T Nation

Thoughts on Current Lab Numbers?

Got my labs back currently 38 years old. Seem to be Having a hard time cutting weight no matter what, zero sex drive, low motivation.

Total test 613
Free 16.4
Dihydrotest 45
T4. 1.43
Dhea 299
Tsh. 2.91
LH. 8.2
Prolactin 6.5
Igf 171
T3 18.5
Estradiol 30.7
Shbg 64

My question is trt worth it??? I know 800-1000 total test seems optimal and I am somehow suffering symptoms of Low T

Your Free T percentage when Total T and SHBG are taken into account is a pathetic 1.38 % of which 2-3 percent is considered normal. So in your case TRT is worth it, the problem you face is the ignorant sick care doctors, even the so called hormone specialists fail at TRT.

Your elevated SHBG is binding up most of your testosterone, Total T isn’t bioavailable, Free T is the free portion of testosterone circulating in the blood and is low. A sick care doctor won’t be able to do much for you and since you’ll need very high levels, that kind of screws you and only a private doctor can help.

Insurance based doctors cannot allow Total T levels >800 and is what you require. Your best bet is to seek a private doctor that specilizes in TRT and not some ordinary doctor who will more than likely be clueless. If you’re going to run thyroid labs, you best test the free master thyroid hormone Free T3 which increases metabolism and body temperatures.

Thyroid isn’t optimal, TSH is too high, 95% of normal individuals have a TSH <2.5 closer to 1.0.

The evidence for a narrower thyrotropin reference range

It has become clear that previously accepted reference ranges are no longer valid as a result of both the development of more highly sensitive TSH assays and the appreciation that reference populations previously considered normal were contaminated with individuals with various degrees of thyroid dysfunction that served to increase mean TSH levels for the group. Recent laboratory guidelines from the National Academy of Clinical Biochemistry indicate that more than 95% of normal individuals have TSH levels below 2.5 mU/liter.

Reference ranges for TSH and thyroid hormones

First of all the distribution of TSH reference range is not normal, with median values (also depending on population iodine intake) usually between 1-1.5 mU/L. On the other hand, upper TSH reference limit is (assay-dependent) usually around 4.2-4.5 mU/L. There is also an argument that significant number of patients (up to 30%) with TSH above 3.0 mU/L have an occult autoimmune thyroid disease.

Thank you! I am working with a trt doctor and they said they want to put me on trt but I was concerned since my Test didn’t appear low… when I was younger in my 20’s I could put 20lbs of muscle on and cut to 8 percent depending on my goals. These last few years I am still muscular but certainly not as lean as I would like and cannot seem to cut weight… no matter my calorie restriction

You don’t need TRT.

It’s for life. And with a TT of over 600 id find out how to increase my FT a bit.

Don’t need it.


How do you figure this percentage? I thought I knew where it was coming from, but what I thought doesn’t equal what you came up with so not sure how it is figured.

Now I am confused… Do I need TRT ? I have my consult tomorrow. I was told i was eligible because of my high SHBG. Is there anything specific i should ask the Doctor when i talk with him tomorrow.

Free T & Bioavailable Testosterone calculator

You need TRT is you want to live a normal long life, men with lower than normal testosterone live poor quality, shorter lives and are the ones with more cardiac events. Young men with high testosterone are not usually having cardiac events like those older men with lower testosterone.

Ask your doctors what ranges he targets, if he says he like his male patients <800 ng/dL, leave at once. Your estrogen is already at the top of the ranges, you may or may not need an estrogen blocker. If your doctor refuses to prescribe a low dosage anastrozole, this may limit his ability to treat you.

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My total T was 576 before I got on TRT and it’s made a major difference in just about every aspect of my life.

Thanks everyone… I am grateful I researched my symptoms and took these steps towards trt. I used to be insanely motivated… meal prepping, up at 330 to workout, go to work… kill myself at work… play or practice whatever sport was in season. I was always excited with life. As of late everything sort of stalled. I’m complacent and tired most of the day. I am hoping to get my old edge back

I’m at a whopping 0.6%, geez.

I’m not sure i understand that calc correctly as it is giving a free t number theoretically, based on his shgb. He has a measured free t number that looks better than the one given on the calculator. What am I missing?

The free T calculator is more accurate than directly measure Free T, LH is released in pulses throughout the day and fluctuates wildly giving you an incomplete picture.

I get that free t varies throughout the day and that the test is just a snapshot but that is pretty much the case with all hormones. From what has been stated on here by physio the same can be said for SHBG.

I am confused on how it can be more accurate than an actual test though. It is taking SHBG, which could vary also, and estimating on how much free t based on how sticky they think the SHGB is. When that seems to vary from person to person. To me it seems to be a tool to estimate your free T and bioavailable T if they were not measured, using those other three measurements. That’s how I understand this line also “These calculated parameters more accurately reflect the level of bioactive testosterone than does the sole measurement of total serum testosterone” from the top of the page. Not necessarily it is more accurate in determining free T over a test.

In saying that you believe it is more accurate, do you believe that the free T measurement is not needed?

It is unlikely to be more accurate for someone on TRT, Your LH is on a steady low ebb resembling zero while on exogynous T, so not much variation to be concerned with. SHBG however will still be swinging all over the place. It is a weird substance, it has two distinct half-lives, very short after initial production but 6 or 7 days after it that for whatever survives the trip out of the liver.

Had my consult with the Doctor. He has prescribed me 160 mg a week broken into two shots. With 500 IU of HCG twice a week. He said to hold off on the AI considering my SHBG is pretty high. I told him if at all possible i would like to avoid using an AI all together but he still prescribed it to have on hand. He said my LH of 8.2 indicated i was likely suffering from primary hypogonadism.

One question for you guys my total t is 613 with a high SHBG… is this considered primary hypo ? It seems my testes are producing T but its getting binded up ? He is aiming for a free T of mid 20’s and with my SHBG wants my total in the 1200-1300 range.

I’m glad to see he is aiming for the optimal Free T ranges (20-26 pg/mL) seen in our 20’s which is where all men should be.

My batch of test, hcg and anti estrogen are on the way. My question for you experts is with a 613 total test 16, estradiol of 30 and shbg of 66 can I get away with a slightly smaller injection of test a week. They want two 80mg injections a week and I want to avoid an AI… should I start with two 70mg a week injections and see how that goes ?

16 was my free test sorry

If you’re going to do TRT, the bigger shot is better for your SHBG. Personally, I think you should be looking for something to lower SHBG and leave the test alone.