T Nation

Working HCG Mono Therapy but No Libido or Sex Drive?!


#1

Hey guys,
I am in need of some opinions on my results and current treatment. I am 28 years old and have been experiencing hormonal imbalance for the last few years. Took me a few years to understand what was going on.

Anyway I am currently seeing a good doctor who specialises in hormones. He currently has me on 25mg DHEA and 25mg Pregnenolone oral tablets. 2 UI HGH, 0.5mg Arimidex 3 times per week and 500 UI HCG 3 times per week.

Before treatment I had depression, weight loss, hairloss, no libido, no morning erections, difficulty maintaining erection, lack of energy etc. All the classic low T symptoms really.

Before I saw my current doctor this year I did a saliva test in September last year 2015, it showed Estrone 150 on a reference range of 25-55. Also my DHT and Androstenedione tested off the charts high. I was asked if I have used steroids, which I have not.

My current treatment plan outlined above has helped me regain energy, better sleep and improved mood and confidence. I now have morning erections every day and I have periods of good sexual activity. I feel about 40-50% better then before but far from good.

I took 5000 UI HCG shot once per week for 3 weeks before lowering dosage. I did not feel any improvements then. I then switched to 1500 UI IM and I almost got close to euphoria within 2 hours of the shot, felt better then I had done in years, but only lasted one day. Since then I have done 500 UI shots 3 times per week, I feel a difference on the days I take them.

Should I increase my dosage of HCG?

My problem now is that sometimes for periods I still struggle with maintaining erection (cialis helps and I take sometimes) but I still have very low libido. I just don’t want sex anymore, sometimes I have sex with my gf just for her pleasure which really feels f**ked up as a guy that should still have a raging libido in my age.

Can anybody shed some light what they think the issue might be of no libido? I mean I have tested 3 times reference range on DHT before and have side effects of high DHT like hairloss but still I have no libido, not horny at all like when I was younger.

I will be taking new labs in 2 weeks, but any second opinions are appreciated.

Labs from last year:

Hematology Panel, 12 Sep 2015 9:15 AM
· Facility: LIFELABS

Flag Results Reference Range


· WBC: A 3.2 giga/L (4.0 - 10.0) (Final)
· RBC: N 4.58 tera/L (4.20 - 5.40) (Final)
· Hemoglobin: N 134 g/l (133 - 165) (Final)
· Hematocrit: N 0.40 (0.38 - 0.50) (Final)
· MCV: N 86 fL (82 - 98) (Final)
· MCH: N 29.3 pg (27.5 - 33.5) (Final)
· MCHC: N 339 g/l (305 - 365) (Final)
· RDW: N 13.2 % (11.5 - 14.5) (Final)
· Platelet Count: N 250 giga/L (150 - 400) (Final)
· Neutrophils: A 1.4 giga/L (2.0 - 7.5) (Final)
· Lymphocytes: N 1.1 giga/L (1.0 - 4.0) (Final)
· Monocytes: N 0.6 giga/L (0.1 - 0.8) (Final)
· Eosinophils: N 0.1 giga/L (0.0 - 0.7) (Final)
· Basophils: N 0.0 giga/L (0.0 - 0.2) (Final)
· Granulocytes Immature: N 0.0 giga/L <0.2 (Final)

Iron / TIBC, 12 Sep 2015 9:15 AM
Flag Results Reference Range


· Iron: N 10 umol/l (10 - 33) (Final)
· TIBC: N 50 umol/l (37 - 72) (Final)
· Iron Saturation: N 0.20 (0.20 - 0.55) (Final)

Vitamin B12, 12 Sep 2015 9:15 AM
Flag Results Reference Range


· Vitamin B12: N 209 pmol/l (150 - 650) (Final)

Ferritin, 12 Sep 2015 9:15 AM
Flag Results Reference Range


· Ferritin: N 53 ug/l (15 - 300) (Final)

TSH, 12 Sep 2015 9:15 AM
Flag Results Reference Range


· TSH: N 1.2 mU/L (0.27 - 4.2) (Final)

Free T4, 12 Sep 2015 9:15 AM
Flag Results Reference Range


· T4 Free (first: Free T4): N 14.8 pmol/l (10.5 - 20.0) (Final)

Free T3, 12 Sep 2015 9:15 AM
Flag Results Reference Range


· T3 Free (first: Free T3): N 5.2 pmol/l (3.5 - 6.5) (Final)

