Testosterone Bloodwork Question

Diet and Nutrition
1

Hello All,
I’ve been a long-time lurker and have been training for about 2 years(Currently following a TBT plan including multiple different squats and deadlifts). I had some bloodwork done several months ago and my testosterone results seemed rather low (as well as it’s been nearly impossible for me to make gains), so I pushed to see an endocrinologist (I am seeing him monday).

I’ve had some updated bloodwork, but it is very different from what it was previously (free testosterone was almost double what it was in my previous test). I’ve included below my test results and a bit of background on myself. I just want to know if my cause for concern is still valid. I’d greatly appreciate any and all input.

March Tests:
Total Testosterone:
Result: 2.89 ng/mL
Reference Range: 2.5 - 9.5 ng/mL
Testing Method: Chemiluminescent Immunoassay

Free Testosterone:
Result: 7.1 pg/mL
Reference Range: 10 to 30 pg/mL
Testing Method: Radioimmunoassay

June Tests:
FSH:
Result: 1.8 mIU/mL
Reference Range: 1.5 - 10.0 mIU/mL
Testing Method: Chemiluminescent Immunoassay

Free Testosterone:
Result: 14 pg/mL
Reference Range: 10 to 30 pg/mL
Testing Method: Radioimmunoassay

(The June test results were the only ones the endocrinologist told me to get before the visit)

Background:
I am 23 years old, 5 ft 7 in, weight about 226lbs and have am roughly 24% bf .About 4 years ago I was closer to 320lbs (I’ve been very obese for most of my life) and went on a very strict low-carb diet. I lost 125 lbs, however I lost a good amount of muscle mass along with the fat.

After I lost the weight I started working out to try and get in shape. I no longer am on a very strict low-carb diet, but I eat clean (Currently following the guidelines setup by precision nutrition).

I made some gains initially, but I have been stuck where I am now since January. I’ve switched things up, taken a break, etc and still cannot seem to make any progress.

My primary care physician does not believe there is any reason for concern, but I am still unsure…and now with the new measurement of free testosterone being so much higher than it was before it just has me more confused.

Thank you in advance for any input, I really appreciate it.

2

Look at your diet, training rest etc, getting plenty of Rest, fat intake? was the test done in the morning? Had you trained hard the day prior or close to it,Alcohol??

do a search and read Cy Willsons Article "level with Me Doc How Long have I got

Phill

3

[quote]Phill wrote:
Look at your diet, training rest etc, getting plenty of Rest, fat intake? was the test done in the morning? Had you trained hard the day prior or close to it,Alcohol??

do a search and read Cy Willsons Article "level with Me Doc How Long have I got

Phill[/quote]

Phil,
Thanks for the quick reply. In terms of rest, I usually get between 6-8 hours of uninterrupted sleep. I make sure I get a healthy dose of fats and I do take a daily dose of Flameout. I also touch alcohol about once a month, and not in any form of large quantity. I also did not have any prior to the testing.

In both tests I had not trained 2 days prior to my blood being drawn, the difference is that the test in march was done in a non-fasted state early afternoon, and the test done this month was done at 8am in a fasted state. I know that testosterone levels are the highest in the morning and that is the best time to get a baseline. The test in March was immediatly after the visit to my PCP (as directed by him), and the test this month I scheduled for early morning.

In regards to the article posted by Cy, I did take a look at it before I posted here. The one problem I’ve discovered in my own research is that the reference ranges used can vary depending on the testing methodology used. My free testosterone test for example was performed with a radioimmunoassay instead of a chemiluminescent assay; which is what I believe Cy’s article is referencing (at least it matches the other reference ranges I’ve found in my google’ing around). Finding a good reference range for the radioimmunology assay other than the one provided to me from my doc has been difficult…

4

Hmm it be nice to know the total on the june test you really have No clue where you are in fasted state first thing in the morning could be very good or for shit.

As for the ranges I hear you and somewhere there is a conversion I think ive seen sorry dont have it on hand.

Sounds like you have all else in line Id try and get anther total test also just get EVERYTHING tests I mean ALL of it get an idea where everything is. Either through your doc or your own.

Here I use this it hits I mean everything like 50 some tests
https://hradmin.securesites.com/orders/index.cfm?action=product_info&SiteCode=preventive_labs&item=309&def=&category=7&next_action=items_bycat

If you are in fact low then make the doc go further anmd not just say You have a prob and treat the symptoms but find the damn prob if its Primary, secondary or both. You may be able to fix the problem without TRT

Good luck
Phill

5

Hex,

Did you get better? What was the outcome?

6

how do you get testosterone tested ?

i’ve seen a pcp once a year for 3 years now and he won’t test my test. he tells me i’m a long way away from needing that done. i told him i think it would be good information to have to set a baseline reference while i’m young but he says there’s no reason to do it unless i have a problem.

i was also interested in testing for heavy metals for baseline purposes, even offered to pay for the test if that was the issue, and he shut me down on that also.

why do doctors bullshit around and not tell you the real reason, which is likely business motivated, they won’t do stuff for you ? this is a joke. i pay 500 bucks a month for health insurance which gets me a 7 minute visit and basic blood work once a year. wtf ?

can’t you just go to a lab and get these tests done ?

