Advice on Blood Test & MRI- Low Testosterone

Pharma
1

Hi Everyone,

I hope all doing well. I am 31 years old Male living in Canada. I always had many symptoms all my life and after many trips to doctor i was able to do blood test, Mri of pituitary & adrenal gland. Following are my results

SYPMTOMS:
•Headches, Pain behind eyes, Neck & Shoulder
•Anxiety espcially going out.
•Hot Flashes, Swollen Face
•Always Cold Feet & Frequent Urination
•Restlessness in legs
•Weakness & lack of energy
•No motivation for anything
•Hard to see purpose in things
•Extreme anger because of the symptoms how much it affects my life
•Less Body & Facial Hair
•Fat Around Abdomen, Skinny arms and hard to put muscle
•Sexually Ok but sometimes do have erectile dysfuction

BLOOD TEST RESULTS:
Result Unit Range
Total Testosterone 12.4 nmol/L (7.6-31.4)
Free Testosterone 329 pmol/L (159-510)
LH 6 IUS/Liter (2.5-16.3)
FSH 5 IU/L (1-16)
Estradiol 58 pmol/L (0-158)
DHEA 12.4 mmol/L (4.3-12.2) HIGH
Prolactin 5 µg/L (4-18)
Progesterone 1 nmol/L (0-0.6) HIGH

TSH 1.70 mIU/L (0.35-5)
Free T4 17.8 pmol/L (12-22)
Free T3 5.1 pmol/L (3.4-5.9)

Cholestrelol, Total 6.27 mmol/L (0 - 5.19) HIGH
Triglycerides 1.40 mmol/L (0 - 1.69)
HDL Cholesterol 1.08 mmol/L (1 - 2.3)
LDL Cholesterol 4.55 mmol/L
NON-HDL-Cholesterol 5.19 mmol/L

Vitamin B12 425 pmol/L (> 221)
Sodium 137 mmol/L (136-146)
Potassium 4.0 mmol/L (3.7-5.4)
HB A1C 5.4 % (0-5.9)

PSA 1.59 µg/L (0-2.5)
Free PSA 0.48 µg/L
Free PSA/Total PSA 0.30 Ratio

Creatinine, Urine 31.8 mmol/L (3.5-24.6) HIGH
Creatinine 68 µmol/L (60 - 110)

Urine Culture NEGATIVE <10e7 CFU/L

ALT 27 U/L (0 - 45)
Ferritin 73 µg/L (24 - 453)
C-Reactive Protein 1 mg/L (0 - 5)
GFR Your results are >=120 This is considered NORMAL.

Red Blood Cells 4.8 (4.7 - 6.0 )
Hemoglobin 131 g/L (135 - 180) LOW
Hematocrit 0.403 (0.420 - 0.520) LOW
MCV 84 fL (78 - 100)
MCH 27 pg (27 - 34)
MCHC 325 g/L (320 - 360)
RDW-CV 12.7 (11.5 - 14.0)
White Blood Cells 8.1 (4.0 - 10.5)
Neutrophils 3.3 (1.5 - 6.6)
Neutrophils 0.41 (0.37 - 0.75)
Lymphocytes 4.1 (1.5 - 3.5) HIGH
Lymphocytes 0.51 % (0.20 - 0.75)
Lymphoc/Neutrophils 1.24 (0.25 - 0.99)
Monocytes 0.5 (0 - 1.0) HIGH
Monocytes 0.07 % (0.02 - 0.10)
Eosinophils 0.1 (0 - 0.7)
Eosinophils 0.02 % (0.01 - 0.11)
Basophils 0.03 (0 - 0.1)
Basophils 0.00 % (0.00 - 0.02)
Immature granulocyt 0.01 (0 - 0.03)
Immature granulocytes 0.001 % (0 - 0.005)
Platelets 225 (150 - 450)
MPV 14.1 fL (7.4 - 12.8) HIGH

PITUITARY GLAND MRI:
The pituitary gland is of small volume measuring 4 mm thick, it is however homogeneous and raises in a uniform way without sign of pituitary adenoma. The pituitary stem is in a central position, it is of normal volume.There is no sign of hypothalamic lesion. The brainstem and basal ganglia appear normal. There is no hydrocephalus, No supratentorial lesion.
Conclusion: Brain study within normal limits. Homogeneous small volume pituitary without sign of pituitary adenoma

ADRENAL GLAND MRI:
7mm left adrenal nodule at the crux of the adrenal gland with features suggestive of a millimeter adrenal adenoma.

