Test Results Before TRT Review

Got my 3rd test results back (they need 3 over 4 weeks to ensure it’s not random?). For people who’ve been around the block on this…how bad are my results & is it likely TRT would be an option?


Name Tested Range Measurement
Albumin 40.2 35-50 g/L
Ferratin 241 30-400 umol/L
Transferrin Saturation 12.3 20-50 %
HDL 1.44 >1.1 mmol/L
LDL 2.05 <3.0 mmol/L
Serum Folate >90.8 8.83-60.8 nmol/L
Cortisol 462 166-507 nmol/L
DHEA Sulphate 11.5 2.41-11.6 umol/L
TSH 1.65 0.27 - 4.20 mU/L
Free T3 4.76 3.1 - 6.8 pmol/L
Free T4 21.3 12.0 - 22.0 pmol/L
FSH 2.3 1.5 - 12.4 IU/L
LH 1.8 1.7 - 8.6 IU/L
Oestradiol 70 41 - 159 pmol/L
Progesterone 0.6 <0.474 nmol/L
SHBG 25 18.3 - 54.1 pmol/L
Testosterone 5.47 8.64 - 29 nmol/L
Free Test (calculated) 0.122 0.2 - 0.62 nmol/L

Total T and Free T Bad.

Your results are very bad. TRT won’t work well at all when you’re iron deficient, as indicated by your transferrin stauration. TRT has the potential to make your iron deficiency worse.

What other medical diagnosed problems do you have?

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Ye the saturation has flagged on every test. My Iron levels themselves seem fine…so is it just a case of consuming more iron?

Iron: 7.4 || 5.8-34.5 || umol/L

Re health: I have social related autism constraints, which has long been managed via therapy; and ADHD which is managed via Elvanse (50mg/day).

Iron isn’t an accurate test, it can change after eating and you can still be iron deficient in the same way someone can have a testosterone deficiency with low normal testosterone.

People mistakenly believe that serum iron is free iron floating around in the body interacting with all your tissue, it’s not.

Check ferritin.

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Ferratin: 241.0 || 30 - 400 || ug/L

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TT and fT (calculated) are bad.
Would be worth getting your fT tested via equilibrium dialysis if you wanted to be sure, as calculated is not that great of a metric. Still, eyeball test says it will be bad after testing.

I’d be looking into your thyroid. Not my area of expertise, but those FT4 is looking spotty.

Progesterone is high. Not sure what causes this or can be done about it - worth bringing up to provider.

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Certain genetic or gastrointestinal disorders (GI bleeding)) can cause low iron saturation, normal iron and ferritin.

Your thinking is that I’m bordering hyper for FT?

Any idea why it’s just the T’s that are stupid low? DHEA shows my body has the hormone to make the T…but doesn’t seem to do anything.

The majority of men with secondary hypogonadism, the cause is obesity, metabolic syndrome and Type 2 diabetes and or lifestyle ie processed foods and lack of exercise. A lot of cases are idiopathic as in no known cause.

Usually the pituitary gland check out normal, so this leads me to believe something upstream of the pituitary gland is at fault.

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Ah…my ADHD medication is a dopamine agonist.

“Iron deficiency is a known risk factor for augmentation during treatment with dopamine agonists”

Well…I was obese 9 months ago (314lbs) after other health issues; but have reduced my weight down to 209lbs over the course of that timeline. Could it be that my body is somehow unaware that I’m not obese anymore?

This is why your testosterone is low.


Are you saying that it’s forever stuck in the very bottom of the range, no matter the timeline?

I’d say “no”, but you are also still in a deficit - no? deficits tend to harm hormone production, which is couterproductive to leaning out. It’s why the universal advice to lose weight is to “never get fat in the first place” (not judging, I was a fatty too).

I would imagine they will rebound to a degree - but your levels are VERY low. I do not know if they will recover to even within range to be totally honest. The only real way to tell would be to prioritize sleep, nutrition, stress reduction, etc. and retest after a few months of that.

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Well…fuck. I didn’t even enjoy getting fat…was in and out of hospital beds! Guess that answers whether or not TRT is the right next step.

Thank you both.

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Another thing, your cortisol is already at the top end, working out increases cortisol, the stress hormone. Cortisol is a testosterone killer, it can destroy the leydig cells in the testicles.

When I was diagnosed with low-T, very low like yours (91 ng/dL 264-916), my cortisol levels were high normal, Type 2 diabetes/obesity → increased cortisol suppressing my testosterone.

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Small mercy I dodged the diabetes train that I was rocketing towards.

Really annoyed now I didn’t get this checked earlier…been doing weight loss on bloody hard mode all this time.

Bad enough. TRT is almost always a choice, but you do not have much of an option.

As low as your total testosterone is, it doesn’t matter how free testosterone is measured. It’s going to be low.

I’d get my testosterone elevated before worrying about anything else.



TRT is approved…started Test E: 60mg * 2 a week, they originally said 120mg once a week but based on what I’ve read here…splitting up may help. So…going to try it this way for now.

Started last Thursday, looking forward to it “kicking in”. My balls got the message they’re being retired, they ache like fuck currently; but small price to pay!

Thank you @TC_Luoma for the Testosterone article that prompted my original test and the advice you guys have given here. For this one random person, it’s been much appreciated!!

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