Prolactin, 12 Sep 2015 9:15 AM
Flag Results Reference Range


· Prolactin: N 5.5 ug/l <15 (Final)


[b]From this year:

12 January 2016:[/b]

WBC 4.76 (4-11)
Neutrophil 35 (45-75)
Lymphocyte 42 (20-45)
Monocyte 18 (2-10)
Eosinophil 3 (4-6)
Basophil 2 (0-1)
RBC count 4.58 (4.5-6)
Hb 13.2 (14-18)
Hct 40 (41-51)
MCV 87.3 (80-98)
MCH 28.8 (27-32)
MCHC 33 (32-35)
RDW 13.4 (11.8-16.5)
Platelet count 231 (150-400)
RBC Morphology Normal

PSA 1.2 (0-4)
Free PSA 0.39
% Free PSA 32.5

Carrion Embryonic Antigen
CEA 2.2 (<4.6 non-smoker)
AFP 2.7 (0-7)

Total Testosterone 6.26 (2.8-8) ng/mL
SHBG 62 (10-60) nmol/L
Albumin 4.8 (3.5-5.2) g/dL
Free Testosterone 85 (90-300) pg/mL
% Free Testosterone 1.35 (2-4.8) % of Total
Bioavailable Testosterone 220 ng/dL
% Bioavailable Testosterone 35 % of Total

Estradiol 18.3 (25.8-60.7) pg/mL
FSH 6.1 (1.5-12.4) mIU/mL
LH 7.3 (1.7-8.6) mIU/mL

TSH 1.13 (0.27-4.2) uIU/mL
Free T3 3.69 (1.9-5.1) pg/mL
Free T4 1.68 (0.93-1.70) ng/dL

DHEA-S 294 (80-560) ug/dL
Cortisol 8.1 (6.24-18 morning) ug/dL

IGF-1 95 (81-424) ng/mL

Stopped all supplements I used myself after this lab. I was using Myokem Alphadex as anti estrogen so you will see at my next labs my estrogen went up. Doctor put me on DHEA 25mg, Pregnenolone 25mg, 1mg Melatonin per day.


3 February 2016:

Estradiol: 49.9 (25.8-60.7) pg/mL
DHEA-S: 630 (80-560) ug/dL

After this labs we agree to continue DHEA, Pregnenolone and Melatonin. We also start HGH at 2 UI per day, building up dosage in two weeks.


23 February 2016:

Estradiol: 34.9 (25.8-60.7) pg/mL
IGF-1: 164 (81-424)

Starting HCG 500 UI 3 times a week, and 0.5mg Arimidex 3 times a week.


#2

Please read these links found here: About the T Replacement Category

  • advice for new guys
  • things that damage your hormones
  • protocol for injections
  • finding a TRT doc - if ever needed

Too much hCG can cause a lot of T–>E2 inside the testes and anastrozole in ineffective there.
Too much DHEA in some guys creates a lot of DHEA–>E2 inside the adrenals.

E2=34 is way too high.

IGF-1=164 seems low for 2 iu hGH per day.

Your hematocrit should be better now. But I am concerned that you might have a blood/iron loss via a GI bleed. You can request an occult blood test that can detect blood in your poop.


#3

Thanks KSman,

Depending on my labs I will probably be changing to daily 250 IU HCG. But only if the labs show it has done anything. I’m hoping for and increase in total T along with increase in free T and lower SHBG. If I don’t see this I am not sure I will continue it since balancing E2 is hard.

My doctor told me that 164 looked ok considering I had only been on it for about a month. He said he expected to see around 200 but considering I am using generic HGH from china it was expected. When I am back in my home country in two months I will be increasing this to 2 IU x2 a day.

Concerning blood loss from GI bleed I kept track of my poop during a period, blood is easy to spot since it makes it dark/black. I eat a very clean diet so I just figure that it is probably not GI. Not sure if I need to check this further.

I am planning on aiming to get my DHT in normal range also, I expect it to be above range since I have hairloss. I have bought some Theaflavin for this to lower it into normal range. Will start after labs. I seem to have no improve libido whatsoever from DHT.

I also bought some Activate Extreme/Endosurge Pro, for the Divanil extract to try and get my SHBG down. I plan on cycling it.

I also plan on changing my diet to more Slow carb / Cycle carbs for workouts. I seem to experience mood issues / anxiety / tiredness after eating a meal with fast carbs. I have investigated and I think it has to do with my free T dropping even lower then my normal low from the amount of glucose and insulin. Right now I don’t get enough exercise each week and a lot of sedentary at work so I think this is the issue.