7

Time of days is an issue too. Your levels will be highest in the a.m. and lower in the p.m.

8

[quote]swivel wrote:
how do you get testosterone tested ?

i’ve seen a pcp once a year for 3 years now and he won’t test my test. he tells me i’m a long way away from needing that done. i told him i think it would be good information to have to set a baseline reference while i’m young but he says there’s no reason to do it unless i have a problem.

i was also interested in testing for heavy metals for baseline purposes, even offered to pay for the test if that was the issue, and he shut me down on that also.

why do doctors bullshit around and not tell you the real reason, which is likely business motivated, they won’t do stuff for you ? this is a joke. i pay 500 bucks a month for health insurance which gets me a 7 minute visit and basic blood work once a year. wtf ?

can’t you just go to a lab and get these tests done ? [/quote]

Actually, its cause it’s generally useless information.

Did you also want a full body CT scan while you’re at it.

Sarcasm aside, a doc generally will not prescribe a test that’s not indicated.

A young man or not, with no symptoms of hypogonadism does not need a LH/FSH, Test or Free Test assay.

As for heavy metals, unless you have a history of exposure with symptoms, I would hardly see why one would order them.

There are things we’d like to know but would provide no real information. For example, I would like to know my HDL/LDL levels, but I am 25, with no risk factors, I would not even prescribe me that test if I asked for it.

A test should be ordered if it helps in diagnosis and would change you management of things. If it doesnt do one or the other, its pretty useless to do.

Anyway, its not a business issue, since docs aren’t paid more or less wheter they prescribe tests or not or write scripts or not.

AlexH

9

[quote]Dandalex wrote:

Actually, its cause it’s generally useless information.

Did you also want a full body CT scan while you’re at it.

Sarcasm aside, a doc generally will not prescribe a test that’s not indicated.

A young man or not, with no symptoms of hypogonadism does not need a LH/FSH, Test or Free Test assay.

As for heavy metals, unless you have a history of exposure with symptoms, I would hardly see why one would order them.

There are things we’d like to know but would provide no real information. For example, I would like to know my HDL/LDL levels, but I am 25, with no risk factors, I would not even prescribe me that test if I asked for it.

A test should be ordered if it helps in diagnosis and would change you management of things. If it doesnt do one or the other, its pretty useless to do.

Anyway, its not a business issue, since docs aren’t paid more or less wheter they prescribe tests or not or write scripts or not.

AlexH

[/quote]

that’s exactly it: i would like to know.

do i need another reason ?

you don’t think it would be useful to know your test levels @ different stages of your life ? or even different times of the year ? or your mercury levels ? the thing with the metals is i eat ALOT of canned fish. i told the doc this and i’m wondering if that’s a wise practice to continue.

seems to me if there are tests for these things we should use them. the doctor’s answer is for me to “moderate my diet”. which may or may not be the right idea - how do you know if you’re only guessing ? why not just do the test and know for sure ? isn’t that what a “check-up” is all about ?

10

Got back from the endo appointment today; and while my results were low, they are still within the normal range, and I should not be worried. I am happy I did go just to get a few of the questions I had answered. I just wanted to make sure that something was not wrong, as I was not seeking replacement therapy.

He did mention that it may become more of a ‘quality of life’ issue as I age because I am naturally on the lower end of the range, but we’ll see how things go and I’ll continue to monitor my levels.

The only thing that irked me during the appointment was he said I should focus on losing weight and get down to 150-160lbs to be at my appropriate BMI even though where I am now I have 170lbs~ of lean mass (I did mention both my bf% the amount of lean mass I have currently), but he still said I should shoot for that target weight.

Also, in regards to what Dandalex said earlier. My PCP originally ordered a large barrage of bloodwork to establish a baseline of where I am now. It does act as a good ‘benchmark’, and it caught a few things that I need to work on to make sure I don’t run into greater problems later in life.

I admit, I probably over-reacted with my request to visit the endo after seeing my testosterone levels initially, but I still feel the visit was worth it in the long run. I learned a few things despite disagreeing with him on losing that much weight.

For now I will go over my diet more and look at where to make improvements in my training.

11

[quote]hex1024 wrote:
The only thing that irked me during the appointment was he said I should focus on losing weight and get down to 150-160lbs to be at my appropriate BMI even though where I am now I have 170lbs~ of lean mass (I did mention both my bf% the amount of lean mass I have currently), but he still said I should shoot for that target weight.
[/quote]

absolute bullshit. you should be pissed.

what is important is keeping lean around the midsection (this type of fat is most associated with all causes of morbidity), eat well, that is carbs based on need and tolerance, fat balance, animal protein, loads of fruits and veggies, regular exercise, and stress management.

you are an individual, applying a group value is meaningless as it ignores real and important variables such as bone structure, muscle mass, etc.

i have developed a test to see if a person is too fat (this is what really causes the health problems): grab your stomach and see what the fold is beside your navel, more than an inch, you lose. you can either deal with it or do something about it, but leaving it at making sure your BMI is in the ‘range’ it ‘should’ be is halfassed.

as for your diet and training, you got the idea, keep getting better than you were, because others can’t or won’t!

12

Swiv, why are you paying $500/month? I hope you’re exaggerating that figure.

And why haven’t you found another doc who is more willing to authorize the bloodwork you’re interested in?