variation from morning to afternoon.


#12

Which is why when you test at 0900 in the AM and your TT is low, it goes EVEN LOWER throughout the day.

I tried to explain this to my endo. I would always get way worse brain fog at the end of the day.

If you are low during the AM, you are damn low during the PM.


#13

In case you want to stay tuned, I retested in the morning at 8:00.

I also have been reading some research that strongly suggests that an intense training session followed by a very high protein meal actually lowers testosterone significantly the rest of the day. It was used at one point at least as a strategy to beat drug tests in sports, so while generally t-levels might not drop that much in over 40 individuals, I want to see if my morning training and heavy protein frontloading for the day might have had an impact. I also was in a 7 week stretch without any deload and the last 2 weeks were high intensity weeks.

By the way, I also have recently seen research evidence that testosterone levels DROP when protein gets up over about 1 gram per pound of bodyweight. Wonder if the might have been part of Bill Pearl’s secret. Anyone else seen the conjecture that a high protein meal, or daily intake might lower test?
@alphagunner @systemlord @studhammer @SkyzykS


#14

Don’t most of us work out almost everyday? This would put you at low t all the time. Maybe it was just after a really “intense” workout.

Never heard of protein lowering testosterone though. Did it say by what mechanism?


#15

I remember reading something along these lines too, but it has been years. The gist of it was basically “and that’s how powerlifters end up with test levels of a 12 year old girl…” but it has been so long that it’s really just a fragment.

Might have been something about test being inaccurately measured due to the amount occupied by androgen receptors or some other such bro science.


#16

One suggested that basically test gets bound to androgen receptors so detectable levels are lower. Possibly too the high protein just boosts IGF-1 which makes the body need less testosterone since they do a lot of the same things.

I was also thinking that high protein diets turn up gluconeogenesis somewhat, since there are excess amino acids available and this might slightly turn up cortisol so the body can use the protein for energy. At really high levels, maybe we are seeing small amounts of ammonia buildup which may lower test. Honestly, I don’t think it is a major effect. I suspect that the high IGF-1 drive from the protein just raises IGF-1 which does a lot of the same things that test would.

Another thing I have been seeing, and I will have to wade through the potential propaganda factor in the research, is that while a LOW fat diet can cause test to crash, high fat diets seem to consistently produce lower T in studies than high carb diets at the same calorie level.


#17

So you are speaking on total testosterone then. I know that higher protein can increase albumin and lower free test a little.

My IGF on TRT has been upper limit normal. Hey did you ever get a second to check the lipids on my Log? @mertdawg I tagged you.


#18

I’ll check it out tomorrow


#19

My retest turned up higher. I tested at 8:00 am.

The reference ranges listed are 250-1100 total and 35-150 free

In my first test, I got 231 and 39
On the morning retest I got 340 and 62

HOWEVER, I am not sure that the time of day was a big deal. By the time I retested I had cut back on my training for the first time in about 20 weeks. Also, I have discovered that my caffeine intake has crept up to probably dangerous levels. I think I had gotten up to 10-14 cups of coffee a day (adjusted for strength since I make it pretty strong). I have had a tendency to gradually drift into stimulant overuse which eventually led me to give up nicotine and ephedra.

I gave up caffeine three days ago, and am sleeping at night it seems like for the first time in 6 months which incidentally was during a vacation when I didn’t have full access for coffee AM and PM.

I am pretty confident that I was running on cortisol which explains why I couldn’t lose abdominal fat like I have been able to in the past. Anyway, I am sure that my T is even higher now but I will probably do another retest in early January as 340/62 is still not optimal. I’m surprised that I built back up to a 350 bench press with low T and running on cortisol and adrenaline for the last 6 months.

To be honest, I really decided to check my T because I was drinking a lot of coffee and felt like my sleep quality was poor, but I was still getting stronger, which is why I didn’t expect a low level.


#20

I’m not sure if you can just give up caffeine after drinking 10-14 cusp a day!! You may wanna cut slowly so that you don’t get nasty headaches, just a thought.