I will post back next week on Saturday when I have new labs.


#4

The occult blood test detects blood that you cannot see. That is what occult means.

You can use a home pregnancy test. If the hCG is good, it will be positive.

In most TRT cases, low dose hCG is used to maintain the testes and increases in T are minor. Increasing T by injections is more cost effective than with hCG.

FT levels are not going to track blood sugar levels.
Fast carbs? Do you feel bad after eating bread/wheat? Gluten intolerant?


#5

I am sure the hCG is good,it’s Pregnyl brand and I get it straight from a clinic. I can also feel my difference in energy, mood and confidence on my injection days.

I won’t be starting T injections since I am only 28 years old and I seem to have testicular function and my total T is not really the problem.

I mean carbs with a high glycemic index like rice, potatoes, sugars.

I am slight Celiac, this has been confirmed by antibodies in blood test. I stopped eating gluten/wheat 2 years ago, I only eat it maybe once every 2-3 months now. I also don’t eat dairy products and I follow a whole foods diet.


#6

Are you reconstituting the hCG yourself or is that being done at the clinic? If you’re not reconstituting it yourself, I’d suggest doing so.

hCG is easily damaged/destroyed through forceful actions simply by shaking or jostling the vial which can easily be done on your way home. Also make sure you’re keeping it in the fridge or freezing individual doses.


#7

Yes I am doing it myself, one 1500 IU vial each week. Keep them in the fridge always, only for 30-60 days max per batch, ice packs when transporting from clinic. I do however let the syringe with hCG reach room temperature before injecting since I find it stings otherwise, is this a bad thing to do?


#8

Letting the syringe warm up is OK. Note that the hCG is at body temperature when injected and takes time to get into circulation from SC or IM.


#9

Ok guys I finally have an update with labs. This is after doing the following protocol for 2 months:

DHEA oral 12.5mg, Pregnenolone oral 25mg, HGH injections 2 IU before bed, HCG 500 IU x3 week, 0,5mg Arimidex x3 week

I skipped Arimidex 10 days counting up to lab, thought I had gone to low E from how I felt.

I took my last HCG injection 3 days prior to test.

Total Testosterone - 6.10 ng/mL - ref: 2.8-8 ng/mL
SHBG - 58.2 nmol/L - HIGH - ref: 10-60 nmol/L
Albumin - 4.6 g/dL - ref: 3.5-5.2 g/dL
Free Testosterone - 88 pg/mL - LOW - ref: 90-300 pg/mL
% Free Testosterone - 1.44 % of Total - LOW - ref: 2-4.8 % of Total
Bioavailable Testosterone - 219 ng/dL -
% Bioavailable Testosterone - 36% of Total -

Progesterone - 0.19 ng/mL - LOW - ref: 0.3 ng/mL (Men age 18-29)
Estradiol (Regular test, no access to ultra sensitive etc) - pg/mL - BORDERLINE LOW - ref: 25.8-60.7 pg/mL
FSH - 2.5 mIU/mL - ref: 1.5-12.4 mIU/mL
LH - 2.6 mIU/mL - ref: 1.7-8.6 mIU/mL

DHEA-S - 469 ug/dL - ref: 80-560 ug/dL
Cortisol (Serum, Morning-Noon) - 6.6 ug/dL (10:18am) - LOW - ref: 6.24-18 ug/dL Morning

IGF-1 - 159 ng/mL - ref: 81-424 ng/mL
Prolactin - 12.19 ng/mL - BORDERLINE HIGH? - ref: 4-15 ng/mL

Ferritin - 89 ng/mL - ref: 30-400 ng/mL
Vitamin B12 - 479.1 pg/mL - ref: 197-771 pg/mL
-

WBC - 4270 cells/mm^3 - LOW - ref: 5000 - 10000
Neutrophil - 54% Low - ref: 55 - 75
Lymphocyte - 35% - ref: 20 - 45 OR 20 - 35
Monocyte - 7% High - ref: 2 - 6
Eosinophil - 3% - ref: 1 - 3
Basophil - 1% - ref: 0 - 1
RBC count - 4.75 Mcells/mm^3 - ref: 4.5 - 6.0
Haemoglobin - 13.2 g/dL - LOW - ref: 14 - 18
Hematocrits - 41% - BORDERLINE LOW - ref: 41 - 51
MCV - 85.7 fL - ref: 80 - 98
MCH - 27.8 pg - ref: 27 - 32
MCHC - 32.4 g/dL - ref: 32 - 35
RDW - 13.2% - ref: 11.8 - 15.6
Platelet count - 234 - 10^3 cells/cu.mm. - ref: 150 - 400
RBC Morphology - Normal

