T Nation

Thought Test was Low, but TSH was High

Free T3, not T3 because T3 is both the inert and active thyroid hormone and there is no way to tell how much thyroid hormone is getting into your cells which is where the rubber meets the road.

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Here’s the rest of the paperwork if there’s anything important I missed. Thank you all for your help

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Vitamin D deficiency was spotted by allergist 2 weeks ago and is being treated

For reference, these are 2 rounds of bloods done almost a week apart from eachother

I’m surprised to see SHBG at 32, this means your SHBG binds androgen very strongly which is uncommon but not unheard of. If I had a Total T at 492, my Free T would be at the top of the reference ranges and is what I shoot for on TRT because I have low SHBG.

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Hmm so is that number in my case good or bad?

Your SHBG is like the cookie monster, it’s bad for the fact you need TRT, but you will require a very high Total T value (>1000) in order to get Free T high enough to have any kind of benefit.

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‘>1000, not <1000

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Damn, unlikely TRT will be prescribed to me I’m assuming. Hopefully I get to the bottom of the thyroid issue and if solves my symptoms

There is no reason to believe that you need or benefit from TRT. Your T levels are around 500 to 600 ng/dl which is a perfectly healthy range for a men your age. Average T levels of healthy, lean men your age are exactly in this range.

SHBG levels are also perfectly normal. Forget about ‘sticky’ SHBG. FreeT measurements are quite unreliable, so its better to go with calculated freeT levels which are around 12 ng/dl, again perfectly normal (range 5 to 25 ng/dl).

What you most likely have is a thyroid issue. As mentioned by others you want to work with your physician to find the reason for the high TSH levels. They could point towards an autoimmune disorder like Hashimotos disease.
You could benefit from thyroid hormone supplementation.

Recommending TRT is just terrible bro science.

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I don’t think Dr. Abraham Morgentaler is considered bro science which is what I based my recommendation on. His Free T is at the bottom of the reference range on one test and not far behind of the other, how can this be normal for a 34 old male?

So forget about the variability in the stickiness of SHBG, or androgen sensitivity and the numbers tell the whole story?

Again you fail to set any specific freeT levels into the context of the reference range.

  1. I have never seen any specific recommendation regarding a target for a freeT from him in any scientific publications.

  2. if there was such a target of 15 ng/dL than it’s in the context of a different ref range. The ref range for calc freeT according to Vermeulen is 5 to 25 ng/dL and numerous studies demonstrated that a calc freeT of 12 is just normal average for young lean and healthy men.

Example of elite athletes

  1. if at a calc freeT of 12 ng/dl TRT is recommended than 50% of young healthy men would be on TRT, which is ridiculous
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You’re making the assumption average normal is normal for him because it’s normal for other men. The Free T ranges go far too low and men get denied TRT because of a few outliers who have no symptoms with low Free T levels which trap everyone in what’s normal.

Dr. Abraham Morgantaller has stated men <15 pg/mL (reference ranges 10.8-26.5) will show benefits on TRT. The problem is sick care and how it operates, normal is thrown in our faces everyday and treatment is denied, then we go private and go on TRT and symptoms vanish in a relatively short peroid of time.

I have seen this scenario repeat for years and tells me we got the it all wrong. You are ultraconservative and there will be those who slip through the cracks, of this I am certain.

I’ll go with a doc that is leading the field of TRT and prostate cancer research over some random guy on the internet who thinks he’s got it all figure out.

My mistake, I referenced what he said in his book “Testosterone for Life” without detailed info you are posting. He had referenced the Labcorp ranges 10.8-26.5 when mentioning the 15 pg/mL, so maybe this is newer information for which I will go back to verify.

All this information I/we have provided still doesn’t tell us what normal is for @longisland34. If he starts thyroid treatment and feels some improvement but is still symptomatic after optimizing his thyroid, then we will know if his T is low because we will likely see increases in SHBG and this will undoubtedly affect his Free T negatively.

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The problem in the study done by Morgentaler is that they used a T analogue assay to measure freeT. This assay is know for its low precision and its inability to take SHBG levels into account. Basically this assay just measures a fraction of total T regardless whether SHBG is low or high. This is also evident by its poor correlation with the equilibrium method.