T Nation

Very Low Free T (Otherwise Normal Labs) + Small Testes + Symptoms


#1

-Age 30
-Height 6’2"
-Waist 32"
-Weight 80kg
-Body is lean, never been “big”

  • Carry fat (not much) on belly/waist
    -TMJ (pain and discomfort… can affect CNS) and mild asthma
  • No hair loss drugs (but was once considering…?)
  • Labs:

Oestradiol 72
Range 28.0-156.0 pmol/L

Testosterone 13.4
Range 8.0 - 29.0 nmol/L

SHBG (Sex Hormone Binding) 31
Range Male 14.5-48.4

Free-Testosterone(Calculated) L 0.228
Range 0.3 - 1.0 nmol/L

This previous set I used an online (reputable) service (finger prick sample blood test).
I also received two further indicators from my GP:

Serum Testosterone 19.4 nmol/L
Range 9.9 - 27.8

Serum TSH 3.28 mIU/L
Range 0.35 - 4.5

-Diet: Eggs, lean meats, at least a portion of veg a day, and grains such as rice and bread. Probably eat too much microwave rice and drink from too many plastic bottles (BPAs?). Lots of coffee.

-Training: Usually two/three times a week but I’ve been of for a couple months because of postgrad studies.

-Occasional testes ache. Small testes and often v tight sack (prepubescent look). Also (sorry for graphic nature) the tubes going into the balls are sometimes painful and feel swollen. I suspect this is all related to my low Free T?

  • Rarely get morning wood

Bio:

I’ve been ignoring this problem for a long while and have only just started seeking help. I’ll break down the symptoms:

Energy
I have long struggled with primarily brain fog but also general tiredness (lots of yawning). In the past year I have resorted to using modafinil to keep me awake (which has its own drawbacks), but my symptoms existed way before this.

Mood/Drive
Along with brain fog and erection trouble, this is my biggest symptom. Whilst (I think?) it’d be difficult to attribute this purely to hormones, my mood has been relatively downcast in recent years. Likewise my drive, which I think goes hand-in-hand with the brain fog problem.

Libido
I don’t think this is a problem. I get horny quite frequently, and the reason I’m on a dry spell (I’m single) is because I’m dealing with my other health problems (and v busy with studies).

Sex
I’ve been using cialis or viagra for almost every sexual encounter for perhaps 4 years now. Since I have no problem getting a (not very strong) erection on my own, I suspect this is more a psychological crutch and performance anxiety. Last time I didn’t use a chemical aid, my erection would fade quickly and it’d be a battle to relax enough to sustain.

Question:
Two GPs I’ve been to now have had ZERO idea of what Free T is. One GP contacted a specialist (Urologist?) about it, and supposedly the specialist was borderline angry and adamant that my labs were fine and Free T didn’t matter (GP even dropped in something about the test for Free T being expensive hence why they wouldn’t test it, I had to go private).
He also had no comment on the size of my testes, which I think are definitely on the smaller side.

**So, is my out-of-range low Free T significant enough to be causing my symptoms alone? Or is it small testes, or both? **
I’ve tried supplements such as zinc and liquid Ionic Boron to no effect, and am healthier/more active than the average man my age.


#2

How did you calculate your free test? With a SHBG of 31 and your current test levels, you are probably double that.


#3

The Free T value was calculated by the laboratory I used. A similar value is offered when I input my T and SHBG levels here: https://www.nebido.com/tools/index.php/en/default/index/free-calculator

(bearing in mind I used the default 4.3 value for Albumin. I have not had my own Albumin measured…)


#4

10-4. I just wouldn’t expect low free T with your total T being between 13.4-19.4 and a SHBG of 31. It would be on the low average side but prob not below target range.


#5

Please read the stickies found here: About the T Replacement Category

  • advice for new guys
  • things that damage your hormones
  • protocol for injections
  • finding a TRT doc
  • thyroid basics - check oral body temperatures

TSH should be closer to 1.0
Your body temps should be low.
Problem could easily be from not using iodized salt and you can fix or supplement.
Low thyroid function can affect other hormones and take away energy and alertness.
Can be worse with stress induced adrenal fatigue and too much caffeine and adrenaline.

Now you need proper lab work. You can order your own labs in most USA stated and we can do diagnostics here.

TT
FT
E2
LH/FSH
prolactin - after 3-4 days of no sex and do not hug babies or puppies
CBC
AST/ALT after not training for a while and no sore mucles
fasting cholesterol
fasting glucose
Vit-D25
TSH
fT3
fT4 [ not T3, T4]
AM cortisol at 8AM

Your problems will be with the doctors. Get knowledge here.