My doctor is saying everything is normal and don’t need any treatment for time being. I am staying most of the time home and don`t feel any energy to go outside. I am really lost & don’t know what route to take from here on. Any advice or help would be greatly appreciated.

Thanks in Advance

2

How the fuck are reference ranges going that low?

That FT ref range is absolutely ABSURD! I remember when 250 pmol/l was the lower end of normal… That TT ref range is ok… but even then, I remember when the cutoff for lower limit was 12… Now it’s 4-7… The upper end for a womans TT is around 3nmol/l

Your levels aren’t great… but depending on pathophysiology, you might be able to normalise things. If purely functional eitology is behind your borderline levels, work on lifestyle.

If hypogonadism is related to diminished pituitary volume… Go private for treatment…

1 Like
3

You don’t need TRT, your natty T levels are great.

You think stabbing a needle into yourself 2x a week will change that? Just get the fuck up and go outside dude. The simplest answer is the best one here.

1 Like
4

Thank you for your response. Do you think if adrenal Adenoma can be causing all the symptoms or any other comment on my blood test would be appreciated :slight_smile:

5

Thanks for your response. I thought my Testosterone was on the lower end. Most probably there is something else going on with my body as my CBC is really messed up
& have adrenal adonema as well. Really frustrates and high level of anxiety when going outside that’s why get difficult.

6

12.4 nmol/l is right around 350ng/dl

Those FT levels aren’t great either. Not “trt” levels of low (well depends on the person I suppose). Mine were 180-200pmol/l, and at the time this was UNDER the reference range (ref range cut off at 230).

These aren’t “great” levels by any means. Depending on your circumstances, my endocrinologist might consider TRT (in very select circumstances) based on these numbers.

OP may very well be able to fix this through lifestyle alteration. Hormones might not even be the cause of his troubles… But low pituitary volume with sub-normal test levels does make me wonder…

1 Like
7

Honestly, I think this has nothing to do with Test or hormones you can control exogenously.

This is well outside of anything I’m informed on, but I would be very hesitant to go looking for a hormonal boogeyman to blame this on… best practices are always to take extreme accountability and take action yourself before looking for an out.

Folks needing to go on diets have been looking to blame ANYTHING but themselves for decades, but we all know the answer as to “why” they got fat. Accountability sucks, but is an absolute necessity to living a normal, functional, successful life.

Good luck buddy, get out there.

1 Like
8

You don’t think that reference ranges serve a purpose related to testing method? Asking in sincerity - I know that lab reference ranges are desperately in need of harmonization, but I have always looked at the related reference range as THE guide. Particularly for FT.

1 Like
9

What is your weight/waist size? Are you doing some ultra restrictive diet of some sort?

1 Like
10

@Voluminous I am 5’11 and 78kg weight. Waist around 34. Diet is pretty normal except it is spicy sometimes. I don’t have any fat except abdomen and little bit gynecomastia

11

Some of your concerns would be consistent with metabolic syndrome, hence the question. But your weight is not an issue, so that’s not it.

Do you have your transferrin saturation levels (iron)?

12

My Iron profile looks fine, i would have to look the exact numbers again but i do have low hemoglobin and hematocrit as you can see in my blood result posted above.

13

No

Considering some reference ranges will comsider a FT of 80pmol/l

Or a TT of 3nmol/l (around 60ng/dl) to be ‘normal’

Using the ref range as ‘the guide’ isn’t reliable. Esp since methods used to calculate total and FT can differ from lab to lab.

There was a study a while back that looked at the lack of harmonisation between ref ranges… found that cutoff points can differ by well over 100%

Generally speaking… I consider a FT below 300 to be “on the lower side”

And below 220-250 is undoubtedly “low”.

TT doesn’t matter as much… but a TT of 300 or below is almost ALWAYS ‘low’. My endocrinolgoist says symptoms tend to begin once levels drop below 15nmol/l. But that is dependent on FT too. If you have very low SHBG, a TT of 400 might be ok.

14

@unreal24278 this is very interesting, if i go with lab results my FT looks like exactly in mid range. But its little bit up from 300 if we consider that as Minimum. My SHBG is really low 15.5nmol/L (13.5-88.5)

15

As @mnben87 stated you have to go by the ranges of the lab that performs your draw. FT is plenty normal.

1 Like