25 - Hydroxy Vitamin D total - 85.80 ng/mL - ref: >= 30 ng/mL
Magnesium; Serum - 2.2 mg/dL - ref: 1.6 - 2.6 mg/dL
Sugar; Glucose NaF (Fasting) - 74 mg/dL - ref: 70 - 110 mg/dL
Zinc; Serum - 99 ug/dL - ref: 70 - 170 ug/dL
ACTH (EDTA) - 28.3 pg/mL - ref: 0 - 71 pg/mL
Urine iodine - 57.4 ug/L - LOW - ref: 90 - 230 ug/L

Cholesterol - 202 mg/dL - HIGH - ref: < 200
Triglyceride - 54 mg/dL - ref: < 150
HDL-Cholesterol - 46 mg/dL - LOW - ref: > 60
LDL-Cholesterol - 134 mg/dL - HIGH - ref: < 100

# Liver Function Test:
Total Protein - 6.8 g/dL - ref: 6.0 - 8.3
Albumin - 4.5 g/dL - ref: 3.5 - 5.0
Globulin - 2.3 g/dL - ref: 2.1 - 3.3
Albumin/Globulin - 1.9 - HIGH - ref: 1.0 - 1.8
Total Bilirubin - 0.9 mg/dL - ref: 0.2 - 1.2
Direct Bilirubin - 0.3 mg/dL - ref: 0.0 - 0.5
AST (SGOT) - 31 U/L - ref: 5 - 34
ALT (SGPT) - 24 U/L - ref: 0 - 55
Alkaline Phosphatase - 54 U/L - ref: 40 - 150

# Electrolyte:
Sodium - 137 mEq/L - ref: 135 - 150
Potassium - 4 mEq/L - ref: 3.5 - 5.5
Chloride - 104 mEq/L - ref: 95 - 110
Total CO2 - 27 mEq/L - ref: 22 - 30

My ideas and take aways are the following:

HCG does not do much for me other then give me temporary mood boost from LH receptor stimulation in the body. Does not affect my labs much other then raising prolactin? I am thinking I want to stop it, i.e. feels like a waste to continue.

Progesterone is LOW, adrenal fatigue? Probable reason to my low cortisol since lack of building blocks for cortisol? I bought a transdermal cream I want to try low dose.

Estradiol is borderline low now so was a good call to stop Arimidex. I don’t feel I want to take an AI because of all these issues it presents with potential low E.

Ferritin move a tiny bit up but RBC not much. I am switching to another type of Iron Protein Plus from Life Extension, also adding Lactoferrin and Liposomal Vitamin C for absorption. Also adding Panax Notoginseng for increasing RBC.

Monocytes and Neutrophils seems to be out of range on this and past tests, low grade infection going on?

Iodine is LOW, this is a surprise. I am thinking that maybe I am hyporthyroid even though my thyroid panel always seems OK. Last time T4 was high so maybe conversion issue? I sure have all the symptoms of hypo including cold hands and feet, hair loss, dry hair and skin, fatigue etc.

Cholesterol is imbalanced because testosterone and iodine issues?


#10

Occult blood test?

Why stop hCG then be surprised that T was low?

Your IGF-1 was crazy low VS your GH dose. Was expecting twice that level.

Have you read the thyroid basics explained sticky?
Check oral body temperatures as suggested.

Why have you been keeping this a secret?
maybe I am hyporthyroid even though my thyroid panel always seems OK.
Last time T4 was high so maybe conversion issue? I sure have all the
symptoms of hypo including cold hands and feet, hair loss, dry hair and
skin, fatigue etc.


#11

Hey KSman, thanks for taking the time to read my post.

I was under the impression that I should not take the HCG shot directly before my labs and I took every 2-3 days. I thought it would still have an effect on total T or something like that which would make us able to see a increase. I was wrong. Still I have no come to the understanding that my bioavailable T is top of range for my age so increasing this more with HCG is maybe not a good idea?

Yes but I am using Ansomone, chinese generic because that is what I can afford here. My doctor told me he would expect IGF-1 to be around 200 on the pharma GH they offer so my results was resonable.

I will go read it now and check temperatures this weekend.

