T Nation

What Do My Numbers Say?


#1

Hi Guys,
I’m new to the forum. I turned 40 in April, but have been struggling with lower energy, irritability and lower libido for a while. It looks like my total test is ok, but I’m confused by what the other numbers mean. I’m a lifelong competitive martial artist, and I want to thrive, not just exist, which my doc seems to have trouble grasping.
Numbers for reference:
Cortisol morning 15.1 ug/dL Range-8.0 - 25.0 ug/dL

Testosterone, TOTAL 686 ng/dL Range->=240 ng/dL

Free T4 1.2 ng/dL Range-0.8 - 1.7 ng/dL

TSH 1.59 uIU/mL Range-0.40 - 4.20 uIU/mL

ALT 17 U/L Range 0 - 36 U/L


#2

Cortisol is to evaluate pituitary and adrenal function.

TSH and free T4 are for thyroid, on the surface, those numbers look OK, but you need free T3 and reverse T3 to get a better assessment of thyroid function. Maybe antibodies as well but if you were have only one thyroid test, it would be free T3.

ALT is a liver function test.

As a guy with low T symptoms, the most important tests are free testosterone, sex hormone binding globulin and estradiol. You really need those to get an idea of what is going on.

Beyond the above, a thorough hormone work-up is indicated and for that, you’ll likely need to find someone who specializes in hormone restoration. I doubt your PCP will consider testosterone, or anything else, with a total test level of 686.

On second thought, may offer you anti depressants.


#3

Thanks Highpull. I know when I got a general work up done in 2013, my free testosterone was:
Testosterone free 101.4 pg/mL 35.0 - 155.0 pg/mL

So that’s pretty good, right? My total back then was 691, so essentially unchanged.
Is there a chance that my free test could have dropped much if my total stayed pretty consistent?

I’ll look into the other tests, thanks for the help!


#4

Unable to tell you much of anything as there are lots of tests missing, you couldn’t come close to diagnosing a testosterone or thyroid deficiency with these limited labs. Thyroid labs are useless, there are many tests missing like Free T3, Reverse T3 and antibodies that could help explain your symptoms.

SHBG must be elevated shrinking your bioavailable testosterone. You can evaluate thyroid function by measuring oral body temperatures per thyroid sticky. You need to be 97.7 upon waking and 98.6 in the afternoon.

Insured healthcare will usually cut corners and run minimal testing often causing you to go undiagnosed for decades, another option is run your own labs at discount labs.

Total T
Free T
SHBG
Estradiol Sensitive (E2)
LH-Luteneizing Hormone
FSH-Folicle stimulating hormone
Prolactin
Cortisol
Thyroid Panel
CBC-complete blood count
Comprehensive Metabolic Panel
Lipid profile/panel


#5

It is pretty good. But, it is just a number and you have symptoms. It may have changed over five years.