T Nation

Symptoms of Low T. Bloodwork Help?

T Replacement
#1

The doctor I am going to ordered up some labwork recently. He says my ranges from the previous labwork were fine, but I thought they were low (it only showed total testosterone at 334).

So here’s the new lab results. I’d really appreciate any advice.

TSH 1.66 Reference Range: 0.40-4.50 mIU/L

GLUCOSE 84 Reference Range: 65-99 mg/dL
Fasting reference interval
UREA NITROGEN (BUN) 15 Reference Range: 7-25 mg/dL
CREATININE 1.16 Reference Range: 0.60-1.35 mg/dL
eGFR NON-AFR. AMERICAN 84 Reference Range: > OR = 60 mL/min/1.73m2
eGFR AFRICAN AMERICAN 97 Reference Range: > OR = 60 mL/min/1.73m2
BUN/CREATININE RATIO NOT APPLICABLE Reference Range: 6-22 (calc)
SODIUM 139 Reference Range: 135-146 mmol/L
POTASSIUM 4.6 Reference Range: 3.5-5.3 mmol/L
CHLORIDE 104 Reference Range: 98-110 mmol/L
CARBON DIOXIDE 28 Reference Range: 20-31 mmol/L
CALCIUM 9.3 Reference Range: 8.6-10.3 mg/dL
PROTEIN, TOTAL 7.2 Reference Range: 6.1-8.1 g/dL
ALBUMIN 4.6 Reference Range: 3.6-5.1 g/dL
GLOBULIN 2.6 Reference Range: 1.9-3.7 g/dL (calc)
ALBUMIN/GLOBULIN RATIO 1.8 Reference Range: 1.0-2.5 (calc)
BILIRUBIN, TOTAL 1.4 H Reference Range: 0.2-1.2 mg/dL
ALKALINE PHOSPHATASE 72 Reference Range: 40-115 U/L
AST 20 Reference Range: 10-40 U/L
ALT 23 Reference Range: 9-46 U/L
TESTOSTERONE,FR(DIALYSIS) AND TOTAL(LC/MS/MS)
Analyte Value
TESTOSTERONE, TOTAL, LC/MS/MS 372 Reference Range: 250-1100 ng/dL
FREE TESTOSTERONE 64.4 Reference Range: 35.0-155.0 pg/mL

WHITE BLOOD CELL COUNT 5.7 Reference Range: 3.8-10.8 Thousand/uL
RED BLOOD CELL COUNT 4.80 Reference Range: 4.20-5.80 Million/uL
HEMOGLOBIN 15.4 Reference Range: 13.2-17.1 g/dL
HEMATOCRIT 44.5 Reference Range: 38.5-50.0 %
MCV 92.7 Reference Range: 80.0-100.0 fL
MCH 32.1 Reference Range: 27.0-33.0 pg
MCHC 34.6 Reference Range: 32.0-36.0 g/dL
RDW 12.0 Reference Range: 11.0-15.0 %
PLATELET COUNT 247 Reference Range: 140-400 Thousand/uL
MPV 9.9 Reference Range: 7.5-12.5 fL
ABSOLUTE NEUTROPHILS 3443 Reference Range: 1500-7800 cells/uL
ABSOLUTE LYMPHOCYTES 1739 Reference Range: 850-3900 cells/uL
ABSOLUTE MONOCYTES 439 Reference Range: 200-950 cells/uL
ABSOLUTE EOSINOPHILS 29 Reference Range: 15-500 cells/uL
ABSOLUTE BASOPHILS 51 Reference Range: 0-200 cells/uL
ABSOLUTE NUCLEATED RBC 0 Reference Range: 0 cells/uL
NEUTROPHILS 60.4 %
LYMPHOCYTES 30.5 %
MONOCYTES 7.7 %
EOSINOPHILS 0.5 %
BASOPHILS 0.9 %
FSH
Analyte Value
FSH 3.4 Reference Range: 1.6-8.0 mIU/mL
LH
Analyte Value
LH 4.4 Reference Range: 1.5-9.3 mIU/mL

#2

All I see is numbers. I dont see any symptoms, how old are you, weight? Overweight? Diet? Workout? You dont want people just judging by a number.

Sorry, I wasn’t trying to be an asshole. Your title mentioned symptoms. How do you feel? Are you experiencing Low T symptoms? Sex Drive? Morning Wood? Motivation? Desire? Brain Fog?

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#3

If doctor is hyper focused on lab numbers are you are symptomatic, find another doctor. Doctors may not think so, but it’s not ok for a younger man to have the testosterone levels are a 80 year old man.

These ranges do not account for age.