I have not been keeping it a secret, since all doctors said my thyroid tests where ok I thought my thyroid was ok. But I choose to do the iodine labs because a suggestion on a forum, and turns out it was a good tip since I am quite low. That thyroid labs can be ok OK but you can still be hypo I did not know, I thought my symptoms was a sign of something else.


#12

It is best to share all lab data with us because of things like this.

It is good to check TT, FT and E2 while on hCG to see what your testes can do.
Pay for a good Rx HGH kit and test IGF-1 on its last day to see what your response is with a good known product?


#13

I have shared every single lab I have done in this thread. My thyroid tests I have posted before. This iodine one is recent. My thyroid labs has come back within range two times last two years, last test T4 for borderline high but that’s it.

I am confused because I thought that if your body would be iodine deficient like me, it should seriously screw up your labs? I am thinking that maybe I should run test for reverse t3 and thyroid antibodies.

Ok I will do that for next tests end of this month, how long before testing should I take HCG? Like is it enough to inject 3-4 times the week working up to the labs?

I can look into trying a Rx HGH but the price would be almost 1000 USD at my clinic for a months 1 IU or something like that, not much. I kinda feel I want to spend that money on labs instead to figure out what is really going on.


#14

Here is temperature from yesterday:

I woke up between 11:30am and 12pm:

temp 12pm= 36.1 celsius (96.98 f)
temp 2pm=36.6 celsius
temp 5pm=36.7 celsius

From what I understand anything below 97.3 f in the morning is likely signs of hypothyroidism. Considering my iodine is also low, I have symptoms and from what I understand labs can sometimes be normal even in these cases.

Is it likely that I am hypothyroid?


Anemias are diagnosed in 20-60% patients with hypothyroidism

http://njthyroidsolutions.com/understanding-thyroid-markers-and-panels

Although the human growth gene does not contain a thyroid hormone response, the thyroid does have influences on the synthesis of IGF-1 in the liver. Adequate amounts of thyroid hormones are required for the healthy production of IGF-1. Anytime reduced IGF-1 markers are demonstrated, thyroid dysfunction must be ruled out. The reduced potential to synthesize IGF-1 may be partly due to the loss of anabolism in hypothyroidism.

http://chriskresser.com/5-ways-that-stress-causes-hypothyroid-symptoms/

Seems to be common with low cortisol from hypothyroid issues also or adrenal fatigue causing it in the first place.


#15

Your testes are the problem, you have got this wrong.

Total T doesn’t mean anything, it’s the free or bio-T that is useful and a good predictor of T production. Your blood work is like mine, high shbg doesn’t “eat up” your free T. It inflates total T to higher ranges than it would have been with low free T. Your FT not rising on hCG, that means your testes aren’t particularly responsive to the LH. Normal high LH/FSH also suggest that your testes are the problem.

You are not hypothyroid. Don’t get into the madness. Your thyroid labs are good. Look for 98.6 in the evening/afternoon with the oral themometer.


#16

Thanks equalo212,

I do not understand that however. What about this:

Bioavailable Testosterone - 219 ng/dL -
% Bioavailable Testosterone - 36% of Total -

Above is my labs, and I tested in this range twice now.

http://www.mayomedicallaboratories.com/test-catalog/Clinical+and+Interpretive/83686

TESTOSTERONE, BIOAVAILABLE
Males
< or =19 years: not established
20-29 years: 83-257 ng/dL
30-39 years: 72-235 ng/dL
40-49 years: 61-213 ng/dL
50-59 years: 50-190 ng/dL
60-69 years: 40-168 ng/dL

This puts me in the upper range on bioavailable T for my age. In that case it means I am a high producer. How would that mean my testes are the problem?


#17

Non-specific ranges are useless and your lab could be testing using another methodology. If this range was true, then no one would be hypogonadal. Take this for an example:

A person who has TT : 350, SHBG: 20. Now this guy is your or my age which is in 20s. Do you think his T is low? Most would think so especially if symptoms are as bad as yours and mine.

BUT, BIO-T of this person would be : 213 ng/dl, very similar to yours and mine! and fT of 9 ng/dl.

In RANGE! No ones hypogonadal or suffering.

Your FT like mine is low, yours is 8.5 in range of 9-30. Mine goes 7-10 in the same range. Does that indicate low T or no? Since one of the most agreed upon concepts in the whole easily misunderstood lingo of hormones is that fT is the biologically active hormone and the body does not give two hoots about biologically inactive hormone even if you believe that you are producing it and SHBG is taking it away.