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#4

Well going by just labs on paper and symptoms, not knowing your age or history, all looks pretty well except for your testosterone levels. I can give my personal symptoms based on my Total T/ Free T and I’ve definitely felt like trash at that point. Messed up mood, depression, no sexual interest etc. The real question is why is it low? More details may help us help you with that part.

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#5

I’m 6’4" and 270 pounds. I have started Intermittent fasting the past few months and reducing my carbs to an almost keto diet, but I haven’t been as strict as I’d like. I don’t work out anymore. I have almost no energy to do much of anything after or even during work. I have almost no libido and it’s affecting my marriage.

Ive been this way all my life pretty much. I blew up in weight around 3rd grade and developed gynecomastia. In my adulthood, when I had the overwhelming desire to workout and tried to commit, I would be crippled for 1-2 weeks after working out whatever muscle group I targeted. This made building muscle impossible.

I starved myself down to around 210 pounds from 280 pounds and didn’t like the way my body looked in pictures/videos. So, I then took prohormones and worked out 3 hours a night with no muscle soreness and quickly recovered. I felt the best of my entire life. I cycled off with a PCT and then met my wife. I stopped working out completely during the dating process. Now I’m back to where I was-- no energy and my muscles won’t recover at all after working out. It makes me want to get back on the prohormones, but I want to be treated properly and not just treat symptoms.

That’s why I’m going to the doctor. I feel like I have all the symptoms of low T and a history of a hormonal imbalance. If TRT is what I need, then I’ll put aside my fear of needles for the possible hope it gives me. If it’s something else, then fantastic and I want to treat that instead.

#7

By the way, I’m 31 now

#8

You definitely need to do something and you may need a hormone/TRT specialist to help you. You need more lab tests, SHBG and E2 plus complete thyroid labs, free T3, free T4, reverse T3, maybe antibodies. DHEA-S and IGF-1 would be good to know.

Your symptoms have to over ride the numbers on the lab report.

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#9

I see your free testosterone #, but I don’t see SHBG. Need to test for that.

#10

Is there a name of a blood panel that would encompass everything I need to get checked, or am I going to have to give a list to my Dr?

#11

Is there a difference between SHBG and globulin?

#12

I’m not an expert (been on TRT about 4 months), but on my tests the range for SHBG is 13-90…don’t think globulin is the same.

Also, your free testosterone is really high in comparison to you total testosterone which is on the lower end…that seems odd to me.

#13

I thought the same thing about my free t, but apparently it’s in a different form of measurement. I think converted to the one all TRT sites use, it moves the decimal to the left one spot. So it is more like 6.4.

64.4 pg/ml converted is 6.44 ng/dl

#14

I think free T is supposed to be 2-3% of Total T. If that’s true, then I’m below 2% if I’m correct in needing to use to same form of measurement for both numbers. If it’s 64.4, then I’m way high on free T

#15

That sounds about right…I was in the same range as you (mid 350’s total T, 8.5 free T). The reference range for free T is 15-30 on my test. You probably have elevated SHBG, but it is my understanding SHBG is not tested for on most regular blood panels…is this a TRT doctor or just general practice?

#16

Right, if you divide 6.44 by your total test, 372 ng/dL, you get 1.73%. It is thought that a free testosterone % of 2-3% is ideal. Your SHBG is probably not real high or real low. SHBG binds around 60% of your testosterone. Other proteins, with weaker binding capacity, do the rest except for the relatively small amount that is free.

#17

It’s a GP. But I know a Dr that seems to be on board with TRT that I’d have to switch completely over to. I’ve decided to give my current Dr a chance to treat me. But if I’m told I need antidepressants, add meds, and a list of other meds, then I’m going to move over (it’s a doctor in the same medical group).

I’m on ADD meds, but I’m hoping the symptoms I have are because of Low T, and TRT will get me off of Vyvanse.

#18

Why don’t you just find a doctor that specializes in HRT? GP’s aren’t going to be property trained in addressing your issues.

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#19

I’ll try finding one. Guess I have to finding a compounding pharmacy and get a referral.

#20

These percentages can be misleading, I didn’t feel well at 2.87 percent, but 3.21 percent boy what a difference. If you’re a guy who naturally operates in the high normal for Free T, midrange isn’t going to provide good results.

Some men are naturally higher than the top of the ranges, quite a bit over the ranges.

GP’s should send you to a doctor trained in male hormone replacement, GP’s usually cave at the first sign of serious symptoms such as high hematocrit and or very high estrogen and force you off TRT until seeing a specialists.

I get all my meds from Empower Pharmacy.

#21

That is interesting. My free T has varied from 2.2% (202 pg/mL) to 3.2% (353 pg/mL). I do not notice any difference.