But in terms of how test results can come out, yes, the way that one can have good or high total T while having low free T is from having high SHBG.

"It’s not that the high SHBG causes the low free T though. Rather it’s completely the other way around: the low free T is the direct outcome of the HPTA function, and would be the same regardless of SHBG amount, but as the amount of T bound to SHBG is a product, so to speak, of both free T and amount of SHBG, high SHBG causes a given free T amount to yield a higher total T value.

If one makes the mistake of taking total T as a valid predictor in its own right, and ignores that free T is what should be looked at, then the high SHBG combined with the wrong assumption leads to the wrong conclusion that things are OK.

Whereas looking at the free T alone and ignoring the other values, as they are only consequences of free T and levels of other things, avoids coming to wrong conclusions."

This is a quote from Bill Roberts who’s a AAS specialist and his opinions are very well respected. You can decide for yourself now.

By the same analogy, A young 25 year old guy with TT: 700, SHBG: 24; will have a Bio-T of 434 ng/dl, way over your bio T range. Would this guy be considered a normally functioning male or an overproducer of T? I am sure you would say that these numbers are ideally minimum what a healthy guy of 25 should be producing, no?


#18

I see what you mean, thanks a lot for that explanation.

Since we are both in a similar situation then, what are your views on correcting this problem?

I have no idea how I ended up with this issue but it seems like less then a year back my free T was in range and better then now.

12/10/2015 - Free testosterone (saliva): 94 pg/mL - ref: 60-135 pg/mL (18-30 years)

I would like to find a solution that does not involve TRT. I have stopped HCG since a week back since I feel I did not benefit much for it towards the end and it caused other issues.


#19

When hCG doesn’t lead to very high T, testes are usually at fault. When you felt better it was still low, maybe i’m wrong with that as i’m not well versed with saliva testing. Look, don’t go by the ranges only. If you were used to higher T levels prior to problems, just being in range won’t work, so TRT is the only option for when Testes are not doing their job. As you will see, fT/Bio-T ranges are all over the place. You will see 3-15 pg/ml, 3-31, 9-45, 9-20. All different ranges. You want to focus extravagantly to ranges or fix yourself?
I just read you replying above as to that your bio T is already high. You have been mislead my friend. Bio-T and fT is low, which are the only factors that matter when determining hypogonadism.

If you don’t mind me asking, Why the resistance to TRT? I would bite anyone’s hand off for offering if it means i’ll not feel like an 80 year old grandpa and actually have the energy to do what i want to do at 25.

For me, i have a bilateral varicocele in my testes which seems to be messing with testicular function. My e2 was high from a restart i did previously which didn’t do anything for me, so i’m on anastrozole 0.5mg/week to reduce. My SHBG has dropped from highest of 67 to now 53.3 and TT has also gone up but that’s expected from the AI and not likely to last but i don’t feel any better. I’m planning on going for TRT for a trial period of 3 months first or maybe more time if i feel good. In the mean time, i am planning for a varicocele repair to be done and once that’s done and recovered from, i will try to come off TRT with a Restart and see how the testes respond.


#20

Also consider the aforementioned range that you quoted, High point of 257 ng/dl. We know that approx. 50-60% of Total Testosterone measured is ideally bio-available, i.e, fT + T bound to serum Albumin. Consider the range for TT in the same article, for their particular methodology to determine T is 240-950 ng/dL, half of which should be bio available, i.e, Bio-T : 120- 475 ng/dl. So you can see how inaccurate that range is.

Quest Diagnostic ranges are: 110-575 ng/dl which matches their TT range( 220-1150 ng/dl).

You and i are closer to the bottom than to the high in both these with <250 ng/dl Bio-T. It must be noted that it’s unclear in studies still as to how much of the Albumin bound T actually gets free. We know that fT is what is biologically relevant for receptor binding.

For reference, if you see threads on here with symptomatic people looking for advice, you’ll often see a TT of less than 300 ng/dl with more fT than you and me.

Have you had your testes examined or had an ultrasound? Look for potential varicoceles, doctors are ignorant on these issues. It’s getting more attention these days of how varicoceles can affect Leydig cell function in the testes. It needs common sense to understand that if something can affect one half of testicular function (Spermatogenesis) due to overall poor environment for the the testes to work, it will also affect to a good degree the other half of testicular function. Depending on the damage that they have caused and duration that they have been affecting the testes, a varicocele repair may restart normal function.